Posterior Nasal Packing and Sleep Apnea

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Abstract
Posterior nasal packing has been reported to be associated with cardiorespiratory complications and, occasionally, with sudden death. To study the rate and incidence of sleep apnea, between October 1989 and September 1990 polysomnography (PSG) was performed in 10 patients who were treated for severe epistaxis with posterior nasal packing. Of these 10 patients, three had obstructive apneas, one had central apneas, and four had a combination of central and/or obstructive and mixed apneas. One patient had no apneas, and one was unable to sleep during PSG. In six patients, PSG was repeated a few months after removal of the packs. Four of these six patients no longer had apneas; one patient had a considerable decrease in number of apneas. One patient did not sleep during the second PSG, however, he had no apneas during the first PSG. This study demonstrates that posterior nasal packing can induce sleep apneas or enhance the severity of an apnea syndrome when present. This may contribute to the cardiorespiratory morbidity and sudden death that has been reported in epistaxis patients treated with posterior packing.