Finding a Cure for Snoring and Obstructive Sleep Apnea:
A Review of Common Treatments
American Academy of Sleep Medicine
Clinical Practice Review Committee
While snoring is a common problem, solutions can be hard to find. Products in stores might give you the impression that they'll make your snoring problems disappear like a bad dream. These products don't always deliver on their promises.
INTRODUCTION
The most common sleep related breathing disorders are obstructive sleep apnea (OSA) and loud snoring. They are both due to the narrowing of the airway during sleep. Snoring is when the tissue in the back of the throat vibrates as you breathe. Patients who snore are more likely to have OSA than people who do not snore. Those who snore have an increased risk of developing high blood pressure.
A doctor can find out if you only have simple snoring, or if your snoring is a sign of OSA. To do this, you will need to take an overnight sleep study. This study is called a polysomnogram. You have OSA if the two things that follow occur:
- You stop breathing due to a blockage of the airway for more than 10 seconds while asleep.
- This happens more than five times per hour of sleep.
If you have OSA, the sleep study will show if it is mild, moderate, or severe. A person with OSA is often very sleepy during the day. This is because you briefly wake up at the end of the times when you stop breathing. These brief awakenings keep you from enjoying long periods of deep sleep. OSA may lead to any of the following:
TREATMENTS
Treatments for snoring and for OSA are similar. The treatment you need will depend on if you have simple snoring or snoring with sleep apnea. It will also depend on the severity of sleep apnea if OSA is present. Apnea associated with sleepiness or with known heart problems is more serious. It requires closer treatment monitoring. Your treatment may also depend on other medical factors. Your doctor will be able to decide which treatment is best for you.
The following are treatment options for snoring and/or OSA:
1. Continuous positive airway pressure (CPAP)
CPAP is a breathing device that is worn while sleeping or napping. It is used to treat OSA, but not simple snoring. CPAP provides a steady flow of air to help keep the airway open. It is the most common treatment for sleep apnea. It works on all patients who wear it. Your doctor will likely have you try CPAP if you have apnea and are sleepy or have high blood pressure. It will also be used for people with OSA who have known heart problems.
2. Upper airway surgery
There are many types of nasal, throat, and jaw surgeries. They can help some but not all people with snoring or apnea.
3. Oral appliances (special mouth guards)
There are many types of special oral appliances for sleep apnea. They can help some but not all people with snoring or apnea.
4. Weight loss
Weight loss will decrease the severity of snoring or apnea. Losing weight should be a priority for any overweight person with OSA. Not all people with snoring or apnea are overweight. But weight gain will make existing snoring or apnea even worse. Weight loss alone may help some but not all people with snoring or apnea.
5. Positional therapy
Avoiding sleeping on your back may help some but not all people with snoring or apnea.
6. Avoiding alcohol, muscle relaxants, and certain medications
These are known to increase snoring and apnea.
Studies have shown that these treatments may be very effective. They reduce the number of times that you stop breathing. They also improve the symptoms of OSA. These treatments also help reduce snoring. How well each treatment works may vary from one person to another. You should consult your doctor or a sleep specialist. He or she can help decide which treatment may be best for you.
STORE PRODUCTS
Many products are sold on drugstore shelves to treat snoring. A few items are also sold to treat OSA. There is very little data to show that these treatments are helpful or safe to use. You should talk to your doctor if you are concerned about snoring or worried that you might have OSA.
The dangers of using these products include the following:
1. They may have harmful side effects. They can also cause problems when taken with other medicines.
2. They may “mask” the problem. The person may mistakenly think he is better if the snoring is not as loud. This keeps him from getting the proper treatment that is needed. This can be harmful if he has a serious health problem like OSA.
A new report studied in detail three popular types of “snore aids.” Sound recordings were measured as patients used them. Nasal strips, spray lubricants, and magnetic pillows were all found to be of no help to people who snore.
This review covers the five common products that follow:
- External nasal dilator strips (ENDS)
- Internal nasal dilators (IND)
- Lubricants
- Dietary supplements
- Magnetic pillows and mattresses
ENDS
External nasal dilator strips (ENDS) open the passages of your nose from the outside. They use springs in an adhesive strip that is placed over the bridge of the nose. One study asked those who sleep with people who snore loudly to rate the snoring of their bed partners. They did this before and after two weeks of using ENDS. They did report that the snoring was reduced with ENDS.
Studies, however, also measured the sound level of snoring with and without the use of ENDS. These studies found no difference in the two sound levels.
One study found that OSA was worse when patients used ENDS compared to when they did not.
Some patients reported skin irritation. There were no other side effects.
CONCLUSION:
ENDS may have only a mild effect on snoring. They are not effective for treating OSA. The side effects are minor.
IND
Internal nasal dilators (IND) open the passages of your nose from the inside. They are placed inside the nostrils and push out. There are three studies showing that using IND reduces snoring. This includes a reduction in the level of sound using a sound meter. There was no effect on OSA. One concern is that there were only a few patients in each of the studies. About 40% of the patients could not sleep with the IND in place. None of the studies reported any major side effects.
CONCLUSION:
The use of IND probably reduces snoring. They have no effect on OSA. They appear to be safe to use.
Lubricants
Lubricants are oils and vitamins that are sprayed into the nose and throat. They are sold with the claim that they reduce snoring. There are a few studies that show some decrease in snoring with lubricants. One study showed that a lubricant was more effective than tap water in reducing the loudness of snoring. No change in OSA was measured with lubricant use. There are no reports of side effects from using lubricants.
CONCLUSION:
Lubricants probably reduce snoring. They have no effect on OSA. They appear to be safe to use. Oily sprays, however, should not be used in young children. They also should not be used in people with swallowing problems. These people might be likely to inhale the material into the lungs after coughing or choking. This could cause pneumonia.
Dietary Supplements
Some herbs and enzymes are sold with the claim that they reduce snoring. Only one study was found that tested this claim. The dietary supplement was more effective in reducing bed-partner reports of snoring than was a placebo. A placebo is a fake pill that really has no medicine. It is used to see if patients think they feel better just because they took a pill.
Sound levels were not recorded. OSA was not evaluated. Side effects have not been reported for these products. Other preparations with the same enzymes have caused mild allergy responses.
CONCLUSION:
Dietary supplements might reduce snoring. They have not been studied for effects on OSA. They might have mild side effects in some patients.
Magnetic Pillows and Mattresses
Only one study has measured snoring and OSA with and without magnetic pillows or mattresses. The study found no change in snoring or OSA.
CONCLUSION:
Magnetic pillows and mattresses probably have no effect on snoring or OSA.
SUMMARY
Some data suggests that ENDS, IND and lubricant sprays may reduce snoring. This data is made up of reports from those who sleep with people who snore loudly. When the sound levels of snoring are measured with a meter, there is nothing to show that snoring improves by using these products.
Buyers should be aware that snore aids have no effect on OSA. These products have not been studied to see if they affect the risks related to snoring and OSA. These risks include heart attack, stroke and high blood pressure. Few side effects have been reported for any of these products.
People with loud snoring should be evaluated by a professional to see if they have OSA. Discuss your sleep problems with a doctor before using over-the-counter treatments for OSA or snoring.
Are You at Risk?
Find out if you are at risk for obstructive sleep apnea. Click here.
Updated on April 14, 2005
