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How to use Snorer.me Signposting™

‘Signposting’ is the medical term for providing free, valid information regarding available services and options and pointing out the right ‘road’….

Snorer.me Signposting™ is designed to connect you with the most appropriate source of help or advice to stop you snoring.

Take ~10 minutes for a lifetime of better (silent) sleep. Here’s a step-by-step Guide to using Snorer.me Signposting™ together with an FAQ.

How does it work?

The terms triage you will no doubt recognise from A&E and signposting from mental health.

This online patient signposting or triage tool for ‘snoring’ (and undiagnosed obstructive sleep apnoea syndrome) has similar aims.

It’s about:

  • Accelerating identification of sleepy snorers to professional assessment and appropriate treatment,
  • Directing benign snorers without relevant co-morbidities to sleep-trained dentists as potential candidates for ‘intra-oral devices’ (mandibular advancement devices);
  • Saving GP time1

Mandibular advancement devices being the NICE recommended option2 for anti-social snoring and mild obstructive sleep apnoea.

Snorer.me Signposting’s™ purposes are to:

1) Direct you to the most appropriate professional

2) Record in your own time, sufficient patient assessment data to permit the professional to:

a) Screen and recognise obstructive sleep apnoea (OSA) symptoms

b) Determine the most appropriate help

Good to know:

Snorer.com is independent. We don’t sell anti-snoring devices, chin straps or whatever! And we don’t benefit from affiliate deals.

Step-by-Step Guide

Yes it’s free. Click on the screenshot images below to expand them.

Then click away from them to return to the main screen

Register and verify your email (check your spam/junk folder)

Register & verify your email

Enter your name and email address, and create a password. We’ll email you a link to verify your account. (Check your spam/bin folders too).

Welcome to Snorer.me Signposting™

Welcome!

You’ve successfully verified your email address and you’ve taken the first step on the path to stop snoring.✓

Select your home from the drop down

Create your profile

Enter your postcode (we don’t share it) and select your specific address from the drop-down box.

We’ll use this to show you the nearest help.

Let's get started!

Let's get started!

If you’re over 18 and in the UK, then let’s get started.

You’re about to begin the journey to quiet, restful sleep.

The first series of questions

First series of questions

The first of 3. Note the progress bar at the top.

Click the buttons Yes/No.

The second series of questions

Second series of questions

The second series of questions.

Click the buttons Yes/No. You’re getting there!  

The third (and final) series of questions

Last series of questions

Click/tap the A, B, C or D image that best reflects how SLEEPY,
(not just tired), you’d be in each situation (i.e. your likelihood to fall asleep).

Select a sleep-trained dentist

Select a sleep-trained dentist

This snorer has been signposted to select a sleep-trained dentist, to be screened for sleep apnoea prior to being dentally assessed for suitability for a prescription anti-snoring device.

Consult your GP

Consult your GP

This snorer has been signposted to their GP, with a view to further investigation; perhaps they’re sleepy as well as a snorer – or they have additional health problems.

Consult your GP

Print your results

Click ‘Print results’ to download your PDF results (top menu).

It will appear in your downloads folder. The file-name is your unique identifier (used instead of your name.)

FAQs

Frequently Asked Questions about Snorer.me Signposting™.
Have a question we haven’t answered? Please get in touch.

What is Snorer.me Signposting™?

Snorer.me Signposting™ is a free triage tool for UK adults. Technically, it is a standalone Clinical Decision Support System designed to:

  • Direct you to the most appropriate professional to help you stop snoring and/or have drowsiness investigated
  • Help a healthcare professional screen you for obstructive sleep apnoea and relevant co-morbidities by capturing your assessment data in your own time and not their clinical time.

Snorer.me Signposting™ asks the questions your GP would, but you get more time to think about your answers.

The aim is for you to obtain appropriate help more quickly and free up GPs to help more complex cases.

Snorer.me Signposting™ does NOT provide you with a diagnosis; neither does it screen you. Decisions (as the name ‘Clinical Decision Support System’ suggests) are made by clinicians.

Triage is by definition limited and cannot be completely accurate; the outcome is based upon the information you provide.

But that’s missing the point:

The Oxford English Dictionary defines ‘triage’ as:

…the assignment of degrees of urgency to wounds or illnesses to decide the order of treatment of a large number of patients or casualties.

We take that to mean directing you to the most appropriate professional, based upon your answers to some basic ‘red-flag’ questions and some professionally agreed-upon boundaries, as published in a pre-treatment screening protocol1.

Signposting is intended to get you in front of someone who can help you rather than merely move you ‘from pillar to post.’ (And we believe you would want that ‘someone’ to have the information they need to help you).

Snorer.me Signposting™ is a Class 1 medical device, a standalone Clinical Decision Support System (CDSS), qualifying as Software as a Medical Device (SaMD). The manufacturer is Snorer.com Ltd. which is registered with the UK Medicines and Healthcare Products Regulatory Authority.

Why do we offer this for free?

The simple answer is:

Because we can“.

The more detailed answer is because snorers need help, not exploitation as commonly happens, and the ‘front-line’ is actually the sleep-trained dentist.

We understand that dentists are not part of the thought process if you have a snoring problem, yet dentists provide the NICE recommended ‘first line’ option for snoring and mild obstructive sleep apnoea (namely a custom-made mandibular advancement device – MAD). 

I haven't received my verification email... (white listing)

Our verification emails are sent out almost instantly. Have you checked your spam and bin folders?

Sometimes email systems can make mistakes and flag emails incorrectly as spam or send them to the bin folders. Try searching your email system for the terms below (without the quotation marks):

Email verification” or “Signposting

We send from: donotreply@snorer.me using a service called: Mailgun. We verify your email (so real people use Signposting and so we don’t waste professionals’ time).

Your email will look like the below screenshot. When you find it – it’s important to ‘white list’ the sender (see below for how to do this).

Verification email

IMPORTANT – WHITE LISTING

When you find your verification email, it’s important to white list us as an email sender that you want to hear from again. These quick and simple instructions ↗ (no affiliation) may ensure you don’t miss updates from your chosen professional.

If you use Gmail then this short video (no affiliation) may help: https://youtu.be/mTUaTMaer2g

Who can use Snorer.me Signposting™?

This service is for adults (over 18) in the United Kingdom.

What it's not...

Snorer.me Signposting™ is not:

  • Screening because screening is something a healthcare professional does together with their face-to-face assessment.
  • A product of a company selling the solution – you won’t come to the end of the questionnaire and be faced with an advert selling ‘just what you need’ [Surprise!]
  • Biased towards a particular treatment or service (as in CPAP or surgery for everyone.)
  • Sponsored or ‘powered by’ an organisation with a product sales agenda.
  • A data-mining tool. Our CDSS is ‘standalone’; it does not link into or use large datasets.
How long will it take?

We estimate Snorer.me Signposting™ will take 10-15 minutes to complete as the questions are a mixture of Yes/No responses and ‘click/tap the picture.’

If you’re signposted to a sleep-trained dentist, they have a week to respond to you. 

If you’re signposted to your GP, print your results and contact your GP immediately.

 

How does Snorer.me Signposting™ work?
Once you are on Snorer.me, you start by creating a profile. We need this information to direct you to your nearest professional. We do not share this information.

Then you complete a 3-part questionnaire about your health and sleep. Depending upon your responses, you may be directed to select a sleep-trained dentist or to your GP (you can always print your results and consult your GP).

What happens next?

If you select a sleep-trained dentist to screen you for sleep apnoea (prior to considering you for a custom-made anti-snoring device) your questionnaire is sent electronically (in de-identified PDF format).

The sleep-trained dentist then reviews this information and determines if (subject to actually seeing you!) they may be able to help you.

If the dentist thinks they can help – you’ll get an email advising you to make an appointment with them in the regular way.

Snorer.me Signposting™ works like this:
Signposting first step  You answer 25 questions on-line.

Signposting second step  Depending upon your answers, you will be signposted to either your GP or to select a UK sleep-trained dentist.

Signposting third step  The professional you’re signposted to, then has the information necessary to help you and determine if you need further investigation (of course subject to their face-2-face assessment).

Signposting fourth step  If you’re signposted to select a sleep-trained dentist, it’s because a custom-made, prescription anti-snoring device is the first way to stop snoring and you do not need to see your GP first (they have nothing to offer you for ‘benign’ anti-social snoring i.e. without sleepiness symptoms or other health issues).

Signposting fifth step  If you’re signposted to your GP, print your results and take them with you. You will save the GP (and yourself) considerable time. You’ve also demonstrated that you’re serious about seeking help.

Side-note about sleep-trained dentists and custom-made anti-snoring devices

Custom-made anti-snoring devices are considered first-line therapy for anti-social snoring. Unlike your General Medical Practitioner, sleep-trained dentists can assess the suitability of patients for treatment with such a custom-made anti-snoring device (Mandibular Repositioning Device – MRD).

Sleep-trained dentists can arrange adequate follow-up and treatment to monitor the effects of such devices on the teeth, gums (periodontal tissues) and your jaw-joints (temporo-mandibular joints – TMJs).

How much does it cost?

Snorer.me Signposting™ is free for patient and GP use.

In order to keep this service free, some sleep-trained dentists may opt to enhance and promote their listing.

Please note:

  1. Oral appliance therapy for snoring (mandibular advancement devices) is currently a private, fee-paying dental treatment. You should enquire with the dentist about fees.
    • Costs are made up of dental clinical fees and the dental laboratory fee for the MAD itself. Clinical fees typically increase with proximity to London and MAD fees range from £150 to ~£1100. So a ballpark would be perhaps between £1000 to £1500 GBP. For your reference Snorer.com does NOT sell anti-snoring devices or receive a commission!
  2. Diagnosis and treatment of sleep apnoea is available free from the NHS for UK citizens.
Does this replace consulting my GP?

No. If you’re sleepy or drowsy when you should be awake, immediately consult your GP.

Snorer.me Signposting™’s purpose is to provide an additional and more direct way for you to access appropriate care for anti-social, benign snoring.

This service is designed to help people who may not recognise their sleep apnoea symptoms (because of the nature of sleep apnoea, the individual is not always aware they have the condition).

Who provides and maintains Snorer.me?

Snorer.me Signposting™ has been developed from industry recognised, published pre-treatment screening and sleep history questionnaires, that have been in use for a decade or more.

Snorer.me was created by Adrian Zacher with expert outsourced IT help. It is provided and maintained by eeZed Ltd. under licence from Snorer.com Ltd. the manufacturer registered with the UK MHRA.

What are the benefits?

Snorer.me Signposting™ benefits you, your GP and the NHS. 

  1. YOU are immediately signposted to your GP if sleep apnoea symptoms are recognised
  2. At a minimum, a sleep-trained dentist will use your responses to screen you for sleep apnoea
  3. YOU no longer have to guess how to stop snoring
  4. YOU avoid the pitfalls of over-the-counter gadget guesswork
  5. YOU help your GP by completing your assessment forms in your own time
  6. YOUR GP has the information they need to assess you straight away (if you’re signposted to a GP)
  7. NHS sleep unit resource usage is optimised. Non-sleepy snorers without co-morbidities (e.g. not obese, not diabetic, no heart conditions etc.) are directed to sleep-trained dentists.
  8. YOUR data is anonymised and kept securely (in accordance with National data retention standards)
  9. YOUR data is not shared or sold.
  10. YOU retain control. You may opt to share your anonymised data with your GP or the sleep-trained dentist of your choice
What are the risks?

Triage is by nature inaccurate. We urge you to consult the medical or dental professional you are directed to about your snoring and/or sleepiness symptoms.

This tool is offered in good faith and includes questions from a published screening protocol1 (that is recognised by professional bodies such as the Association for Respiratory Technology and Physiology UK and professional indemnity insurers). We consider the possible theoretical risks arising from your use of Snorer.me Signposting™ are far outweighed by the benefits.

However, despite our best efforts, it is always possible that we’re hacked and your data is compromised. We take electronic and physical measures to mitigate against this, including anonymising your data.

Learn more in our Privacy Policy. ↗

Professional information

Basic Premise

In an ideal world, the patient’s own GP is the right person to help every snorer. GP’s have access to a patient’s medical history, they are the trusted ‘first-to-mind’ for the Public and they rightly control who accesses NHS secondary care.

However, nobody (especially GPs – being the caring professionals they are) likes to feel impotent, unable to offer much assistance to those in need.

But snoring? 

Snoring is far from benign: the social consequences for the snorer (and partner) demand help. Yet, first-line therapy for benign snoring i.e. without hypersomnolence or relevant co-morbidities, is a device prescribed by a dentist.

Intra-oral devices (MADs) are recommended by NICE for snoring and mild OSA and where PAP is refused, or the patient is non-compliant. However, at present a patient and medical mindset exists that does not have “Going to the dentist” as part of the thought process.2 

Snorer.me Signposting™ is merely a triage tool. It captures in the individual’s own time, sufficient patient assessment data to permit a professional to:

  1. Screen for obstructive sleep apnoea (and relevant co-morbidities)
  2. Determine the most appropriate way to help

If we accept that only snoring patients complaining of daytime sleepiness (somnolence), with a positive history of obstructive sleep apnoea are likely to be referred for specialist investigation, then snoring patients with no relevant medical history and a negative obstructive sleep apnoea (OSA) history are unlikely to be screened at a specialist level.

In the UK, a sleep-trained dentist can (in an indemnified way) screen and recognise obstructive sleep apnoea symptoms. As such, they are the most appropriate professional to offer first-line therapy (a custom-made anti-snoring device) to those who do not merit further investigation in secondary care.

Should an individual snore, with or without experiencing sleepiness during their normal awake time then this Clinical Decision Support System which uses (amongst other questions) a pictorial version of the Epworth Sleepiness Scale3 and the published Stradling Dookun pre-treatment screening questions4 could reasonably be considered appropriate to capture the data for professionals to use and determine the necessity for further investigation in accordance with their current assessment criteria (which of course may change).

Why would clinicians use a Clinical Decision Support System (CDSS)?

Clinicians use a CDSS to capture patient data that enables them to screen and recognise symptoms of a condition (where they are medico-legally entitled to) in order to improve patient care, by eliminating unnecessary testing, thus enhancing patient safety and avoiding potentially dangerous and costly complications. This web based app is a standalone, CE marked medical device.

Real World Effectiveness Data

Snorer.me Signposting™ utilises (amongst other questions) the BSDSM pre-treatment screening protocol4 . The patient data collected by this app is intended to be used by a professional working to this protocol (or its evolution), which has been in use in the UK for a decade (published in the BDJ 2009).

Research data to support real world effectiveness of the current BSDSM protocol has yet to be obtained. Regardless, the BSDSM protocol is considered a positive contribution to patient care and as such it is recognised by dental professional indemnity insurers, the Association for Respiratory Technology and Physiology (UK) and it forms a part of the ARTP’s Standard of Care for MADs.

NHS Five Year Forward View

The Next Steps section of the NHS Five Year Forward View ‘Harnessing Technology and Innovation‘ ↗ makes specific reference to:

  • Increase the use of apps to help people manage their own health

Snorer.me Signposting™ is a stand alone, web-based app designed to help people manage their health by signposting them to the most appropriate professional.

The role of sleep-trained dentists in the United Kingdom

Unlike a General Medical Practitioner, sleep-trained dentists can assess the suitability of patients for treatment with a custom-made anti-snoring device (Mandibular Repositioning Device – MRD) and can arrange adequate follow-up treatment to monitor the effects of such devices on the teeth, periodontal tissues and temporo-mandibular joints.

Sleep-trained dentists in the UK may screen and recognise OSA symptoms and refer such patients to their GP with a view to further investigation.

Snorers the sleep-trained dentist has screened for OSA, who are not somnolent, have no OSA history or relevant co-morbidities would not normally be referred for further investigation.

Consequently, a sleep-trained dentist may in defined circumstances consider offering oral appliance therapy i.e. a custom-made anti-snoring device to manage the patient’s snoring (Professional Indemnity Insurers have position statements on this activity).

Are you a sleep-trained dentist in the UK? Learn more about receiving signposted patients.

Best practice standards

Snorer.me Signposting’s™ information content has been validated through our Information Standard process (we are members of NHS England’s “The Information Standard”).

We are actively working towards full compliance with the recent National Institute for Health and Care Excellence Evidence Standards Framework for Digital Health Technologies (March 2019)  ↗ and are a registered stakeholder for the in development ‘Obstructive sleep apnoea/hypopnoea syndrome and obesity hypoventilation syndrome in over 16s‘ ↗ NICE Guideline. We note a ‘Key Issue’ identified in the NICE Guideline final scope document is:

Initial identification, assessment and referral. 

Further reading

NHS Networks: Releasing capacity in General Practice (10 High Impact Actions) https://www.networks.nhs.uk/nhs-networks/releasing-capacity-in-general-practice/messageboard/1-active-signposting 

Suggestions / Comments / Criticism

This free signposting tool is supplied in good faith because we want to help: we want to get things right. Let us know your thoughts. Have we succeeded? Could things be better?

We welcome and appreciate your input. 👍

We would like to highlight these key parts of our T&Cs and Privacy Policy:

  • Our patient signposting service is called Snorer.me Signposting™ (available here: https://me.snorer.com/)
    “Snorer.me Signposting™”, provides UK adult snoring patient signposting to optimise use of both GP/GDP clinical time and finite NHS secondary care sleep diagnostic services.
  • Snorer.me Signposting™ is a free service. In order to keep it this way some dentists may opt to enhance and promote their listing.
  • SHOULD YOU BE ADVISED NOT TO PERFORM A VIGILANCE CRITICAL ROLE BY THE DOCTOR/SLEEP-TRAINED DENTIST YOU AGREE TO DEFEND, INDEMNIFY, AND HOLD SNORER.COM LTD., ITS OFFICERS, DIRECTORS, EMPLOYEES, AGENTS, LICENSORS, AND SUPPLIERS, HARMLESS FROM AND AGAINST ANY CLAIMS, ACTIONS OR DEMANDS, LIABILITIES AND SETTLEMENTS INCLUDING WITHOUT LIMITATION, REASONABLE LEGAL AND ACCOUNTING FEES, RESULTING FROM, OR ALLEGED TO RESULT FROM, YOU FAILING TO FOLLOW THIS PROFESSIONAL MEDICAL ADVICE.
  • Snorer.com Ltd. its subsidiaries, affiliated companies, joint venturers, business partners, licensors, employees and agents accept no responsibility or any liability for the decisions, actions or inaction by healthcare professionals you are signposted to.
  • We will NOT use your email address and/or phone number to contact you for marketing purposes.
  • After your use of signposting, we may invite you to complete an optional survey (see below), for medical research purposes, to understand the choices you made.

Have you used Signposting?

Please complete this questionnaire (just 10 questions – 3 or 4 mins of your time) and let us know your thoughts, so we can understand the choices you made after using signposting.

Thanks!

References

1. Zacher A, Easton E. P076 Signposting for snoring: does it optimise use of GP time? Online surveys of patients and sleep-trained dentists BMJ Open Respiratory Research 2019;6:doi: 10.1136/bmjresp-2019-bssconf.76 Available here: https://bmjopenrespres.bmj.com/content/6/Suppl_1/A47.2 ↗ [Accessed 20th November 2019]

2. NICE Guideline: Obstructive sleep apnoea syndrome. Available here: https://cks.nice.org.uk/obstructive-sleep-apnoea-syndrome#!scenario ↗ [Accessed 2nd October 2019]

3. Ghiassi R, Murphy K, Cummin AR, et al Developing a pictorial Epworth Sleepiness Scale Thorax 2011;66:97-100.

4. Stradling J and Dookun R. (2009), Snoring and the role of the GDP: British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol. BDJ Available (full text) here: https://www.nature.com/articles/sj.bdj.2009.214 ↗ [Accessed 29th March 2019]

Snorer.me Signposting is a CE marked Clinical Decision Support System (CDSS) Software as a Medical Device (SaMD).

Snorer.com Ltd. is the manufacturer registered with the UK Medicines and Healthcare Products Regulatory Authority.

Copyright Snorer.com (2019) All rights reserved.

Created by Adrian Zacher. Page last updated 20th Nov 2019.

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