An evidence‐based approach to the management of snoring in adults

Al‐Hussaini, Ali; Berry, Sandeep

doi:10.1111/coa.12341

Cited by 8 publications

(7 citation statements)

References 34 publications

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“…Further studies using such methods are encouraged, to confirm the findings of the present study. Effective treatments are also available for snoring, such as low-level continuous positive airway pressure (CPAP), oropharyngeal exercises, oral appliance therapy, and the use of specific types of pillows [29][30][31][32][33] . A recent review indicated that CPAP, the first-line treatment for OSAS, may be beneficial with regard to liver disease in people with OSAS, independent of metabolic risk factors 34 .…”

Section: Discussionmentioning

confidence: 99%

Self-reported snoring is associated with nonalcoholic fatty liver disease

Wang

Gao

et al. 2020

Sci Rep

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Although nonalcoholic fatty liver disease (nAfLD) is associated with obstructive sleep apnea syndrome (oSAS), studies on the direct relationship between nAfLD and snoring, an early symptom of oSAS, are limited. We evaluated whether snorers had higher risk of developing nAfLD. the study was performed using data of the Tongmei study (cross-sectional survey, 2,153 adults) and Kailuan study (ongoing prospective cohort, 19,587 adults). In both studies, NAFLD was diagnosed using ultrasound; snoring frequency was determined at baseline and classified as none, occasional (1 or 2 times/week), or habitual (≥3 times/week). Odds ratios (ORs) and hazard ratios (HRs) with 95% confidence intervals were estimated using logistic and Cox models, respectively. During 10 years' follow-up in Kailuan, 4,576 individuals with new-onset NAFLD were identified at least twice. After adjusting confounders including physical activity, perceived salt intake, body mass index (BMi), and metabolic syndrome (MetS), multivariate-adjusted oRs and HRs for nAfLD comparing habitual snorers to non-snorers were 1.72 (1.25-2.37) and 1.29 (1.16-1.43), respectively. These associations were greater among lean participants (BMi < 24) and similar across other subgroups (sex, age, MetS, hypertension). Snoring was independently and positively associated with higher prevalence and incidence of nAfLD, indicating that habitual snoring is a useful predictor of nAfLD, particularly in lean individuals. Nonalcoholic fatty liver disease (NAFLD) is one of the most common chronic liver diseases worldwide 1. NAFLD affects approximately 25% of the global population 2 , with more than 10% of cases occurring in lean people 1. The prevalence of NAFLD ranges from 6.3% to 27.0% in Chinese adults 3 and is increasing at a rate of 0.594% per year 4. The rising prevalence of NAFLD, in conjunction with the pandemic of obesity and metabolic syndrome (MetS), represent an increasing global public health burden 5. Snoring is a common condition that is easily detected by co-sleepers. In a recent study among 10,139 people living in rural areas of northern China, 47.2% of men and 37.8% of women self-reported snoring 6. Several meta-analyses have revealed that snoring is associated with higher risks of diabetes 7 , gestational diabetes mellitus, pregnancy-induced hypertension and preeclampsia 8 , cardiovascular disease, and all-cause mortality 9,10. Multiple randomized controlled trials have suggested a possible causal relationship between obstructive sleep apnea syndrome (OSAS) and NAFLD 2,11. Snoring is an early symptom of OSAS; 12 however, to our knowledge, few studies have investigated the direct relationships between self-reported snoring and NAFLD. Thus, we conducted the first cross-sectional study and first independent validation cohort study designed to investigate whether individuals who self-reported snoring had a higher prevalence and incidence of NAFLD. Low-to-moderate alcohol intake may have beneficial effects in patients with NAFLD 13,14. Conversely, alcohol increases upper air...

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Section: Discussionmentioning

confidence: 99%

Self-reported snoring is associated with nonalcoholic fatty liver disease

Wang

Gao

et al. 2020

Sci Rep

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“…Thus, virtually all current treatments involve methods to open the airway. Life‐style modifications include weight loss, smoking cessation, limiting alcohol consumption, and improved sleep hygiene . Over‐the‐counter treatment options include nasal sprays, nasal strips or dilators, lubricating sprays, and “anti‐snore” clothing and pillows.…”

Section: Introductionmentioning

confidence: 99%

“…Life-style modifications include weight loss, smoking cessation, limiting alcohol consumption, and improved sleep hygiene. [10][11][12] Over-the-counter treatment options include nasal sprays, nasal strips or dilators, lubricating sprays, and "anti-snore" clothing and pillows. Surgical correction is usually reserved for patients with associated moderate to severe OSA.…”

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confidence: 99%

A new office‐based procedure for treatment of snoring: The S.I.Le.N.C.E. study

Friedman

Gillespie

Shabdiz

et al. 2020

Laryngoscope Investig Oto

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Objective Demonstrate the safety and effectiveness of palatal foreshortening and stiffening in reducing snoring severity in nonobstructive sleep apnea (non‐OSA) patients complaining of chronic disruptive snoring. Methods In a US‐based 8‐center, open‐label, prospective, single‐arm cohort study, 52 consenting adults with chronic disruptive snoring (snoring impacting a patient's life and causing patient or bed partner to seek medical intervention) were treated via office‐based placement of resorbable, bidirectional, barbed suture implants into the soft palate under local anesthesia. Prior to intervention, home sleep tests (HSTs) were performed to rule out OSA and to document snoring noise level. Both subject and their bed/sleep partners (also consented) completed questionnaires including: bed/sleep partner's scored visual analog scale (VAS) for subjects' snoring severity, and subject scoring for Epworth Sleepiness Scale (ESS) and Pittsburgh Sleep Quality Index (PSQI). Following intervention, HSTs, VAS, ESS and PSQI were repeated at 30, 90 and 180 days. Results Mean baseline bed/sleep partner VAS was 7.81 ± 1.59. Mean postimplant VAS scores decreased significantly at each measured interval; to 5.77±2.35 (P < .001) at 30 days, 4.48 ± 1.81 (P < .001) at 90 days, and 5.40 ± 2.28 (P < .001) at 180 days. Post treatment improvements in daytime sleepiness and QOL were also observed. Two partial extrusions were reported. No further adverse events were identified. Conclusion The current study demonstrates the safety and efficacy of the Elevoplasty procedure in reducing snoring severity over a follow‐up period of 6 months. Level of Evidence 2b

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“…Obstructive sleep Apnea (OSA) is a sleep-related breathing disorder characterized by recurrent episodes of apnea and/or hypopnea, which leads to decreased oxygen saturation [1]. Snoring occurs because of a partially obstructed airway, typically due to the collapse and vibration of the pharyngeal tissues [2]; whereas, OSA occurs when there is no airflow despite a respiratory effort. Snoring and OSA can have adverse effects even on those other than the patients, such as impaired relationships with spouses or partners [3].…”

Section: Introductionmentioning

confidence: 99%

Efficacy and Tolerability of the Nasal Airway Stent in the Treatment of Snoring

Miyoshi¹,

Ikumi²,

Fumika³

et al. 2019

Clin Med Rev Case Rep

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Introduction: The nastent™ classic, a nasal airway stent (NAS), is a tube-shaped medical device that is positioned from the nose to the soft palate near the uvula. It is expected to reduce snoring by preventing the narrowing and obstruction of the airway and reduce apnea/hypopnea index (AHI) in patients with obstructive sleep apnea (OSA). Objective: We aimed to examine the tolerability and effectiveness of NAS in snoring. Methods: We prospectively enrolled subjects who had not been treated for sleep apnea syndrome (SAS) and had no serious complications. We examined the effectiveness of NAS by recording the snoring sounds. A questionnaire survey on the pain caused by NAS treatment was conducted. Results: Out of 23 subjects recruited, 18 completed the study. Most of the subjects showed improvements of snoring measured as the percentage of snoring time in their total sleep time, average snoring volume, maximum snoring volume, and snoring index (SI, percentage of snoring time in total sleep time multiplied by average snoring volume) after the use of NAS. In time, the subjects got accustomed to wearing the NAS, presenting fewer complaints of discomfort and improvement in sleep in most cases. Out of 23 subjects recruited, five subjects showed an AHI > 5. However, only two subjects who showed an AHI > 5 completed the study. Conclusion: The NAS helped to reduce the snoring loudness and duration in most subjects. Pains caused by NAS treatment gradually decreased as the subjects became accustomed to it.

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An evidence‐based approach to the management of snoring in adults

Abstract: A structured history of snoring and its associated symptoms, comprehensive examination including flexible laryngoscopy and sleep studies where relevant, in addition to targeted investigations, should lead to the correct diagnosis and appropriate management.

Cited by 8 publications

References 34 publications

Self-reported snoring is associated with nonalcoholic fatty liver disease

Self-reported snoring is associated with nonalcoholic fatty liver disease

A new office‐based procedure for treatment of snoring: The S.I.Le.N.C.E. study

Efficacy and Tolerability of the Nasal Airway Stent in the Treatment of Snoring

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