Abstract
Objective. To quantify the effectiveness of nasal expiratory positive airway pressure (nasal EPAP) devices or Provent as treatment for obstructive sleep apnea (OSA). Methods. PubMed and six other databases were searched through November 15, 2015, without language limitations. Results. Eighteen studies (920 patients) were included. Pre- and post-nasal EPAP means ± standard deviations (M ± SD) for apnea-hypopnea index (AHI) in 345 patients decreased from 27.32 ± 22.24 to 12.78 ± 16.89 events/hr (relative reduction = 53.2%). Random effects modeling mean difference (MD) was -14.78 events/hr [95% CI -19.12, -10.45], p value < 0.00001. Oxygen desaturation index (ODI) in 247 patients decreased from 21.2 ± 19.3 to 12.4 ± 14.1 events/hr (relative reduction = 41.5%, p value < 0.00001). Lowest oxygen saturation (LSAT) M ± SD improved in 146 patients from 83.2 ± 6.8% to 86.2 ± 11.1%, MD 3 oxygen saturation points [95% CI 0.57, 5.63]. Epworth Sleepiness Scale (ESS) M ± SD improved (359 patients) from 9.9 ± 5.3 to 7.4 ± 5.0, MD -2.5 [95% CI -3.2, -1.8], p value < 0.0001. Conclusion. Nasal EPAP (Provent) reduced AHI by 53.2%, ODI by 41.5% and improved LSAT by 3 oxygen saturation points. Generally, there were no clear characteristics (demograp...Continue Reading
References
Apr 18, 1981·Lancet·C E SullivanL Eves
Feb 12, 1998·Annals of Internal Medicine·J LauC H Schmid
Jul 18, 2002·American Journal of Respiratory and Critical Care Medicine·Yüksel PekerJan Carlson
Mar 8, 2003·Archives of Internal Medicine·Sanjay R PatelNajib T Ayas
Sep 6, 2003·BMJ : British Medical Journal·Julian P T HigginsDouglas G Altman
Jun 18, 2004·American Journal of Respiratory and Critical Care Medicine·Maree BarnesRobert J Pierce
Mar 24, 2006·Sleep·Peter GayUNKNOWN American Academy of Sleep Medicine
Dec 1, 2006·Sleep & Breathing = Schlaf & Atmung·Victor Hoffstein
May 25, 2007·Sleep·Adam G ElshaugJanet E Hiller
Feb 6, 2008·Proceedings of the American Thoracic Society·Terri E Weaver, Ronald R Grunstein
Mar 28, 2008·Sleep·Raphael HeinzerAmy S Jordan
Feb 23, 2010·International Journal of Surgery·David MoherUNKNOWN PRISMA Group
Aug 6, 2010·Thorax·Andrew S L ChanPeter A Cistulli
Jan 25, 2011·Sleep Medicine·James K WalshPaula K Schweitzer
Apr 5, 2011·Sleep·Richard B BerryClifford A Massie
Jul 30, 2011·Journal of Applied Physiology·C W BragaI Ayappa
Oct 18, 2011·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Meir H KrygerClifford A Massie
Apr 17, 2013·American Journal of Epidemiology·Paul E PeppardKhin Mae Hla
Jun 1, 2013·Thorax·Valentina A RossiMalcolm Kohler
Oct 25, 2013·The Laryngoscope·Anneclaire V VroegopEvert Hamans
May 9, 2014·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Amit ChopraErik K St Louis
Jun 17, 2014·Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine·Suraiya A KureshiCarole L Marcus
Jul 26, 2014·Sleep·Richard J SchwabMatt Vaska
Sep 13, 2014·The Laryngoscope·Macario CamachoRobson Capasso
Apr 22, 2015·The Laryngoscope·Michael FriedmanNinos J Joseph
Citations
Dec 23, 2016·Epidemiology and Psychiatric Sciences·K KoutraL Chatzi
Sep 12, 2018·Expert Review of Respiratory Medicine·Macario CamachoClete A Kushida
Feb 16, 2018·The European Respiratory Journal·Ali AzarbarzinAndrew Wellman
Nov 7, 2017·Internal Medicine Journal·Anna MohammadiehPeter A Cistulli
Dec 25, 2017·European Archives of Oto-rhino-laryngology : Official Journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : Affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery·Macario CamachoSoroush Zaghi
Jan 11, 2017·Pulmonary Medicine·Macario CamachoClete A Kushida
Sep 14, 2017·Respirology : Official Journal of the Asian Pacific Society of Respirology·Geraldo Lorenzi-FilhoPatrick J Strollo
Apr 21, 2021·Archivos de bronconeumología·Olga MedianoUNKNOWN el Spanish Sleep Network