목적: Previous research has explored the effect of nasal congestion on the emergence and exacerbation of obstructive sleep apnea (OSA) but yielded diverse analysis methodologies and outcomes. Some prior studies have identified that the major nasal inspiratory resistance is located at the anterior portion of the inferior turbinates. Our study focuses on evaluating the influence of the nasal cross-sectional area (CSA) on OSA at this specific site, utilizing both acoustic rhinometry (AR) and computed tomography (CT) coronal view. 방법:Medical records of patients who underwent polysomnography, paranasal sinus CT, and AR were extracted between December 2018 and December 2022. We excluded individuals below 18 years of age and those lacking physical measurement data. Participants were categorized into mild to severe OSA and non-OSA groups based on their apnea-hypopnea index (< or ≥ 5/hour), and the clinical characteristics were compared between the groups. We also analyzed moderate to severe OSA cases against others and severe OSA against others. Furthermore, correlation analysis was performed between the continuous variables. 결과:Finally, 308 patients were enrolled in the study. Compared to the non- OSA group, those with mild to severe OSA showed a higher prevalence of males, older age, and higher BMI (p = 0.004, 0.001, and 0.022). Nasal CSA measurements by AR and CT did not differ significantly across groups, yet binomial logistic regression indicated that sex, age, BMI, and AR-measured nasal CSA significantly impacted OSA (p = 0.004, <0.001, 0.036, and 0.050, respectively). The minimum value between right and left CSAs measured by AR was inversely related to OSA likelihood, particularly in non-obese individuals, as evidenced by logistic regression analysis (p = 0.015). This association was not observed in obese patients. When comparing moderate to severe OSA cases with the others and when comparing severe OSA cases with the others, no significant CSA differences were found, even after adjusting for confounding factors. In correlation analysis, AR- measured CSA negatively correlated with the apnea-hypopnea and obstructive apnea-hypopnea indexes (p = 0.048 and 0.046), though these correlations lost significance when controlling for BMI and age. 결론:Nasal CSA at the inferior turbinate anterior head level, along with sex, age, and BMI, significantly influences OSA development. Before adjusting confounders, the absence of significant CSA differences might be attributed to age-related CSA increase due to atrophic changes. The association between CSA and OSA might be obscured in obese patients by more pronounced oropharyngeal narrowing. CT-measured CSA showed no significant correlation with OSA, unlike AR measurements. Further understanding of the nasal CSA-OSA relationship could be crucial in enhancing preventive and therapeutic strategies for OSA in patients with nasal obstruction.