Snoring can be indicative of increased upper airway resistance, a symptom of chronic sleep apnea, or associated with comorbidities such as obesity and hypothyroidism; it can also occur in the absence of any of these conditions (primary snoring). While treatment primarily targets therapies for the associated conditions (like obesity), mechanical appliances, continuous positive airway (CPAP), and surgical approaches such as uvulopalatopharyngoplasty (UPPP) are not recommended as first-line therapy in primary snoring. Presently there are no FDA-approved medications for treating the primary pathology of snoring.
Published in the journal Sleep and Breathing, a systematic literature review sought to assess studies evaluating the effect of specific pharmacotherapy on snoring and its various indices. Only nine randomized controlled trials (RCTs) and one interventional study were identified. The drugs in the studies included serotonergic drugs, nasal lubricants and homeopathic medications, pseudoephedrine and domperidone, corticosteroids, surfactants, and botulinum toxin.
None of the studies showed strength of data and the authors conclude that there is no consistent data from these drug trials to support pharmacologic treatment for primary snoring. Medications that have been previously evaluated in the treatment of sleep apnea syndrome (protriptyline, paroxetine, fluoxetine, mirtazapine, ondansetron, buspirone, and salmeterol) should be evaluated in larger, well-designed trials for the therapy of snoring; a trial of proton pump inhibitors could also benefit patients if research indicates that antireflux therapy with domperidone reduces primary snoring. In the meantime, patients with primary snoring may need to stick with non-pharmacologic therapies like nasal strips.