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Current Claims: Somnoplasty and oral appliances both reduce loud snoring in non-apneic patients. A comparison of treatments for snoring: Somnoplasty vs oral appliances. R Cartwright, D Caldarelli, TK Venkatesan, F Diaz Introduction: Many treatments aimed at the reduction or elimination of loud snoring have been developed recently but few have undergone comparative testing. One issue has been the question of an appropriate criterion measure. This was pointed out by Hoffstein et al (1994) as "snoring is in the ear of the beholder." Should the effectiveness be measured by spouse report, technician’s rating or some more objective recording device? Method: This study addresses whether somnoplasty is more effective than oral appliances for the control of loud snoring as measured objectively in the laboratory by a MESAM 4 device, and the relation of the MESAM count to the bed partner’s rating of loudness. Subjects: 31 subjects, 8 females and 23 males all complaining of loud snoring, as reported by the bed partner, with EDS and/or fragmented sleep of the subject. All were screened with one night of 12 channel PSG and found to have A+HI,15 and SaO2>85%. These were offered treatment at no cost. 10 elected somnoplasty, 7 were treated with Rest Assured that moves the mandible forward and 14 used Snorex, which holds the tongue forward. The 21 0A pts all had two nights of testing, one with and one without the OA device. The MESAM 4 used a program, which counted the percent of sleep time in loud snoring, soft snoring and time without snoring. The somnoplasty patients were recorded with MESAM only once at 8 weeks past their last treatment (5 patients had a single treatment to 3 sites, and 5 had 2 treatments to 3 sites). However there were bed partner snoring ratings before and after treatment on a 10 point scale. Results: Table 1 gives the mean % time in loud snoring and no snoring for the 21 OA patients at baseline and after treatment and the %s for the 10 somnoplasty patients after treatment on MESAM4. Table 1 Baseline Treatment OA Treatment Somnoplasty 1) Paired t test shows a significant difference between baseline loud and OA loud 2.414 p. 02. 2) There was no difference between OA and somnoplasty post treatment results on the MESAM. 3) For the somnoplasty group bed partners’ rating on a 10 pt. Scale, snoring dropped from a mean of 7.30 (2.35) to mean of 2.65 (2.16) t=4.574 df 9, p.001. 4) The correlation of % loud snoring by MESAM 4 and spouse report was significant r=.777 p. 008. 5) Comparing the time in sleep with no snoring at baseline, and after both OA and somnoplasty, shows the % time >.90, 5% Baseline 25% after OA and 44% after somnoplasty. While the percent of <50% no snoring sleep time was 10% at baseline, 10% wearing an OA, and 0% after somnoplasty. APPS, 1999 (abstract). |