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

To assess the impact of nasal obstruction on obstructive sleep apnea (OSA) indicators and summarize the limited available data on mouth taping during sleep.

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.

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.

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.

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.