Lasers in Medical Science

, Volume 33, Issue 2, pp 399–406 | Cite as

Outpatient erbium:YAG (2940 nm) laser treatment for snoring: a prospective study on 40 patients

  • Isabelle Fini Storchi
  • Steven Parker
  • Francesca Bovis
  • Stefano Benedicenti
  • Andrea AmaroliEmail author
Original Article


Snoring is a sleep phenomenon due to the partial upper airway obstruction during sleep which causes vibration of the tissues of the rhino-oro-hypopharynx and less frequently the larynx. This study evaluated the use and effectiveness of the erbium:YAG 2940-nm laser as an adjunctive in providing treatment for patients suffering from chronic snoring-related sleep disorders. A prospective study of 40 consecutive patients with snoring and sleep disorders was performed, assessing data before and after three Er:YAG laser treatment sessions. During laser treatment, the pain was almost absent. There were no side effects, except a very mild sore throat in 1 out of 40 patients. The patient’s evaluation of satisfaction of the results obtained after the treatments showed that 85% of cases were very satisfied, 5 patients (12.5%) reported being fairly satisfied with the treatment and only 1 subject (2.5%) was not satisfied. Mallampati, Friedman Tongue Position, and degree of O (oropharynx) at nose oropharynx hypopharynx and larynx classification were significantly decreased after the laser sessions. The decrease of Epworth Sleepiness Scale and Visual Analogue Scale for loudness of snoring, waking up during sleep because of snoring, dry mouth on waking, and choking was all statistically significant. The incidence of dreaming during the night also raised significantly; 30/40 (75%) of cases perceived less tightness in their throat and better breathing after treatment. These results were stable at 20 months follow-up (14–24 q) in 72% of cases. Nonsurgical and non-invasive Er:YAG laser treatment demonstrated to be a valid procedure in reducing the loudness of snoring.


Laser therapy Sleep disorder Obstructive sleep apnea syndrome Snoring 


Compliance with ethical standards

Conflict of interest

The authors declare that there is no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

Informed consent

Informed consent was obtained from all individual participants included in the study.


  1. 1.
    Mannarino MR, Di Filippo F, Pirro M (2012) Obstructive sleep apnea syndrome. Eur J Intern Med 23(7):586–593CrossRefGoogle Scholar
  2. 2.
    Gałecki P, Florkowski A, Zboralski K, Pietras T, Szemraj J, Talarowska M (2011) Psychiatric and psychological complications in obstructive sleep apnea syndrome. Pneumonol Alergol Pol 79(1):26–31PubMedGoogle Scholar
  3. 3.
    Petruson B (1990) Snoring can be reduced when the nasal airflow is increased by the nasal dilator. Nozovent Arch Otolaryngol Head Neck Surg 116(4):462–464CrossRefGoogle Scholar
  4. 4.
    Sanches I, Martins V, dos Santos JM (2015) Obstructive sleep apnea refractory to treatment due to floppy epiglottis. Arch Bronconeumol 51(2):94CrossRefGoogle Scholar
  5. 5.
    Xu H, Yu H, Jia R, Gao Z, Huang W, Peng H (2015) The preliminary study of the origin characters of snore in simple snorers. Lin Chung Er Bi Yan Hou Tou Jing Wai Ke Za Zhi 29(11):977–979 983PubMedGoogle Scholar
  6. 6.
    Server EA, Alkan Z, Yiğit Ö, Yasak AG (2016) Long-term results of pillar implant procedure. Kulak Burun Bogaz Ihtis Derg 26(5):258–264CrossRefGoogle Scholar
  7. 7.
    Olszewska E, Panek J, O’Day J, Rogowski M (2014) Usefulness of snoreplasty in the treatment of simple snoring and mild obstructive sleep apnea/hypopnea syndrome—preliminary report. Otolaryngol Pol 68(4):184–188CrossRefGoogle Scholar
  8. 8.
    Chiesa Estomba CM, Rivera Schmitz T, Ossa Echeverri CC, Betances Reinoso FA, Fariña Conde J, Alonso Parraga D (2015) The treatment of snoring by radiofrequency-assisted uvulopalatoplasty and results after one-session protocol: a prospective, longitudinal, non-randomized study. Eur Arch Otorhinolaryngol 272(10):3059–3063CrossRefGoogle Scholar
  9. 9.
    Pazos G, Mair EA (2001) Complications of radiofrequency ablation in the treatment of sleep-disordered breathing. Otolaryngol Head Neck Surg 125(5):462–466CrossRefGoogle Scholar
  10. 10.
    Rombaux P, Hamoir M, Bertrand B, Aubert G, Liistro G, Rodenstein D (2003) Postoperative pain and side effects after uvulopalatopharyngoplasty, laser-assisted uvulopalatoplasty, and radiofrequency tissue volume reduction in primary snoring. Laryngoscope 113:2169–2173CrossRefGoogle Scholar
  11. 11.
    Nishigawa K, Hayama R, Matsuka Y (2017) Complications causing patients to discontinue using oral appliances for treatment of obstructive sleep apnea. J Prosthodont Res 61(2):133–138CrossRefGoogle Scholar
  12. 12.
    Epstein LJ, Kristo D, Strollo PJ Jr, Friedman N, Malhotra A, Patil SP, Ramar K, Rogers R, Schwab R, Weaver EM, Weinstein MD (2009) Clinical guideline for the evaluation, management and long-term care of obstructive sleep apnea in adults. J Clin Sleep Med 5:263–276PubMedGoogle Scholar
  13. 13.
    Cetinkaya EA, Turker M, Kiraz K, Gulkesen HK (2016) Er:Yag laser treatment of simple snorers in an outpatient setting. ORL J Otorhinolaryngol Relat Spec 78(2):70–76CrossRefGoogle Scholar
  14. 14.
    Sher AE, Thorpy MJ, Shprintzen RJ, Spielman AJ, Burack B, McGregor PA (1985) Predictive value of Muller maneuver in selection of patients for uvulopalatopharyngoplasty. Laryngoscope 95:1483–1487CrossRefGoogle Scholar
  15. 15.
    Vicini C, De Vito A, Benazzo M, Frassineti S, Campanini A, Frasconi P, Mira E (2012) The nose oropharynx hypopharynx and larynx (NOHL) classification: a new system of diagnostic standardized examination for OSAHS patients. Eur Arch Otorhinolaryngol 269(4):1297–1300CrossRefGoogle Scholar
  16. 16.
    Westcott CJ, Hopkins MB, Bach K, Postma GN, Belafsky PC, Koufman JA (2004) Fundoplication for laryngopharyngeal reflux disease. J Am Coll Surg 199(1):23–30CrossRefGoogle Scholar
  17. 17.
    Friedman M, Hamilton C, Samuelson CG, Lundgren ME, Pott T (2013) Diagnostic value of the Friedman tongue position and Mallampati classification for obstructive sleep apnea: a meta-analysis. Otolaryngol Head Neck Surg 148(4):540–547CrossRefGoogle Scholar
  18. 18.
    Smith SS, Oei TP, Douglas JA, Brown I, Jorgensen G, Andrews J (2008) Confirmatory factor analysis of the Epworth Sleepiness Scale (ESS) in patients with obstructive sleep apnoea. Sleep Med 9(7):739–744CrossRefGoogle Scholar
  19. 19.
    Majaron B, Srinivas SM, Huang HL, Nelson JS (2000) Deep coagulation of dermal collagen with repetitive Er:YAG laser irradiation. Lasers Surg Med 2:215–222CrossRefGoogle Scholar
  20. 20.
    Beltram M, Drnovsek-Olup B (2004) Histological and biomolecular analysis of new collagen synthesis after “smooth” mode Er:YAG laser skin resurfacing. Lasers Surg Med Suppl 16:56Google Scholar
  21. 21.
    Beltram M, Zivin M, Drnovsek B (2010) Collagen synthesis after laser skin resurfacing of the periocular skin. ZdravVestn 79:I-111–I-116Google Scholar
  22. 22.
    Dams SD, de Liefde-van Beest M, Nuijs AM, Oomens CW, Baaijens FP (2010) Pulsed heat shocks enhance procollagen type I and procollagen type III expression in human dermal fibroblasts. Skin Res Technol 16(3):354–364PubMedGoogle Scholar
  23. 23.
    Mantovani M, Rinaldi V, Salamanca F, Torretta S, Carioli D, Gaffuri M, Pignataro L (2015) Should we stop performing uvulopalatopharyngoplasty? Ind J Otolaryngol Head Neck Surg 67(Suppl 1):161–162CrossRefGoogle Scholar
  24. 24.
    Li S, Wu D, Shi H (2015) Reoperation on patients with obstructive sleep apnea-hypopnea syndrome after failed uvulopalatopharyngoplasty. Eur Arch Otorhinolaryngol 272(2):407–412CrossRefGoogle Scholar
  25. 25.
    Tang JA, Salapatas AM, Bonzelaar LB, Friedman M (2017) Long-term incidence of velopharyngeal insufficiency and other sequelae following uvulopalatopharyngoplasty. Otolaryngol Head Neck Surg 156(4):606–610CrossRefGoogle Scholar
  26. 26.
    Sippus J (2015) Case report: NightLase procedure—laser snoring and sleep apnea reduction treatment. J Laser Health Acad. ISSN 1855–1913Google Scholar
  27. 27.
    Svahnström K (2013) Er:YAG laser treatment of sleep-disordered breathing. J. Laser Health Acad. ISSN No.2:1855–9913Google Scholar
  28. 28.
    Miracki K, Vizintin Z (2013) Nonsurgical minimally invasive Er:YAG laser snoring treatment. J. Laser Health Acad. ISSN No.1:1855–9913Google Scholar
  29. 29.
    Lovato A, Kotecha B, Vianello A, Giacomelli L, Staffieri A, Marchese-Ragona R (2015) Nasal and oral snoring endoscopy: novel and promising diagnostic tools in OSAS patients. Eur Arch Otorhinolaryngol 272(7):1793–1799CrossRefGoogle Scholar
  30. 30.
    Lee CYS (2015) Evaluation of a non-ablative Er: YAG laser procedure to increase the oropharyngeal airway volume: a pilot study. Dent Oral Craniofac 1(3):56–59Google Scholar
  31. 31.
    Unver T, Aytugar E, Ozturan O, Kıran T, Ademci E, Usumez A (2016) Histological effects of Er:YAG laser irradiation with snoring handpiece in the rat soft palate. Photomed Laser Surg 34(8):321–325CrossRefGoogle Scholar
  32. 32.
    Soares D, Folbe AJ, Yoo G, Badr MS, Rowley JA, Lin HS (2013) Drug-induced sleep endoscopy vs awake Müller’s maneuver in the diagnosis of severe upper airway obstruction. Otolaryngol Head Neck Surg 148(1):151–156CrossRefGoogle Scholar
  33. 33.
    De Vito A, Carrasco Llatas M, Vanni A et al (2014) European position paper on drug-induced sedation endoscopy (DISE). Sleep Breath 18:453–465CrossRefGoogle Scholar
  34. 34.
    Campanini A, Canzi P, De Vito A, Dallan I, Montevecchi F, Vicini C (2010) Awake versus sleep endoscopy: personal experience in 250 OSAHS patients. Acta Otorhinolaryngol Ital 30:73–77PubMedPubMedCentralGoogle Scholar
  35. 35.
    Jmarchn 2017 Attribution 2.0 Generic (CC BY 2.0),
  36. 36.

Copyright information

© Springer-Verlag London Ltd., part of Springer Nature 2018

Authors and Affiliations

  1. 1.Department of Surgical Sciences and Integrated Diagnostic (DISC)University of GenoaGenoaItaly
  2. 2.Department of health science (DISSAL)University of GenoaGenoaItaly

Personalised recommendations