Clinical Effectiveness of Nasal Dilators in Sleep-Disordered Breathing: A Systematic Review and Meta-Analysis

TL;DR

Nasal dilators do not significantly improve sleep-disordered breathing outcomes and are not recommended as a standalone treatment.

Contribution

This study provides a comprehensive meta-analysis on the clinical effectiveness of nasal dilators for sleep-disordered breathing.

Findings

No significant differences were found in apnea-hypopnea index or other sleep metrics between nasal dilator users and controls.

Nasal dilators may be useful as an adjunct in mild cases or for nasal congestion.

The study included 17 studies with 496 participants, providing robust evidence for the lack of monotherapy effectiveness.

Abstract

Background: Nasal dilators are widely used as a noninvasive intervention for snoring and obstructive sleep apnea (OSA), yet their objective effects on sleep-disordered breathing and polysomnographic outcomes remain uncertain. This systematic review and meta-analysis aim to assess the effectiveness of nasal dilators in managing sleep-disordered breathing.

Methods: Scopus, PubMed, Web of Science, and ProQuest were systematically searched from inception to January 2024 for studies assessing the efficacy of internal or external nasal dilators in adult patients with sleep-disordered breathing. The standardized mean difference (SMD) was used to pool and compare the findings across studies using a random-effects model.

Results: Our search strategy yielded 290 records, of which 17 studies with a pooled population size of 496 participants were found to be eligible for inclusion. We did not find any significant differences in apnea-hypopnea index, apnea index, hypopnea index, snoring index, sleep time, sleep architecture, REM latency, oxygen saturation, and nasal airway resistance between participants who received nasal dilators and control subjects.

Conclusions: Nasal dilators cannot be recommended as monotherapy for sleep-disordered breathing. However, it may be helpful as adjunctive therapy in specific populations with mild symptoms or nasal congestion.

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