Impact of Nasal Obstruction and Mouth Taping on Sleep Apnea Indicators: Systematic Review and Meta-Analysis.

OBJECTIVE: To assess the impact of nasal obstruction on obstructive sleep apnea (OSA) indicators and summarize the limited available data on mouth taping during sleep. DATA SOURCES: A systematic search was conducted in October 2024, encompassing 5 electronic databases: PubMed, MEDLINE, Web of Science, Cochrane, and CINAHL, to evaluate the impact of breathing routes on OSA indicators. REVIEW METHODS: Eligible studies included those that induced nasal obstruction either non-surgically (eg, experimental studies or postintervention for epistaxis) or surgically (eg, postseptoturbinoplasty) and their impact on reported sleep apnea indicators, such as Apnea-Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), mean and nadir oxygen saturation. A Meta-analysis was conducted on studies of nasal obstruction. Due to limited data, no meta-analysis was performed for mouth taping; only 2 studies were narratively reviewed. RESULTS: Nasal obstruction was associated with a clinically significant increase in AHI (+13.78 events/h) and ODI (+7.45 events/h), alongside a modest nonclinically significant decrease in the average (-0.70%) and nadir (-1.75%) SpO2. Conversely, a narrative review of two studies on mouth taping found it reduced AHI in patients with mild OSA. The heterogeneity among studies limits the generalizability of these data. CONCLUSION: Nasal obstruction, whether induced non-surgically or in surgical settings, was associated with worsening of OSA indicators and may precipitate OSA-like abnormalities in previously healthy individuals. These findings underscore the importance of nasal breathing and support further investigation into the breathing route as a modifiable factor in sleep-disordered breathing.