Nose and Sleep-disordered Breathing

The nose is the input channel for the airflow. Its rigid and erectile structures determine the outline and the output of the airflow in the upper airway. Nose obstruction, due to reversible or non reversible factors, produces collapsing forces that are manifest downstream in the collapsible pharynx. Moreover, nose pathologies result in unstable oral breathing, decreased activation of nasal-ventilatory reflex and reduced lung nitric oxide. Long-term oral breathing impacts on the craniofacial growth. The management of nose pathologies coud be medical, mechanical (nose dilators) or surgical. Nasal management should be integrated in a multimodal approach, considering the involvement of a multi-level obstruction, and truly reflecting the complexity of sleep disordered breathing.