Impact of Functional Rhinoplasty on Sleep-Disordered Breathing: A Systematic Review and Meta-Analysis

Ang LF, Chua NYM, Loh SBJ, Di Pierro F, Ng CL.

What this paper says

Pooling eight studies with 1,192 adults with sleep-disordered breathing, functional rhinoplasty produced a large drop in nasal obstruction scores and moderate improvements in sleepiness and sleep quality.

Overview

A blocked nose worsens snoring and sleep apnoea, but the effect of nasal surgery on validated sleep outcomes had not been pooled. The Singapore-led authors registered a PRISMA 2020 review (PROSPERO CRD420251168358), searched PubMed, Embase and Cochrane to September 2025, and pooled standardised mean differences with Hartung-Knapp confidence intervals.

Sections of note

Eight studies, 27 cohorts, 1,192 patients.
Nasal obstruction (NOSE): SMD -4.99 (95% CI -9.12 to -0.85), a large effect.
Daytime sleepiness (Epworth): SMD -1.09 (95% CI -2.33 to 0.15), moderate but crossing zero.
Sleep quality (Pittsburgh): SMD -0.74 (95% CI -1.21 to -0.26).
Functional status (FOSQ-10): SMD 0.41 (95% CI 0.16-0.65).
Heterogeneity was substantial and small-study effects were detected.

What it means for a patient

If you have sleep-disordered breathing and a structurally blocked nose, functional rhinoplasty is likely to help breathing a lot and sleep symptoms somewhat.
It is described as an adjunct for selected patients, not a cure for sleep apnoea.
The studies were mostly observational and varied, so the sizes of the sleep benefits are uncertain.

Why this paper matters

It is the first quantitative synthesis linking functional rhinoplasty to validated sleep outcomes. Limits: observational data, high heterogeneity, publication bias signals, no objective sleep-study endpoints pooled.

Terms

Sleep-disordered breathing (SDB): snoring and obstructive sleep apnoea.
Functional rhinoplasty: nasal surgery aimed at breathing rather than appearance.
Epworth Sleepiness Scale: a questionnaire measuring daytime sleepiness.
Pittsburgh Sleep Quality Index: a questionnaire on overall sleep quality.
Standardised mean difference (SMD): an effect size; 0.8 or more is large.

Summary written by rhinoplasty.cc from the abstract, 2026-09-08; not medical advice. The authors' own abstract follows.

From the abstract

“Structural nasal obstruction is an important modifier of sleep-disordered breathing (SDB), but the specific impact of functional rhinoplasty on validated sleep-related outcomes has not been quantitatively synthesized. Objective And Hypothesis: To systematically review and meta-analyze studies of adults with SDB…”

Excerpt; the full abstract is on PubMed.