Reply: Up-to-date data on NightLase laser treatment of snoring for discussion

To the Author,
Although we appreciate the enthusiasm of the author of ‘Up-to-date data on Nightlase laser treatment of snoring for discussion’, we disagree with the content.

Firstly, the conclusion in the Australasian Sleep Association position statement is consistent with a key commentary from a panel of world experts in Kezirian et al.,1 in relation to Er-YAG LASER marketed as Nightlase: ‘without peer-reviewed published studies validating successful outcomes…. we do not recommend this therapy’.

Secondly, the systematic review and meta-analysis2 referenced by Dawson contains only level 4 evidence case series. The authors highlight the many methodological concerns of these studies, and themselves state that ‘randomized controlled trials, objective data, multicentre cooperation and long-term outcomes are needed to confirm the benefits of this laser for snoring’.

Thirdly, it is noteworthy that ‘coblation, radio frequency’ are NOT ‘ablative LASER procedures’ as Dawson inaccurately asserts. There is no LASER in either coblation or radiofrequency.

Finally, we welcome multicentre clinical trials as per Dawson's suggestion. However, such trials require great rigour, ideally including: preliminary multicentre outcomes publications, Equipoise evaluations and Protocol papers3 prior to executing and reporting on such trials.4 None of these have been published to date and more data are required before Er-YAG LASER can be recommended as a treatment for snoring.