Surgical procedures and non‐surgical devices for the management of non‐apnoeic snoring: a systematic review of clinical effects and associated treatment costs

Abstract

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Redefining the timing of surgery for obstructive sleep apnea in anatomically favorable patients

“…A further advantage of the one‐off component of surgery relates to costs, because the costs of CPAP, estimated in the United Kingdom as £20,000 (roughly US$30,000) per quality‐adjusted life year, typically are lifelong . Main et al published a meta‐analysis of 30 randomized, cross‐over, and other controlled clinical trials, as well as certain eligible pre‐ and post‐treatment studies, specifically comparing the costs of nonsurgical (CPAP, mandibular advancement splints, and tongue‐retaining devices) versus surgical treatment of OSA . though they admitted that data were scarce, the authors estimated that, in the United Kingdom, the average cost of a UPPP procedure at the time was £1,230 to £1,550, depending on the length of hospital stay (1 vs. 2 nights) versus £220 annually for CPAP, meaning that the costs associated with CPAP would start to exceed those of surgery within 6 to 7 years.…”

Do wind and brass players snore less? A cross‐sectional study of snoring and daytime fatigue in professional orchestral musicians

“…This is an attractive concept as these recreational activities are safe, cost‐effective and potentially enjoyable in their own right. Existing treatments have significant drawbacks in terms of efficacy, cost and morbidity 9,10 .…”

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

“…concluded that Pillar implants, which are designed to be inserted into the soft palate to reduce vibration and collapsibility, were efficacious in significantly reducing bed‐partner‐assessed snoring sound in patients with snoring, and in patients with mild‐to‐moderate obstructive sleep apnoea significantly reduced the Epworth Sleepiness Scale score and apnoea–hypopnoea index. A systematic review of 27 studies of overwhelmingly level III evidence demonstrated that in patients with non‐apnoeic snoring uvulopalatopharyngoplasty, laser‐assisted uvulopalatoplasty, radiofrequency ablation of the soft palate and Pillar implants were all associated with a significant reduction in patient or bed‐partner‐reported snoring levels . Another systematic review of 49 clinical studies of multi‐segmental surgical interventions, defined as involving at least two of the frequently involved anatomical sites (nose, oropharynx and/or hypopharynx) in adults with obstructive sleep apnoea, demonstrated improved outcomes in terms of reduction in apnoea–hypopnoea index, but this benefit was predominantly from level III evidence …”