The Relationship Between Continuous Positive Airway Pressure And Allergic Rhinitis In Patients With OSAHS

Objective: The aim of this study is to research the changes of nasal symptoms in obstructive sleep apnea hypopnea syndrome(OSAHS)patients after continuous positive airway pressure(CPAP)treatment and to determine whether these changes are related to the concentration of house dust mites(HDMs)in CPAP device,understanding the relationship between CPAP and allergic rhinitis(AR).To improve the awareness of prevention and management of AR in OSAHS patients with CPAP therapy for clinical doctors is subsequent aim.Methods: We retrospectively investigated 350 CPAP user and 100 non-CPAP user by telephone in OSAHS patients who diagnosed in our sleep center,recording and comparing their nasal symptoms and original basis information.The skin prick test was performed in patients with rhinitis,and a logistic regression was used to analyze the risk factors for the increase of nasal syndrome score.At the same time,the concentration of dust mites in the air conditioning filter,CPAP device filter and bedroom dust in the household of 10 OSHAS patients were detected by ELASA.Result: Compared with non-CPAP user,there was a higher prevalence of AR in CPAP user(16.8% vs.7.1%,P=0.018),and it was higher than the prevalence of AR(7.83%)in the local area.The onset of AR among the OSAHS patients with no previous history of AR significantly increased within the first year of CPAP therapy compared with the control group(5.7% vs.0%,respectively;P = 0.033).Meanwhile,the patients with a history of AR were more likely to exacerbate rhinitis symptoms within the second year of treatment compared with the control group(51.7% vs.0%;p=0.027).Adequate compliant of CPAP use(OR 2.53,95% CI 1.05-6.13,P= 0.040),low frequency change for filter(OR 2.87,95% CI 1.35-6.11,P= 0.006),and a history of allergic diseases(OR 21.92,95% CI 9.21-52.17,P=0.000)were independent risk factor relating to an increase in nasal syndrome score.The results of HDMs concentration shown no significant difference was observed between CPAP and air condition filters while both were higher than that in bedroom dust(all P < 0.05).Conclusion: 1、There is a relationship between CPAP and AR,and CPAP increases the risk of the onset and exacerbation of AR in OSAHS patients.2、The concentration of HDMs in CPAP filter is similar to that of air conditioner,and both of them are much higher than that in the bedroom ground dust,which means that CPAP user may be exposed to high concentration of allergen and it may be one of the reasons for the AR caused by CPAP treatment.