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Nasal obstruction may worsen OSA indicators
Increases in apnea-hypopnea events were greatest among patients with an elevated baseline index, while evidence supporting mouth taping remained preliminary.
To examine the effects of nasal obstruction and mouth taping on obstructive sleep apnea (OSA) indicators.
Approach:
Study Search: Investigators searched PubMed, MEDLINE, Web of Science, Cochrane, and CINAHL for relevant studies.
Study Inclusion: The review included 17 studies with 354 adult participants, focusing on nasal obstruction and mouth taping.
Meta-Analysis: 15 studies (n = 304) were included in the meta-analysis of nasal obstruction; 2 studies on mouth taping were reviewed narratively.
Outcome Measures: Outcomes included Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), and oxygen saturation levels.
Statistical Analysis: Random-effects meta-analyses were conducted when at least 3 studies reported comparable outcomes.
Key Findings:
Nasal obstruction was associated with a mean AHI increase of 13.78 events per hour.
The increase in AHI varied by baseline AHI: 9.56 events per hour for AHI < 5, and 24.11 events per hour for AHI ≥ 5.
Nasal obstruction was associated with a mean ODI increase of 7.45 events per hour, which was not statistically significant.
Average oxygen saturation decreased by 0.70 percentage points, and nadir oxygen saturation decreased by 1.75 percentage points, although these reductions were characterized as not clinically meaningful.
Both mouth taping studies showed a decrease in AHI but did not achieve statistically significant improvements in oxygen saturation.
Interpretation:
Acute nasal obstruction is associated with worsening sleep apnea indicators.
Limitations:
Most studies were observational, limiting causal interpretation.
Study populations and methods varied substantially.
Definitions of hypopnea were inconsistent, potentially affecting pooled estimates.
Only 3 studies were rated as good quality; 8 as fair, and 6 as poor.
Conclusion:
The evidence suggests that nasal obstruction worsens OSA indicators.
