Effectiveness of the Er:YAG Laser in Snoring Treatment Based on Systematic Review and Meta-Analysis Results

Background: Snoring and mild to moderate obstructive sleep apnoea (OSA) are common sleep-related breathing disorders with increasing demand for minimally invasive treatment options. This study aimed to systematically evaluate the efficacy and safety of erbium:yttrium-aluminium-garnet (Er:YAG) laser therapy for these conditions. Methods: A systematic review and meta-analysis were conducted in line with PRISMA guidelines. Studies published between 2015 and 2025 were retrieved from major biomedical databases based on predefined inclusion criteria. Data were extracted on treatment outcomes, laser parameters, patient characteristics, and adverse effects. Results: Fifty-six studies were included. Er:YAG laser treatment, particularly in non-ablative SMOOTH and long-pulse modes, significantly reduced snoring intensity and improved subjective sleep quality. High patient satisfaction (65-85%) and a favourable safety profile were observed, with adverse effects generally mild and transient. Therapeutic effects typically lasted 12-24 months, though 25-40% of patients required maintenance sessions. Treatment success was associated with BMI, oropharyngeal anatomy, smoking status, and baseline apnoea-hypopnoea index scores (AHI 5-30 events/hour). Conclusions: Er:YAG laser therapy appears to be a safe and effective short- to medium-term treatment for selected patients with snoring or mild to moderate OSA. Optimising patient selection and treatment protocols may enhance long-term outcomes. Based on moderate-quality evidence for the immediate effects and safety profile, but low to very low quality evidence for long-term outcomes, erbium:yttrium-aluminium-garnet laser treatment appears to be a potentially effective and well-tolerated option for achieving short- to medium-term improvement in carefully selected patients with primary snoring or mild to moderate obstructive sleep apnoea. The practical significance of these findings lies in the refinement of candidate selection criteria, laser parameter settings, and the development of optimal protocols for long-term snoring control.