Objective:

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.

Sources:

• OTO Open