Treatment options for snoring and obstructive sleep apnoea

Treatment options for snoring depend on a number of factors, but the two key ones are these:

  • Do your patients snore through their nose or their throat?
  • Do your patients snore AND have obstructive sleep apnoea (OSA)?  

At ResMed, we have solutions for throat snorers without sleep apnoea as well as for throat snorers with sleep apnoea. This includes both mild to moderate OSA as well as more severe cases of OSA. 

Throat snorers without sleep apnoea

Your patients fall into this category if they’ve tested for sleep apnoea and obtained an Apnoea-Hypopnoea Index (AHI) score of less than 5. If you don’t know what your patient’s AHI level is, we recommend you perform a sleep test, or refer them to a colleague who can. Understanding your patient’s sleep apnoea conditions will allow you to make optimal treatment choices.

At ResMed, we believe one of the most efficient treatment options for throat snoring is a custom-made mandibular repositioning device (MRD) like Narval CC.1,2 These oral appliances, which go by many names — mandibular advancement devices, intraoral devices, oral appliances, and mandibular repositioning devices (MRDs) — work by holding the lower jaw in a position during sleep that reduces the collapse of the airway and expands the space behind the tongue, to help prevent apnoea and snoring.

Is your patient a nose snorer? Then MRDs are not recommended; they won’t solve your patient’s problem. We invite you to investigate options that include sprays, nose strips, chin straps and more. Visit your country’s sleep association for recommendations.

Throat snorers with mild to moderate OSA

If your patients’ AHI levels fall between 5 and 30, ResMed offers both the Narval MRD as well as full range of CPAP therapy options. MRDs are a clinically-proven alternative to CPAP therapy for snorers with mild to moderate OSA.3,4,5 They have higher levels of acceptance, so users are less likely to drop out of treatment.4 Among regular users, they are almost as effective as CPAP in reducing AHI levels.6

Throat snorers with severe OSA

If your patients’ AHI levels are over 30, you’ll no doubt recommend PAP therapy as a first choice. There are different types of PAP therapy, including APAP, CPAP, and bi-level therapy. ResMed has a full range of masks, devices and accessories to make PAP therapy as comfortable and non-intrusive as possible.

If your patient has demonstrated that they cannot get used to PAP therapy, or have allergies to it, then as a sleep physician you can prescribe an MRD. In fact, in the largest multilevel study of its kind, users with severe OSA who regularly wore Narval CC were just as likely to reduce their AHI levels by 50% as wearers with mild to moderate OSA.1

Other options to stop snoring include surgery and radiofrequency treatment.  

References

  • 01

    Vecchierini MF & al. A custom-made mandibular repositioning device for obstructive sleep apnoea-hypopnoea syndrome: the ORCADES study. Sleep Med. 2016 Mar;19:131-40. doi: 10.1016.

  • 02

    Lim et al. Oral appliances for OSA. Cochrane Database of Systematic Reviews 2009, Issue 3.

  • 03

    Practice Parameters for the Treatment of Snoring and Obstructive Sleep Apnea with Oral Appliances: An Update for 2005, AASM report, Sleep 2006;29(2): 240-243, US Guidelines.

  • 04

    Non-CPAP therapies in obstructive sleep apnoea, ERS task force. Eur Respir J. 2011 May;37(5):1000-28, Systematic Review. Recommendations (European).

  • 05

    B. Fleury et al. OSAHS treatment with mandibular advancement oral appliance. Rev Mal Respir. 2010 Oct;27 Suppl 3:S146-56. Systematic Review. Recommendations (France).

  • 06

    Vanderveken OM. Objective measurement of compliance during oral appliance therapy for sleep-disordered breathing. Thorax. 2013 Jan;68(1):91-6.

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