photonics hv Article Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients Isabelle Fini Storchi 1 , Massimo Frosecchi 1 , Francesca Bovis 2 , Angelina Zekiy 3 , Stefano Benedicenti 1 , Andrea Amaroli 1,3, * ,† and Robert A. Convissar 4,†   Citation: Fini Storchi, I.; Frosecchi, M.; Bovis, F.; Zekiy, A.; Benedicenti, S.; Amaroli, A.; Convissar, R.A. Snoring and Sleep-Related Symptoms: A Novel Non-Invasive 808 nm Wavelength Diode Laser Non-Ablative Outpatient Treatment. A Prospective Pilot-Study on 45 Patients. Photonics 2021, 8, 69. https://doi.org/10.3390/ photonics8030069 Received: 4 January 2021 Accepted: 24 February 2021 Published: 3 March 2021 Publisher’s Note: MDPI stays neutral with regard to jurisdictional claims in published maps and institutional affil- iations. Copyright: © 2021 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/). 1 Department of Surgical Sciences and Integrated Diagnostic (DISC), University of Genova, Largo R. Benzi 10, 16132 Genova, Italy; ifinistorchi@gmail.com (I.F.S.); frosecchi@aim.com (M.F.); benedicenti@unige.it (S.B.) 2 Department of Health Science (DISSAL), University of Genoa, Via Pastore 1, 16132 Genoa, Italy; francesca.bovis@gmail.com 3 Department of Orthopaedic Dentistry, First Moscow State Medical University (Sechenov University), Trubetzkaya Street, 8, Bldg. 2, 119991 Moscow, Russia; zekiy82@bk.ru 4 Laser Dentistry, New York Presbyterian Hospital-Queens, 56-45 Main Street, Flushing, NY 11355, USA; LaserBobDDS@gmail.com * Correspondence: andrea.amaroli.71@gmail.com † These authors contributed equally. Abstract: Background: Surgical treatments for snoring and sleep-related symptoms are invasive, may have complications, have inconstant success rates, and may have a significant relapse rate. Methods: We evaluated the effectiveness of a non-surgical, non-invasive outpatient 808 nm diode laser treatment. Forty-five patients with snoring and sleep disorders were treated with an Elexxion- Claros ® 50W Diode Laser 808-nm using the specific SNORE3 application. The possible presence of obstructive sleep apnea syndrome in patients was diagnosed with Polysomnography. The Epworth sleepiness scale was reported pre- and post-laser treatments. Patients were classified according to both Friedman tongue position and Mallampati classification. During treatment, the pain reported by patients was measured on a visual analogue scale. Results: The following data improved significantly: visual analogue scale for the loudness of snoring, Epworth sleepiness scale, waking up during sleep because of snoring, dreaming during the night, dry mouth on awakening, daytime sleepiness, tiredness on awakening, Mallampati score, Friedman tongue position and degree of oropharynx at nose, oropharynx, hypopharynx, and larynx classification (p < 0.001). A cessation of choking in 89% of the patients and of restless legs syndrome in 83% of the patients (p ≤ 0.005 and p ≤ 0.025) was also noted after the laser treatments. All of the patients who reported suffering from headaches upon waking (10 subjects) reported the complete cessation of this phenomenon after laser therapy. Conclusions: diode laser treatment is a promising procedure not only in reducing the loudness of snoring, but also in raising the global quality of sleep, a statistically significant reduction of AHI, and a cessation of bothersome phenomenon related to apnea. Results were sustainable at one year post-treatment. Keywords: obstructive sleep apnea syndrome; snoring; polysomnography; sleep disorder; diode laser 1. Introduction Sleep is mandatory for human life and optimum functioning of the human body and its organ systems [1,2]. Snoring can be dangerous for patients because it can generate an obstructive sleep apnea syndrome (OSAS), or mask an existing OSAS, which is correlated with several cardiovascular [3], neurologic [4], psychiatric [5], and metabolic disorders [6]. OSAS affects 1–5% of children 2–8 years of age [7,8]. In adults, moderate–severe OSAS affects 23.4% of female and 49% of male subjects, and these data may increase with aging and weight Photonics 2021, 8, 69. https://doi.org/10.3390/photonics8030069 https://www.mdpi.com/journal/photonics