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Pulmonary Medicine
Volume 2016, Article ID 4841310, 7 pages
Review Article

Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis

1Tripler Army Medical Center, Division of Otolaryngology, Sleep Surgery and Sleep Medicine, 1 Jarrett White Rd, Tripler AMC, Honolulu, HI 96859, USA
2Uniformed Services University of the Health Sciences, 4301 Jones Bridge Road, Bethesda, MD 20814, USA
3Tripler Army Medical Center, Division of Otolaryngology-Head & Neck Surgery, Tripler AMC, Honolulu, HI 96859, USA
4Clay County Hospital, 911 Stacy Burk Drive, Flora, IL 62839, USA
5Sleep Disorders Center, Sunnyside Community Hospital, 1016 Tacoma Avenue, Sunnyside, WA 98944, USA
6Department of Psychiatry and Behavioral Sciences, Sleep Medicine Division, Stanford Hospital and Clinics, Redwood City, CA 94063, USA

Received 23 July 2016; Revised 29 September 2016; Accepted 10 October 2016

Academic Editor: Dimitris Georgopoulos

Copyright © 2016 Macario Camacho et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.


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 to events/hr, value 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.