title: Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis.
abstract: Objective. To systematically review the international literature for studies evaluating internal (NoZovent) and external (Breathe Right Strips) nasal dilators as treatment for obstructive sleep apnea (OSA).Study Design. Systematic review with meta-analysis.Methods. Four databases, including PubMed/MEDLINE, were searched through September 29, 2016.Results. One-hundred twelve studies were screened, fifty-eight studies were reviewed, and fourteen studies met criteria. In 147 patients, the apnea-hypopnea index (AHI) was reported, and there was an improvement from a mean ± standard deviation (M ± SD) of 28.7 ± 24.0 to 27.4 ± 23.3 events/hr,pvalue 0.64. There was no significant change in AHI, lowest oxygen saturation, or snoring index in OSA patients when using nasal dilators. However, a subanalysis demonstrated a slight reduction in apnea index (AI) with internal nasal dilators (decrease by 4.87 events/hr) versus minimal change for external nasal dilators (increase by 0.64 events/hr).Conclusion. Although nasal dilators have demonstrated improved nasal breathing, they have not shown improvement in obstructive sleep apnea outcomes, with the exception of mild improvement in apnea index when internal nasal dilators were used.
authors.affiliation: Tripler Army Medical Center, Division of Otolaryngology, Sleep Surgery and Sleep Medicine, 1 Jarrett White Rd, Tripler AMC, Honolulu, HI 96859, USA.
authors.forename: Macario
authors.identifier: 0000-0001-9200-9085
authors.initials: M
authors.lastname: Camacho
authors.affiliation: Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA.
authors.forename: Omojo O
authors.initials: OO
authors.lastname: Malu
authors.affiliation: Tripler Army Medical Center, Division of Otolaryngology-Head & Neck Surgery, Tripler AMC, Honolulu, HI 96859, USA.
authors.forename: Yoseph A
authors.initials: YA
authors.lastname: Kram
authors.affiliation: Clay County Hospital, 911 Stacy Burk Drive, Flora, IL 62839, USA.
authors.forename: Gaurav
authors.identifier: 0000-0002-9329-9659
authors.initials: G
authors.lastname: Nigam
authors.affiliation: Sleep Disorders Center, Sunnyside Community Hospital, 1016 Tacoma Avenue, Sunnyside, WA 98944, USA.
authors.forename: Muhammad
authors.identifier: 0000-0001-9512-3334
authors.initials: M
authors.lastname: Riaz
authors.affiliation: Tripler Army Medical Center, Division of Otolaryngology-Head & Neck Surgery, Tripler AMC, Honolulu, HI 96859, USA.
authors.forename: Sungjin A
authors.initials: SA
authors.lastname: Song
authors.affiliation: Tripler Army Medical Center, Division of Otolaryngology-Head & Neck Surgery, Tripler AMC, Honolulu, HI 96859, USA.
authors.forename: Anthony M
authors.initials: AM
authors.lastname: Tolisano
authors.affiliation: Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Redwood City, CA 94063, USA.
authors.forename: Clete A
authors.initials: CA
authors.lastname: Kushida
mesh_terms: D058109:Airway Management / Q000295:instrumentation / Q000379:methods; D002986:Clinical Trials as Topic; D004106:Dilatation / Q000295:instrumentation*; D004867:Equipment Design; D006801:Humans; D012720:Severity of Illness Index; D020181:Sleep Apnea, Obstructive / Q000503:physiopathology / Q000628:therapy; D012913:Snoring / Q000503:physiopathology / Q000628:therapy; D016896:Treatment Outcome