{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:16:26Z","timestamp":1760058986996,"version":"build-2065373602"},"reference-count":38,"publisher":"MDPI AG","issue":"5","license":[{"start":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T00:00:00Z","timestamp":1747180800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation","award":["DTCRD108(2)-E-09"],"award-info":[{"award-number":["DTCRD108(2)-E-09"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Medicina"],"abstract":"<jats:p>Background and Objectives: Oral appliances (OAs) are commonly used to manage sleep-disordered breathing conditions, including primary snoring, and offer an alternative treatment for individuals with obstructive sleep apnea (OSA) who cannot tolerate continuous positive airway pressure (CPAP) therapy. Our study analyzed the possible factors associated with higher snoring rates compared with those associated with lower snoring rates. Materials and Methods: A customized dental brace with a tongue compressor was the essential part of the Lin OA (LOA). The compressor is available in various lengths, ranging from 0.5 to 3.0 cm across different versions. The participants wore the LOA throughout the night while sleeping. Their snoring rates were recorded using the SnoreClock app on their cell phones. Results: The analysis included 36 participants, comprising 30 males and 6 females. The participants had a mean age of 44.91 \u00b1 9.96 years, a mean BMI of 26.18 \u00b1 3.50 kg\/m2, and an average recording duration of 398.27 \u00b1 77.56 min per session. In total, 4052 sleep recordings were analyzed. The number of files for females was less than that for males (563 vs. 3489). In this study, individuals belonging to the highest one-third based on the baseline snoring rate (H group) experienced a significant reduction in snoring, approximately 84.8%, when using the LOA-3 cm device equipped with a 3 cm tongue compressor. The individuals who belonged to the lower two-thirds based on the baseline snoring rate were classified as the L group. Among male participants, snoring decreased by approximately 66.4%. Similarly, among female participants in the L group, snoring decreased by approximately 69.3% when using the LOA-3 cm. Conclusions: In this study, we observed a significant reduction in snoring for the two groups of participants wearing the LOA-3 cm, with the rate decrements ranging from 66.4% to 84.8%. This reduction was more pronounced in the H group than in the male participants in the L group. Further studies are needed to explore the reasons for these findings.<\/jats:p>","DOI":"10.3390\/medicina61050893","type":"journal-article","created":{"date-parts":[[2025,5,14]],"date-time":"2025-05-14T10:06:52Z","timestamp":1747217212000},"page":"893","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Impacts of an Oral Appliance on Snoring in Adults with Varying Degrees of Snoring Severity: A Preliminary Study"],"prefix":"10.3390","volume":"61","author":[{"given":"Yu-Hsiang","family":"Cheng","sequence":"first","affiliation":[{"name":"Department of Finance, Shih Hsin University, No. 1, Ln. 17, Sec. 1, Muzha Road, Wenshan Dist., Taipei City 116, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Jui-Kun","family":"Chiang","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Dalin Tzu Chi Hospital, Buddhist Tzu Chi Medical Foundation, No. 2, Minsheng Road, Dalin, Chiayi 622, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6270-5418","authenticated-orcid":false,"given":"Yen-Chang","family":"Lin","sequence":"additional","affiliation":[{"name":"Nature Dental Clinic, Puli Township, Nantou 540, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hsueh-Hsin","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Radiation Oncology, Taichung Veterans General Hospital, Taichung 407, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yee-Hsin","family":"Kao","sequence":"additional","affiliation":[{"name":"Department of Family Medicine, Tainan Municipal Hospital (Managed by Show Chwan Medical Care Corporation), 670 Chung-Te Road, Tainan 701, Taiwan"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1968","published-online":{"date-parts":[[2025,5,14]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"131","DOI":"10.1016\/j.smrv.2009.06.002","article-title":"The acoustics of snoring","volume":"14","author":"Pevernagie","year":"2010","journal-title":"Sleep Med. Rev."},{"key":"ref_2","doi-asserted-by":"crossref","first-page":"40","DOI":"10.1016\/j.sleh.2017.10.003","article-title":"Relationship of sleep pattern and snoring with chronic disease: Findings from a nationwide population-based survey","volume":"4","author":"Yunus","year":"2018","journal-title":"Sleep Health"},{"key":"ref_3","first-page":"175","article-title":"Prevalence of snoring and witnessed apnea in Taiwanese adults","volume":"31","author":"Chuang","year":"2008","journal-title":"Chang Gung Med. J."},{"key":"ref_4","doi-asserted-by":"crossref","first-page":"2221","DOI":"10.2169\/internalmedicine.4723-20","article-title":"Relationship between Snoring and Lifestyle-related Diseases among a Japanese Occupational Population","volume":"59","author":"Sekizuka","year":"2020","journal-title":"Intern. Med."},{"key":"ref_5","doi-asserted-by":"crossref","first-page":"45","DOI":"10.3200\/JACH.57.1.45-52","article-title":"Prevalence of snoring in college students","volume":"57","author":"Patel","year":"2008","journal-title":"J. Am. Coll. Health"},{"key":"ref_6","first-page":"18","article-title":"The prevalence of snoring in adult population","volume":"14","author":"Kara","year":"2005","journal-title":"Kulak Burun Bogaz Ihtis. Derg."},{"key":"ref_7","doi-asserted-by":"crossref","first-page":"210","DOI":"10.1080\/08037050510034248","article-title":"Prevalence and association of snoring, anthropometry and hypertension in Korea","volume":"14","author":"Park","year":"2005","journal-title":"Blood Press."},{"key":"ref_8","doi-asserted-by":"crossref","first-page":"504","DOI":"10.1136\/thx.2004.031591","article-title":"Craniofacial profile in Asian and white subjects with obstructive sleep apnoea","volume":"60","author":"Lam","year":"2005","journal-title":"Thorax"},{"key":"ref_9","doi-asserted-by":"crossref","first-page":"977","DOI":"10.1007\/s11325-011-0596-8","article-title":"Gender difference in snoring and how it changes with age: Systematic review and meta-regression","volume":"16","author":"Chan","year":"2012","journal-title":"Sleep Breath."},{"key":"ref_10","doi-asserted-by":"crossref","first-page":"1779","DOI":"10.1378\/chest.130.6.1779","article-title":"Longitudinal study of risk factors for habitual snoring in a general adult population: The Busselton Health Study","volume":"130","author":"Knuiman","year":"2006","journal-title":"Chest"},{"key":"ref_11","doi-asserted-by":"crossref","first-page":"S202","DOI":"10.1093\/sleep\/19.suppl_10.S202","article-title":"Snoring as part of a dose-response relationship between sleep-disordered breathing and blood pressure","volume":"19","author":"Young","year":"1996","journal-title":"Sleep"},{"key":"ref_12","doi-asserted-by":"crossref","first-page":"2289","DOI":"10.1001\/archinte.160.15.2289","article-title":"Association of hypertension and sleep-disordered breathing","volume":"160","author":"Bixler","year":"2000","journal-title":"Arch. Intern. Med."},{"key":"ref_13","doi-asserted-by":"crossref","first-page":"209","DOI":"10.1007\/s11906-001-0040-8","article-title":"Are sleep-related breathing disorders important contributing factors to the production of essential hypertension?","volume":"3","author":"Silverberg","year":"2001","journal-title":"Curr. Hypertens. Rep."},{"key":"ref_14","first-page":"11","article-title":"Snoring and excessive daytime somnolence and risk of cardiovascular diseases","volume":"105","author":"Bednarek","year":"2001","journal-title":"Pol. Arch. Med. Wewn."},{"key":"ref_15","doi-asserted-by":"crossref","first-page":"1165","DOI":"10.1111\/ggi.13763","article-title":"Japan Gerontological Evaluation Study Group Prevalence and clinical impact of snoring in older community-dwelling adults","volume":"19","author":"Wada","year":"2019","journal-title":"Geriatr. Gerontol. Int."},{"key":"ref_16","doi-asserted-by":"crossref","first-page":"901","DOI":"10.1378\/chest.109.4.901","article-title":"Upper airway resistance syndrome, nocturnal blood pressure monitoring, and borderline hypertension","volume":"109","author":"Guilleminault","year":"1996","journal-title":"Chest"},{"key":"ref_17","doi-asserted-by":"crossref","first-page":"475","DOI":"10.5664\/jcsm.27938","article-title":"Does snoring intensity correlate with the severity of obstructive sleep apnea?","volume":"6","author":"Maimon","year":"2010","journal-title":"J. Clin. Sleep Med."},{"key":"ref_18","doi-asserted-by":"crossref","first-page":"265","DOI":"10.1002\/lary.27314","article-title":"Snoring and carotid artery disease: A new risk factor emerges","volume":"129","author":"Deeb","year":"2019","journal-title":"Laryngoscope"},{"key":"ref_19","doi-asserted-by":"crossref","first-page":"677","DOI":"10.1038\/nrcardio.2010.145","article-title":"Mechanisms of vascular damage in obstructive sleep apnea","volume":"7","author":"Kohler","year":"2010","journal-title":"Nat. Rev. Cardiol."},{"key":"ref_20","doi-asserted-by":"crossref","first-page":"R2208","DOI":"10.1152\/ajpregu.2000.279.6.R2208","article-title":"Cardiorespiratory interactions during resistive load breathing","volume":"279","author":"Calabrese","year":"2000","journal-title":"Am. J. Physiol. Regul. Integr. Comp. Physiol."},{"key":"ref_21","doi-asserted-by":"crossref","first-page":"856","DOI":"10.1152\/jappl.1993.75.2.856","article-title":"Effects of high-frequency oscillating pressures on upper airway muscles in humans","volume":"75","author":"Henke","year":"1993","journal-title":"J. Appl. Physiol."},{"key":"ref_22","doi-asserted-by":"crossref","first-page":"151","DOI":"10.1016\/0034-5687(91)90058-Q","article-title":"Snoring during NREM sleep: Respiratory timing, esophageal pressure and EEG arousal","volume":"85","author":"Stoohs","year":"1991","journal-title":"Respir. Physiol."},{"key":"ref_23","doi-asserted-by":"crossref","first-page":"95","DOI":"10.12968\/hmed.2007.68.2.22830","article-title":"Snoring: Referral, investigation and treatment","volume":"68","author":"Trotter","year":"2007","journal-title":"Br. J. Hosp. Med."},{"key":"ref_24","doi-asserted-by":"crossref","first-page":"773","DOI":"10.5664\/jcsm.4858","article-title":"Clinical Practice Guideline for the Treatment of Obstructive Sleep Apnea and Snoring with Oral Appliance Therapy: An Update for 2015","volume":"11","author":"Ramar","year":"2015","journal-title":"J. Clin. Sleep Med."},{"key":"ref_25","doi-asserted-by":"crossref","first-page":"903","DOI":"10.1007\/s11325-015-1304-x","article-title":"Three-dimensional assessment of anatomical balance and oral appliance treatment outcome in obstructive sleep apnoea","volume":"20","author":"Sutherland","year":"2016","journal-title":"Sleep Breath."},{"key":"ref_26","doi-asserted-by":"crossref","first-page":"215","DOI":"10.5664\/jcsm.3460","article-title":"Oral appliance treatment for obstructive sleep apnea: An update","volume":"10","author":"Sutherland","year":"2014","journal-title":"J. Clin. Sleep Med."},{"key":"ref_27","first-page":"39","article-title":"Definition of an effective oral appliance for the treatment of obstructive sleep apnea and snoring: A report of the American Academy of Dental Sleep Medicine","volume":"1","author":"Scherr","year":"2014","journal-title":"J. Dent. Sleep Med."},{"key":"ref_28","first-page":"1","article-title":"Treatment efficacy of a titratable oral appliance in obstructive sleep apnea patients: A prospective clinical trial","volume":"12","author":"Dieltjens","year":"2016","journal-title":"B-ENT"},{"key":"ref_29","doi-asserted-by":"crossref","first-page":"521","DOI":"10.1016\/j.jds.2021.07.017","article-title":"Effects of a novel oral appliance on snoring in adults: A pilot study","volume":"17","author":"Kao","year":"2022","journal-title":"J. Dent. Sci."},{"key":"ref_30","unstructured":"(2025, January 10). Nature Dental Clinic. Available online: https:\/\/alliswell.tw\/?lang=en."},{"key":"ref_31","doi-asserted-by":"crossref","first-page":"173","DOI":"10.1016\/j.jbmt.2016.11.003","article-title":"Defining the fascial system","volume":"21","author":"Adstrum","year":"2017","journal-title":"J. Bodyw. Mov. Ther."},{"key":"ref_32","doi-asserted-by":"crossref","first-page":"81","DOI":"10.1007\/s11325-021-02359-3","article-title":"Validation of snoring detection using a smartphone app","volume":"26","author":"Chiang","year":"2022","journal-title":"Sleep Breath."},{"key":"ref_33","doi-asserted-by":"crossref","first-page":"463","DOI":"10.5935\/1984-0063.20220068","article-title":"Correlation between snoring sounds and obstructive sleep apnea in adults: A meta-regression analysis","volume":"15","author":"Chiang","year":"2022","journal-title":"Sleep Sci."},{"key":"ref_34","doi-asserted-by":"crossref","first-page":"557","DOI":"10.1016\/j.rmed.2003.11.017","article-title":"Risk factors associated with habitual snoring and sleep-disordered breathing in a multi-ethnic Asian population: A population-based study","volume":"98","author":"Khoo","year":"2004","journal-title":"Respir. Med."},{"key":"ref_35","doi-asserted-by":"crossref","first-page":"63","DOI":"10.1007\/s11325-009-0319-6","article-title":"Risk factors for snoring among Japanese men and women: A community-based cross-sectional study","volume":"15","author":"Nagayoshi","year":"2011","journal-title":"Sleep Breath."},{"key":"ref_36","doi-asserted-by":"crossref","first-page":"1","DOI":"10.1007\/s11325-006-0084-8","article-title":"Review of oral appliances for treatment of sleep-disordered breathing","volume":"11","author":"Hoffstein","year":"2007","journal-title":"Sleep Breath."},{"key":"ref_37","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1001\/jamainternmed.2015.2051","article-title":"Oral Appliance Therapy in Patients With Daytime Sleepiness and Snoring or Mild to Moderate Sleep Apnea: A Randomized Clinical Trial","volume":"175","author":"Marklund","year":"2015","journal-title":"JAMA Intern. Med."},{"key":"ref_38","doi-asserted-by":"crossref","first-page":"150","DOI":"10.1111\/j.1365-2869.1995.tb00205.x","article-title":"Basic Nordic Sleep Questionnaire (BNSQ): A quantitated measure of subjective sleep complaints","volume":"4","author":"Partinen","year":"1995","journal-title":"J. Sleep Res."}],"container-title":["Medicina"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/893\/pdf","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,9]],"date-time":"2025-10-09T17:32:29Z","timestamp":1760031149000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.mdpi.com\/1648-9144\/61\/5\/893"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,5,14]]},"references-count":38,"journal-issue":{"issue":"5","published-online":{"date-parts":[[2025,5]]}},"alternative-id":["medicina61050893"],"URL":"https:\/\/doi.org\/10.3390\/medicina61050893","relation":{},"ISSN":["1648-9144"],"issn-type":[{"type":"electronic","value":"1648-9144"}],"subject":[],"published":{"date-parts":[[2025,5,14]]}}}