Why do nasal strips cause sore throats

Take a deep breath at night - wake up refreshed in the morning

The duration of sleep should not be less than six hours. The average in Germany is 7.14 hours. The amount of comfortable sleep is usually higher. For late risers this is more than nine hours, but for very short sleepers it can only be six hours.

Normal sleep structure

How long the comfort sleep amount is can be seen e.g. B. on vacation, after reducing the sleep deficit in the first few nights. Usually you build up a sleep deficit during the week and reduce it again at the weekend.

The sleep structure is characterized by the repeated repetition of the sleep cycle (every 90 to 100 minutes). A sleep cycle includes the sequence of sleep stages 1 (superficial sleep), 2 (medium-deep sleep), 3 and 4 (deep sleep) as well as dream sleep (REM).

Sleep quality is good if you fall asleep within 30 minutes, sleep deeply for 15 to 20% of the night, dream 20 to 25% and if you quickly find yourself back to sleep after waking up occasionally (mostly unnoticed, not remembered).

What affects sleep

The external factors that have a major impact on sleep quality include noise, light, temperature, oxygen content in the air and sleeping comfort. All sensory antennas are only switched off in deep sleep. Even loud snoring from the person next to us cannot harm us. In the other stages of sleep we are more easily awakened.

Internal factors that influence the quality of sleep include psychological or physical stress due to overload or an illness, e.g. B. Depression. Women sleep worse during pregnancy and menopause. In addition, many drugs and stimulants such as alcohol, nicotine and coffee can reduce the quality of sleep. There is no need to explain that pain, itching, sweating, the urge to urinate or tinnitus can significantly disrupt sleep.

Obstruction of nasal breathing

A prerequisite for a healthy and restful sleep is the maintenance of body functions, albeit at a lower intensity. The heart rate and blood pressure decrease and the breathing rate decreases.

When the airways are open and continuous, the adequate supply of breathing air is guaranteed. But many sleepers have a problem here. For a healthy sleep we need nasal breathing, whereby the ratio of mouth breathing to nasal breathing depends on the sleep stage and the sleeping position. As the night progresses, nasal airway resistance increases, so we breathe more nasally when we fall asleep and breathe more through our mouth when we wake up. If you lie on your back, this change takes place faster than if you lie on your side.

The nose is a problem area because it causes more than half of the total airway resistance that air has to overcome on its way to the lungs. The nasal airway is short, but it is the narrowest part of the entire airway with z. T. only 1 to 3 mm wide. The front part of the nose in the area of ​​the nostrils is of great importance, especially the mucous membrane of the turbinates. Naturally occurring swelling of the mucous membrane, which changes every 0.5 to 10 hours from one half of the nose to the other, is called the nasal cycle. While the supine position has no effect on the nasal cycle, it is interrupted by the side position.

Even a simple cold or an allergic reaction can narrow the nasal airways so that the sleeper often wakes up and cannot get a good night's sleep. Other reasons for a narrowed nose can include polyps, curvature of the septum, and oversized turbinates. Nicotine and alcohol consumption, pregnancy and old age also have a negative effect.

snoring

The cause of the snoring noise lies in the soft palate, where the soft palate vibrates due to the obstruction of the airway. This can be extremely aggravated by obstructed nasal breathing.

The frequency of snoring increases with age; between the ages of 41 and 65, around 60% of men and 40% of women snore occasionally. About 95% of all sleep apnea patients snore.

Obstruction of mouth breathing

Nasal breathing becomes even more important when breathing through the mouth is impeded during sleep. Here the tone of the tongue muscles, the soft palate and the side walls of the throat play a special role, especially in the supine position. With a reduced tone, snoring and other breathing disorders occur, which those affected often do not notice. If, however, both mouth and nose breathing are impeded at the same time, this usually leads to waking reactions with shortness of breath, racing heart and feelings of fear.

Symptoms of Impaired Breathing

Obstructed nasal breathing leads to frequent wake-up reactions, especially if one has been lying on one side for a long time and the nasal cycle is interrupted. The result is that the person concerned does not recover during sleep and often suffers from inexplicable daytime sleepiness. Obstructed nasal breathing can make snoring extremely worse. Many snorers do not feel relaxed after waking up in the morning and usually also experience a dry mouth.

Means that make breathing easier

Patients who complain of unrest in the morning, dry mouth or snoring usually do not know that disturbed nocturnal breathing may be the cause. This is usually the case if your nasal breathing is hindered by a runny nose or allergic reactions, even during the day, or if you consume excessive amounts of alcohol.

A simple means of improving nasal breathing during sleep - and also during the day - are so-called nasal strips, a nasal plaster that spreads the nostrils from the outside. According to clinical studies, the patch reduces nasal resistance by approx. 14 to 25%. In further studies, it not only led to immediate relief of nasal breathing, but could also reduce the number of nocturnal wake-up reactions, improve oxygen saturation during sleep, increase the quality of sleep, reduce snoring and in this way improve the quality of life. The patch can also be combined with nasal ventilation therapy (nasal continuous positive airway pressure, nCPAP) (see below).

One advantage of the nasal patch over the equally effective nasal dilators is its safe long-term use. Positive predictors for the use of the patch are older age, frequent snoring, relatively narrow nasal airways and the poor effect of medicinal measures, with which the patch can be combined well, by the way.

One means to improve mouth breathing is the chin band, which prevents the lower jaw from folding down and thus a narrowing of the base of the tongue. The chin band is less effective than the nasal patch and there are no scientific studies on its use. Nevertheless, if tolerated when worn, it can be quite useful for so-called healthy snorers and those with only a few respiratory disorders.

Questionable means

Preparations with essential oils, vitamins and menthol are often offered to help with difficult throat breathing. The mechanism of action on the pharyngeal mucosa is still largely unclear, apart from the cooling effect.

So far there are no mechanical dilators or activators for the pharynx. All aids from the bed furniture store, such as magnetic or specially shaped pillows or mattresses, have so far failed to provide scientific proof of reducing snoring or improving the quality of sleep.

Sleep medical measures

Frequent interruptions to sleep, nocturnal shortness of breath, night sweats, frequent urination, and morning headaches are symptoms of an obstructive breathing disorder such as sleep apnea. These patients should contact a sleep doctor. The gold standard for the treatment of moderate sleep apnea is nasal ventilation therapy (nCPAP). An alternative for moderate sleep apnea is the mandibular protrusion splint; Surgical measures are less effective.

Ways to improve sleep quality

The purely mechanical opening of the nose with a nasal strip is a gentle, safe procedure to improve nighttime breathing and thus the sleep and quality of life of many patients with sleep disorders.

Finally, some measures are mentioned that the person concerned can carry out himself and that the pharmacist can point out to him. These include weight control, avoidance of excessive alcohol consumption and healthy sleep hygiene with sufficient sleep time. For nasal breathing, lying on your back is more advantageous than lying on your side.


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Interdisciplinary sleep medicine center
Luisenstrasse 13a, 10117 Berlin
www.charite.de/schlaflabor