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TOOLS · INTERPRETER
NOSE scale: how blocked is your nose?
The NOSE scale (Nasal Obstruction Symptom Evaluation) turns five quick ratings into a score from 0 to 100. The higher the score, the more your nose gets in the way — which matters if you use a nasal CPAP mask.
Published scoring · Stewart et al., Otolaryngology–Head and Neck Surgery 2004
- About 1 minute
- Free, no sign-up
- Counts toward your Sleep Check-up
Sleep Check-up
0 of 6 checks done
Finish this one to reach 1 of 6.
- NoSAS (not started)
- STOP-Bang (not started)
- Berlin (not started)
- Epworth (not started)
- Insomnia (not started)
- NOSE (next)
Take the NOSE scale, a 5-question nasal obstruction score from 0 to 100, and see how a blocked nose affects your CPAP mask choice.
What your result looks like
A sample result. Yours appears here the moment you finish, with what it means and what to do next. Every possible result is listed beside it.
Severe
65/100
0100
Your NOSE score shows severe nasal obstruction.
Nasal breathing is difficult much of the time. A mouth-covering mask is usually the practical choice while the cause is assessed.
- Talk to your clinician or an ENT about nasal blockage
- See full face mask options
0No nasal obstruction
Your NOSE score is 0: no nasal obstruction reported.
5–25Mild
Your NOSE score shows mild nasal obstruction.
30–50Moderate
Your NOSE score shows moderate nasal obstruction.
55–75Severe
Your NOSE score shows severe nasal obstruction.
80–100Extreme
Your NOSE score shows extreme nasal obstruction.
Milestone addedNOSE done · 4 of 6 checks
Saved to your account. We'll remind you to retake in 30 days.
What this tool does
NOSE was designed by ear, nose and throat researchers to measure how much nasal obstruction bothers you, and is widely used around nasal surgery. For CPAP users it answers a practical question: can I rely on my nose all night?
It cannot tell you why your nose is blocked.
How the score works
| Rating | Points per item |
|---|---|
| Not a problem | 0 |
| Very mild problem | 1 |
| Moderate problem | 2 |
| Fairly bad problem | 3 |
| Severe problem | 4 |
Add the five items (0–20) and multiply by 5.
| Score | Severity |
|---|---|
| 0 | None |
| 5–25 | Mild |
| 30–50 | Moderate |
| 55–75 | Severe |
| 80–100 | Extreme |
Reading your result
0, none. Choose a mask on comfort and sleep position.
5–25, mild. Nasal masks usually work; humidification helps.
30–50, moderate. Watch for mouth leak; consider a mouth-covering mask on bad nights.
55–75, severe. A full face or under-nose full face mask is the practical default while you get it checked.
80–100, extreme. Get a clinical assessment. Nasal-only masks are unlikely to work for now.
A blocked nose and your CPAP mask
Nasal masks and nasal pillows deliver pressure through the nose only. When the nose is blocked, many people open their mouth during sleep. Air escapes, leak climbs, therapy works less well, and you wake with a dry mouth. The mask finder reads your NOSE band: when your nose is often blocked, it ranks mouth-covering masks first and adds a chin-strap note to nasal options.
In Apnealytics, compare leak P95 on Mask fit and leak with the weeks you scored high here. Mask Analytics shows seal and AHI per mask you have logged, so you can see which held up better on congested nights.
Sources
- Stewart MG, Witsell DL, Smith TL, Weaver EM, Yueh B, Hannley MT. Development and validation of the Nasal Obstruction Symptom Evaluation (NOSE) scale. Otolaryngology–Head and Neck Surgery, 2004.
- Lipan MJ, Most SP. Development of a severity classification system for subjective nasal obstruction. JAMA Facial Plastic Surgery, 2013.
FAQ
What is a normal NOSE score?
A score of 0 means no nasal obstruction. Scores of 5 to 25 are classed as mild, common during allergy season or a cold. The severity bands come from Lipan and Most (2013). There is no pass mark; the scale describes how much your nose bothers you.
Can I use a nasal mask with a blocked nose?
With mild blockage, usually yes, especially with heated humidification. With moderate or worse blockage, nasal-only masks often lead to mouth breathing and leak. A full face or under-nose full face mask avoids the problem. Some people keep both and switch on congested nights.
Why does a stuffy nose raise my CPAP leak?
When nasal resistance goes up, your body opens the mouth to breathe. With a nasal mask, pressurised air then escapes through the mouth. The machine logs that as leak, and the pressure reaching your airway can drop. Watching leak P95 alongside your NOSE score helps you spot the connection.
How often should I retake the NOSE scale?
Monthly works well, and again after any change such as starting a nasal spray, allergy treatment or surgery. The Sleep Check-up reminds you after 30 days. Comparing saved scores shows whether a treatment helped, and whether bad-nose weeks line up with high-leak weeks.
Does the NOSE score diagnose a deviated septum?
No. The NOSE scale measures symptoms, not anatomy. A deviated septum, enlarged turbinates, nasal polyps, allergies and a simple cold can all produce a high score. An examination by a clinician or ENT specialist is needed to find the cause.
Diagnosed and on CPAP? See if it's working.
Apnealytics reads your machine's SD card and shows residual AHI, leak and usage every night. Your first 30 nights are free.
Screening tool, not a diagnosis. A result here cannot tell you whether you have sleep apnea, insomnia or any other condition — only a licensed clinician can diagnose. If you are very sleepy during the day or have dozed while driving, see a doctor promptly.
