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  1. Article: The use of topical nasal steroids to improve continuous positive airway pressure compliance in patients with obstructive sleep apnea: An updated systematic review and meta-analysis of randomized control trials.

    Segsarnviriya, Charnsiri / Prakassajjatham, Mantana / Chirakalwasan, Naricha / Hirunwiwatkul, Prakobkiat / Chaitusaney, Busarakum / Charakorn, Natamon

    Asian Pacific journal of allergy and immunology

    2023  

    Abstract: Background: Nasal steroids are commonly prescribed to reduce nasal side effects, which are the primary cause of continuous positive airway pressure (CPAP) intolerance in obstructive sleep apnea (OSA) patients.: Objective: We conducted a systematic ... ...

    Abstract Background: Nasal steroids are commonly prescribed to reduce nasal side effects, which are the primary cause of continuous positive airway pressure (CPAP) intolerance in obstructive sleep apnea (OSA) patients.
    Objective: We conducted a systematic review and meta-analysis of OSA patients to assess the effect of nasal steroids on CPAP compliance and nasal symptoms.
    Methods: PubMed, Scopus, Ovid, and Cochrane Library were searched through March 2022. Randomized controlled trials (RCTs) evaluating the effects of nasal steroids on CPAP compliance in adult patients, which reported quantitative data on CPAP use and nasal symptoms, were included.
    Results: Three RCTs (224 patients) were eligible for the meta-analysis. At the 4-week follow-up, the study did not demonstrate a statistically significant difference in CPAP compliance (average hours of CPAP use per night: mean difference 0.45; 95% confident interval (CI) (-0.01, 0.90); P = 0.06, percentage of nights device used: mean difference 1.79; 95%CI (-2.59, 6.17); P = 0.42). There was also no difference in overall nasal symptoms (mean difference 0.47, 95%CI (-0.00, 0.94); P = 0.05), with significantly more sneezing and rhinorrhea among patients with nasal steroids (sneezing: mean difference 0.64, 95%CI (0.23, 1.05); P = 0.002, rhinorrhea: mean difference 0.78, 95%CI (0.24, 1.31); P = 0.005).
    Conclusions: At the 4-week follow-up, the pooled results did not demonstrate significant benefits of nasal steroids on CPAP compliance. There was also no significant benefit for relieving nasal symptoms. To further explore the benefit of nasal steroids on CPAP use, additional, longer-term studies are required.
    Language English
    Publishing date 2023-04-17
    Publishing country Thailand
    Document type Journal Article
    ZDB-ID 605782-2
    ISSN 2228-8694 ; 0125-877X
    ISSN (online) 2228-8694
    ISSN 0125-877X
    DOI 10.12932/AP-081122-1498
    Database MEDical Literature Analysis and Retrieval System OnLINE

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  2. Article ; Online: The effects of topical nasal steroids on continuous positive airway pressure compliance in patients with obstructive sleep apnea: a systematic review and meta-analysis.

    Charakorn, Natamon / Hirunwiwatkul, Prakobkiat / Chirakalwasan, Naricha / Chaitusaney, Busarakum / Prakassajjatham, Mantana

    Sleep & breathing = Schlaf & Atmung

    2017  Volume 21, Issue 1, Page(s) 3–8

    Abstract: Objectives: The purpose of the study was to conduct a systematic review and meta-analysis in patients with obstructive sleep apnea (OSA), evaluating effects of topical nasal steroids on continuous positive airway pressure (CPAP) machine use and nasal ... ...

    Abstract Objectives: The purpose of the study was to conduct a systematic review and meta-analysis in patients with obstructive sleep apnea (OSA), evaluating effects of topical nasal steroids on continuous positive airway pressure (CPAP) machine use and nasal symptoms.
    Search methods: Data source: A comprehensive search of Pubmed, Scopus, Web of Science, and the Cochrane Library was performed through April 2016. Manual searches and subject matter expert input were also obtained. Studies assessing effects of nasal steroids on CPAP machine use in adults, which reported quantitative outcome data of CPAP compliance, were included.
    Results: Two studies (144 patients) met inclusion criteria. Both were randomized, placebo-controlled clinical trials (RCT). Pooled fixed effects analysis did not identify a statistically significant difference between both the groups for average duration of CPAP machine use per night. But there was an overall increase in the usage of 0.4 h (95 % confidence interval (CI) (-0.20, 1.00); P = 0.19) in favor of nasal steroids. Difference of percentage of nights with CPAP use was not demonstrated (mean difference 0.06, 95 % CI (-0.27, 0.39); P = 0.71). There was also no significant difference in nasal symptoms (mean difference 0.63, 95 % CI (-0.11, 1.36), P = 0.1).
    Conclusion: Nasal steroids showed benefits on CPAP use, but did not reach statistical significance. Data was based on meta-analysis of RCTs of 4-week follow-up in unselected OSA patients. Future controlled studies with selected group and longer follow-up duration are needed to confirm the benefits of nasal steroid on CPAP compliance in OSA patients.
    Language English
    Publishing date 2017-03
    Publishing country Germany
    Document type Journal Article ; Review
    ZDB-ID 1500381-4
    ISSN 1522-1709 ; 1520-9512
    ISSN (online) 1522-1709
    ISSN 1520-9512
    DOI 10.1007/s11325-016-1375-3
    Database MEDical Literature Analysis and Retrieval System OnLINE

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