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OBJECTIVE: We administered a questionnaire survey to a working population in an attempt to clarify the relationships between self-reported nasal obstruction, observed apnea during sleep, and daytime sleepiness. STUDY DESIGN: A total of 7980 daytime workers were asked to complete questionnaires about nasal obstruction, apnea during sleep, and daytime sleepiness. Of the 7702 responses, the data from 4818 subjects were analyzed. Nasal obstruction and observed apnea were graded into 3 categories. Daytime sleepiness was assessed by the Epworth Sleepiness Scale. RESULTS: Subjects with chronic nasal obstruction had 5.22 and 2.17 times higher odds for having habitual observed apnea and excessive daytime sleepiness (EDS), respectively, compared with those without nasal obstruction (P < 0.001). After adjusting for 3 potential confounding factors (age, sex, and body mass index) and the presence of habitual observed apnea, odds ratios for having EDS decreased, but still remained significant. CONCLUSION: Nasal obstruction is likely to cause daytime sleepiness, at least in part, by causing sleep-disordered breathing including apnea during sleep.

Objectives: There has been growing awareness that nasal obstruction may impair various daily and social activities. We performed a questionnaire survey on a working population to clarify the relationships among nasal obstruction, daytime sleepiness, and quality of life (QOL). Methods: Seven thousand nine hundred eighty daytime workers were asked to complete questionnaires, and the data from 7,180 subjects without any missing answers were finally analyzed (90.0% of the total participants). The severity ofnasal obstruction was graded into the following three categories: never/rarely, sometimes, and always/often. Daytime sleepiness and QOL were assessed by the Epworth Sleepiness Scale and the Medical Outcomes Study 36-Item Short-Form Health Survey, respectively. Results: Younger subjects reported a higher degree of nasal obstruction. Subjects who reported a higher degree of nasal obstruction had higher daytime sleepiness and lower quality of life. Subjects with higher daytime sleepiness had lower quality of life. The degree of nasal obstruction was not associated with body mass index. Conclusions: Taking into account the impact of nasal airway resistance on sleep-disordered breathing, the present results suggest that chronic nasal obstruction impairs QOL, at least partially, through excessive daytime sleepiness possibly caused by sleep-disordered breathing. We stress that sufficient and appropriate rhinologic treatment may improve the quality of daily and social activities of individuals with sinonasal diseases.

BACKGROUND Apical tubules (ATs) in marginal cells (MCs) of the stria vascularis appear in limited stages of differentiation of the MCs, but their origin and roles remain uncertain. The present study was designed to solve the problem of whether the ATs are intracellular compartments derived from the Golgi apparatus (GA). METHODS The cochleae of Wistar rats at ages of postnatal days 1, 3, and 5 were prepared for electron microscopy and cytochemistry using thiamine pyrophosphatase (TPPase) and coenzyme A phosphatase (CoA-Pase) as marker enzymes of trans Golgi cisterns and fluorescent labelled lectin, griffonia simplicifolia agglutinin-I (GS-1). RESULTS The ATs appeared in the apical cytoplasm of the MCs between postnatal days 1 and 5. Reaction products of TPPase and CoA-Pase activities were localized in the trans-Golgi cisterns and the ATs, which were occasionally in a close apposition to the GA. The reaction was found along the apical plasma membrane of the MCs only in case of TPPase. Heavy reactions to GS-1 were seen in the supranuclear region as well as along the apical plasma membrane of the MCs. CONCLUSIONS The present ultrastructural and cytochemical studies indicate that the ATs, which appear in the MCs at limited perinatal stages, originate from the trans-Golgi cisterns. These ATs may be involved in the apical plasma membrane supply for the differentiation of the MCs prior to the generation of EP.