TABLE 1.
Key recommendations for treatment of primary snoring
| Key recommendation | Level of evidence | Level of certainty | |
|---|---|---|---|
| Non‐surgical treatment | |||
| Weight loss | Recommended in appropriate snoring patients in view of the additional health benefits | D | High |
| Alcohol | Alcohol consumption reduction should be recommended in all patients | D | High |
| Medications | Advice may include avoidance of long term use of benzodiazepines and opioids should be avoided in patients with primary snoring | D | Moderate |
| Complementary and alternative remedies | Minimally harmful but uncertain long‐term utility and not advisable | D | Low |
| EPAP | Minimally harmful with some treatment effect but costly long‐term use | C | Low |
| Positional therapy | Considered a reasonable, mostly low risk trial option in supine dominant snorers | C | Moderate |
| Oral appliance therapy | MAD should be considered first line treatment in patients with primary snoring following occlusal examination by an appropriate Dentist combined with Sleep Physician assessment | B | High |
| CPAP | Option if patients are willing to trial and/or committed to CPAP use | B | High |
| Myofunctional therapy | Low risk option but significant commitment is required to achieve a small reduction in snoring | B | Low |
| Surgical treatment | |||
| Nasal surgery | Recommended in patients who also complain of nasal obstruction and have objective evidence of septal deviation ± turbinate hypertrophy on nasal endoscopy | C | High |
| Radiofrequency palatal surgery | May be effective as a short‐term option but patients may require additional therapy. | B | Moderate |
| Uvulopalato‐pharyngoplasty | Recommended treatment modality for soft palate surgery, offered to patients who have considered MAD or CPAP therapy | B | High |
| Palatal soft tissue implants | Effective treatment in the short term, however have an unacceptably high rate of extrusion and limited sustained clinical benefit with the potential to worsen OSA | C | Moderate |
| Injection snoreplasty | May be offered in patients with palatal flutter, however results are not consistently predictable and unlikely to be sustained long term | C | Low |
| Combination therapy | Reasonable in clinical context when the risks of each and combination therapies have been discussed | B | Moderate |