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By Anthony J. Brown, MD

NEW YORK (Reuters Health) Sept 19 - Three of the most popular over-the-counter treatments for snoring provide neither objective nor subjective improvements in the condition, new research shows.

"This is the first trial to compare snoring treatments that the consumer is bombarded with," lead author Dr. Peter G. Michaelson, from the Wilford Hall USAF Medical Center in San Antonio, Texas, told Reuters Health. "Our study is also unique because it included objective as well as subjective measures of snoring."

Dr. Michaelson will be presenting his team's findings next week at the annual meeting of the American Academy of Otolaryngology-Head and Neck Surgery in Orlando, Florida.

The study included 40 adult patients with socially disruptive sleeping and no evidence of obstructive sleep apnea. On alternating nights for 1 week, the patients were instructed to sleep regularly or to use one of three snoring treatments. Thirty-seven patients completed the study.

The snoring treatments included mouth spray (Snorenz), nasal dilator strips (Breathe Right Strips), or ergonomically shaped pillow (Snore-No-More).

A special take-home device, called the SNAP test, was used to objectively assess snoring. "The SNAP test allows us to determine loudness, frequency, and also where the snoring is coming from," Dr. Michaelson noted.

To evaluate production satisfaction, the patients and their sleep partners were asked to complete a questionnaire each morning.

There was no evidence that any of the treatments improved snoring when compared with the nights in which no treatment was used, the authors note.

For physicians, "the first question that needs to be asked when evaluating snoring is whether it's just snoring alone or is it symptomatic of obstructive sleep apnea," Dr. Michaelson said. "The second question is where the snoring is coming from. Answers to these questions will help guide treatment," he added.

"The take-home message for patients is that there are a number of effective non-invasive and surgical treatments for snoring and that they shouldn't delay evaluation by trying a bunch of over-the-counter remedies first," Dr. Michaelson noted.

But Dr. Andy Anderson, vice-president of regulatory affairs at Breathe Right maker CNS, Inc., told Reuters Health that the study was flawed. While his company "always maintained that it could take a few days before the strips start to work," Dr. Anderson said he was familiar with the study and he understood that the Breathe Right strips were not tested on two or more consecutive nights.

"In our labeling, we recommend that patients use the strips for 5 to 7 days to achieve maximum results," Dr. Anderson noted. "If no improvement is seen in that time we recommend that they see a physician."

The makers of Snorenz and Snore-No-More could not be reached for comment.