Introduction: Epistaxis is the most frequent symptom of hereditary hemorrhagic telangiectasia (HHT) and can severely affect quality of life. Until now, no optimal treatment method exists, therefore a multitude of different therapeutic approaches are applied. One option is the closure of the nasal nostrils, the so-called Young"s procedure. It has already been demonstrated that nasal blockage can worsen or induce obstructive sleep apnea (OSA) in healthy young women, however, no objective data existed if this would also apply to HHT patients which are more accustomed to nasal blockage by blood crusts and nasal packings. Material and methods: A pre- and postoperative sleep testing based on peripheral arterial tonometry (WatchPAT, Itamar, Israel) was performed, as standard polygraphy using nasal pressure sensors could not be applied. Testing was done during one night at a week before and 2 days after bilateral nasal closure in a female patient of 67 years. Results: pAHI (PAT-AHI) rose from 19.5 before to 33.3 after surgery, while total sleep time decreased moderately from 8 hours 19 minutes to 7 hours 39 minutes. Time spent in supine position did not show a relevant difference between the two measurements (272 vs. 239 minutes). Minimal oxygen saturation dropped from 80% to 72%. Conclusion/Discussion: The procedure of nasal closure is – despite of its side effects – increasing quality of life and can lead to permanent and complete cessation of epistaxis in HHT patients. Although a causal relationship cannot be proven in this case report, the potential of worsening preexisting obstructive sleep apnea should be discussed with patients with a nasal closure before surgery and preoperative sleep testing should be considered in patients with high pretest probability.

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