Impact of Nasal Obstruction on Sleep Quality and Obstructive Sleep Apnea: A Narrative Review

Background: Obstructive sleep apnea (OSA) is a common and clinically significant sleep disorder involving recurrent episodes of upper airway collapse during sleep. While pharyngeal obstruction is the primary mechanism, nasal obstruction may also increase airway resistance, promote mouth breathing, and contribute to sleep disruption and OSA severity. Objective: This narrative review aims to explore the impact of nasal obstruction on sleep quality and OSA severity, with a particular focus on pathophysiological mechanisms, clinical implications, and therapeutic relevance. Methods: Relevant literature published between 2000 and 2025 was identified through PubMed and Google Scholar using keywords such as “nasal obstruction”, “obstructive sleep apnea”, “nasal breathing”, “sleep disturbances”, “nasal surgery”, and “CPAP adherence”. Included studies were review articles, meta-analyses, and original clinical research involving adult populations. Results: Although nasal obstruction alone is rarely the primary cause of moderate to severe OSA, it may negatively influence sleep quality, promote mouth breathing, worsen upper airway collapsibility, and reduce adherence to CPAP therapy. Medical and surgical interventions aimed at improving nasal airflow have shown variable results in sleep-related outcomes. Conclusion: Nasal obstruction plays a significant yet complex role in OSA and sleep quality. Improving nasal patency may enhance patient-reported outcomes and facilitate more effective management of sleep-disordered breathing.