There are various treatments for snoring, and these overlap with the treatments for OSAHS. Currently, there is no medication that consistently prevents or treats snoring in all snorers. Most of the nonsurgical therapies include modification or elimination of risk factors related to snoring and OSAHS.
- Obesity has been consistently shown to be related to snoring and obstructive apnea.10 Therefore, a recommendation for weight loss is a common modality in the treatment of snoring and sleep apnea. The extent of weight loss that will reduce one's snoring is as yet unknown, but losing as little as 3 kg has been previously noted to be beneficial in reducing sleep apnea and its most common symptomp's snoring.
- Avoidance of alcohol, especially immediately before bedtime, may be necessary to treat snoring. Snorers are recommended to avoid drinking alcohol 3 to 5 hours before going to bed.
- Various medications may be helpful, including nasal lubricants, nasal decongestants, and anti-inflammatory drugs such as inhaled steroids, if nasal obstruction or congestion is present. This is especially common with allergic rhinitis and acute episodes of snoring.
- Smoking has been linked to SDB. Smoking cessation is recommended for the treatment of snoring and OSAHS.
- Sleeping in a lateral decubitus or side-lying position is recommended by most sleep experts. Although the result of such recommendations is unknown, techniques such as the sewing of tennis balls to the back of sleepwear or using a wedge-pillow to promote side-lying sleep can be instituted to prevent snoring related to a supine sleep position. (These therapies are not recommended for the treatment of obstructive sleep apnea or hypopnea with hypoxemia.)
- Nasal dilators are devices that are used to improve asymptomatic snoring and consist of external and internal devices placed on or in the nares. The external device is an adhesive strip that adheres to the nares and expands the nasal passage. An internal device is inserted into both nares and it splints the nasal passage open with its elastic action.
- Oral appliances are also used to improve asymptomatic snoring. Oral appliances are divided into two categories: Tongue-retaining and mandibular-advancement devices. Oral appliances enlarge the oral airway by preventing the tongue from collapsing into the airway during sleep. Two types of oral appliances exist: Adjustable appliances, which allow the appliance to be titrated or advanced, and nonadjustable appliances, which are fixed.
- Nasal continuous positive airway pressure (CPAP) prevents snoring, but patients with primary snoring show poor adherence to this therapy.
- Nasal and pharyngeal surgeries are commonly used to treat snoring when nonsurgical therapies fail. The reason why surgery is not recommended as a first-line treatment is related to the availability of nonsurgical measures and the uncertainty of the success of surgical procedures.
- Uvulopalatopharyngoplasty (UPPP) and laser-assisted uvulopalatoplasty (LAUP) procedures involve full or partial uvulectomy with reconstructive surgery of the pharynx and/or palate. The best candidates for these types of surgeries are patients with primary snoring who are not obese and have abnormal anatomy including enlarged tonsils, adenoids, and small pharyngeal inlet. Interventions such as UPPP are not generally recommended as first-line therapy for sleep apnea.
