The quality of evidence is downgraded by inconsistency (statistical heterogeneity).
A Cochrane review [Abstract] 1 included 5 studies with a total of 240 children aged 1 to 18 years with mild to moderate OSA (apnoea/hypopnoea index, AHI 1 to 30 per hour). Follow-up time ranged from 6 weeks to 4 months.
Montelukast compared to placebo: Children receiving oral montelukast had lower AHI (MD −3.41, 95% CI −5.36 to −1.45; 2 studies, n=103, statistical heterogeneity, I2 =54%), lower respiratory arousal index (MD −2.89, 95% CI −4.68 to −1.10; 2 studies, n=103, I2 =59%) and nadir of oxygen saturation (MD 4.07, 95% CI 2.27 to 5.88; 2 studies, n=103) compared to placebo group. There was no statistically significant difference in desaturation index (MD −2.50, 95% CI −5.53 to 0.54; 2 studies, n=103, I2 =88%).
Intranasal corticosteroids compared to placebo: There was no statistically significant difference in AHI (MD −3.18, 95% CI −8.70 to 2.35; 2 studies, n=75, I2 =63%), in desaturation index (MD −2.12, 95% CI −4.27 to 0.04; 2 studies, n=75), respiratory arousal index (MD −0.71, 95% CI −6.25 to 4.83; 2 studies, n=75; I2 =72%), and nadir oxygen saturation (MD 0.59%, 95% CI −1.09 to 2.27; 2 studies, n=75) between intranasal corticosteroids and placebo.
Adverse events were assessed and reported in all studies and were rare, of minor nature (e.g. nasal bleeding), and evenly distributed between study groups.No study examined the avoidance of surgical treatment for OSA as an outcome.
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