From the Guidelines
Snoring treatment should prioritize the use of mandibular advancement devices (MAD) as a first-line treatment for mild to moderate obstructive sleep apnea (OSA) and primary snoring, due to their effectiveness in reducing snoring events and improving quality of life, as supported by the most recent evidence 1. When considering treatment options for snoring, it's essential to evaluate the severity of the condition and the presence of underlying sleep apnea.
- For mild snoring, lifestyle changes such as weight loss, avoiding alcohol before bedtime, and sleeping on your side can be effective.
- Over-the-counter options like nasal strips and anti-snoring mouthpieces can also help keep airways open.
- However, for more persistent snoring, especially when associated with OSA, MAD have been shown to be a highly effective treatment option, reducing the frequency and duration of apneas, hypopneas, and snoring events, while also improving nocturnal oxygenation and quality of life 1.
- Continuous positive airway pressure (CPAP) machines are still considered the gold standard for moderate to severe OSA, but MAD can be a suitable alternative for patients who are intolerant of CPAP therapy or prefer alternative treatment.
- It's crucial to note that the treatment of snoring and OSA requires a multidisciplinary approach, involving collaboration between sleep physicians, dentists, and other healthcare professionals, as emphasized in recent guidelines 1.
- Regular follow-up and monitoring are necessary to assess the effectiveness of treatment and address any potential side effects or complications, highlighting the importance of ongoing care and management in the treatment of snoring and OSA.
From the Research
Snoring Treatments
- Behavioral changes and general measures, such as weight loss, reduction of alcohol consumption, and sleep position training, are possible treatment options for primary snoring 2.
- Conservative treatment options include positioning therapy and weight loss, while mandibular protrusion splints can lessen snoring in suitable cases 3.
- Surgical treatment options are available, including uvulopalatopharyngoplasty and maxillar-mandibular surgery, although their role remains controversial 4.
- Intra-oral devices and continuous positive airway pressure (CPAP) are also treatment options for snoring, with CPAP being the treatment of choice for moderate-to-severe obstructive sleep apnoea 5, 4.
- Minimally invasive procedures to treat snoring are currently under evaluation, and a multidisciplinary approach is necessary for an accurate management of the disease 4, 6.
Treatment Effectiveness
- The effectiveness of treatments for primary snoring can be assessed using various outcomes, including snoring frequency and intensity, sleep quality, and daytime functioning 6.
- However, the level of evidence for many diagnostic and therapeutic techniques remains limited, and further research is needed to establish evidence-based recommendations for the management of primary snoring 3, 6.
- Randomised controlled trials with strict discrimination between patients with primary snoring and obstructive sleep apnoea (OSA) are needed to inform clinical decision-making 6.
Future Research Directions
- The development of a core outcome set to inform standardised reporting for future research on primary snoring is necessary to facilitate comparison of outcomes across different therapies 6.
- Network meta-analyses using some outcomes is feasible and can help to determine the optimal intervention for primary snoring 6.