Influence factor of nasal airflow laterality in patients with obstructive sleep apnoea: an exploratory study

Obstructive sleep apnoea (OSA) and nasal ventilation laterality (NVL) may exhibit a bidirectional pathophysiological relationship. This study quantified the influence of OSA severity on NVL dynamics through synchronized split-channel airflow measurements and polysomnographic recordings in 65 patients. Analysis across three dimensions—NVL instability, skewness, and nasal cycle duration—revealed distinct pathological patterns: compared to primary snore and mild OSA patients, moderate-to-severe OSA patients demonstrated significantly reduced skewness, increased instability during sleep, and shortened nasal cycle duration. Sleep architecture, particularly the N3 stage, exerted a stabilizing effect on NVL patterns. Notably, the lateral position enhanced both skewness and stability, regardless of left and right nasal cycle dominance. These findings may indicate that autonomic dysfunction associated with OSA preferentially affects NVL regulation, whereas neuroregulatory capacity appears to remain intact during the consolidated deep sleep stage. Clinical trial registration: Clinical trial registered with www.chictr.org.cn. The distribution characteristics and influencing factors of left and right nasal and oral airflow in OSA patients (CTR2400088754).