Definition of severity, management, and follow-up of isolated snoring in adults: An international consensus.

Abstract

Introduction: Isolated snoring (IS), defined by nocturnal upper airway vibration without apneas, remains a prevalent yet underrecognized condition lacking standardized definitions for severity and management. Despite its significant impact on bed partners' sleep quality and social life, no consensus exists on severity criteria or follow-up practices. This international Delphi consensus aimed to define IS severity, address the management of nasal comorbidity, and establish follow-up protocols to support personalized patient care.

Methods: A two-round Delphi process was conducted from December 2024 to April 2025, involving 35 otolaryngology experts from 16 countries. Thirty-nine initial statements were developed by a steering committee and evaluated using a 9-point Likert scale. Consensus was defined as≥75% agreement.

Results: Of 58 evaluated statements, 44 reached consensus. IS severity was associated with frequency of snoring, bed partner's complaints, and impact on the couple's quality of life, while objective acoustic parameters alone were not deemed reliable indicators. Nasal obstruction was recognized as a treatable comorbidity that may be assessed before snoring management. Personalized management using validated subjective tools was strongly recommended. For follow-up, expert consensus supported a 3- to 6-month reassessment using smartphone apps or quality-of-life metrics, with distinctions made between clinical and research goals.

Conclusion: This consensus supports a patient- and partner-centered approach to IS. It discourages reliance on isolated acoustic data for severity grading, promotes proactive management of nasal factors, and highlights the need for individualized treatment strategies. Future research should aim to validate objective and subjective tools to further standardize care pathways for IS.