Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis

Table 3

Pre- and postnasal EPAP means, standard deviations, mean differences, and confidence intervals for polysomnography outcomes.

Research studies	Study type	Patient characteristics			Apnea-hypopnea index (mean/SD, except)				Epworth Sleepiness Score (mean/SD except)
Author, year			Age, years	BMI Kg/m^2	Pre-NEPAP	Post-NEPAP	MD (95% CI)	value	Pre-NEPAP	Post-NEPAP	MD (95% CI)	value
Colrain et al., 2008 [12]	Original	30	50.1 ± 9.8	28.2 ± 4.0	24.8 ± 22.1	14.2 ± 21.8	−10.60 (0.745, −21.945)	0.0665	—	—	—	—
			49 ± 12.9F	27 ± 5.34F
Rosenthal et al., 2009 [16]	Original	28	49.8 ± 10.2	30.1 ± 5.9	24.5 ± 23.6	15.5 ± 18.9	−9.00 (2.456, −20.456)	0.1211	8.7 ± 4.0	6.9 ± 4.4	−1.80 (0.453, −4.053)	0.115
Hwang et al., 2009 [20]	C. abstract	6	26–39	—	8 to 97	<20 in 3 pts	—	—	—	—	—	—
Westbrook et al., 2009 [21]	C. abstract	58	—	—	26.6 ± 24.8	13.7 ± 20.1	−12.90 (−4.596, −21.204)	0.0026	—	—	—	—
Berry et al., 2011 [18]	Original	229	47.7 ± 13.4	32.6 ± 7.0	14.4	5.6	—	—	9.9 ± 4.7	7.2 ± 4.2	−2.70 (−1.881, −3.519)	0.0001
Kryger et al., 2011 [19]	Original	34	50.1 ± 13.6	32.5 ± 7.5	15.7	4.7	—	—	14	7	—	—
Patel et al., 2011 [13]	Original	19	54.3 ± 12.0	33.5 ± 5.6	34 ± 30.0	19.9 ± 26.0	−14.10 (4.371, −32.571)	0.1303	—	—	—	—
Walsh et al., 2011 [17]	Original	43	53.7 ± 10.9	34.9 ± 6.7	43.3 ± 29.0	16.4 ± 12.2	−26.90 (−17.359, −36.441)	0.0001	12.3 ± 4.8	8.7 ± 4.4	−3.60 (−1.625, −5.575)	0.0005
Adams 2011 [22]	C. abstract	131	—	—	25.8	4.2	—	—	—	—	—	—
Hwang et al., 2011 [23]	C. abstract	36	56.3 ± 12.6	34.1 ± 9.5	22.7 ± 19.4	8.9 ± 9.9	−13.80 (−6.560, −21.040)	0.0003	—	—	—	—
Massie and Hart 2011 [24]	C. abstract	30	51 ± 10	32 ± 6	17.1	4.9	—	—	7.2	5.5	—	—
Adams 2012 [25]	C. abstract	72	≥65	—	26.3	4.7	—	—	—	—	—	—
Massie 2012 [26]	C. abstract	31	—	—	17.5	5	—	—	10.6	5.9	—	—
Rossi et al., 2013 [14]	Original	22	63.2 ± 8.7	33.4 ± 6.6	36.5 ± 15.1	27.6 ± 16.4	−8.90 (0.692, −18.492)	0.0681	7 ± 5.8–9.0	9.3 ± 4.8	2.30 (5.620, −1.020)	0.1692
Deoras et al., 2013 [27]	C. abstract	42	≥18	—	—	−22.4 ± 21	—	—	9.8	7.6	—	—
Mansfield et al., 2013 [28]	C. abstract	21	—	—	32 ± 5.0	9.0 ± 6.0	−23.00 (−19.56, −26.44)	0.0001	7 ± 10	6 ± 11	−1.00 (5.56, −7.56)	0.7595
Martin et al., 2014 [29]	C. abstract	50	—	—	19.3 ± 12.6	5.5 ± 13.1	−13.80 (−8.699, −18.901)	0.0001	—	—	—	—
Friedman et al., 2015 [15]	Original	38	51.5 ± 11.6	29.4 ± 5.0	18.1 ± 13.0	7.4 ± 10.1	−10.70 (−5.379, −16.021)	0.0001	10.1 ± 5.5	8.5 ± 5.0	−1.60 (0.803, −4.003)	0.1886
Total patients		920
Combined means			50.2 ± 12.7	32.2 ± 6.7	27.32 ± 22.24	12.78 ± 16.89	−14.54 (−17.59, −11.49)	<0.0001	9.94 ± 5.29	7.42 ± 4.98	−2.52 (−1.766, −3.273)	<0.0001

21 patients.
Mean change in AHI.
Combined means of studies included in meta-analysis.
Median (25–75).
NEPAP: nasal EPAP (Provent); SD: standard deviation; C. abstract: conference abstract; F: female; Kg/m²: kilogram per square meter.