{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,29]],"date-time":"2026-09-29T14:07:42Z","timestamp":1790690862396,"version":"4.1.0"},"reference-count":50,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T00:00:00Z","timestamp":1787788800000},"content-version":"vor","delay-in-days":57,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,7,1]],"date-time":"2026-07-01T00:00:00Z","timestamp":1782864000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["OTO Open"],"published-print":{"date-parts":[[2026,7]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess the impact of nasal obstruction on obstructive sleep apnea (OSA) indicators and summarize the limited available data on mouth taping during sleep.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Data Sources<\/jats:title>\n                    <jats:p>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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Review Methods<\/jats:title>\n                    <jats:p>Eligible studies included those that induced nasal obstruction either non\u2010surgically (eg, experimental studies or postintervention for epistaxis) or surgically (eg, postseptoturbinoplasty) and their impact on reported sleep apnea indicators, such as Apnea\u2010Hypopnea Index (AHI), Oxygen Desaturation Index (ODI), mean and nadir oxygen saturation. A Meta\u2010analysis was conducted on studies of nasal obstruction. Due to limited data, no meta\u2010analysis was performed for mouth taping; only 2 studies were narratively reviewed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Nasal obstruction was associated with a clinically significant increase in AHI (+13.78\u2009events\/h) and ODI (+7.45\u2009events\/h), alongside a modest nonclinically significant decrease in the average (\u22120.70%) and nadir (\u22121.75%) SpO\n                      <jats:sub>2<\/jats:sub>\n                      . 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.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Nasal obstruction, whether induced non\u2010surgically or in surgical settings, was associated with worsening of OSA indicators and may precipitate OSA\u2010like 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\u2010disordered breathing.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/oto2.70294","type":"journal-article","created":{"date-parts":[[2026,8,27]],"date-time":"2026-08-27T19:52:44Z","timestamp":1787860364000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impact of Nasal Obstruction and Mouth Taping on Sleep Apnea Indicators: Systematic Review and Meta\u2010Analysis"],"prefix":"10.1002","volume":"10","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-3671-3971","authenticated-orcid":false,"given":"Nawaf A.","family":"Alshehri","sequence":"first","affiliation":[{"name":"College of Medicine King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nada F.","family":"Alsaif","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abdullah N.","family":"Abdulrazaq","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raaoum M.","family":"Jabor","sequence":"additional","affiliation":[{"name":"College of Medicine King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ahmed A.","family":"Al\u2010Sayed","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery, College of Medicine King Saud University Riyadh Saudi Arabia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,8,27]]},"reference":[{"issue":"2","key":"e_1_2_11_2_1","first-page":"97","article-title":"Obstructive sleep apnea syndrome: a literature review","volume":"64","author":"Maspero C","year":"2015","journal-title":"Minerva Stomatol"},{"key":"e_1_2_11_3_1","doi-asserted-by":"publisher","DOI":"10.1152\/physrev.00043.2008"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/S2213-2600(19)30198-5"},{"key":"e_1_2_11_5_1","volume-title":"Essential Chapter 4 Physiology and Pathophysiology of Nasal Breathing","author":"Behrbohm H","year":"2017"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.1152\/jappl.1999.87.1.400"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.03.00047903"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.103.4.1032"},{"issue":"6","key":"e_1_2_11_9_1","doi-asserted-by":"crossref","first-page":"458","DOI":"10.2223\/JPED.1561","article-title":"Evaluation of atopy among mouth\u2010breathing pediatric patients referred for treatment to a tertiary care center","volume":"82","author":"Barros JRC","year":"2006","journal-title":"J Pediatr"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.20991"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1164\/ajrccm.153.1.8542125"},{"key":"e_1_2_11_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0002-9416(69)90034-7"},{"issue":"1","key":"e_1_2_11_13_1","first-page":"3","article-title":"Physiological and pathophysiological implications of upper airway reflexes in humans","volume":"50","author":"Nishino T","year":"2000","journal-title":"J Physiol Sci"},{"key":"e_1_2_11_14_1","doi-asserted-by":"publisher","DOI":"10.1164\/arrd.1987.135.6.1316"},{"key":"e_1_2_11_15_1","doi-asserted-by":"publisher","DOI":"10.1152\/japplphysiol.00907.2003"},{"key":"e_1_2_11_16_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e318042aef7"},{"key":"e_1_2_11_17_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-020-05904-0"},{"key":"e_1_2_11_18_1","doi-asserted-by":"publisher","DOI":"10.1177\/154405910408300912"},{"key":"e_1_2_11_19_1","unstructured":"HigginsJPT ThomasJ ChandlerJ et al. eds. 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