To compare the effectiveness of a mandibular repositioning splint (MRS) and nasal continuous positive airway pressure (CPAP) device as first-line treatments for disruptive snoring.Prospective randomized crossover trial.Twenty snorers received 3 months of treatment with both an MRS and nasal CPAP. Snoring Outcomes Survey (SOS), Snoring Bed Partner Survey, and Epworth questionnaires were completed serially. Changes in questionnaire scores were analyzed with a general linear statistical model and by analysis of variance.There was a significant difference between the three preference outcomes for the mean SOS changes (P = 0.003). The mean SOS change was significantly greater for those who preferred MRS to CPAP (mean score difference, 27.15). Eight snorers chose final long-term MRS treatment, five chose nasal CPAP, and seven chose neither.The majority of disruptive snorers can be managed effectively with conservative treatments and therefore avoid surgery.