Anti-Snoring Devices: What Works and What Doesn't

Evidence-based | Last updated June 2025

Snoring results from turbulent airflow through a partially obstructed airway during sleep. The obstruction can occur at the nose, mouth, throat, or a combination. Identifying where your snoring originates is essential because different devices address different anatomical causes. Using a device designed for nasal obstruction won't help throat-origin snoring.

Understanding Snoring Origin

A simple self-test for snoring origin: close your mouth and snore intentionally. If you can recreate the snoring through your nose, it likely has a nasal component. If you can only reproduce it through your mouth (open mouth), it's more likely palatal or pharyngeal snoring originating in the throat. Most chronic snoring in adults originates primarily from vibration of the soft palate and uvula, with nasal obstruction as a contributing or exacerbating factor.

Nasal Strips (Breathe Right and Equivalents)

Adhesive strips applied to the outside of the nose that physically pull the nostrils outward, increasing the cross-sectional area of the nasal passage. They are most effective for people whose snoring is driven primarily by nasal obstruction — deviated septum, nasal valve collapse, or congestion-related obstruction that narrows airflow.

Evidence for nasal strips is modest and population-specific. They work well for some people with purely nasal snoring and essentially not at all for throat-origin snoring. They're also used by athletes during exercise — the sports application is better studied than the sleep application. Worth trying as a first step given the low cost and complete absence of side effects.

Internal Nasal Dilators

Spring-loaded devices inserted into the nostrils to hold them open from inside. Generally considered more effective than external nasal strips because they directly address nasal valve collapse (the most common form of nasal obstruction). Requires some tolerance for a foreign object in the nose. Available in reusable silicone versions (Mute, Rhinomed) and disposable versions.

For people with nasal valve collapse as their primary snoring cause, internal dilators can be significantly more effective than external strips. Like strips, they have no meaningful effect on non-nasal snoring.

Mandibular Advancement Devices (MADs)

Mandibular advancement devices — also called mandibular repositioning devices — hold the lower jaw (mandible) forward during sleep, which indirectly pulls the tongue and soft palate away from the posterior pharynx, increasing airway dimensions. They have the strongest evidence base of any OTC or custom anti-snoring device for reducing snoring from throat obstruction.

OTC vs Custom-Fitted MADs

OTC MADs (boil-and-bite style, similar to a sports mouthguard) are significantly less expensive ($30-150) than dentist-made custom devices ($1,000-2,500). Custom devices allow more precise advancement control, better retention, and typically less jaw discomfort. For initial treatment, OTC MADs are a reasonable first attempt. If effective but uncomfortable, a custom device is worth pursuing.

Effectiveness

Multiple systematic reviews confirm that MADs reduce snoring frequency and loudness compared to placebo or inactive control. For mild-to-moderate sleep apnea, MADs are also an evidence-based alternative to CPAP (though generally less effective for severe apnea). Unlike nasal devices, MADs address airway-origin snoring rather than nasal-origin snoring.

Side Effects

• Jaw soreness and tooth discomfort, particularly initially (usually improves over 1-4 weeks)
• Excessive salivation
• Dry mouth
• Temporary TMJ discomfort
• With long-term use: possible minor tooth movement or bite changes (more of a concern with continuous use over years — monitor with dentist)

Not suitable for people without adequate dentition, active periodontal disease, TMJ disorders, or certain orthodontic appliances.

Tongue-Retaining Devices (TRDs)

Rather than advancing the jaw, tongue-retaining devices hold the tongue forward using suction, preventing it from falling back and obstructing the airway. They are less commonly used than MADs because many users find them more uncomfortable, but they are appropriate for people who cannot tolerate jaw advancement (e.g., those with dentures or severe TMJ disorders). Clinical evidence for effectiveness is reasonable but more limited than for MADs.

Chin Straps

Elastic straps that wrap around the chin and head to prevent the mouth from opening during sleep. The theory is that keeping the mouth closed prevents mouth breathing and the throat vibration associated with open-mouth breathing. Evidence for chin straps in reducing snoring is limited, and they have minimal effect on people whose snoring originates in the nose or who breathe through the nose but still snore. They work for a subset of mouth-breathing snorers and are inexpensive enough to try. They can be used alongside a CPAP nasal mask to prevent mouth breathing that would defeat CPAP treatment.

Positional Therapy Devices

Snoring in most people is significantly worse in the supine (back sleeping) position because gravity allows the jaw and tongue to fall backward, narrowing the airway. For patients with position-dependent snoring or sleep apnea, avoiding the supine position can dramatically reduce events.

Types of Positional Devices

• Positional alarm devices: Wearable devices (worn on the chest or back) that vibrate when you roll onto your back, prompting repositioning without full awakening. The Night Shift and similar devices have good clinical evidence for reducing AHI and snoring in positional OSA.
• Anti-snore pillows and wedge pillows: Designed to encourage side sleeping or elevate the head. Less evidence than vibration-based devices but inexpensive and harmless.
• Backpack method: Old-fashioned but effective — a tennis ball or foam tube sewn into the back of pajamas makes supine sleeping uncomfortable enough to prompt rolling over. Effective for position-dependent snoring and has been used in clinical studies.

Throat Exercises: Myofunctional Therapy

Myofunctional therapy refers to exercises that strengthen the muscles of the tongue, soft palate, and oropharynx. Stronger upper airway muscles resist collapse during sleep, reducing both snoring and sleep-disordered breathing.

A 2015 randomized controlled trial published in CHEST found that oropharyngeal exercises (targeting tongue, soft palate, and lateral pharyngeal walls) reduced snoring frequency by 36% and snoring intensity by 59% over three months. A meta-analysis of oropharyngeal exercise studies found significant reductions in AHI for mild-moderate sleep apnea as well.

Evidence also exists for two unconventional exercises: singing (particularly throat-targeted vocal exercises) and playing the didgeridoo. A randomized trial showed that didgeridoo playing for 25 minutes daily significantly reduced OSA severity. These work through the same mechanism — strengthening upper airway muscles through regular vibration and resistance.

Apps and online programs offer guided myofunctional therapy exercises. A speech-language pathologist trained in myofunctional therapy can provide personalized guidance.

Devices That Have Limited Evidence

• Anti-snore pillows with specific contours (not specifically pillow height/elevation — positioning matters, but specific pillow designs have limited RCT evidence)
• Electronic anti-snore devices that detect snoring sounds and deliver a mild stimulus — may disrupt sleep rather than help
• Herbal throat sprays — no meaningful clinical evidence

When to See a Specialist

Snoring that is loud, frequent, and accompanied by any of the following warrants a physician evaluation before spending money on OTC devices:

• Witnessed apneas (partner observes you stopping breathing)
• Excessive daytime sleepiness despite adequate time in bed
• Morning headaches
• Waking with gasping or choking
• High blood pressure (hypertension)
• Childhood snoring (should always be evaluated)

See an ENT (otolaryngologist) if you have nasal obstruction, structural issues like a deviated septum, or if surgical options for snoring are being considered. See a sleep specialist if sleep apnea screening is needed.