How to stop snoring: The definitive, step-by-step Guide (2019)

How to stop snoring: The definitive, step-by-step Guide (2019)


The Definitive Guide (2019)

Nobody wants to snore.

So, this step-by-step, evidence-based Guide will tell you exactly how to stop. And if your snoring is actually a symptom of sleep apnoea – we’ve got you covered.

If you work with the medical and dental professions that you already trust to care for you, you’ll quickly and permanently stop snoring (and ensure any sleep apnoea is identified and treated). Here’s how to do just that.

Bottom line: If you want to stop snoring permanently, sleep in the same bed as your other-half (and wake up with them smiling), you’ll love this Guide.

How to stop snoring permanently

Peer review and about the Author

default image

Emeritus Professor of Respiratory Medicine, John Stradling MD FRCP

This is a very comprehensive manual for those interested in understanding why they snore and what to do about it. Adrian Zacher has many years of experience in this field. Take time to read it carefully as there is a great deal of information to digest. Armed with this information one should be able to make informed choices as to what to do about snoring and possible sleep apnoea.

Prof. John Stradling How to stop snoring guide. October 24, 2018

View more reviews
Rated 5/5 based on 14 customer reviews

I’m a sleep-industry insider with a quarter of century of sleep medicine experience.

Adrian Zacher MBA

Author and Sleep Apnoea Evangelist

In this guide you’ll learn all about:

Signposting the treatment routes to stop snoring and recognise sleep apnoea symptoms


Self-help ways to stop snoring & signposting to treatment options

Assessment and screening for obstructive sleep apnoea (OSA)


Assessment and screening for Obstructive Sleep Apnoea (OSA)

Sleep testing and diagnosis


Sleep testing and diagnosis

Stop snoring treatment options


Treatment options

Stop snoring treatment follow-up



Stop snoring FAQs





Self-help ways to stop snoring & Signposting to treatment options

If you snore AND ARE DROWSY, please consult your GP immediately. Being drowsy needs medical attention.

If you’re not drowsy, here are 6 lifestyle changes to consider, as the first ways to stop snoring.

Then we’ll introduce Signposting™ – which is a new, free, CE marked software tool to connect you with most appropriate medical or dental professional.

Signposting the treatment routes for snoring and sleep apnoea

6 self-help ways to stop snoring

Here are 6 self-help ways to stop snoring. These are known as lifestyle changes:

Lose weight to stop snoring  If you’re overweight, try to lose weight. We get fat inwards as well as outwards and weight around your neck reduces the diameter of your airway. If the airway in your throat gets narrower, the air you breathe has to travel faster and this makes the walls of your airway vibrate (in other words it makes you snore).

Stop drinking alcohol in the evening to stop snoring  Avoid evening alcohol. Alcohol super relaxes your throat – which makes it floppy and prone to vibrate (and you snore). I know that drinking alcohol in the evening is exactly when you want to drink it – so you have to choose.

Stop smoking to stop snoring  Stop smoking. Smoking inflames the tissues of your throat which makes your airway narrower, so you snore.

Get off your back to stop snoring  Get off your back! Gravity pulls your tongue backwards and narrows your airway. Your mouth may also fall open and as it does so your jaw moves downwards and backwards and this also narrows your airway. And no, a chin strap is NOT the answer (here’s why).

Breathe through your nose to stop snoring  Keep your nose clear. If you can’t breathe through your nose you have to breathe through your mouth. When you mouth opens it moves downwards and backwards – narrowing the airway in your throat. Ditto point 4.

Avoid sedative medication to stop snoring  Avoid sedative medication i.e. sleeping pills and painkillers (Consult your GP re alternatives if you have a diagnosed condition that necessitates their use).

Download a PDF with more self-help ways to stop snoring self-help ways to stop snoring


Need a reminder of why you’re trying to stop snoring?

Being free of snoring means:

  • You may maintain intimacy with your partner
  • You may share hotel rooms
  • You may stay over at friends
  • You may fly long-haul without complaint
  • You won’t experience a sore throat / dry mouth on waking
  • No more ridicule

Sadly, self-help and lifestyle changes may be insufficient, or their effect may not last over time.

This is when you need directing to the most appropriate healthcare professional. 

Which is exactly what Signposting™ does:

Are you the partner of a snorer?
This free Guide is for you.

Free Guide for the partner or family member of a snorer

Carry on guessing?

You can either carry on guessing if your snoring is a symptom of sleep apnoea or you can use Signposting™.

We think you’re here because you want definite answers. Signposting™ is the first step to definitively answering your question:

How to stop snoring?

The Oxford English dictionary defines signposting as:

A sign giving information such as direction and distance...”

In medicine, signposting is about providing free, valid information, about available services and options… and pointing out the right ‘road’…. 

The image above illustrates one of the questionnaires used inside Signposting™. Signposting™ works like this:

Signposting first step  You answer 25 questions on-line.

Signposting second step Depending on your answers, your GP or a UK sleep-trained dentist then uses your answers to rapidly screen1 you for sleep apnoea, and determine if you need further investigation.

Signposting third step  If you don’t need a sleep study, then a custom-made, prescription anti-snoring device is the first way to stop snoring.

Interested in bringing the guess work to an end? Signposting™ is now live. Click to learn more. Its FREE!

Or if you’re a:

  • A UK-based sleep-trained dentist and want to help more snorers, click here↗ [new tab]

Snoring is a problem in many relationships. If it’s 100% happening to you – it’s tempting to react in desperation and buy the first ‘miracle snoring cure’ when self-help doesn’t help!

Sadly, the evidence for such quick fix gadgets doesn’t support this way of thinking: Don’t waste your money.

So what’s the best way to deal with problem snoring?

And how do you find out if your snoring is actually a symptom of obstructive sleep apnoea (OSA)?

Well, that’s what chapter 2 is all about…



Assessment of snoring and screening for obstructive sleep apnoea

Assessment and screening occur when a healthcare professional checks to see if your snoring needs further investigation – for example by conducting a sleep study.

There’s an advantage to early detection (i.e. you “nip it in the bud“), and we’re getting ever closer to definitively knowing:

How to stop snoring.

Assessment and screening for sleep apnoea

Step 1. Assessing and screening for sleep apnoea symptoms

What is Obstructive Sleep Apnoea / Apnea (OSA)?

What is Obstructive Sleep Apnoea (OSA)?

Obstructive sleep apnoea (OSA) is when your breathing is disrupted while you are asleep. The airway in your throat repeatedly narrows and not enough air gets to your lungs despite continued efforts to breathe. Sufferers snore and may be drowsy in the day because they must wake up to breathe. 

When snoring is a problem, whether you’re drowsy in the day or not, please consult your GP (Primary Care Physician – we use ‘GP’ throughout this Guide).

Your GP has your medical history to hand and they want you to be well.

However, we’re increasingly aware that the average GP is extremely time-poor. Therefore, to make better use of their clinical time, you may be asked to complete an assessment form in your own time – and to return for another appointment.

So your options are: 

1. Fill in the forms and return to your GP

Your GP will use the information on the form to screen you for obstructive sleep apnoea (OSA) and other related conditions, and determine if you need further investigation in a sleep unit or perhaps by referring you to an ENT (Ear, Nose and Throat) department.

Your GP may be clued up about snoring, but equally, they may not be. Currently, sleep medicine in the UK and elsewhere, is not part of core medical training.

We’d suggest you download our GP Guidelines ↗ and send them to your GP before your appointment (to give them time to read it).

2. Waste your money on OTC (over-the-counter) snoring cures, aids and gumshields

Learn how to compare OTC gumshields and custom-made dental devices ↗ (known as mandibular repositioning splints or mandibular advancement devices) and find out if chinstraps for snoring are dangerous, or safe and effective.

How to find a GP?

If you’re in the UK and don’t have a GP you can find one here: find a GP 2

Punch in your location (PRO TIP: It works better with a place name rather than postcode).

Take your pick:

Find GP services

Step 2. Consult your GP

Return to your GP with your completed assessment forms (ideally you completed the forms with the help of your partner – they may have a different perspective…).

Now, the outcome of your GP appointment may go 1 of 3 ways:

Option 1: Referral to a sleep unit

After reviewing your assessment forms, consulting your medical history and perhaps a physical examination; your GP may suspect that you’re suffering from obstructive sleep apnoea (find out more about OSA in the FAQ) or something else that is making you drowsy (as well as snore) and considers further investigation necessary.

They may then refer you to a sleep unit for further investigation.

If you often experience daytime drowsiness when driving, ask someone else to take you to the appointment, as you might be told by the doctor that you cannot legally drive yourself home.


Keep hold of your referral paperwork and if you’re in England, visit the NHS e-referral website: e-referral service 3

You will need your:

  1. booking reference (first page)
  2. year of birth
  3. and the (automatically generated) password to login (that’s on the last page).

TIP: Compare waiting times. If you are prepared to travel for a consultation, you may find you can be seen sooner.

NHS e-Referral website

NHS e-Referral service

If you’re in Scotland the GP will make a referral for you and the Hospital will contact you with an appointment. Similar electronic patient referral management systems are being rolled out. As we learn of them we will add them here.

Option 2: Lifestyle change & local management

If your GP does not suspect obstructive sleep apnoea (OSA) they may suggest lifestyle changes (e.g. lose weight if you’re overweight, stop smoking (if you do), quit the evening alcohol, get off your back when sleeping, exercise…).

Option 3: Dental appliance for snoring

If your GP does not suspect obstructive sleep apnoea: they may consider your snoring to be ‘benign’, they may offer lifestyle advice (as Outcome 2), and suggest you consult a sleep-trained dentist with a view to a prescription dental appliance.

This type of dental appliance is known as a custom-made mandibular repositioning splint (MRS).

Grab this ↗ free, evidence-based Guide about how to choose a ‘mouthpiece’ to stop snoring.

The NHS will not fix snoring*

Bad news?

Only option 1 above (Referral) involves NHS treatment.

* In exceptional circumstances some ‘benign’ snorers (i.e. not sleepy) may dependent on the availability of local expertise and budget, be offered a hospital dental laboratory manufactured oral appliance.

Options 2 and 3 require you to take action yourself.

So, now you’re wondering:

How can I stop snoring?

If you’re given Option 2 (lifestyle change) or 3 (dental appliance for snoring), the good news is that you’re unlikely to have sleep apnoea symptoms.

Hang on:

Don’t go and feed the ‘circling sharks’ by buying an over-the-counter ‘cure’.

There’s very good evidence 4 that custom-made, adjustable dental appliances for snoring (aka mandibular repositioning splints) will help with anti-social snoring. Below are two examples (there are many more to choose from). The images below are used with permission from SomnoMed UK Ltd. and Somnowell (UK) Ltd. respectively.

Custom-made, adjustable dental devices for snoring
Custom-made, adjustable dental devices for snoring

Clinical research5 has established that custom-made dental appliances are NOT the same as over-the-counter ‘gumshields’ or other mechanisms, and neither are they valid as a trial of whether a custom-made dental appliance will work.

So, be sure to bookmark my independent review of the top 13 criteria for choice of ‘gumshield’, so you can come back to it later.

Otherwise its time for…


Diagnosis of obstructive sleep apnoea

Assume you’ve been offered an appointment at the sleep unit for further investigation.

When you’re diagnosed, you know if your ‘snoring’ is actually sleep apnoea and how bad it is.

Soon, you will sleep better – and more quietly.

Medical diagnosis of sleep apnoea

Snoring and Sleep Apnoea happen for a reason

It’s a “cause-and-effect” relationship, while the ’cause’ is unknown; until you’re diagnosed, the ‘effect’ is the all too familiar, loud snoring problem….

An investigation into the cause of ‘snoring’ is called an assessment. This typically includes an overnight sleep study and a review of your medical history.

All of which helps the specialist respiratory medicine physician come to a diagnosis.

When you have a diagnosis, the doctor will determine what is the most appropriate treatment, and this (finally and definitively) answers your question:

How to stop snoring?

How to know if your snoring is actually sleep apnoea:

Step 1

You will be invited to attend the Hospital sleep unit for basic assessments including height and weight measurements, your medical history and a review of your GP referral letter.

It’s not a bad idea to take a copy of your Signposting™ printout with you as well (just in case its been mislaid).

Step 2

Some time later, you will be invited to the sleep unit (should a sleep study be considered appropriate).

Home Sleep Testing (HST) is, in the UK, the default way to examine your sleep quality and quantity. Home Sleep Testing is testing of your sleep at home, in your own bed. Learn more about home sleep testing new window

You will be loaned some sleep test equipment, to put on over your pyjamas, before you go to sleep. The sleep physiologist will show you how to use it. The sleep-test equipment records (amongst other things) your snoring, how much oxygen there is in your blood and how much of the night you sleep on your back.

sleep study equipment

In the morning when you wake up, turn it off, repackage it and return it promptly to the sleep unit. The data it has captured is then downloaded and analysed by a skilled sleep physiologist. They will ‘score’ your sleep study and create a report to accompany your medical history.

The sleep doctor will then review your scored sleep study, sleep physiologist’s report, your medical history and assessment forms. If possible, and if there is sufficient data, they will then diagnose your sleep condition and severity.

Step 3

You will be sent a letter inviting you to attend the sleep unit offices to review your diagnosis with the Sleep Doctor. They will discuss the ramifications of their diagnosis, and their proposed course of action. 

They may also offer lifestyle advice.

My advice is to listen. These medical professionals are experts and they’re motivated to provide you with the best care, factoring in your health, occupation and lifestyle.

Once again, its not a bad idea to take a copy of your Signposting™ printout with you as well.

Diagnosed with obstructive sleep apnoea syndrome (OSAS)?

If you’re diagnosed with obstructive sleep apnoea syndrome (OSAS):

  • First-line therapy is Positive Airway Pressure therapy (PAP)
  • Second-line therapy is a prescription, custom-made mandibular repositioning splint (MRS)
  • Surgery is usually only considered appropriate to enhance the use of PAP and MRS

Chapter 4 (coming up in a moment) explains more about these treatment options.

Not diagnosed with obstructive sleep apnoea syndrome?

If you are not diagnosed with obstructive sleep apnoea syndrome of a severity that merits treatment with Positive Airway Pressure therapy (PAP) then the healthcare system of the country you live in, determines whether prescription mandibular repositioning splints (MRS) are a funded therapy:

  • If you’re in the UK, then you will most likely be told no NHS help is available. That said, sleep units often have an informal network of dentists that may help you as a private, fee-paying patient.
  • If you’re not in the UK, then you should discuss what options exist with your sleep doctor. In the US and in some EU countries your healthcare system may contribute to the cost of treatment.

Now it’s time for:

First-line and second-line therapies

Initial and preferred therapy is known as ‘first-line’ and the backup option as ‘second-line’.



Treatments for snoring and sleep apnoea

Treatment follows diagnosis.

In this chapter we’ll introduce the various prescription ways to stop snoring and treat obstructive sleep apnoea.

The choice of treatment (made by your Doctor) is the definitive answer to your question:

How to stop snoring?

Treatment for snoring and sleep apnoea permanently

3 Categories of treatment for snoring & sleep apnoea

There are essentially 3 categories of prescription treatment for snoring and obstructive sleep apnoea syndrome (OSAS) or in other words – three ways to stop snoring and treat sleep apnoea:

  1. Dental appliances known as Mandibular Repositioning Splints (MRS)
  2. Positive Airway Pressure (PAP)
  3. Surgery (both soft and hard tissue in the nasal and respiratory airway) and exceptionally bariatric (stomach surgery to reduce weight)

Your sleep Doctor will determine which category of therapy is most appropriate for you.

Additionally, if you’re in the UK your sleep-trained dentist may offer you a prescription, custom-made MRS if you do not require further investigation in a sleep unit.

 Mandibular Repositioning Splints (MRS)

How do dental appliances for snoring work?

Dental appliances for snoring (known as Mandibular repositioning splints or MRS) keep your airway open and stop snoring by holding your jaw forwards (repositioning it).

This does two things:

  1. Keeps your tongue away from the back of your throat
  2. Tensions your soft palate

The effect of an MRS is similar to that of the anaesthetist’s hands with an unconscious patient. The dental appliance moves the jaw forwards (and in turn the tongue) to open your airway and help you breathe.

They do not cure snoring:

You must wear the MRS (while you sleep) for it to work.

How do dental appliances (mandibular repositioning splints) work?
Mandibular repositioning splints mechanically open the airway in your throat

What happens next?

The sleep-trained dentist will assess your suitability (from a dental perspective) for an oral appliance.

Factors include ability to protrude your lower jaw more than 5mm, oral hygiene, jaw-joint health, number and distribution of teeth.

If an oral appliance is prescribed they will take impressions of both your jaws (moulds of your mouth) and a bite registration in a forward posture (how your jaws meet when you close your mouth).

This information is then sent to a specialist dental laboratory for the dental technician to make your oral appliance. When it is fitted you will learn how to insert, remove and perhaps how to adjust it. You will be requested to visit the dentist again in a week to two weeks, and again at regular intervals.

How to choose a 'Mouthpiece' (MRS) Anti-Snoring Device?

Co-author: Adrian Zacher MBA
Peer Reviewer: Dr Shouresh Charkhandeh DDS

In this NHS England’s Information Standard Accredited Guide, you’ll learn in jargon-free language:

  • What a ‘Mandibular Repositioning Splint’ is
  • How to choose the best ‘mouthpiece’ for you
  • What the sleep-trained dentist can do
  • How to compare over-the-counter with prescription anti-snoring devices

No signup is required.

No credit card.

Nothing at all in fact.

We do this to help – because we can.

Anti-Snoring Device Guide

Meet the co-authors

Adrian Zacher. Click for full profile [new tab]

Adrian Zacher MBA

Author and founder of, co-founder and former CEO of the British Society of Dental Sleep Medicine

Dr Roy Dookun BDS

Dr Roy Dookun BDS

Co-founder and former President of the British Society of Dental Sleep Medicine

Dr Shouresh Charkhandeh DDS Click for full profile [new tab]

Dr Shouresh Charkhandeh DDS

Award-winning Dental Sleep Medicine Dentist

 Positive Airway Pressure (PAP) therapy

What is PAP for sleep apnoea? And how does it work?

Positive Airway Pressure (PAP) therapy for obstructive sleep apnoea (OSA) is a treatment that prevents your airway narrowing or collapsing while you sleep. PAP works by pumping air into your nose (and or mouth) through a mask worn over your face.

PAP therapy is considered the ‘gold standard’ or reference therapy for obstructive sleep apnoea.

For those who can tolerate PAP (an arduous therapy) it’s absolutely transformative.

A common misconception is that oxygen is pumped in. This is rarely the case.

PAP therapy pneumatically splints open your airway while you sleep

The left-hand image illustrates airway narrowing on breathing in. The right-hand image illustrates how PAP prevents this.

What happens next?

Sleep apnea treatment with Positive Airway Pressure therapy

  1. Have a PAP mask fitting and loan of an Automatic PAP
    After you receive your OSAS diagnosis, you usually have an appointment the same day, with a sleep unit nurse.At this appointment the sleep unit nurse will:

    – Provide an explanation of PAP therapy
    – Fit you with a PAP mask
    – Loan you an automatic PAP machine (an automatic PAP establishes over the following 2 weeks your specific PAP therapy pressure)
    – Supply you with support details

  2. Return to collect ‘your own’ PAP machine
    Approximately 2 weeks later, you return to the Hospital sleep unit and the data from your APAP machine is used to setup your treatment device. This is routinely a fixed or continuous pressure PAP machine.
  3. Return for a 3-month review and sleep test
    You will be sent a letter inviting you for a 3-month review and another sleep study using your PAP therapy. The idea is to determine both subjectively (how to do you feel?) and objectively (what does the sleep study data say?) if you are adequately treated and restored to normal function.

    You will meet with the sleep unit practitioner/nurse to review your latest sleep study data and see how you’re getting on with PAP therapy. This is the time to seek help with niggles with mask fit (if you haven’t already).

How to choose PAP therapy?

Co-author: Adrian Zacher MBA
Co-author: Dr Lizzie Hill PhD

In this 3-part NHS England’s Information Standard Accredited Guide, you’ll learn in jargon-decoded language:

  • How PAP therapy works
  • What to consider when selecting a ‘mask’
  • What ‘titration’, ‘ramping’ and ‘humidification’ mean… and more
  • Includes details of support groups and PAP user feedback

No signup is required. No credit card.
Nothing at all in fact.
We do this to help – because we can.

Snoring & Obstructive Sleep Apnoea Overview Guide

Meet the co-authors

Adrian Zacher. Click for full profile [new tab]

Adrian Zacher MBA

Author and founder of,
co-founder and former CEO of the British Society of Dental Sleep Medicine

Dr Lizzie Hill PhD Click for full profile [new tab]

Dr Lizzie Hill PhD

Dr Lizzie Hill PhD RPSGT EST. Clinical Sleep Physiologist (RCCP M-Level registered); Education Lead, British Sleep Society & President, European Society of Sleep Technologists.

 Surgery for snoring and obstructive sleep apnoea

Surgery for snoring aims to improve the airway in your throat
  1. Soft tissue surgery for snoring and sleep apnoea is appropriate to enhance the use of dental splints and Positive Airway Pressure therapy (PAP). This includes surgery on the inside of your nose, soft palate and base of your tongue to remove physical obstructions and improve tissue tone.
  2. Hard tissue surgery will change the way you look. It moves the bones of your face. Hard tissue surgery aims to eliminate the need for other therapies (i.e. dental splints and PAP).
  3. Bariatric surgery may exceptionally be considered when your health and quality of life are impacted by obesity. Qualifying criteria varies – consult your doctor.
Uvulopalatopharyngoplasty (UPPP) surgery for snoring
Soft tissue surgery (UPPP)


Bi-maxillary osteotomy permanent treatment for sleep apnoea
Hard tissue (bone)

Bi-maxillary osteotomy.

What happens next?

Accuracy of the diagnosis is essential for surgery to provide a satisfactory result. Sleep nasendoscopy is sometimes performed to confirm the surgical site.

Read our Surgical Guide ↗ for a jargon-decoded explanation of all the options.

Things to discuss, when considering surgery for snoring and sleep apnoea

Co-author: Adrian Zacher MBA
Co-author: Professor Bhik Kotecha FRCS
Co-author: Professor Iain Ormiston FRCS

In this NHS England’s Information Standard Accredited Guide, you’ll learn in jargon-free language:

  • About soft tissue, hard tissue and bariatric surgery
  • When surgery is considered appropriate
  • Includes ‘non-gory’ image explanations
  • Details of support groups

No signup is required.
No credit card.
Nothing at all in fact.
We do this to help – because we can.

Snoring & Obstructive Sleep Apnoea Overview Guide

Meet the co-authors

Adrian Zacher. Click for full profile [new tab]

Adrian Zacher MBA

Author and founder of, co-founder and former CEO of the British Society of Dental Sleep Medicine

Professor Bhik Kotecha Click for full profile [new tab]

Professor Bhik Kotecha MB, MPhil, FRCS (Ed, Eng, Orl), DLO

Professor Kotecha is the Clinical Lead for the Sleep Disorders Unit at the Royal National Throat, Nose & Ear Hospital, London.

Professor Iain Ormiston FRCS Click for full profile [new tab]


Professor Ormiston is doubly qualified in medicine and dentistry holding dental and medical/surgical fellowships, FDSRCS, FRCS. He is also a Fellow of the Hong Kong Academy of Medicine.

Check out Chapter 5 (Follow-up) to appreciate what it should look like, and Chapter 6 our expansive (FAQs) section.


Follow-up of snoring and sleep apnoea patients

Follow-up for both snorers and those with OSA is essential.

Snoring may become sleep apnoea, and sleep apnoea may worsen or an initially successful therapy fail to control drowsiness in the long-term.

But what does follow-up look like?

What does it entail?

Follow-up of snoring and sleep apnoea treatment


If you’re struggling with therapy do not give up. If you’re using an oral appliance go back to the dentist. If you’re on CPAP go back to the sleep unit directly. 

The importance of follow-up for snoring and sleep apnoea therapy users cannot be overstated.

However, snorers who are prescribed a mandibular repositioning splint are commonly NOT followed-up to assess whether:

  1. Their mandibular repositioning splint continues to provide satisfactory control of their snoring
  2. Or, if their snoring has developed into sleep apnoea

What should follow-up of ‘snorers’ look like?

MRS therapy follow-up Mandibular Repositioning Splints (MRS) are typically prescribed for ‘benign’ snorers or those with less severe sleep apnoea.

Follow-up by the dentist MUST include assessment of perceived sleepiness or drowsiness and ideally an annual home sleep apnoea test (HSAT) performed to determine if the mandibular repositioning splint is effective.

Dental changes should be communicated to you by your dentist and your risk/benefit analysis reviewed.

PAP therapy follow-up PAP therapy today, commonly incorporates sophisticated monitoring technology, to follow how much it is used and how effective it is.

Less commonly remote ‘titration’ or adjustment of therapy pressure to optimise treatment may occur. This has an unfortunate tendency to get tied up in data access and use permissions.

Annual follow-up is required to identify if daytime drowsiness symptoms have returned – if so they need investigating.

Surgery for snoring follow-up Surgery for snoring. It is vital that follow-up home sleep apnoea testing (HSAT) is performed for those who have undergone surgery for snoring.

The ‘fire alarm’ of snoring has been removed. What if the far more serious fire of sleep apnoea develops?

Changes in weight, lifestyle (particularly evening alcohol consumption) may give rise to sleep apnoea symptoms that need investigating.


Driving or similar vigilance critical roles

When obstructive sleep apnoea syndrome treatment is effective (i.e. no more drowsiness when you should be awake) and most importantly the treatment is adequately used, driving may resume. 

It is the individual’s responsibility to ensure they are fit to drive.

It should be noted that if you are a vocational driver or perform some other vigilance critical role (i.e. a pilot or such like) then you will be actively monitored to ensure the safety of those around you.

Should sleepiness / drowsiness symptoms return you must immediately cease driving/flying and contact your sleep unit. They will be keen to assist you.

Summing up follow-up and condition change

Regrettably, nil follow-up and symptomatic treatment of ‘snoring’ without any, or perhaps inadequate assessment of sleep apnoea symptoms, is today encouraged or through regulatory inaction, effectively condoned.

Consequently, the snorer and partner are exploited for profit:

  • Some custom dental appliance manufacturers (with a short-term view) may neglect to mention to dentists who prescribe mandibular repositioning splint therapy, that without sleep training, the dentist is practising outside the bounds of both their expertise and professional indemnity insurance. 
  • Over-the-counter (OTC) mandibular repositioning splints are commonly sold on-line and in the pharmacy as Class 1 (low-risk) devices. This is (in my assessment) irresponsible and typically delays effective treatment of sleep apnoea and its co-morbidities. Check out this exhaustive post new window about the silly claims the manufacturers make.
  • Finally, medical professionals may wish to reconsider condoning or suggesting a snoring patient use an over-the-counter gadget not least because they may find themselves personally liable for the harm such oral appliances can and do cause to teeth and jaw joints, but because oral appliance therapy is the practice of dentistry.

Snoring and sleep apnoea both change as we get older (and typically gain weight). 

Our lifestyle may also change, so in summary:

What works tonight, may not work tomorrow night.



FAQs about how to stop snoring

We conclude with a snoring and sleep apnoea Frequently Asked Questions (FAQ) section.

Have a question that isn’t answered? Ask it below by commenting, if we don’t personally know the answer, we’ll find someone who does!

Please note we cannot give medical advice.

Snoring and sleep apnea FAQ

Snoring: a technical explanation

Assume a fixed volume of air travels into your lungs while you sleep (typically this is around 500 ml). If your airway narrows, the air must travel faster for the same volume, to enter your lungs in one breath. As the air speeds up, floppy airway walls move in-and-out and make the snoring noise.

Snoring FAQs ⤴

What does surgery offer for sleep apnoea?

Surgery may appear a ‘quick-fix’ solution. However, diagnosis and accurate identification of precisely WHERE the problem is, dictates the success or outcome of surgery, which in itself is challenging.

Surgery for sleep-related breathing disorders, is split by whether bone needs to be operated on. If not then ‘soft-tissue’ surgery, is intended to improve the effective use of other therapies (see above). In contrast, surgery on the bones of the face, is intended to eliminate the need for other therapies.

This is major surgery and it will change the way you look.

A final option is to bypass the collapsing area of the throat. This is known as a tracheotomy and it’s not normally considered, until everything else has failed. Grab the Surgery for snoring Guide.

Snoring FAQs ⤴

I would like to undergo surgery to stop my snoring…

Question continued:

I would like to undergo surgery to stop my snoring, I have been to my doctor regarding this and they referred me to a specialist, who gave me a machine to test for sleep apnoea.

The results came back fine (I don’t have sleep apnoea). Yet my snoring is so bad that it keeps my partner awake, and they already sleep with ear plugs. Not sure what else to do. Have tried sleep spray, strips, mouthguard etc.


We cannot give medical advice. However we can offer personal opinion on the UK situation: Consult your GP.

You will find that surgery for snoring without sleep apnoea (the machine the specialist sent you home with to test your sleep overnight) is NOT provided by the NHS. Which means that if you’re a suitable patient you would have to pay for surgery. Of course I do not know if you’re in the UK reading this!

We have 2 things to help you make a more informed decision:

  1. Things to discuss when considering surgery for snoring and sleep apnoea Guide
  2. How to stop snoring: The definitive, step-by-step Guide (2019)

Have you tried a custom-made oral appliance for snoring? These are fundamentally different to over-the-counter devices and (if you get the right one) will help most people. You can find more about them here

Finally, I suggest you contact the ↗ forum on Facebook. ↗ It may help to discuss things there.

Snoring FAQs ⤴

How would I go about getting surgery and how much would it cost?

First you must be screened for obstructive sleep apnoea. Consult your GP (additionally if you’re in the UK a sleep-trained dentist) and heed their advice.

Three important things to note:

  1. Surgery is an option when all other options have failed.
  2. Surgery is usually only considered to improve the effect of PAP or an oral appliance.
  3. If your weight changes it will impact upon the success (or otherwise) of surgery.

If your GP considers it appropriate, you would be referred to the nearest ENT department or you can choose somewhere else if you wish. (the NHS Constitution gives you this choice).

At the ENT department they would assess you, examine your nose and throat and perhaps do a nasendoscopy or a sleep nasendoscopy in an attempt to identify where the snoring is coming from. Various surgical options exist but the difficulty is in identifying precisely where the problem is. It may be many areas.

Surgery is a private option. You could discuss the cost of this with the GP and then the ENT department.

Snoring FAQs ⤴

What is obstructive sleep apnoea?

Sleep apnoea can be thought of as the serious side of snoring. The problem is, without professional assessment its impossible to say if snoring is (or is not), a symptom of sleep apnoea.

Sleep apnoea may be observed as periods of silence between snores. The snorer’s chest and stomach continue to move up and down, but no air enters their lungs, until they wake up and breathe. As you can imagine, sleep apnoea eliminates deep, restorative sleep. If left undiagnosed and untreated, the sufferer will experience multiple short and long-term health consequences.

Ultimately, untreated sufferers will die sooner than would otherwise be expected. Sleep apnoea affects the individual in what is called apnoeaic episodes. These typically last 10 seconds and can be as long as 2 minutes at a time – they occur occasionally with most people who snore and this can be considered relatively normal.

However, most observers only notice the ‘tip of the iceberg’ and the condition may be far more serious. The severely affected individual will experience daytime symptoms that may be described as ‘a cross between jetlag and a hangover‘. The partner will notice the noise and occasional moments of silence – this is when the individual is not breathing!

Get a better understanding of snoring and sleep apnoea, by grabbing our free Overview Guide.

Snoring FAQs ⤴

How to stop snoring: ‘Tips and Tricks’?

For some snorers a quick and easy solution to stop snoring, is to change sleep position

(get off your back). This may immediately reduce or stop the annoying noise: “TURN OVER!” might be something you’ve heard before…?

Sadly, changing sleep position alone, doesn’t cure snoring for everyone. This is because there are many reasons, with as many solutions, for why someone may snore each night. That’s why you need expert signposting and professional screening and assessment.

Snoring FAQs ⤴

Is snoring an act which absolutely cannot be controlled?

Yes. It is an unintentional and uncontrollable phenomenon. While the individual can lower certain risk-factors (see above), they can’t choose ‘not’ to snore. It would be like asking someone, not to breathe!

Snoring FAQs ⤴

Snoring risk factors

There are a number of risk-factors, some may be quickly and easily fixed… Others may not.

Lifestyle changes include:

  • maintaining your ideal weight,
  • not smoking,
  • reducing alcohol consumption (and not drinking that glass or two of wine/beer in the evening – which is exactly when you WANT to drink it – I know!)

These are useful things to work on. However, lifestyle changes take time and are not always effective even then.

For example, if your lower jaw is ‘set back’ in relation to your upper jaw, this may make your airway narrower and predispose you to snore. You may also snore if you have enlarged tonsils and adenoids – physical obstructions in your nose or throat – that limit the size of your airway. If you’re concerned about this, your GP is the first person to contact to seek a referral for an ENT assessment.

As we get older, it’s a fact of life that our body tissue becomes less elastic (we’re back to tone again) as we age. This ‘floppiness’, together with excess weight, is a contributory factor to why we snore.

Snoring FAQs ⤴

If we are more tired, do we snore while sleeping?

If we’re exceptionally tired, we may lose body tone more rapidly and more deeply, when we go to sleep, so yes if we’re prone to snore, this would mean we snored more loudly or frequently.

Snoring FAQs ⤴

Why do anything about snoring?

You mean apart from not being anti-social?!

Snoring may be a symptom of Obstructive Sleep Apnea (OSA). OSA makes your heart race as the oxygen in your blood drops. This places strain on your heart and because after every stoppage of breathing, you start to wake up, you do not get a good nights sleep. This affects the way you feel and your behaviour the following day.

UARS is a milder version of this and can be thought of as in between snoring (mild interference in airflow) and obstructive sleep apnea (when the airway is closed or obstructed).

Snoring FAQs ⤴

Why don’t we wake-up from our own snoring?

A classic warning sign of obstructive sleep apnoea is waking up and: …hearing the end of your own snore…

Typically, this would be as a result of what is known as an ‘apneaic episode’ or period of not breathing.

Typically, the sufferer doesn’t remember this. They take a breath and go back to sleep.

Its sounds like this:

Snoring…. Stop breathing… silence…. Partially awaken. [Gasp / cough / scratch / roll over.] Snoring… Stop breathing….silence Partially awaken.  [Gasp / cough / scratch / roll over.]

Repeat. All night.

However, most snorers do not wake themselves up, they just irritate those who are trying to sleep within earshot…

Snoring FAQs ⤴

When does snoring indicate a more serious problem?

If you snore loudly with occasional pauses in breathing, and you frequently wake up during the night, you may be suffering from sleep apnoea.

Ask your partner, or a member of your family to listen for signs of this disorder.

Sleep apnoea is periods when you stop breathing while you’re sleeping. These interruptions in your breathing, which can last 10 seconds or longer, occur when the muscles in your soft palate, uvula, tongue and tonsils relax during sleep.

This is the same process involved with normal snoring, but with sleep apnoea, the airway narrows so much that it closes. Your breathing stops, cutting off the flow of oxygen into your body and reducing the elimination of carbon dioxide (CO2) from the blood.

Your brain detects this rise in CO2 and briefly wakes you up, re-opening your airways and re-starting your breathing. This process can be repeated many times during the night.

Proper sleep can become impossible, resulting in severe fatigue and a decreased quality of life. Sleep apnoea in adults can increase the risk of serious health problems such as heart failure, because it deprives the sufferer of adequate levels of oxygen, making the heart work harder than normal.

Snoring FAQs ⤴

How can I tell if I snored last night?

Well, you could ask your long-suffering partner! But what if you don’t have a partner? (Or if they’re not in the same bed?). Well, if you wake up with a sore throat or perhaps a dry mouth, this probably means that yup, you were snoring.

To get slightly more scientific about it, you could buy a voice-activated dictaphone or if you have a smartphone, there are apps that may detect snoring.

A word of caution: Light from your phone at bedtime could interfere with falling and staying asleep.

Snoring FAQs ⤴

Why do some people snore so loudly?

Some people are born with certain traits and characteristics that pre-dispose them to be snorers, such as a heavy set lower jaw, a large neck circumference and a high body mass index (BMI).

Snoring FAQs ⤴

Why does alcohol make you snore more loudly?

Alcohol further relaxes the soft tissue in the throat and worsens any snoring noise created.

Snoring FAQs ⤴

My doctor doesn’t seem to listen or take me seriously?

Some people and some doctors, do not take anti-social snoring very seriously.

Question. Is treatment really necessary?

Answer. Both ends of the spectrum deserve treatment. Benign snoring can be far from benign. The social consequences can be extremely distressing, snoring may be a symptom of obstructive sleep apnoea and as such investigation for this possibility is reason enough to take what the patient reports seriously.

The misery of snoring to both the partner and the snorer is not worthy of the joke approach. We can help you inform your Doctor of the serious social consequences, and the economic and longer-term health benefits of the available treatment options.

Snoring FAQs ⤴

Should I visit a doctor about my snoring?

Your Doctor (General Medical Practitioner or Primary Care Physician) has access to your medical history. As such they will be able to make an informed decision about how appropriate the available treatment options are for you. They will want to know and discuss how your life (and that of your partner) is affected.

Snoring FAQs ⤴

What will the sleep or ENT consultant do?

Upon referral from a doctor, the hospital consultant will examine you and discuss all the treatment options with you.

There are many options available and not all are suitable for everyone. You may need to spend a night at the hospital and be examined while sleeping.

Snoring FAQs ⤴

What will the dentist do?

Upon referral from a Hospital Consultant the Dentist will examine the condition of your mouth and your oral hygiene. You must have good oral hygiene and be prepared to work hard to maintain it.

If you have periodontal problems or extensive crown and bridge work Sleep appliances may not a good idea. You must have sufficient good teeth in both jaws to hold the appliance in place.

Exceptionally in the UK, a sleep-trained dentist may screen your for sleep apnoea (and if they don’t recognise the need for further investigation into your sleep problem) offer you a mandibular repositioning splint without you having to be medically diagnosed beforehand. 

Snoring FAQs ⤴

Why not buy a mandibular repositioning splint on-line or at the local pharmacy)?

It’s essential that the presence or absence of obstructive sleep apnoea (OSA) is established before using any treatment or ‘cure’ for snoring. Why? Because some people with undiagnosed OSA (remember snoring may be a symptom of OSA), do not adequately respond to oral appliance therapy (the typical pharmacy bought stop snoring ‘cure’), and their underlying condition may continue to deteriorate, while their snoring noise is perhaps a little muffled, (but this is not a definitive guide to anti-snoring devices – this is.) 

It would be a bit like turning off the fire alarm (the snoring) and ignoring the fire.

Snoring FAQs ⤴

Is sleep apnoea classed as a disability?

The Sleep Apnoea Trust Association 6 state: [new tab]

Untreated, obstructive sleep apnoea can be very disabling. But it is not a disability as the condition can be treated by a simple painless non-surgical approach available entirely free of charge on the NHS. For most patients, the treatment, using a CPAP machine, is wonderfully effective and dramatic. Many users experience a return to energy levels that they have not enjoyed for many years.

The main symptoms such as constant and excessive sleepiness, memory impairment, mood swings, irritability and

under performance at work are quickly eliminated. 2 Longer term benefits are still being intensively researched, but the 20% reduction in life expectancy 3, if not diagnosed and treated, is rapidly mitigated

The best treatment for OSA on the NHS is continuous positive airway pressure (CPAP). This involves wearing a mask over the nose (or nose and mouth) during sleep, connected to a quiet pump beside the bed. It supplies slightly pressurised air to keep the throat open. The mask allows the breathing to return to normal during sleep and usually ends the snoring! Many partners enjoy sleep that they have not experienced for even longer, as they are not disturbed by their partner’s snoring any more.

When successfully treated, any concerns about driving while sleepy disappear, and no driving restrictions are imposed by the DVLA.

Snoring FAQs ⤴

Do men snore more than women?

Yes. Snoring affects more men than women. However, a large neck circumference, fat deposits on the neck and a heavy set lower jaw predispose both sexes to snore.

As we get older our soft tissue loses some of its elasticity and this allows it to vibrate when the air (your breathing) passes – creating the snoring noise. After the menopause, women may snore just as much as men of a similar age.

Snoring FAQs ⤴

Do dental mouthguards work for sleep apnoea?

Yes, in selected cases. Over-the-Counter (OTC) gumshields for snoring are NOT the same thing as custom-made, adjustable prescription Mandibular Repositioning Splints (MRS).

There are a few important points to remember:

  • You should be screened for sleep apnoea BEFORE using any ‘mouthguard’
  • Clinical research has established that OTC gumshields are not valid as a trial or therapeutic device5

Adrian has examined how to choose the best anti-snoring device ↗ and also looked at the claims made by OTC dental devices ↗ for snoring manufacturers.

Grab our free Guide about how to choose a mouthpiece to stop snoring.

Snoring FAQs ⤴

What is the latest treatment for sleep apnoea?

The sleep apnoea treatment market is expanding rapidly (as are our waistlines – obesity being a compounding variable for sleep apnea). The latest treatment today, will be superseded tomorrow.

As of June 2018, I have seen a novel CPAP launch that permits the use of ‘low-flow’ positive air pressure (high air pressure being a major cause of treatment non-use). Check them out Fresca Medical. 

Snoring FAQs ⤴

What works best to stop snoring?

There are many variables to consider and everyone is different.

That’s why a ‘One-Size-Fits-All’ approach will never work.

See your GP or a sleep-trained dentist and put this question to them IN CONTEXT. They will have access to your medical (and dental history) and be able to guide YOU individually to answer: “What works best to stop snoring?”

Snoring FAQs ⤴

Can snoring in children be indicative of a medical problem?

Children should not routinely snore each night: If they do, then consult your GP and seek an ENT assessment.

The ENT specialist will examine your child’s tonsils and adenoids, at the back of their throat. These can become swollen and make it hard for your child to breathe. Surgery permanently cures this.

If your child snores occasionally, perhaps because they have a cold or hayfever symptoms, then this should pass and it’s nothing to worry about.

Your GP is only human, and they may not know much about snoring and sleep apnoea. Print and take with you
the: GP Guidelines for Snoring and Sleep Apnoea.

Snoring FAQs ⤴

Are there societal or evolutionary ‘benefits’ from snoring?

An internet myth about snoring proposes we snore to warn off prowling predators: “I am sleeping here”, Cue caveman:


Or perhaps its a warning noise:

Do not disturb!“?

However, it’s more likely our early, grunting ancestors, didn’t snore at all! We started to snore, as we developed the ability to speak, perhaps due to a design compromise in our throat.

Our throat must be: Flexible enough to pass food to our stomach when we swallow (the wave like action of peristalsis).

Yet rigid enough not to collapse as we breathe These are contradictory requirements. If we contrast man with apes, their throat is more rigid (as they do not compromise their need to breathe, to be able to talk).

Snoring FAQs ⤴

Do you know someone who snores?

Share this with them. But first, put the noise to one side for a moment, have you observed periods of silence in between their snores?

The silence is when they’re NOT BREATHING. Their chest and stomach rises and falls, as they make increasing efforts to breathe, yet no air enters their lungs.

They’re suffocating. Yes really!

Eventually, they come up from deeper sleep enough to cough, take a breath… and resume snoring.

Repeat. All night, every night.

They wouldn’t tolerate someone strangling them while awake – yet at night the snorer with untreated sleep apnoea – does it to themselves.

Learn how you might help them by reading our Partner’s Guide

Other types of sleep and breathing issues

This page has focused on snoring and obstructive sleep apnoea (OSA), but you should know that there are other types of sleep and breathing issues (less common) where the ‘drive’ to breathe momentarily pauses.

A review of medical history, sleep study and an expert medical diagnosis is essential before starting any treatment because some people are made worse with regular PAP therapy.

If you are concerned about your own or someone else’s sleep or daytime alertness, I urge you to consult a sleep-trained professional. You would be helping them immensely.

Now, over to you

You’ve read how to stop snoring. Now, it’s time to act.

  • What will you do first?
  • Did this Guide help?

Or maybe you have a question about something we talked about.

Either way, let us know by leaving a quick comment below right now.

Thanks, Adrian & Emma.

Comment or write a review about how you will stop snoring permanently
default image

Darren Umbers (Former Regional Director UK & Ireland, Philips Respironics)

Well done Adrian, anything that helps people find help and navigate the confusing terminology and landscape to better understand what they need to reclaim their days and nights is a win with me. There are both too many people not getting the help that they need, as well as too many people being mis-sold the help that they don’t need. I think that your guide will be a help to close the information inequality gap for many people.

Darren Umbers How to Stop Snoring (The Definitive Guide) October 25, 2018

View more reviews
default image

Mike McEwan, (Former VP Europe – ResMed)

An excellent overview and specific advice. Very useful.

Mike McEwan How to stop snoring Guide October 6, 2018

View more reviews

Add your review

What are you reviewing? Please enter its name

1 - 5 out of 5, where 5/5 is the best and 1/5 is the worst


  1. Snoring and the role of the GDP: British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol. Stradling J. and Dookun R. BDJ Mar 2009 Available here: [accessed 25 Feb 2019]
  2. Find GP services: ↗ [accessed 25 Feb 2019]
  3. NHS e-referral website. Available here:: ↗ [accessed 25 Feb 2019]
  4. Basyuni S, Barabas M, Quinnell T. An update on mandibular advancement devices for the treatment of obstructive sleep apnoea hypopnoea syndrome. Journal of Thoracic Disease. 2018;10(Suppl 1):S48-S56. doi:10.21037/jtd.2017.12.18. Available here: ↗ [accessed 2nd Oct 2018]
  5. Vanderveken OM, Devolder A, Marklund M, et al, 2008. Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med; 178: 197–202. Available here: ↗ [accessed 12 April 2017]
  6. Is sleep apnoea a disability? Available here: ↗ [accessed 25 Feb 2019]

Signposting™ is a CE mark marked, Clinical Decision Support System, Software as a Medical Device. The Manufacturer is Ltd.

Signpost icon made by Freepik from is licensed by CC 3.0 BY

Page created by Adrian Zacher and Emma Easton. All rights reserved. Last updated 19th March 2019.


What’s the best Anti-Snoring Device? Sleep-expert reviews top 13 criteria

What’s the best Anti-Snoring Device? Sleep-expert reviews top 13 criteria

Rated 5/5 based on 14 customer reviews

What’s the best Anti-Snoring Device?

The best anti-snoring device is only prescribed after you’ve been screened for Obstructive Sleep Apnoea / Apnea (OSA).

The best one:

  • Stops your snoring
  • Costs you the least money (because it isn’t a false economy)
  • Creates the least side-effects (and helps you sleep and breathe at the same time)
I’m a sleep-industry insider with a quarter of century of sleep medicine experience. Adrian Zacher MBA

Author, Dental Sleep Medicine Instructor and Sleep Apnoea Evangelist

Yet, anti-snoring devices (Mandibular Advancement Devices – MADs) or ‘gumshields for snoring’ are big business on the internet and in the pharmacy.

So, the challenge as a snorer is:

How to choose one that actually works?!

Snoring aids and cures are increasingly popular as we recognise the impact poor sleep has upon our health, daytime functioning and work performance.

A Daily Mail article Ten Snoring Cures new window reviewed 10 ‘cures’ available in the UK. The journalist tried to stop his own snoring, with chin straps, pillows, sprays and ‘gumshields’, aka anti-snoring devices.

default gravatar

If you are looking for impartial advice about snoring from an expert in the field, the highly respected Adrian Zacher should be your go to. We applaud Adrian’s work, to raise awareness about the health implications of snoring, and the importance of custom-made devices for long-term success.

Lucie Ash Director Somnowell How to choose the best anti-snoring device September 7, 2018

View more reviews

He had little success and concluded his review by quoting a snoring expert, Consultant Respiratory Physician, Dr Tom McKay, from Edinburgh Royal Infirmary Sleep Centre, UK, as saying:

‘Sprays don’t have any great effect although nasal steroids have a small role if you’ve got nasal congestion. It can help to lose weight or avoid alcohol last thing at night or to sleep lying on your side. Various forms of gumshield are reasonably successful – maybe 50 or 60 per cent.’

So, its a reasonable question to ask….

Which Anti-Snoring Devices really work?

‘Gumshields for snoring’ could more accurately be described as mandibular advancement devices (MAD). They are also known as mandibular repositioning devices (MRD) or even sometimes mandibular advancement splints (MAS) !

But there are essentially just two categories:

  Over-the-Counter (OTC) ‘gumshields’
  Prescription, Custom-Made Dental Appliances

In this updated for 2019 review, I examine how both categories of anti-snoring device measure up against my Top 13 criteria for choice (see call out box) to determine which ones really work, and if they’re safe and effective.

And the best bit?

Each section concludes with my verdict and there’s a free bonus at the end!

CAUTION: Snoring may be a symptom of Obstructive Sleep Apnoea / Apnea (OSA)

Snoring may be Sleep Apnoea / Apnea (OSA)

Snoring is a major symptom of sleep apnoea/apnea.

Without a home sleep test (which your GP can arrange for you) and a professional medical assessment, your purchase of an OTC anti-snoring device, could harm you and if you snore because you have undiagnosed Obstructive Sleep Apnoea (OSA) the OTC gadget delays effective (and free on the NHS!) treatment that will prolong your healthy life.

Consult your GP if you snore. Especially if you snore and are drowsy during your normal awake time.
Grab our GP Guidelines and take them with you.

In the UK, you can also find sleep-trained dentists who can screen you and recognise Obstructive Sleep Apnoea/Apnea (OSA) symptoms2, make custom anti-snoring devices for snorers, without a prior medical diagnosis, or if they suspect OSA refer you on for further investigation.

Learn more about OSA in our award-winning, information guide: Overview of Snoring and Obstructive Sleep Apnoea (OSA)

Clinical evidence (proof) that the MAD works

No. 1. Clinical evidence (proof) that the Anti-Snoring Device works

What does 'clinical evidence' actually mean?
Medical and dental experts review medical devices (clinical research) to establish if they work. Their research produces data and information which can be thought of as ‘proof’ that something does or does not work, and how well it works in certain circumstances. The evidence they create is also judged for quality.

Judging Anti-Snoring device (MAD) research quality

When selecting an anti-snoring device, it’s important to look at this clinical evidence. To judge the quality of a mandibular advancement device’s (MAD’s) clinical research evidence, you need to look past the headlines claiming “Clinical research– tick”.

What was the outcome of the research?!

Typical patient-centred measures of outcome

Measurement of what patients perceive as important effects from wearing an MAD typically include:

  • Partner reported snoring (derrr… a no-brainer!)
  • Daytime sleepiness
  • Quality of life
  • Adherence (long-term use)
  • Device preference
Gumshields for snoring
Gumshields or ‘Boil-and-Bite’ anti-snoring devices, have been clinically researched head-to-head against custom-made, prescription, adjustable anti-snoring devices and found to be lacking.

Our results suggest that the thermoplastic device cannot be recommended as a therapeutic option nor can it be used as a screening tool to find good candidates for mandibular advancement therapy.3

…patients overwhelmingly found the ready-made MRD difficult to tolerate…4

…96% of patients reported minor adverse events, which related predominantly to discomfort.4 [referring to a study by Dr. Tim Quinnell 5

Prescription, custom made MADs
Today, clinical research has established that custom made MADs are first-line therapy (the default first option) for snoring and mild obstructive sleep apnoea / apnea.

MAD research now focuses on:

Predictors of satisfactory outcome before purchase (who will benefit and why) and which type of custom made MAD is most effective for a given genotype (which MAD is best for YOU as opposed to a vanilla approach).

Expert’s verdict on clinical evidence for MADs
It is not enough to say that an MAD has been clinically researched. Such research may have proved the MAD didn’t work!

A positive outcome from clinical research can be thought of as a ‘guarantee’ of sorts.

My advice is to do your homework (grab the Bonus Mouthpiece Guide at the end) and be guided by a sleep-trained dentist. You can find one on via our Links new window page.

[Note: Below is an advanced topic about typical MAD research metrics. So, if you’re new to clinical evidence, feel free to skip this tip].

Typical Mandibular Advancement Device (MAD) research quality metrics include:
  • Total sample size (the ‘N’ or number of patients who used the device)
  • Could they tolerate it in their mouth (known as tolerance)
  • How many hours they used it for each night (known as compliance)
  • How many nights they used it for per week (part of the compliance metric)
  • Partner reporting of cessation of snoring
  • Perceived sleepiness before and after use
  • Before and during use blood oxygenation level
  • Before and during use AHI (apnoea hypopnea index – an index used to indicate the severity of sleep apnea. The number of apnea and hypopnea events per hour of sleep)
  • Whether a placebo was used with a control group
  • Whether patients crossed over to a different therapy / device
  • Whether the researchers and/or patients were ‘blind’ (who was aware which device was a placebo or an actual MAD?)
  • Has the research been published in a high profile and peer-reviewed journal? (This means other experts in the field judge it for quality)

No. 2. Anti-Snoring Device costs

OTC gumshields and ‘treatments’ might appear cheaper than custom-made, prescription appliances & dentist fees, BUT…

Are they a false economy?

Why use a dentist to get an Anti-Snoring Device (MAD)?

Financially, its tempting to cut out the dentist.

After all, a large part of the cost to you when purchasing a mandibular advancement device, is their clinical time.

The device fees vary, but what are you paying for?

Dentists know about teeth, gums and jaw-joints
That is what they do.

While Dentistry may initially seem expensive, the risks of not using an expert are considerable. Remember, you are relying on the anti-snoring device to hold open your airway while you sleep. Think carefully before you choose.

Some dentists are specially trained in snoring and sleep apnoea / apnea, known as sleep-related breathing disorders (SRBD) and work closely with medics. Dentists with a special interest in sleep, can help you find the correct balance of benefits versus side-effects.

If you have certain medical conditions, or grind your teeth, you might break an OTC ‘gumshield’ whilst you’re asleep. When you are asleep you cannot spit out pieces of a broken gadget. You could INHALE or SWALLOW pieces.

You can find sleep-trained dentists on our Links page. In the UK, look for the British Society of Dental Sleep Medicine.

Expert's verdict on whether to cut out the dentist
Don’t do it.

The terrifying thought of bits of MAD breaking off and being inhaled while you sleep, should surely make you realise you need to see a sleep-trained dentist and use a prescribed custom-made, adjustable anti-snoring appliance, made to quality standards.

In case you’re wondering, I’m not a dentist.

Anti-snoring device (mandibular advancement device - MAD)

Example of a custom-made Mandibular Advancement Device (MAD). Image above used with permission from SomnoMed.

Mandibular Advancement Device (MAD) made from metal

Example of a custom-made Mandibular Advancement Device (MAD). Image above used with permission from SomnoWell.

over the counter: anti-snoring devices

No. 3. Comfort and bulk of Anti-Snoring Devices (MAD)

An MAD that is so uncomfortable to wear, soon ends up being thrown across the bedroom or just left in the bathroom at bedtime…

Both the design and clinical expertise in how an anti-snoring device is supplied, directly impacts your likelihood of successfully wearing it (and therefore whether it stops your snoring) – particularly during the first two weeks of use.

This is when most people who aren’t going to get on with them, quit. It might seem obvious:

but if you don’t wear it – it doesn’t work.

OTC gumshields for snoring
Generally OTC gumshields for snoring are “one-size-fits-all”.

They have to be bulkier in size to adapt to your teeth than custom-made devices. This would mean it feels like you are squeezing a tennis ball into your mouth – Oh, and then you’re expected to sleep!

Custom-made MADs
A sleep-trained dentist will ensure that your MAD fits properly and doesn’t hurt.

They will also ensure you know how to put the device into your mouth and get it out again.

Expert's verdict on comfort and bulk
As a general rule, custom-made anti-snoring devices are less bulky than ‘gumshields’.

Due to the lack of accuracy of the ‘fit’ and one-size-fits-all approach of gumshields, they may be too large, too small or take up so much room in your mouth you can’t close your lips and you find yourself dribbling attractively!

Warning! Is this the best anti-snoring device for you? UK expert review

No. 4. Will an Anti-Snoring Device (MAD) damage my teeth and gums?

You wear these things in your mouth.
What impact will it have?

Gumshields for snoring
Its quite possible that a gumshield will place excessive load upon an individual tooth/teeth.

Over time your teeth will move. It will hurt.

And you will either stop wearing the mandibular advancement device and accept the financial loss (good luck trying to get a refund on a used product), or under duress from your partner and family, continue wearing it and risk losing the tooth or an expensive crown/cap/bridge.

Prescription, custom-made MADs
Prescription Mandibular Advancement Devices on the other hand, can be designed to avoid certain teeth if they are identified as at risk.

An expert sleep-trained dentist can help identify (and save that tooth) if it could not withstand the lateral loading required.

A dental technician would ‘block out’ the identified tooth and not include it in the custom-made device.

Expert's verdict on risk to your teeth and gums

All anti-snoring devices will aggravate your oral hygiene. 

However, a sleep-trained dentist would ensure BEFORE you had an MAD, that your hygiene and oral condition (teeth, gums and jaw-joints) were satisfactory before you began to use it.

Try to keep the device as clean as possible. Use your toothbrush and toothpaste on it each morning. Don’t use chlorine based denture cleaners on gumshield based devices – it makes them hard and brittle (unusable) rapidly. Instead, use a baby bottle sterilising fluid (follow the manufacturer’s instructions).

Brush and floss your teeth carefully and consider using a chlorhexidine mouthwash. If you spit blood when you clean your teeth consult a dentist/hygienist.

‘Boil-and-Bite’ devices will flex when worn and over time, this will procline (tilt forwards) your lower incisors and retrocline (tilt backwards) your upper incisors.

Certain custom-made anti-snoring devices are designed to avoid this tooth tilting movements.

Consult your sleep-trained dentist.

No. 5. Will an Anti-Snoring Device damage my jaw-joints?

Jaw pain is truly horrible and once you have a jaw pain problem it persists.

All types of mandibular advancement device (MAD) work by moving your lower jaw forwards, and the amount it does this to be effective, and not hurt too much, is specific to you.

Gumshields for snoring
Some gumshields for snoring are only adjustable in large increments, while others you have to fit the device – rather than the device actually fit you (again you may lose your money).
Custom-made MADs
Custom made, adjustable, prescription MADs really win when considering your jaw joint. In fact, it’s possible, with some of the custom made ones to start off wearing it with no (or very little) change in your jaw position.

While of course it won’t initially prevent snoring in this position, the dentist will gradually advance your jaw until you stop snoring over a matter of weeks or perhaps even longer (this is known as titration). This gives you, your device (and your jaw joint) time to get accustomed.

Which means you STOP SNORING!

And don’t permanently harm yourself. Yay!

Expert's verdict on jaw-joint risk
Your sleep-trained dentist will screen you for sleep apnoea, assess your teeth, gums and examine your jaw joints.

They will take X-rays and put things right beforehand if necessary. If it doesn’t look like its a good idea, they’ll suggest:

  • You DON’T have one,
  • Explain why,
  • And direct you to appropriate help.

If everything is OK, they’ll monitor the effect the MAD is having upon your teeth, gums, jaw joint and snoring.

If your jaw joint isn’t healthy before you start using an anti-snoring device then it may cause irreversible harm. (The exception is when a specialist sleep and jaw joint pain [Temporo-Mandibular Joint Dysfunction or TMD] dentist prescribes a device for BOTH issues.)

A sleep-trained dentist would know what to avoid and ensure you did not experience premature posterior contact (see call out box) that would damage your jaw-joint.

Premature posterior contact

This gets a bit technical.

A common problem particular to ‘gumshields’ occurs when the device is adjusted forwards known as ‘protrusion’ (you might do this in an attempt to increase the effect – and stop the snoring noise). The upper and lower parts of the device may then come into contact on just your back teeth.

This acts like a ‘bit’ for a horse – it gives you something to chew on. It ‘gags’ open the bite (keeps your jaws more open than they should be) and this uneven bite places enormous load on your jaw joints.

It would be even worse for your jaw joint, if this was on one side only, and as you close your mouth, your jaw has to ‘rotate’ around this ‘premature contact’. What the above means, is that your jaw has to move in unnatural ways.

This hurts. And if you use the device in this position (because you’re trying to appease your partner) you will irreversibly damage your jaw joint.

No. 6. Retention /  Fit of your Anti-Snoring Device (MAD)

How well your anti-snoring device fits, is known in dental terminology as ‘retention’.

But retention has two meanings in Dental Sleep Medicine (DSM is the term for MADs used to help with sleep-related breathing disorders, including snoring and OSA).

The first meaning is how well it keeps hold of your teeth, or to put it another way, how well it ‘clips on’ or stays in place. 

Most MAD designs rely upon its ability to ‘clip’ into place to then be able to hold your jaw forwards – and stop you snoring.

The second DSM interpretation of ‘retention’ relates to the MAD’s ability to hold open your airway, retain it in a forward position, and prevent you from snoring.

So, the right amount of retention (or fit) is essential for it to work.

Over-the-Counter ‘gumshield’ vendors make their money by relying on you being too lazy to seek a refund when it doesn’t work.

Read this expert review of ways they separate you from your money. ↗

Gumshields and retention
This is unavoidably technical. So, feel free to skip to my verdict.

Due to the necessary choice of thermo-plastic (it softens and becomes adaptable to you, when heated in boiling water) material used in ‘boil and bite’ devices, getting and keeping the right degree of retention, for the long-term is nigh on impossible.

The material ‘wants’ to go back to its original shape as it cools down, which is technically due to both the elastic memory and elastic recovery of the material. There’s more about the material used in the Lifespan or ‘Cost per wear’ section below.

Custom-made MADs
Custom-made dental devices for snoring are made for you (on prescription) from raw materials by a registered dental technician. While the materials used vary, they usually only become thermoplastic (soften when warmed up) when heated over 100 deg C.

On the other hand, ‘Customised fit‘ devices are the ‘Boil-and-Bite’ gumshield type of MAD (and I know you know water boils at 100 deg. C!).

Expert's verdict on retention of Anti-Snoring Devices
Boil-and-Bite gumshields for snoring as a general rule, cannot provide good retention.

Without good retention or ‘clip’ to your teeth, gumshields will not stop you snoring. End.

No. 7. Can I adjust the position of my Anti-Snoring Device (MAD)?

The ability to adjust the forward position of your jaw (adjust the protrusion to prevent snoring) impacts upon both comfort and how well it works.

The optimum position is unique to you. It has to be just far enough forward to prevent you from snoring, yet not so far forward, it hurts your jaw joints.

Fixed devices (sometimes called ‘monobloc’ devices) take an arbitrary approach to the forward position of your lower jaw. This primitive design (exhibited by both over-the-counter gumshields and some old tech custom-made ones) is likely to be less than ideal for comfort and effect.

Gumshields for snoring
For the MAD to prevent snoring it must prevent your mouth from falling open.

You should NOT need a chinstrap in addition to your anti-snoring device. If a chin straps is suggested then:

You need a different MAD.

If you’re trying to ensure you breathe through your nose and stop your mouth falling open, then read Chinstraps for snoring? Safe, Effective or Dangerous? [new window]. In my chin strap review, I examine if they have a role for snoring and obstructive sleep apnea (OSA).

If you can only breathe through your mouth and/or sometimes struggle to breathe through your nose, then consult your GP and seek an ENT assessment.

Custom-made, adjustable MADs
Custom-made, adjustable MADs are inherently adjustable (the clues in the name!)

The important thing to understand about adjustable MADs relates to their range of movement, and:

  • Whether this is sufficient
  • Whether it dictates a hard to tolerate initial position

The most modern custom-made adjustable MADs have between 8-10mm range of movement. If more is needed – you will most likely need a remake (more money).

Expert's verdict on ability to adjust the protrusion
Clearly, fixed or monobloc devices fail this test 🙂 A new anti-snoring device would need to be made if the jaw position was incorrect. Adjustable anti-snoring devices need to have sufficient range of motion to coincide with your jaw range of motion – or you must start in a forward jaw position, which may impact your ability to get along with the MAD initially.

No. 8. Life-span or ‘cost-per-wear’ of your Anti-Snoring Device

To ensure your purchase of an anti-snoring device (MAD) is not a waste of money or a false-economy, you have to consider:

  • Its outright price (don’t forget the clinical fees) and VAT (if its for snoring)
  • Its length of useful life

Amongst other things…

Gumshields for snoring
A material that softens in boiling water called ‘Ethylene Vinyl Acetate (EVA) or EVA’ is commonly used in gumshield type anti-snoring devices.

  • This material absorbs saliva from your mouth (and also any cleaning chemicals that may then leak back out into your mouth overnight – nice).
  • They are damaged if you grind your teeth because the material is soft and elastic.
  • Their typical lifespan is 6 months to 1.5 years before the EVA constructed gumshield becomes too smelly and unpleasant to use.
  • They also distort and place high lateral loads on your front teeth – making them very sore in the morning.
Custom-made Anti-Snoring Devices
Some early design variants of custom-made anti-snoring devices, are also made from EVA ‘blow down’ or vacuum formed blanks of CE marked material by a registered dental technician.

However, most are typically made from a type of denture acrylic (polymethylmethacrylate) or ‘PMMA’, and as such are stronger and less likely to absorb saliva than EVA materials. Some new variants are made from a type of ‘Nylon’ (polyamide) and are very strong in thin section (see Comfort and bulk above). This means they will last longer and therefore the ‘cost per wear’ may be reduced.

In the UK, it is also possible to obtain a custom-made anti-snoring device manufactured entirely from metal (known as ‘Chrome’ = Cobalt chrome wiki link: new window ) While this type of manufacture may cost more (they are more time consuming to make) the material cross-section is extremely thin (fractions of a millimetre are possible) making the bulk in your mouth minimal (see comfort and bulk above). Additionally, the metal device does not absorb saliva or cleaning agents.

The downside is that any adjustment of ‘fit’ of metal devices may be problematic and over time the clasps (bits that wrap around your teeth to hold [retain – remember that?] the device in your mouth) may ‘relax’ and need adjusting.

Expert's verdict on lifespan of MADs
Broadly speaking its a sliding scale of cost versus lifespan.

The high-end devices using nylon or chrome are thinner and less bulky but are also difficult (if not impossible) to adjust. This does not mean to say its a problem, they just have to be perfectly made.

So, if its not – then it needs to be remade: Do not accept a poor fitting custom made anti-snoring device.

No. 9. Control of mouth opening

When using a mandibular advancement device (MAD) it is essential to prevent your mouth from falling open for effective snoring relief and to avoid making your airway narrower than it would be without a mandibular advancement device.

It should not be necessary to resort to a chin strap to control this. Yes, I’ve been over this point in Retention above, but…

Why does vertical opening matter?

The lower jaw rotates backwards as it opens which further narrows your airway and makes snoring worse (or if you have sleep apnoea / apnea may increase the severity and duration of apneaic episodes).

If your jaw is protruded with a mandibular advancement device (MAD) and your jaw falls open your airway may be narrower than without using an MAD.

See the three X-ray diagrams below, to understand why vertical opening with an MAD should be avoided. The red dots highlight how the airway increases / decreases with protrusion and vertical opening.

Images courtesy of Dr Ulrich Huebers DDS.

The diagram (below left) shows the size of the airway in your throat without a mandibular advancement device (MAD).

The diagram (below centre) shows the ideal situation. The mandibular advancement device advances the jaw and opens the airway in your throat.

The third diagram (below right) shows how the airway becomes narrower with both protrusion and vertical opening. Disaster.

rest position before a mandibular advancement device
Mandibular Advancement Device (MAD) with NO vertical opening in protrusion
mandibular advancement device
Gumshields and custom-made MADs
Both categories of MAD (Boil-and-Bite gumshield and custom-made MADs) can fail when examined against this important test metric.

  • Jaw advancement must increase as the mouth opens (protrusion must increase proportionally [to maintain the same effect] if vertical opening occurs).
  • Less protrusion correlates with:
    1. Less side-effects (including less risk of tooth movement and jaw pain)
    2. Increased tolerance and improved long-term compliance.

An interincisal opening (the distance measured between the upper and lower front teeth) of more than 5 mm has been associated with lower patient adherence (long-term use), perhaps as a result of discomfort.6

Expert's verdict on mouth opening
Minimal vertical opening (as in just sufficient to permit the lower jaw to advance without the upper and lower teeth hitting each other) should routinely be considered ideal. More than this may be necessary in selected cases where:

  • the tongue is large
  • the jaw is small

However, opening beyond 5mm (measured between the incisors) is uncomfortable, inhibits lip closure and detrimentally impacts long-term use. A design principle for MADs is control of vertical opening (note my previous comment about not needing a chin strap).

No. 10. Ability to move side-to-side (lateral movement)

It might seem obvious, but unless the MAD is worn, it cannot stop your snoring.

As such, it must be comfortable to use. Part of this comfort equation is the MAD not creating a ‘trapped’ sensation.

This may occur when the lower jaw is unable to move from side-to-side.

Gumshields and custom-made MADs
Some MADs (both custom-made and ‘Boil-and-Bite’) exhibit the capability to move laterally (side to side) while some do not. My viewpoint is that you should look for one that does permit movement.
Expert's verdict on lateral movement
If you grind your teeth (brux) then this will significantly impact the life-expectancy of your MAD. In fact, you may work harden metal components necessitating their earlier replacement, than would otherwise be expected.

Finally, while it is perhaps a contentious area, if you routinely ‘brux’, then an anti-snoring device that does not permit side-to-side (lateral) movement may actually disrupt your sleep. One theory suggests that this is because your attempts to move are hindered.

The opposing theory suggests you will no longer brux when your apnea is resolved. The jury is out.

No. 11. Does the Anti-Snoring Device mechanism invade your tongue-space?

Ever had a filling or a crown? You may recall how you were very conscious of it. You probably explored it with your tongue and it felt alien. Every anti-snoring device will feel huge in your mouth when you start to use it.

Consequently, less is more!


Less physical presence in your mouth, squashing your tongue, enhances your ability to initially accept it and keep using it – and stop snoring…

The concept behind an MAD is to advance the jaw, and in turn, move the tongue forwards and away from the back of your throat.

This increases your airway dimensions and improves tissue tone, which stops you snoring.

So, when an MAD is too bulky, it squashes your tongue. Which is self-defeating.

Gumshields and tongue space
Typically, gumshields are bulky and squash your tongue. They may even have rough or sharp edges which may cause tongue ulcers.

Technically, this may occur with ‘gumshields’ at the junction between two materials, typically with devices that have a hard-outer shell and a softer thermoplastic liner, or when they are crudely ‘adjusted’ with home equipment i.e. scissors!

Prescription, custom-made MADs


Some primitive custom MADs are bulky and invade tongue space. Materials technology is continually improving, and thinner cross-section devices are now appearing on the market using laser sintered polyamide (a type of nylon).

While traditionally manufactured metal (known as ‘chrome’) devices are available. These may be expensive to make (as they are labour intensive) and may necessitate plastic and metal combined devices, which builds in failure points (because dissimilar materials exhibit different mechanical properties).

Placement of the adjustment mechanism

The placement of adjustment mechanisms in the tongue space is uncomfortable and counter-productive (see concept note above in introduction to this point). Some early custom MADs used orthodontic screw mechanisms in the palate or inside the lower jaw (lingually).

A sleep-trained dentist will guide you when you choose. To get informed for that conversation download our free, evidence-based How to Choose a Mouthpiece Guide. new window

Expert’s verdict on tongue space invasion
If you can’t wear your MAD, then its pointless having it. Consequently, comfort has to be a pivotal deciding factor when selecting one.

Anything placed where your tongue can contact it, is a negative. Remember less is more, when it comes to MAD design.

No. 12. Easy to Keep Clean (Extend useful life, hygiene)

Consult your dentist and the MAD manufacturer’s instructions on how to clean your MAD.

I would suggest that broadly speaking you should (every time you remove it in the morning) use a toothbrush and toothpaste on the device before/after cleaning your teeth. Floss if you have the enthusiasm and discipline… and consider using a chlorhexidine mouthwash too.

Having worked in this industry for longer than I care to remember, I know that MADs must be:

  • Easy to keep clean
  • Not absorb cleaning fluid or saliva
  • Ideally not have intricate mechanisms to retain food and bacteria
  • Be entirely made of one material

Bacterial biofilm (a slimy film of infectious microbes) will form on the device. It’s important to pay extra attention to your oral hygiene (and keep the MAD clean with a toothbrush immediately you remove it in the morning).

Gumshields for snoring
As I mentioned in Biocompatibility above, these materials absorb saliva (and cleaning fluids) so bacteria are drawn into the material itself – not just on the surface. Ewww.
Prescription, Custom MADs
Again, as I mentioned in Biocompatibility, the use of materials with better properties, more suited to long-term use in your mouth, should have less detrimental impact. You will of course need to keep them clean and remove the biofilm – and keep your teeth and gums really clean.

See a dental hygienist if you need assistance keeping on top of this. Its an investment.

Expert’s verdict
Prescription, custom-made MADs utilise materials that are better-suited to long-term use. They are inherently easier to clean and keep clean. This is vital when you consider the number of people who have gum disease (gingivitis) whose condition would be aggravated by an MAD, perhaps to such an extent that they risked losing a tooth.

Top Tip

If you are lucky enough to have a marble bathroom, make sure that the MAD cleaning fluid does NOT splash out (powder or granule type cleaning products are commonly a type of acid that permanently damages marble). Ideally, clean your MAD elsewhere! (Voice of experience! Customer reported the above to me when I ran Zacher Sleep Appliances).

No. 13. Side-effects of Anti-Snoring Devices (Mandibular Advancement Devices)

There’s always a down-side!

Or in ‘English’:

“You don’t get nowt for nowt”

The most common side-effect from Anti-Snoring Devices (MADs)
The most common initial side-effect from using anti-snoring devices is related to saliva. Some people find they dribble while wearing the device during the first few weeks of use. Others may find they have a dry mouth.
The next most common side-effect is jaw ache
This is normally transient and may arise during the ‘titration’ period (where the device is adjusted to gradually advance your lower jaw and stop you snoring).

If this occurs, the correct advice is to speak with your dental clinician. It normally resolves itself but do not suffer in silence.

Longer term, changes in the position of your teeth may occur
This is due to the weight of your lower jaw (think gravity) and the muscles attached to it combining to attempt return of your jaw to its normal position. These forces are all transferred to your teeth and their roots.

This is why even the most wonderful anti-snoring devices are NOT suitable for children – because they would act like an orthodontic device and move their teeth in uncontrolled ways (exceptionally an orthodontist may prescribe an anti-snoring device for certain children with particular needs).

Expert's verdict on side-effects
It is really important to keep things in perspective: Not snoring, breathing and sleeping at the same time or perhaps minor tooth movement?

However, as I have highlighted throughout this review all anti-snoring devices have side-effects.

A sleep-trained dentist would screen you for sleep apnoea, help you stop snoring and minimise (and if necessary correct) any side-effects. They also carry professional indemnity insurance and use prescription anti-snoring devices made to quality standards by registered dental technicians.


Download our free, NHS England’s Information Standard accredited, evidence-based, expert-written and jargon-decoded Guide

(that’s a mouthful!):

> How to Choose a ‘Mouthpiece’ to Stop Snoring

You’ll learn about your options and be able to make more informed choices.

No registration is required.

They’re also free on Google Play:

google play

If you’re worried about snoring and/or experience excessive daytime sleepiness consult your Doctor or a sleep trained Dentist.

Grab our GP Guidelines and take them with you or get in touch and we’ll try to point the way (but we cannot give medical advice).

Finally, if contacting your Doctor about sleepiness is not an option for you consider the ASAP Anonymous Sleep Apnoea Process™.

NHS England's Information Standard UK
top-selling anti-snoring devices


This review has examined the best anti-snoring devices, both Over-the-Counter and custom-made, against my top 13 criteria, to help you choose an anti-snoring device that works, and is safe and effective.

My final verdict is that while a ‘boil-and-bite’ gumshield may prevent snoring for a short while (if you fit the gadget) they are ultimately a false economy and won’t work for long (if at all).

Longer-term, if you were to persevere with a ‘gumshield’ for snoring, it would:

  • Create unpleasant and sometimes permanent, unmanaged dental side-effects
  • Potentially irreversibly damage your jaw-joints
  • And it delays potential OSA diagnosis and effective treatment

In conclusion, clinical research 3 has established that ‘boil-and-bite’ gumshields are not valid as either a trial or treatment device.

But this is not a definitive guide to OTC anti-snoring device manufacturers’ claims. This is.


So then, what works to stop snoring?

My advice is to read this.

Here’s the next step:

Found this review useful?

Write a review below, and let me know.


default image

Really helpful when I was worried about my OH’s snoring. Gave me info on what to worry about. Next stop the GP.

Mrs P Really interesting stuff! May 24, 2018

View more reviews

default gravatar

If you are looking for impartial advice about snoring from an expert in the field, the highly respected Adrian Zacher should be your go to. We applaud Adrian’s work, to raise awareness about the health implications of snoring, and the importance of custom-made devices for long-term success.

Lucie Ash Director Somnowell How to choose the best anti-snoring device September 7, 2018

View more reviews

Found this useful?

Let others know what you think.

What are you reviewing? Please enter its name

1 - 5 out of 5, where 5/5 is the best and 1/5 is the worst

Reviews and ‘How-to’ Guides related to Anti-Snoring Devices:

Here are some more high quality posts reviewing anti-snoring devices, snoring and sleep apnoea / apnea products, cures and aids!

Dental Appliances for Sleep Apnoea |

Dental appliances for sleep apnoea are an appealing option. But how do you know if they will work without buying one? This post explores how predictor or titration dental appliances for sleep apnoea came to be and the vital role they may play building trust between medical and dental sleep professionals.

read more


Anti-Snoring Device – generally considered a product worn in your mouth to stop you snoring.

Boil-and-Bite – a type of gumshield for snoring that may be adapted to you by softening the material in boiling water.

Custom-made – a bespoke device made exclusively for you by a registered dental technician, working to prescription, using CE marked materials. In Europe working to the Medical Devices Directive  administered in the UK by the Medicines and Healthcare Products Regulatory Authority (MHRA).

DSM Dental Sleep Medicine – the management of sleep related breathing disorders using dental devices.

Gumshield for snoring – see ‘Boil-and-Bite’ above.

Information Standard – NHS England’s Information Standard. Organisations that join The Information Standard are showing their commitment to producing good quality health and care information.

MAD Mandibular Advancement Device – Jaw advancing device, worn at night while asleep to hold forward the lower jaw to stop snoring and prevent obstructive sleep apnoea / apnea.

MAS Mandibular Advancement Splint – See ‘MAD’.

MRD Mandibular Repositioning Device – See ‘MAD’.

OSA Obstructive Sleep Apnoea – When an individual is unable to sleep and breathe at the same time. Visually, a repetitive pattern of breathing interruptions (apnoeas) occurring while the individual sleeps, due to a physical obstruction in the airway.

OTC – Over-the-Counter product sold over the pharmacy counter without prescription, medical assessment or review of medical history.

Sleep-trained Dentist – A dentist that has undergone special interest training in sleep. As such they are able to obtain professional indemnity insurance.

TMD – Temporo-Mandibular Joint Dysfunction. Jaw-ache or pain, due to abnormal or impaired movement.


  1. Snoring cures success ‘exaggerated’ new window [accessed 16th Oct 2016]
  2. Stradling, J. and Dookun, R. 2009, Snoring and the role of the GDP: British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol, British Dental Journal, 206, 307 – 312. Available here: new window [accessed 12 April 2017]
  3. Vanderveken OM, Devolder A, Marklund M, et al, 2008. Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med; 178: 197–202. Available here: new window [accessed 12 April 2017]
  4. Ready-Made Versus Custom-Made Mandibular Repositioning Devices in Sleep Apnea: A Randomized Clinical Trial, Johal A, Haria P, Manek S, Joury E, Riha R. Ready-Made Versus Custom-Made Mandibular Repositioning Devices in Sleep Apnea: A Randomized Clinical Trial. Journal of Clinical Sleep Medicine : JCSM : Official Publication of the American Academy of Sleep Medicine. 2017;13(2):175-182. doi:10.5664/jcsm.6440. Available here: new window [accessed 18th June 2018]
  5. A crossover randomised controlled trial of oral mandibular advancement devices for obstructive sleep apnoea-hypopnoea (TOMADO). Quinnell TG, Bennett M, Jordan J, Clutterbuck-James AL, Davies MG, Smith IE, Oscroft N, Pittman MA, Cameron M, Chadwick R, Morrell MJ, Glover MJ, Fox-Rushby JA, Sharples LD. Thorax. 2014 Oct; 69(10):938-45. Available here:  new window [accessed 18th June 2018]
  6. Pitsis AJ, Darendeliler MA, Gotsopoulos H, et al: Effect of vertical dimension on efficacy of oral appliance therapy in obstructive sleep apnea. Am J Respir Crit Care Med 166:860, 2002. Available here:  new window [accessed 18th June 2018]

Created by Adrian Zacher new-window | Page last updated 25th Nov 2018

Chin straps for Snoring: Safe, Effective or Dangerous? Sleep-expert Review (2019)

Chin straps for Snoring: Safe, Effective or Dangerous? Sleep-expert Review (2019)

Rated 5/5 based on 14 customer reviews

So your mouth opens and you snore when you fall  asleep…

If during the night, when you fall asleep your mouth opens and you start snoring, then it’s easy (but perhaps mistaken) to think a chin strap to stop it doing so, would be a simple solution.

So, if you’re wondering:

Do chin straps work? Are they safe and effective?

Then read this independent sleep-industry expert (no affiliate links!) review. 

I’m a sleep-industry insider with a quarter of century of sleep medicine experience.

Adrian Zacher MBA

Author, Dental Sleep Medicine Instructor and Sleep Apnoea Evangelist,

Snoring and mouth-opening: The case for a chin strap

As you breathe IN (inhale) the soft tissue in your throat and sometimes nose, together with your uvula (the dangly bit hanging from the roof of your mouth) may vibrate as the air passes.

This makes the snoring noise

If your mouth is closed while you sleep (sounds positive for the chin strap – for a moment) then assuming you can… your breathing has to occur through your nose, which is what your nose is designed for.

Sounds good in principle…

And if you Google “chin straps for snoring” you will see there are plenty to choose from. With lovely colours, different length straps and sizes etc. etc.

But almost all cup your chin and have straps that go around the back of your head.

So its a reasonable question to ask:

Do chin straps make snoring better or worse?


Do chin straps make snoring better or worse?

When your airway gets narrower the air you breathe must travel faster. As the air speeds up, it makes floppy tissue in your airway vibrate and this makes the snoring noise.

If you sleep on your back, the problem is not that your mouth falls open, its because as your mouth opens your jaw moves backwards, which allows your tongue to reduce the size of the airway in your throat.

A chin strap exaggerates this backwards movement of your jaw, making your airway smaller and your snoring worse.

The diagram below (used with permission from Elsevier Press1) and taken from our FREE How to Choose a Mouthpiece Guide illustrates the negative consequence of backward jaw movement.

Three airway examples: normal, with apnea, restored.

On the far left the airway is normal and open.

Breathing occurs freely and quietly.

The middle picture shows how the jaw and tongue have moved backwards and no breathing is possible.

This is technically known as ‘mandibular retrusion’ and it is not safe. It is dangerous.

The third diagram on the right illustrates how a ‘Mouthpiece’ protrudes the jaw and helps the individual sleep and breathe at the same time.

More about them later in this post.

How does jaw position relate to snoring?

This brief video will will show you how jaw position relates to snoring:

Video length = 26 seconds

chin straps and airway volume

The X-ray images on the left have red highlighted areas, that indicate the size of the airway behind the tongue.

The right-hand one illustrates how airway volume increases with protrusion.

What does the clinical research say about chin straps?

Since I first published this post (2017) I have seen some vendors of chin straps misquote a case study2 (which means ONE patient) to make out that clinical research proves chin straps are a valid option for snoring and obstructive sleep apnoea (OSA).

Which is not the case at all. 

The key things to know about chin straps are:

  1. Clinical research has proved chin straps are not effective for snoring
  2. If you use Positive Airway Pressure therapy for sleep apnoea / apnea then a chin strap may help avoid mouth leak

Since the case study (2007) found one patient experienced an improvement with a chin strap, Bhat, et al,3 (2014) established chin straps had no place in treating sleep-disordered breathing and snoring. Indeed the original case study authors also published a paper4 (2014) trying to clear things up:

We learned that entrepreneurs were advertising high priced (to our mind) chin straps for treatment of snoring and OSAS, and that information from our case report was used to bolster claims of chin strap effectiveness.

They continued:

The lead author spent considerable time answering emails and phone calls to state unequivocally that we at Eastern Virginia Medical School Sleep Medicine did not support the use of the chin strap for the treatment of OSAS, and that more investigation was warranted.

Here’s the pertinent extract:

We thus applaud Bhat et al. for their work in investigating the potential utility of the chin strap for treatment of snoring and OSAS.

They demonstrated that the chin strap appears to be an ineffective treatment for a typical apnea population.

Which means that chin straps for snoring are not safe nor effective, and they also delay diagnosis and effective treatment.

For the sake of a balanced argument, in the next paragraph I will explain how some patients using Positive Airway Pressure (PAP) therapy for obstructive sleep apnoea (OSA) may find certain chin straps have a role.

A chinstrap alone is not an effective treatment for OSA. It does not improve sleep disordered breathing, even in mild OSA, nor does it improve the AHI in REM sleep or supine sleep. It is also ineffective in improving snoring. Bhat, S, et al, 2014. Journal of Clinical Sleep Medicine

The Efficacy of a Chinstrap in Treating Sleep Disordered Breathing and Snoring (2014)

I use Positive Airway Pressure (PAP):  Will a chin strap help with mouth leak?

A chin strap may help if you use a nasal mask and air is escaping from your mouth5.

However, the real solution if you use PAP and have mouth leak, is a full face mask.

Grab our freeHow to Choose Positive Airway Pressure (PAP) Guide‘ ↗ to learn more.

I would add, that if you’re fixed on buying a chin strap, then find one that is designed to just close the mouth and NOT pull your lower jaw backwards

The big PAP companies sell these: look for Philips Respironics. (No I’m not on commission and no, I do not have, or want, an affiliate link! Thank you).

Don't buy a chinstrap if you want to stop snoring!

If snoring is a problem…

You can’t ‘fix’ something if you don’t know what is wrong.

So, see your Doctor/Primary Care Physician (and/or a sleep-trained dentist if you’re in the UK) and have a review of your medical history before you decide to ‘treat’ yourself to anything.

Grab our completely free (no registration or email required), British Medical Association Patient Information Awards, winning Overview of Snoring and Sleep Apnoea Guide

What about Mouthpieces?

I mentioned ‘protrusion‘ earlier and this is what a ‘mouthpiece’ technically known as a mandibular (jaw) advancement device (MAD) does.

There are two basic groups. They work by holding your jaw more forwards and this opens your airway behind your tongue.

The first group you can buy in shops and on-line, the second group of MAD is custom-made exclusively for you by a dentist with a special interest in sleep apnoea. Be careful not to confuse custom-made with customised (customised means a ‘gumshield’ adapted or customised to you).

But this is not a definitive guide to choosing a dental device (Mandibular Advancement Device – MAD) to stop snoring. This is.

chinstrap or dental device for snoring?

What about Surgery?

Although surgeries are rarely performed, surgical approaches have been largely confined to:

  • Reduction of the soft palate and uvula (dangly bit at the back of the mouth)
  • Removal of nasal polyps (‘lumps’ inside your nasal airway)
  • Septum straightening (correcting a crooked nose)
  • Advancing the upper and lower jaws which advances the soft palate and tongue, opening up the airway, known as an MMA (MMA = Maxilla (upper jaw) Mandible (lower jaw)

If you want to know more about safe and effective ways to stop snoring and treat obstructive sleep apnoea/apnea, then grab our free, evidence-based Information Guide:

Things to discuss when considering surgery for snoring and obstructive sleep apnoea

What about surgery for snoring?


Chin straps do not stop snoring and may well be dangerous. 

I implore you NOT to waste your money, harm yourself, your loved one or I pray your children.

Chin straps have been clinically proven to be neither safe nor effective.

And they could mask symptoms of obstructive sleep apnoea / apnea (OSA) and/or delay your eventual OSA diagnosis and effective treatment.

OSA if left untreated may:

  • Reduce your life expectancy
  • Increase your risk of stroke
  • Increase your risk of a fatal heart attack
  • Predispose you to type II diabetes, depression, impotence and driving or work place accidents to name but a few!

Thanks for reading. Now share this with your long suffering friends. (If you dare!)

Created by Adrian Zacher. Last updated 12th Nov 2018.

Related posts

Here are some more of high quality posts about snoring and sleep apnoea / apnea, ‘cures’, assessment, diagnosis and treatments.

Dental Appliances for Sleep Apnoea |

Dental appliances for sleep apnoea are an appealing option. But how do you know if they will work without buying one? This post explores how predictor or titration dental appliances for sleep apnoea came to be and the vital role they may play building trust between medical and dental sleep professionals.

read more


Airway Volume The volume is the amount of space that a exists in your throat to breathe through.
Information Standard NHS England’s Information Standard. Organisations that join The Information Standard are showing their commitment to producing good quality health and care information.
MAD Mandibular Advancement Device Jaw advancing device, worn at night while asleep to hold forward the lower jaw to stop snoring and prevent obstructive sleep apnoea / apnea.
Mandibular Retrusion Backwards movement of your jaw
MMA Surgery to move both jaws. MMA = Maxilla (upper jaw) Mandible (lower jaw).
OSA Obstructive Sleep Apnoea When an individual is unable to sleep and breathe at the same time. Visually, a repetitive pattern of breathing interruptions (apnoeas) occurring while the individual sleeps, due to a physical obstruction in the airway. Apnoea is spelt Apnea in the US.
Palate Roof of your mouth.
Polyps Refers to nasal polyps in this Guide. These are ‘lumps’ inside your nasal airway.
Protrusion Forwards movement of your jaw.
Septum is the tissue that separates the left and right airways in the nose, dividing the two nostrils.
Sleep-trained Dentist A dentist that has undergone special interest training in sleep. As such they are able to obtain professional indemnity insurance.
Soft-palate Soft tissue behind your palate (roof of your mouth).
Uvula ‘Dangly’ bit at the back of the mouth.


1. Sleep-disordered Breathing, Adrian Zacher & Michael McDevitt, Carranza’s Clinical Periodontology – E-Book: Expert Consult: Online, Elsevier Health Sciences, 2017. Accessible here: new window [accessed 24th May 2018]

2. Vorona RD, Ware JC, Sinacori JT, Ford ML, Cross JP. Treatment of severe obstructive sleep apnea syndrome with a chin strap. J Clin Sleep Med. 2007;3:729–30.

3. The Efficacy of a Chinstrap in Treating Sleep Disordered Breathing and Snoring, Bhat, S, et al, 2014, Journal of Clinical Sleep Medicine, new window [accessed 24th May 2018]

4. Vorona RD, Ware JC. Use of a chin strap in treating sleep-disordered breathing and snoring. J Clin Sleep Med. 2014;10(12):1361. Published 2014 Dec 15. doi:10.5664/jcsm.4304 Available here: window [accessed 4th Nov 2018]

5. Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP. Bachour, Adel et al. 2004, Sleep Medicine, Volume 5, Issue 3, 261 – 267 new window [accessed 24th May 2018]



Found this useful? Write a review and let us, and others know what you think.

default image

I found this document clear, understandable with no jargon and recommend the advice given to any sufferers.

Sylvia Explanation of subject May 26, 2018

View more reviews

TURN OVER! You’re Snoring… Heard that before? Too many times…

TURN OVER! You’re Snoring… Heard that before? Too many times…

Rated 5/5 based on 14 customer reviews

If you or your partner snore, then the words:

TURN OVER! – You’re Snoring… 

May be all too familiar!

Of course, the premise here is that the snorer (me!) will stop snoring in a different position (off their back most probably) and the offended, sleep disrupted partner, can then try to go back to sleep…

Most people have heard of ways to help ‘train’ the snorer to get off their back (known as ‘Positional therapy’) including perhaps a tight fitting T-shirt with a tennis ball sewn into the back of it.

The idea being to make it uncomfortable to sleep this way (known as ‘supine’).

I’m a sleep-industry insider (learn more about me: Adrian Zacher) ↗ with a quarter of century of sleep medicine experience. Adrian Zacher MBA

Author, Dental Sleep Medicine Instructor and Sleep Apnoea Evangelist

Getting more serious

These approaches then develop slightly to include foam tubing or pillows attached to the offending snorer’s back.

All these methods can help, but any change in sleep position throughout the night and over the course of time isn’t documented, and perhaps its not a lifelong solution:

So who knows what’s happening?

Certainly, the snorer’s partner may appreciate some noise reduction, but when they themselves are asleep – what’s going on?

Enter the new high-tech solutions and some more jargon (or when you know this device ‘buzz’ words) to explain:

  • Vibrotactile feedback: Essentially this means that when the device detects that the snorer is on their back it vibrates, just enough to encourage the snorer to turn over. You may know this, perhaps on your mobile/cellphone, as ‘Haptic feedback’.
  • Supine dependency: This is when the snorer either only snores when sleeping on their back, or that sleep apnoea is worsened when sleeping this way.

There are currently two competitors in this space and I was lucky enough to have the chance to try the NightShift device.

Point to note here: 

I don’t get paid for my thoughts and ramblings or get some other kickback.

Before I continue, its important to note that the NightShift device is a prescription medical device and that snoring may be a symptom of obstructive sleep apnoea (OSA).

If you are concerned about OSA you should consult your Doctor.

Now we have that out of the way, lets take a look at this thing:

Here’s a shot, I grabbed from the company leaflet:

NightShift device
Here it is on my hand (to give you some idea of scale).
NightShift on my hand for scale

My personal experience

I was impressed with the packaging and pleased to see how small the device was.


The strap around the neck looks like it will throttle me – BUT – actually it contains two magnets to separate and release, right under my Adams apple. So if my wife gets annoyed with me… it separates.

The straps are actually quite comfortable, it just feels a bit strange the first few nights.

Note: The strap has loops (the manufacturer calls them retention bands) to slip the excess through. I mistakenly thought that mine had these loops missing, but they were at the end of the straps, over the magnets…

See the picture below (yes, its a bit small and hard to make out [its the ‘lump’ at the end] but it will become clearer in context below):

Neckstrap of NightShift device
You have to slide the loops along the strap, to limit the amount it can move.
See picture below:
slide the loops along

After getting the straps right, I turned it on…


Charge it first by plugging it into your computer with the micro USB lead that it comes with.

The next thing to do (which again I didn’t do the first night) is to head over to the manufacturer’s website (with the Nightshift device plugged in to your computer) and correct the time and date:

You need to have a current version of Java running on your PC for this to work. Get Java

So, did it work for me? Did I turn over?


Put it this way, I use it every night.

I also use an oral appliance ‘mouthpiece’ and together the Nightshift controls my snoring and I feel better rested in the morning.

However, the first few nights of using it, I actually felt worse on waking as the device was making me turn over to sleep on my side. (At least it wasn’t my wife screaming at me “Turn over! You’re snoring….”)

This is to be expected I guess.

Now after a few weeks of using it, it must be changing my behaviour.

When I had it charged it lasted in excess of 3 nights. Its neat how when you turn it on, it vibrates to indicate how many nights of use it can provide.

I also like the delay in starting the vibrations for 15 minutes, so you can get to sleep before it starts working.

Did I turn over?

Have a look at the graph below and I will attempt to explain what they mean. 

This ‘3 day graph’ shows that my attempts to sleep ‘supine’ (on my back) have decreased considerably. I have deliberately spaced the nights chosen to give some idea of change.

The most recent data is the first graph. This shows improvement!

Look at the red line. This is when I was sleeping on my back and just following the line you can see I turned over like a good boy.

Now look at the second and third graphs and you will see I am sleeping less on my back, than I originally was.

It works!

There is the capability to record and display up to 12 months data, which I anticipate when I have been using it for some time, will prove valuable as there will be more data to work with.

Its interesting to see that it records how much I was snoring too… (click the image below to make it a bit bigger)

3 day detailed report

How to use the NightShift device

Here’s a user instruction video placed on YouTube by the manufacturer.

I make no representations as to how useful or valid it is.


I think this is a fascinating area with real potential to manage sleep-related breathing disorders.

According to the manufacturer’s research 83% of participants had a 50% reduction in AHI (apnoea hypopnea index), 90% had > 35% reduction in AHI. The mean reduction across all participants was 69% and the median reduction was 79%.1

Combining an oral appliance with positional therapy appears to manage snoring and for those with supine dependent, mild to moderate obstructive sleep apnoea – reduce the incidence of apnoeaic episodes.

Its not clear to me, but I would imagine that it would also reduce the length of the apnoeaic episode too.

The take-away message seems to be:

‘Turn over and you will sleep better yourself 

Finally, a question occurred to me when thinking about this post and discussing my experience with the supplier:

  • Is the device really ‘training’ me to turn over?
  • What would happen if I stopped using it after a period of training?
  • Would I ‘forget’ and resume supine sleep?

The inventor Dan Levendowski was kind enough to let me know that yes it was training me – but continual use is advisable.

It just remains for me to add my thanks to Advanced Brain Monitoring and GDS Medtech for letting me try this product and review it.

Night Shift is CE marked and gained FDA clearance on the 3rd June 2014.

Here are some more high quality posts about snoring and sleep apnoea products, cures and aids:

Dental Appliances for Sleep Apnoea |

Dental appliances for sleep apnoea are an appealing option. But how do you know if they will work without buying one? This post explores how predictor or titration dental appliances for sleep apnoea came to be and the vital role they may play building trust between medical and dental sleep professionals.

Reference and Related

The NightShift research paper, “Capability of a neck worn device to measure sleep/wake, airway position, and differentiate benign snoring from obstructive sleep apnea“, published in the Springer Journal in Feb 2015 new-window


NightShift crowdfunding page: new-window (now closed – Nov 2018)

Found this useful? Please take a moment and write a review:

What are you reviewing? Please enter its name

1 - 5 out of 5, where 5/5 is the best and 1/5 is the worst

Created by Adrian Zacher new-window Last updated 18th Oct 2018

Dental Devices for Snoring: 9 Crazy Claims Sleep-expert Reviewed (2019)

Dental Devices for Snoring: 9 Crazy Claims Sleep-expert Reviewed (2019)

Rated 5/5 based on 14 customer reviews


Over-the-counter (OTC) dental devices for snoring sound so great! 

So, I’m going to show you everything you need to know about their claims.

Researched over 4 years, this comprehensive review, also looks at the regulatory framework governing the device manufacturers.

Do they stop snoring? Are they easy to self-fit? 

Let’s find out…

I’m a sleep-industry insider (learn more about me: Adrian Zacher) with a quarter of century of dental sleep medicine experience. Adrian Zacher MBA

Author and Sleep Apnoea Evangelist,

Claim 1 – OTC dental devices stop your snoring

After all, that’s what you buy them for…

Verdict: Do OTC dental devices stop your snoring?

Sadly, these gadgets do not always stop snoring. But don’t take my word for it, the BBC, when covering a ‘Which?’ report1 (the UK’s consumer champion) noted, that claims made for their success were an ‘exaggeration’.

Indeed, the BBC report had a callout box stating, “Many snoring products simply don’t live up to their claims”.

in other words… “they don’t work”.

Hmm… It seems lots of OTC dental devices are sold, and the Which? report is a bit old (2001), so could the Beeb and Which? have looked at the wrong devices?

Let’s continue…

Many snoring products simply don’t live up to their claims

Emma Copeland,
Health Which?

stop OTC devices don't work

Claim 2
Does what the expensive ones do

You might think:

I will try this (OTC device) and if it works, then I’ll get a custom one”?

Which on the face of it, seems reasonable…

Verdict – Are they the same as the expensive ones?
Clinical research2 has shown that OTC dental devices bear little resemblance to custom-made ones.

But it’s harmless right?


If you fail with an OTC dental device for snoring, you may also think a custom-made anti-snoring device won’t work, which is known as a ‘false negative’.

This ‘false negative’ delays people getting valid help. Which for the snorer with undiagnosed sleep apnoea, who has tried and failed with an OTC dental device for snoring, is a potentially life-and-death issue.

They may kill themselves (and others) should they fall asleep in unsuitable circumstances

Did you know?

Diagnosed (and untreated) sleep apnoea sufferers are up to 15 times more likely to have road traffic accidents3. They may injure or kill themselves (and others) should they fall asleep driving or performing a similar vigilance critical activity.

I recently created these posts (and updated some older ones):

OTC beaten up

Claim 3 – OTC dental devices for snoring are cheap

Over-the-Counter, dental devices for snoring range in cost from approx. £50 – £200 GBP. But remember you’re bypassing medical assessment and diagnosis, and then bypassing the dentist.

DIY appears to save money, but….


What are the risks of bypassing Dentists?

Verdict - Are OTC dental devices for snoring actually 'cheap'?
Moving past the medical risks of self-diagnosis for a moment…. which we’ll come to in Claim 5.

Dentists are experts in mouths, teeth and jaw-joints. Bypass them and self-fit your OTC dental devices for snoring and you’re asking for trouble.

Always a pleasure, having failed at DIY, to then ask an expert to clear up after you…

What does the sleep-trained dentist do?
From a dental perspective, if you use an OTC dental device for your snoring you’re ‘going it alone’. The sleep-trained dentist would monitor your teeth for what is known as ‘uncontrolled orthodontic tooth movement’. Which means your teeth tilting in various undesired ways. This could result in a change to how the teeth in your upper and lower jaws bite together (creating what is known as a malocclusion).

That same sleep-trained dentist would also monitor your gums (periodontal condition) and jaw-joints. They wouldn’t prescribe a custom-made, dental device until they were sure it wasn’t going to harm you.

And, if they felt it necessary they would take X-rays to ensure your roots could withstand the lateral loads the device creates – and they carry professional indemnity insurance should anything go wrong…

While perspective is needed when considering tooth movement and breathing, a dentist and a custom-made, prescribed anti-snoring device can limit and control things.

OTC dental devices for snoring ultimately cost you more money and cause you pain
MONEY – perhaps much more than you would spend on a prescription alternative to correct jaw pain, dental and periodontal issues (assuming you don’t lose your teeth or any existing crown & bridge work aka ‘caps’).

PAIN both short-term and perhaps permanent, chronic pain:

SHORT-TERM PAIN if you’re lucky, short-term pain from overloading individual teeth (typically the upper front incisors). This is short-term if you stop wearing the device, resume snoring, ‘put it down to experience’

PERMANENT (CHRONIC) JAW PAIN from an imposed incorrect ‘bite’ (when you close your teeth together). Jaw pain is known as temporo-mandibular joint dysfunction (TMD). It may be caused by devices that don’t close together evenly (known as a ‘premature posterior contact’) or devices that force your jaw to move beyond its limits.

Risky Business
Having tried to wear the OTC device a few nights and found yourself dribbling profusely when it’s in your mouth, experiencing tooth ache and jaw-ache in the morning…. you might now think to return it for a refund.

Nope. You’re unlikely to be successful with any claim on the promoted ‘Money-back guarantee’, because the device is now ‘used’. Gotcha!

Permanent pain and occlusal change

So, OTC anti-snoring devices have other costs, even if financially they at first appear ‘cheap’. They may cause you permanent, chronic pain and occlusal change (which means how your teeth ‘bite’ together).

In 2014, an eminent British dental expert, Dr R.J. Wassell, published in the British Dental Journal4 about ‘Over-the-Counter’ devices (he focused on devices for people who grind their teeth – ‘bruxists’). This is relevant, because he notes OTC devices sold online (and he includes those for snoring and sleep apnoea) are purchased by individuals as a possible alternative to manage their condition, without the need for a dental or medical consultation.

He notes safety information on many internet sites was “notable for its paucity” or was totally lacking.  He points out that manufacturers are not obliged to provide safety information online, but it must be provided with the product and observes that the MAUDE adverse events database5, maintained by the FDA, “showed a number of potentially serious adverse events associated with these splints including choking hazards, tissue damage and occlusal changes”.

Dr Wassell advised the GDC about the OTC device market in 2014. What are we to conclude from their apparent inaction, some 4 years on?

Claim 4 – Easy to self-fit

If you go around professional assessment, ‘treat’ yourself with an OTC gadget and amazingly no longer snore (which is unlikely) you might assume you’re fine.

Are you?

Verdict - Are you OK and are they easy to self-fit?
You should be screened for sleep apnoea before using any dental device for snoring (see Claim 5) and we looked at why going the DIY route (cutting out the dentist) is a bit dumb in Claim 3. However, for the sake of argument, let’s explore this ‘Easy to Self-Fit’ claim.

IF you read the instructions, you’ll learn you must heat up each part and – while its hot – ‘squidge’ (for want of a better word) the device onto your teeth.

Repeat this for the other jaw.

OK, not so bad you might think. But it gets worse…

For some devices, you must do both jaws AT THE SAME TIME and ensure both parts correctly line up. Or it won’t work and you can’t get your money back. Oh don’t forget to make sure it clicks comfortably into place or…

It won’t work.

If the pieces don’t line up – it won’t work – you will have to heat it up again, reform the material and try again. Assuming of course, that the material can withstand another heat cycle…

Try now to claim on the ‘Money-Back Guarantee’. Hah! Good luck with that!

But of course, this is exactly what the OTC dental device for snoring manufacturer wants. They’ve had your money after all – and there’s no comeback on them, if you give up. Regardless of whether it doesn’t work or causes you problems.

All the above assumes you fit the device – i.e. the shape of your mouth and the alignment of your jaws suit the device. Which is totally backwards, it would be like the shops only selling underpants in one or two sizes…


Anti-snoring devices, exist at the point where medicine and dentistry meet

Both are essential


Claim 5 – Quick Fix – No need to wait

Anti-snoring devices, exist at the point where medicine and dentistry meet.

I’ve highlighted the importance of the dental role.

But is a medical assessment essential?

Verdict - Is it a 'quick fix'?
Medical assessment (screening for sleep apnoea at a minimum) for your breathing is a no-brainer. Subsequent dental assessment (should anti-snoring devices be the proposed option), is necessary because the anti-snoring device used to help you breathe, is in your mouth.

Cutting out either professional is, shall we say, ‘foolish’? Bypassing assessment and/or prescription (going the DIY route), is risky because the snorer may have undiagnosed, and therefore untreated, sleep apnoea/apnea.

Claim 6 – Adjustable in protrusion

(How much they push your chin forwards)

Some, but not all, OTC anti-snoring devices are adjustable in protrusion. In either relatively large steps or for more money, with a screw-thread at the front of the mouth, like a ‘volume control knob’!

volume control knob
Verdict - Are OTC dental devices adjustable in protrusion?

The increment technology (approx. 2mm steps) is inherently flawed, because assuming everything else is good…, the difference between an effective position and a painful, impossible to tolerate one, may be much less e.g. 0.5mm.

Outcome: It won’t work

Problems with the volume control
As for the ‘volume control knob’ type, you fit the device in one position and as you adjust it (most likely forwards, because you’re still snoring and think more advancement is required), the ‘biting’ relationship changes. Which changes the alignment of the upper and lower parts of the device, most likely making it hard or even impossible to close your mouth and put your teeth together evenly.

Now, you’re in trouble, whichever way you go:

  • If you persist with the device (because you feel emotionally blackmailed by your partner) and ignore the pain, you risk creating permanent dental and jaw-joint issues. See Claim 3 above.
  • If you stop wearing the device, you’re in ‘hot water’ with your partner, because you’ve ‘quit’ trying to stop snoring…

Oh, and forget the ‘Money-Back Guarantee’ – you’ve used the device. Did you read the small-print? No, thought not.

stop snoring

Claim 7 –
Fits most people’s teeth and jaws

I covered ‘Easy – Self-Fit’ (Claim 4) above, and arguably, yes, the overall shape of OTC dental devices for snoring approximates people’s teeth and jaws BUT,

and here’s the thing:

Verdict - Do OTC dental devices for snoring fit most people’s teeth and jaws?

  1. 1OTC dental devices for snoring are inherently bulky (to make them ‘one-size-fits-all’ so they cannot be discrete and comfortable). Which means you may attractively dribble while it’s in your mouth. If it isn’t comfy you won’t wear it, and of course if you don’t wear it – it won’t work.
  2. 2You might struggle connecting the two parts, once in place in your mouth (upper and lower jaw). If you struggle with it – you’re unlikely to wear it – if you don’t wear it – it won’t work.
  3. 3It might not stay in place on your teeth. Your dentist will call this ‘poor retention’. If it doesn’t fit properly then (you guessed it) – it won’t work.

Above, are three more reasons why it’s pointless, struggling in the bathroom mirror with boiling water, squidging bits of hot plastic into your mouth.

Incidentally, custom-made, prescription devices would be remade or professionally adjusted if they exhibited these problems.

You guessed it…  

It won’t work

Where everything gets lost with which Regulator is responsible

I also contacted the Charities Commission because one business, seemed ‘confused’ about its commercial status, variously claiming to be a ‘not-for-profit’ organisation or a Charity.

The result of all the above?

The status quo: Encouraging snorers to DIY their diagnosis, ‘treatment’ and follow-up. Which is wrong on so many levels. 

Regrettably, unlike snorers, the above regulatory organisations are (so far) silent…

As for claiming ‘FDA Cleared’ [FDA means Food and Drug Administration and they control the US market for medical devices]…. my advice is to read what it is cleared for.

OTC devices have been FDA cleared for snoring – not for sleep apnoea/apnea. This means the manufacturers can market them.

But, I must repeat, in the US (just like the rest of the world), there is:

NO WAY to differentiate between snoring and sleep apnoea/apnea symptoms without an overnight sleep study.

Seriously though, after reading this, do you think DIY is sensible? There’s more about the US system in Claim 9 below.

Do You Recall This Materials Scandal?
Relying on a manufacturer’s assertion the product or materials used are safe (which is what you do with an EU Class 1 device, US Class 2 device) leaves you potentially at risk, should the manufacturer not be entirely honest. I’m not saying they’re all dishonest but…

Do you remember this?

French firm, Poly Implant Prothese (PIP) manufactured breast implants using industrial grade silicone not medical device grade7,8. And this was for an implanted medical device (EU Class 3) that should have been tightly regulated. Not something seen as ‘low-risk’ e.g. an OTC anti-snoring device….

Having a professional at least look at the product before you rely upon it to help you breathe while you’re defenceless (asleep) might be considered a good idea!

Surely consulting an expert is no-brainer…?

CE mark

Claim 9 –
OTC dental devices for snoring are: Low-Risk

A bunch of boring but essential rules exist for US and European medical devices. In medical device language, they control how devices are ‘placed on the market’.

Verdict - Are OTC dental devices for snoring 'Low-Risk'?
In the process of researching this, I found some US pre-market notifications (FDA 510k’s) for OTC dental devices for snoring and observed that the FDA review boards for some were ‘dental’ (were any medical professionals involved?).

In Europe, the medical device ‘Class’ is defined by the manufacturer, when they register with the ‘Competent Authority’. If they choose, they may opt for ‘Low-Risk’ (Class I) without any checks on this decision – no external assessment. They may then put the CE mark on their packaging.

OSA trivialised
This trivialises undiagnosed sleep apnoea / apnea

Sadly, EU regulators appear impotent, despite my notification (and notifications by others and also some reputable professional organisations). They fail to protect the Public (yes, I did say that). They continue to allow unscrupulous businesses to sell dental devices for snoring directly to the Public, because the manufacturers have declared the product a ‘low-risk’ Class 1 device.

In May 2017, I happened to visit a leading brand, High Street pharmacy. Amongst the snore-relief products (which irritates me enough) I found an OTC dental devices for snoring that claimed to treat SLEEP APNOEA / APNEA… [lost for words].


In the US, the FDA does assess whether medical devices are safe and categorised correctly, before they’re sold. The FDA took legal action against one manufacturer9 – yet the device is still available. The FDA did make the manufacturer stop claiming their product treats sleep apnoea/apnea. Consequently, the manufacturer calls it a ‘Snore Relief Device’…

A quote below from an OTC anti-snoring device website Disclaimer (brand name removed), where they proclaim the device is for sale in Europe without a doctor’s prescription and the materials are safe [accessed 22 Oct 2016]:

OTC dental device for snoring Disclaimer - what does this tell you?
Seriously, when you see disclaimers and legal notices like the below on a page – what does it tell you?!

OTC disclaimer

“The XXXXX mouthpiece is designed to cure snoring but the United States, FDA will not allow us to make the claim that our mouthpiece is a cure for sleep apnea, which is a medical condition. Should you suffer from this complaint then you should consult your doctor. While we do not claim to cure sleep apnea, many people have found relief from it as an additional benefit of eliminating snoring with the XXXXX mouthpiece.

Though the FDA won’t allow us to sell the XXXXXX anti-snoring mouthpiece without a doctor or dentist prescription, it is approved for sale in Europe under the European Union Seal of Approval without a doctor’s prescription.

We have deliberately decided to not pursue FDA approval for our product because of the associated costs that we would have to pass on to you, our customer. It has always been our intent to provide a low-cost snoring relief solution. Rest assured, 100% of our product is sourced and made in the USA with non-toxic, latex and BPA-free materials.

It just so happens that the XXXXXX mouthpiece also works very well as a “sports” mouthpiece. That is why we have decided to only sell the very same “anti-snoring” mouthpiece in the United States as a XXXXXX brand “sports mouthpiece”.

Stating: “Should you suffer from this complaint [sleep apnoea/apnea] then you should consult your doctor”, is scandalous. It is impossible to differentiate between snoring and sleep apnoea (unless you’re a sleep-trained expert!) If it was easy, we wouldn’t need Doctors or sleep units….

Arguing the toss, by saying manufacturers comply with the rules, just means the rules are wrong, inadequate or in reality unpoliced. Regardless of which side of ‘the pond’ you are, unscrupulous manufacturers are swerving the existing rules and lack of action by the regulators to sell (in my view) incorrectly categorised products (that should be prescription items), directly to the naïve Public. Buyer beware!

To add insult to injury…. In the UK, dental devices for snoring (both OTC and custom-made) are classified by HMRC as ‘luxury items’10.  Which means they’re standard rated (currently 20% VAT).

What an indictment!

It just goes to show, how poorly sleep-related breathing disorders, of which snoring is one, are understood.

In this way, they’re:

  1. 1Avoiding the cost (and the commercial risk of failure) of a ‘Notified Body’ assessment
  2. 2Gaining access to the whole EU market without external verification of that decision
The correct way to approach a snoring or drowsiness problem:
  1. Professional screening for sleep apnoea using a recognised protocol
  2. Diagnosis if sleep apnoea is suspected
  3. Prescription of the appropriate therapy/treatment

If the proposed treatment is an anti-snoring device, you then have a dental examination prior to being prescribed an appropriate custom-made one.

Although not yet widely adopted, the UK refines this process further by permitting sleep-trained dentists to screen for sleep apnoea6, and in defined circumstances, provide a custom anti-snoring device, without a prior medical diagnosis. Sleep-trained dentist are ideally placed to help simple or ‘benign’ snorers.

This pragmatic solution short-circuits the costly, time-consuming and pointless referral to hospital, of anti-social snorers without sleepiness symptoms or other comorbidities (other related health problems).

The expensive-to-the-system (ask yourself who’s profiting?) alternative, which at the time of writing is current practice in the US and Europe is:

  • For every snorer to be assessed by their GP (Primary Care Practitioner) and then if sleep apnoea/apnea is suspected, referred for further investigation to a sleep centre. This ‘paper assessment’ is time-consuming and requires knowledge that your GP/PCP may not possess.
  • Only for the individual (who after consuming secondary care resources) doesn’t merit treatment with Positive Airway Pressure (PAP) therapy, to then be lost to the system, when they’re ‘advised’ to obtain an anti-snoring device (no formal referral being made due to a silo mentality – see my post about Guidelines for the medical profession).

And they’ve cost the system how many thousands of pounds/euros/dollars? Perhaps in some US States things aren’t so bleak, so perhaps I’m being cynical. But this IS the overall picture.

We’ve been over the medical and dental consequences of buying OTC anti-snoring device, but to summarise:

  • Is BREATHING important to you? Assuming staying alive is important, why would you trust this device to keep your airway open, when you’re ASLEEP?
  • How much would you pay for a pair of glasses (spectacles)?
  • Quite a lot, I imagine because you consider it essential to see. Why then do you think your teeth, gums and jaw-joint are any less important?
  • Do you like to eat without chronic long-term pain in your jaw joint(s)? and to retain your smile?

Illustration of how OTC dental devices for snoring delay Diagnosis and Treatment

Encouraging self-diagnosis and self-treatment to profit from sales of an OTC dental devices for snoring, is irresponsible, harmful to the individual’s health, costly and perhaps dangerous to society.

The step-by-step illustration below is meant to illustrate what typically happens. While fictitious and dramatised, it is based on typical disease progression.11 


  1. 1“Johnny Snorer” self-diagnoses his snoring and buys an OTC dental device for snoring online. Miraculously his snoring is silenced, but his undiagnosed sleep apnoea remains untreatedhe remains drowsy during the day, yet doesn’t snore at night.
  2. 2“Johnny” has a near-miss on the motorway because he ‘nodded off’ for a moment. This time, he’s fortunate not to have an accident. He brushes it off and later forgets all about it.
  3. 3“Johnny” is prescribed high blood pressure medication. He falls asleep on the settee immediately after dinner – every night. He never sees the end of the movie. His wife leaves the bedroom after he goes to sleep because his snoring is so bad.
  4. 4He wakes up with a headache every morning, feels hungry all the time, and struggles with his weight. His wife cannot broach the subject of his snoring, because it just ends up in blazing row.
  5. 5“Johnny” has lost interest in sex. His relationship is in crisis, he’s irritable and not much fun to be around. His weight gain is seemingly out of control.
  6. 6“Johnny” is diagnosed with type II diabetes. His GP sends him for dietary advice.
  7. 7His family thinks he “Drives like he’s Drunk” and are very worried about him.
  8. 8His work performance is woeful, and when he has an accident at work through inattention, his employer issues a formal warning and refers him to Occupational Health. His GP refers him for a sleep study.
  9. 9His obstructive sleep apnoea syndrome is diagnosed, some years after he began using an OTC dental device for his snoring.
  10. 10 He begins PAP therapy and rediscovers his love of life. His erectile dysfunction resolves itself and he begins to take exercise. He feels “ten years younger”. He fights to hold on to his job, his home and his family.
  11. 11 Sadly, irreversible damage has been done, to his heart, blood vessels and metabolism. He’s lucky not to have had a stroke.


Time and Money

Everyone likes to save money, but OTC dental devices for snoring are a false-economy, and in my view incorrectly categorised medical devices, that delay sleep apnoea diagnosis and effective treatment.

The personal and socio-economic cost of quite possibly years of mismanaged, undiagnosed sleep apnoea, through the inappropriate sale and use of OTC dental devices for snoring, far exceeds the cost of consulting trained professionals.

Effective, life-transformational, sleep apnoea therapy is NHS funded (it’s ‘free’ in the UK) because it makes economic sense for the NHS to pay for it12.  Businesses that sell OTC dental devices for snoring have flourished in a vacuum because, until now, there has been no viable alternative. Snorers searched online and were easy ‘prey’.

The Real Problem

Is how these things are supplied

Verdict: What to do if you snore?

So what do you do if you snore?

Your GP is there to help, but you must realise that the NHS will NOT fix your snoring.

GPs must determine if your snoring is a symptom of sleep apnoea that needs a hospital referral for further investigation by sleep study. Their problem is that they’re ‘time-poor’.

The solution is to get someone else to screen you!

In the UK, a sleep-trained dentist can screen you for obstructive sleep apnoea and in defined circumstances provide a custom-made, anti-snoring device without a prior medical assessment.

We train dentists online to screen for OSA, and we are creating a signposting tool.

Grab our GP Guidelines for snoring and sleep apnoea, and take them with you.


I am reliably informed, (name withheld) that should a medical professional, suggest to a snoring patient that they use an Over-the-counter dental device for snoring (self-fit), their professional indemnity insurer would consider them having acted outside their area of professional expertise.

They would then be personally liable for the dental consequences.

Clearly, the correct thing to do, is to refer to appropriate expertise: a sleep-trained dentist. I blogged about the need for Guidelines for the Medical Profession when it comes to oral appliance therapy, in 2012!

Here are two useful resources, if you’re struggling with a snoring problem:

More about Signposting signposting utilises the British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol, as published in the British Dental Journal (2009) by Prof. Stradling and Dr Dookun BDS.

This forms part of the ARTP (Association for Respiratory Technology and Physiology (UK)) Standards of Care for MRDs (mandibular repositioning Devices) 13.

The relevant extract from the Standards of Care Document:

Both Dental Protection (UK) Ltd and the Dental Defence Union would indemnify individual members to treat simple, uncomplicated snoring with an MRD following a pre-treatment screening protocol, without the involvement of a medical practitioner, subject to proof of appropriate, formal training. Such cover would be considered on an individual member basis, and application should be made to the relevant underwriting department.

Found this useful?

Let others know what you think.

What are you reviewing? Please enter its name

1 - 5 out of 5, where 5/5 is the best and 1/5 is the worst



  1. Snoring cures success ‘exaggerated’ [accessed 16th Oct 2016]
  2. Vanderveken OM, Devolder A,  Marklund M, et al, 2008. Comparison of a custom-made and a thermoplastic oral appliance for the treatment of mild sleep apnea. Am J Respir Crit Care Med; 178: 197–202. Available here:[accessed 12 April 2017]
  3. Horstmann, S. et al, 2000, Sleep related accidents in sleep apnea patients. Sleep 1;23(3):383-9.
  4. Wassell, R. J. et al 2014. Over-the-counter (OTC) bruxism splints available on the Internet. British Dental Journal 216. E24. Available here: [accessed 9th April 2017]
  5. FDA maintained MAUDE database of adverse events:
  6. Stradling, J. and Dookun, R. 2009, Snoring and the role of the GDP: British Society of Dental Sleep Medicine (BSDSM) pre-treatment screening protocol, British Dental Journal, 206, 307 – 312. Available here: [accessed 12 April 2017]
  7. Breast implant register for UK in the wake of the PIP scandal. [accessed 17th October 2016]
  8. Wikipedia link [accessed 9th April 2017]
  9. The legal fight between the FDA and an OTC anti-snoring device manufacturer: [accessed 8th August 2017]
  10. HMRC VAT Notice 701/57: health professionals and pharmaceutical products [accessed 27 Oct 2016]
  11. Punjabi NM. The Epidemiology of Adult Obstructive Sleep Apnea. Proceedings of the American Thoracic Society. 2008;5(2):136-143. doi:10.1513/pats.200709-155MG.
  12. Weatherly, H. et al. 2009. An economic analysis of continuous positive airway pressure for the treatment of obstructive sleep apnea-hypopnea syndrome, International Journal of Technology Assessment in Health Care. Available here: [accessed 9th April 2017]
  13. ARTP standards of care v.4 [accessed 15th June 2017]

© eeZed Ltd / 2018. All rights reserved.
Images © artenot/
Created by Adrian Zacher | Page last updated 14th Nov 2018

CE mark signposting is CE marked, clinical decision support software, software as a medical device. 

manufacturer Manufacturer is Ltd. 94 High Street, Sutton Courtenay, Abingdon, Oxfordshire, OX14 4AX, UK.