Effect of high-flow nasal cannula therapy on adults with obstructive sleep apnea: A meta-analysis.

BACKGROUND

Obstructive sleep apnea (OSA) is a prevalent sleep-related breathing disorder. There has been some evidence that patients with OSA may benefit from high-flow nasal cannula (HFNC). This meta-analysis aims to assess the effect of HFNC on adults with OSA.

METHODS

A systematic literature search was performed using PubMed, Embase, and Cochrane Library databases before April 2024. Inclusion criteria encompassed studies involving adult OSA patients treated with HFNC, assessed by respiratory polygraphy or polysomnography.

RESULTS

A total of 12 studies, comprising 327 patients, were included in the meta-analysis. The pooled analysis revealed that HFNC therapy led to a significant reduction in apnea-hypopnea index (mean difference [MD] = -8.90; 95% confidence interval [CI] -10.47, -7.34), improved mean and lowest oxygen saturations (MD = 2.56 and 8.46, respectively), and reduced oxygen desaturation index (MD = -28.4; 95% CI -33.75, -23.06). No significant changes were observed in REM sleep percentage and sleep efficiency. HFNC also showed a tendency to decrease the total arousal index by 12.22/h (95% CI -18.40, -6.04) and the respiratory arousal index by 10.65/h (95% CI -15.65, -5.66).

CONCLUSION

HFNC therapy is a promising alternative for managing OSA. It significantly reduces apnea-hypopnea index, improves oxygenation, and decreases sleep disruptions in adults with OSA.