Anti-snoring products

Is there any evidence to support claims for over-the-counter anti-snoring products?
 
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  • Updated:27 Apr 2006
 

01 .Introduction

Anti snoring products

In brief

  • Although snoring is usually more of a problem for the bed partner than the snorer, heavy snoring may be a sign of sleep apnoea, a more serious condition.
  • Evidence to support most of the claims of effectiveness made by manufacturers of snoring products is pretty thin on the ground.
  • There’s no single cause for snoring, and it can be due to a combination of causes. So there’s no ‘one-cure-fits-all’ available, although lifestyle changes seem to be the most successful and safest treatment.

Please note: this information was current as of April 2006 but is still a useful guide today.


According to the Guiness Book of Records, the loudest snores recorded reached 93 decibels — about the volume of a business engine.

This isn’t funny if you’re regularly losing sleep because of your partner’s snoring, or if you’re repeatedly woken by a dig in the ribs for your snoring.

Snoring can create social, relationship and health problems — for the partner as well as the snorer.

Studies of women whose partners snore find they have more health problems than those whose partners don’t, with some even ending up with hearing loss.

Good night — and good luck

There’s no shortage of anti-snoring products on the market. We found:

  • Pillows
  • Nasal strips and dilators
  • Essential oils inhalations and throat sprays
  • Homeopathic throat sprays and tablets.
 
 

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02.What causes snoring plus sleep apneoa

 

What casues snoring?

Snoring occurs when there’s any kind of collapse, blockage or restriction to the upper airway that hinders the flow of air through the back of the mouth or nose.

The snoring sound is created by the vibration of the soft tissues at the back of the throat. You may snore intermittently or frequently for a number of reasons:

  • You’ve got a cold.
  • You’ve been drinking alcohol, which causes the tongue and muscles in the throat to relax.
  • You’re overweight. Overweight people have extra bulk around the neck that can restrict their airways. Being overweight is the most common cause of persistent snoring. There’s also experimental evidence that abdominal fat pushes the chest up towards the upper airway, which then loses its tension, becoming floppy.
  • You’ve got an enlarged tongue, uvula, tonsils or adenoids.
  • You take sleeping pills or muscle relaxants.
  • You have nasal congestion or a bent septum (the wall that separates the nostrils).
  • You have an illness such as hypothyroidism or a disease affecting the central nervous system.
  • You have sleep apnoea.
  • Finally, some people only snore when they’re lying on their back.

Sleep apneoa

If your snoring is accompanied by pauses, snorts and gasps for air, get referred to a sleep specialist to be tested for sleep apnoea.

Obstructive sleep apnoea (OSA) is a condition where breathing stops many times during the night.

Symptoms include:

  • snoring
  • waking feeling unrefreshed
  • daytime sleepiness
  • mood swings

Causes

OSA may be caused by:

  • carrying too much weight
  • anatomical factors such as enlarged tonsils
  • alcohol or sedative use.

Left untreated it can leave you dangerously tired, irritable, and more vulnerable to high blood pressure and coronary disease.

Diagnosis

This usually involves a trip to a sleep lab where you’ll undergo polysomnography (tests measuring your physiological activity as you sleep).

Treatment

  • Weight loss.
  • Avoid alcohol and sedatives.
  • Nasal CPAP (continuous positive airway pressure) is thought to be the most effective non-invasive treatment for OSA. The CPAP machine has a nasal mask that blows air through the nose and holds the airway open, helping you breathe regularly through the night.
  • In some cases, surgery may be suggested. The ENT specialist we consulted said surgery can be helpful but only if it’s performed on the appropriate people, such as those who aren’t overweight but have a large palate that’s causing obstruction.
  • Sleep apnoea or chronic snoring may also be treated with mandibular splints — dental appliances that can move the jaw forward or stop the tongue falling backwards. Experts say the newer appliances are more comfortable than the bulky mouthguards of old, and are good for people with apnoea who can’t tolerate the CPAP machine. Mandibular splints must be prescribed by a sleep medicine or ENT specialist, who’ll then refer you to a dentist and dental technician to make and fit the device.

Tips for a silent night

If there’s no convincing evidence that any of these products is effective at reducing snoring, what can you do?

Experts say lifestyle changes are the best solution.

  • If you snore because you’re overweight, get some support to help you stick to a sensible eating and exercise plan. Even moderate weight loss has been shown to reduce or stop snoring.
  • Snoring is yet another good reason to quit smoking.
  • Avoid sleeping pills, tranquillisers and muscle relaxants, and don’t drink alcohol at least four hours before going to bed.
  • If you only snore when sleeping on your back, train yourself to sleep on your side. (Wedging a pillow behind your back, or the old trick of sewing a tennis ball onto the back of your pyjama top, might work for you.

A happy ending…

One of our ‘guinea-pig’ couples, Ruth and Ivan, reported back that they’d followed advice on lifestyle changes with considerable success. Ivan had lost some weight and, with the help of Ruth’s gentle (and not-so gentle) prodding, had trained himself to sleep on his side.

Ruth was very happy to say that over the last few months, Ivan’s snoring has improved remarkably. It’s rarely loud enough to wake her. When it does, it’s because he’s lying on his back. She gently nudges Ivan and he rolls over immediately — and the snoring ceases.

This article last reviewed April 2006

03.The research and the products

 

The research

In search of evidence, we contacted the manufacturers or suppliers of 10 popular anti-snoring products, asking them to provide documentation to support their product’s claims.

We also searched medical literature and spoke to the following experts:

  • An otolaryngologist (ear, nose and throat (ENT) specialist)
  • A researcher from a sleep centre
  • A professor of sleep medicine
  • A dental prosthetist
  • An aromatherapist.

We asked them for their take on these products and the supporting research that we’d found.

Pillows

We looked at two pillows:

  • DENTONS Anti-snore Silent Knight Therapeutic Pillow
  • DICK WICKS Magnetic Anti-snore Pillow.

DENTONS

  • The label on this pillow claims it stops or reduces snoring for the 70% of people who snore “… due to restricted breathing, caused by bad posture during sleep.” Despite repeated requests, the company didn’t provide evidence to back up this claim.

DICK WICKS

  • The company told us its Magnetic Anti-snore Pillow prevents snoring by supporting the user’s neck, keeping the soft palate away from the throat. It had no studies to support this theory.
  • The magnetic part of the pillow is supposed to reduce pain (the company said some customers claimed a reduction in pain meant a reduction in snoring too). Again, it didn’t provide evidence to support this claim. And when CHOICE looked at static magnet therapy (September 2004), we didn’t find conclusive evidence for pain relief either.

The only clinical trial of a pillow we could find compared three popular snoring aids (a nasal strip, a throat spray and a specially designed pillow). It found all three ineffective.

  • Theoretically, something that extends the neck may open the airway. But experts doubt a pillow could hold a person in one position to keep their neck extended for the whole night.

Nasal Strips and dilators

Nasal strips and dilators help open the nasal passages so the user can breathe more freely through the nose rather than the mouth.

The ENT specialist from the Australian Society of Otolaryngology, Head and Neck Surgery (ASOHNS) thought these devices could help a small number of people whose snoring is caused by certain types of nasal obstruction.

BREATHE RIGHT

  • The website for BREATHE RIGHT nasal strips lists a number of studies related to this product’s various uses, including as an anti-snoring device.
  • These studies show contradictory results – for instance, an independent study showed BREATHE RIGHT nasal strips to be ineffective, while another (financed in part by the products’ sole distributor) showed a reduction in the frequency of snoring in a group of patients with rhinitis.

PHARAMCURE Nozovent

  • This company’s website has links to clinical trials of its product. While these showed positive results, our ENT and sleep medicine experts thought the way the product was rated was too subjective to be considered reliable.

APOLLA Snore Free

  • We couldn’t find any studies of the APOLLA product, though the manufacturer supplied a testimonial.

Essential oils

One essential oil product is designed to be inhaled. The other is sprayed at the back of the throat.

AROMATHERAPY CLINIC Anti Snoring Blend

  • This product is a mixture of essential oils that can be dabbed on the skin, inhaled directly or diffused in an oil burner. The literature for this product claims are that it “… clears sinuses and enhances the function of the respiratory tract”.

ESSENTIAL HEALTH Helps Stop Snoring

  • Helps Stop Snoring is a throat spray. Its website says it “works by re-toning this soft tissue, ‘the Soft Palate’, which when taut and active cannot reverberate to cause snoring”.
  • We found two clinical trials — one (financed by the manufacturer of Helps Stop Snoring) found it effective in reducing snoring, while another independent trial of an unnamed essential oils product with the same ingredients showed no significant difference between the product and a placebo.
  • The ENT specialist thought the methodology of both trials was unreliable. A representative from the International Federation of Aromatherapists said while both these blends may clear congestion, she couldn't see how essential oils could improve poor muscle tone at the back of the throat.
  • The professor of sleep medicine agreed with the aromatherapist and said there was no evidence to support this theory.

Homeopathic products

We found two homeopathic throat sprays and some homeopathic tablets.

GREEN PHARMACEUTICALS SnoreStop Extinguisher

  • SnoreStop comes in the form of a homeopathic throat spray or tablets, and has a clinical trial to support its claims (again, financed by its manufacturer).

BRAUER Snore Eze

  • BRAUER supplied a list of ingredients and their properties.
  • A representative from the Australian Homeopathic Association said the ingredients in these homeopathic products were listed in the Materia Medica — the reference book of homeopathic medicines — as some of the many possible snoring treatments. However, the specific ingredient suiting a particular patient mightn’t have been included. He said a homeopath would usually only prescribe the single most appropriate medicine for the individual rather than a generalised ‘one-cure-fits-all’ approach.
  • Our ENT specialist thought the clinical trial of SnoreStop was poorly designed, and that one trial wasn’t enough to establish if it really worked. He said the best way to determine a treatment’s efficacy was via a meta-analysis — an overview of a number of studies that compares and draws conclusions from all the results.

This article last reviewed April 2006

We also asked eight couples to try some of the products to find out how easy and comfortable they are to use.

What were they like to use?

While one user isn’t enough to find out conclusively whether a product works, some of the snorers’ partners did think the product lessened the frequency or volume of the snoring.

However, the professor of sleep we consulted pointed out that in his experience, snorers’ partners often report improved symptoms with placebos, so subjective observation alone wouldn’t be enough to prove the product worked.

As noted elsewhere in this article, it would take a number of scientific, properly designed trials to objectively determine each product’s efficacy. Our guinea pigs just told us what they thought they’re like to use.

Ruth and Ivan:

  • Ivan, the snoring partner, said SnoreStop Extinguisher (a homeopathic product) was easy to use as it didn’t smell or taste bad. Ruth thought Ivan’s snoring was quieter at first.

Nick and Alex:

  • Nick tried the SnoreStop homeopathic tablets and thought they tasted fine. He and Alex noticed no effects, adverse or otherwise.

Gene and Liz:

  • Gene thought the essential oils (aromatherapy) Anti Snoring Blend stopped him snoring because the smell kept him awake. Liz said, “The smell was very unpleasant for both of us.” They abandoned it after one night.

Dorothy and Peter:

  • Peter’s snoring not only disturbs his partner Dorothy, but also wakes him. He tried the BREATHE RIGHT nasal strips, and said they were easy and comfortable to use. Dorothy thought his snoring was quieter, but Peter didn’t notice any significant results.

Scott and Kyoko:

  • Kyoko hoped the DICK WICK’S Magnetic Anti-snore Pillow would be more effective than her usual methods to control Scott’s snoring: “I pinch his nose, turn his head, kick his legs and tell him he’s snoring.” However, Scott was unimpressed with the pillow — by night four he was waking up every hour with a stiff neck.

Willa and Hao:

  • Willa and her husband Hao tried the DENTONS Anti-snore Silent Knight Therapeutic Pillow. Unlike Scott, he found this pillow quite comfortable, so he slept (and snored) soundly.

Antonio and Maria:

  • Maria tried the Nozovent nasal dilator, but found her nose felt like

“… it was being stretched to the limit — after a while it became unbearable.” The product comes in three sizes, so she may have got the wrong one.

Linda and Vern:

  • Vern’s snoring wakes Linda four or five times a week. He tried the essential oil spray Helps Stop Snoring, which he said tasted “unusual” but he eventually got used to it. He thought it wasn’t very cost-effective. Linda thought his snoring was quieter.

This article last reviewed April 2006

Studies indicate that in some children learning difficulties, aggressive behaviour and hyperactivity are influenced by snoring and breathing difficulties at night.

  • If your child snores and has behavioural or learning problems, take them to a sleep specialist.
  • If a weight problem is causing the snoring, this needs to be addressed with diet changes and exercise.
  • Surgical removal of the adenoids and tonsils (adenotonsillectomy) may also be recommended for children whose snoring is caused by enlarged tonsils or adenoids.
  • Your child may also snore but not have behavioural and learning problems. If you notice that their snoring is severe or accompanied by pauses, gasps or snorts, have them tested for sleep apnoea.

Over the counter treatments for kids?

A researcher from the University of South Australia’s Centre for Sleep Research said over-the-counter treatments shouldn’t be used, as: their effectiveness and safety for children haven’t been confirmed, and some products may interfere with a child’s development.

This article last reviewed April 2006