TY - JOUR T1 - Cross-talk between upper and lower airways in obstructive sleep apnoea and the effect of orally inhaled steroid JF - ERJ Open Research JO - erjor DO - 10.1183/23120541.sleepandbreathing-2017.P37 VL - 3 IS - suppl 1 SP - P37 AU - Ioannis Koutsourelakis AU - Spyros Zakynthinos Y1 - 2017/04/01 UR - http://openres.ersjournals.com/content/3/suppl_1/P37.abstract N2 - Background Obstructive sleep apnea is associated with inflammation both in the nose and the lung. However, it remains unknown whether there is cross-talk between upper and lower airways, as in asthma. This study aims to examine the interaction between nose and lung in obstructive sleep apnea patients by determining the effect of inhaled budesonide on nasal inflammation and obstructive sleep apnea severity.Methods Twelve obstructive sleep apnea patients (9 men; mean age 43.2±7.2 years; mean body mass index 29.2±3.4 kg/m2) underwent three-week therapy with oral budesonide (600 µg b.i.d.) using Turbuhaler®-devices, then three weeks washout period, and thereafter three-week therapy with an identically looking placebo (twice per day). The patients underwent four assessments, at the start and end of each treatment period, which consisted of: overnight polysomnography with concomitant measurement of breathing route pattern, assessment of subjective symptomatology using the Epworth Sleepiness Scale Score, and anterior rhinomanometry in supine position during wakefulness without decongestion.Results Apnea-hypopnea index decreased from 11.8±3.2 to 10.5±2.2 events·h−1(p=non-significant), whereas Epworth Sleepiness Scale went from 9.7±3.4 to 6.1±3.8 (p<0.05) and nasal resistance went from 2.5±0.3 to 1.9±0.2 cmH2O·L−1·s (p<0.05).Conclusions It appears that there is an interaction between upper and lower airways in obstructive sleep apnea patients, but not strong enough to affect obstructive sleep apnea severity. ER -