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Effects of heated humidification on positive airway pressure side effects in patients with obstructive sleep apnoea: a meta-analysis

  • Sleep Breathing Physiology and Disorders • Review
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Abstract

Purpose

An earlier study found that heated humidification reduced the side effects of positive airway pressure (PAP) in patients with obstructive sleep apnoea (OSA). However, other studies disagreed with this finding. Therefore, we evaluated the relationship between heated humidification and the side effects of PAP in patients with OSA.

Methods

According to the Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines, six databases were searched for relevant randomised controlled trials (RCTs) performed from January 1999 to June 2021.

Results

From 1012 retrieved articles, we identified 9 eligible RCTs. Compared to the control group, the heated humidification group reported improvements in dry nose (pooled standardised mean difference [SMD] =  − 0.70, 95% confidence interval [CI] =  − 0.96 to − 0.45, I2 = 0%, p < 0.00001), blocked nose (SMD =  − 0.47, 95%CI − 0.69 to − 0.25, I2 = 36%, p < 0.0001), runny nose (SMD =  − 0.22, 95%CI − 0.44 to 0, I2 = 0%, p = 0.05), dry mouth (SMD =  − 0.62, 95%CI − 0.87 to − 0.37, I2 = 0%, p < 0.00001), and dry throat (SMD =  − 0.61, 95%CI − 0.90 to − 0.33, I2 = 41%, p < 0.0001), but did not enhance positive airway pressure adherence (pooled mean difference [MD] = 0.24, 95% CI − 0.10 to 0.58, I2 = 0%, p = 0.17).

Conclusions

Heated humidification improved some PAP side effects in patients with OSA but did not increase PAP adherence. Additional large-scale multi-centre RCTs are needed to verify the long-term effects.

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Funding

This work was supported by the Shanghai Jiao Tong University School of Medicine: Nursing Development Program, the Effect of “Internet + ” remote guidance on continuous positive airway pressure side-effects in patients with OSAHS programme (Grant No. Jyhz2129), Effects of telemedicine system interventions in improving continuous positive airway pressure adherence in patients with obstructive sleep apnoea: a systematic review (Grant No. X within hospital-2320), Shanghai Municipal Commission of Science and Technology (Grant No. 18DZ2260200), and Innovative research team of high-level local universities in Shanghai (SHSMUZLCX20211702).

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Author notes

  1. Yuli Hu, Zuoyan Zhang and Fang Fang contributed equally to this work

Authors and Affiliations

  1. Shanghai Jiao Tong University Affiliated Sixth People’s Hospital, No. 600, Yishan Road, Xuhui District, Shanghai, China

    Yuli Hu, Zuoyan Zhang, Fang Fang, Jun Ma, Sanlian Hu & Jian Guan

  2. Shanghai Key Laboratory of Sleep Disordered Breathing, Shanghai, China

    Yuli Hu, Fang Fang & Jian Guan

  3. School of Nursing, Soochow University, Suzhou, China

    Jiaxin Yang

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  1. Yuli Hu
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Correspondence to Sanlian Hu or Jian Guan.

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Hu, Y., Zhang, Z., Fang, F. et al. Effects of heated humidification on positive airway pressure side effects in patients with obstructive sleep apnoea: a meta-analysis. Sleep Breath 27, 67–75 (2023). https://doi.org/10.1007/s11325-022-02596-0

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