A TV ad for acupressure sleep aid company Goodnightsnoring.com was seen on 24 April 2017. The ad opened with a female presenter describing the “Good Night Ring” sleep aid. She said, “Hi there, I’d like to tell you about the recent Good Night Ring user trial which involved 136 couples. Let me give you some more amazing facts about the good night user trial. 80% of snorers would recommend the ring to other snorers.” This statement also appeared as on-screen text.
The ad then cut to a man and a woman sitting together. On-screen text stated “82% of partners felt more refreshed after 14 days”. Smaller text beneath that stated “Real testimonials represented by actors”. The woman said, “I feel so much more refreshed in the morning I would recommend it to anyone whose partner snores.” Further on-screen text said, “79% of partners would recommend it”.
The ad then cut back to its presenter who said, “So why not buy one today, risk free, and see if the Good Night Ring could help you.”
The complainant, who believed the ad gave the impression that the Good Night Ring was scientifically effective for treating snoring when they understood it was not, challenged whether the claims were misleading and could be substantiated.
Cumbre International Ltd t/a Goodnightsnoring.com said the ad’s script was based on an independent user trial, conducted in 2015, where over a 14-day period 136 healthy adult male and female snorers and their partners were interviewed about the efficacy of the ring.
Goodnightsnoring.com said Clearcast had advised that a perception-based study (the user trial) was an acceptable method to gather supporting evidence and would not mislead consumers. They said that they exceeded 100 participants in order to ensure validity of the data produced by the study.
Goodnightsnoring.com said the on-screen text and voice-over clearly stated the evidence supporting the claim was based on the perception of the participants and therefore did not imply scientific efficacy. They said the ad did not claim the Good Night Ring treated snoring or sleep apnoea.
The user trial participants were all between the ages of 18 and 70 years old and had partners who regularly shared their bed and noticed their snoring. Subjects were directed to use the Good Night Ring following the on-pack instructions. Goodnightsnoring.com compared the responses of snorers and their partners after one day’s and 14 days’ use. The snorers and their partners were asked to complete a questionnaire that asked about sleep quality and snoring. After 14 days of use, 86.7% of snorers said they enjoyed a better night’s sleep while wearing the ring; 80.15% would recommend the ring to other snorers; 82.35% of partners said they noticed the snorer snored less frequently after 14 days; and 80.15% reported a lower volume of snoring.
Goodnightsnoring.com also submitted a randomised, double-blind, cross-over trial that involved 40 (39 after exclusion) participants, to substantiate that the Good Night Ring was effective at treating snoring. The results of a Mori customer telephone survey were also submitted.
Clearcast advised Goodnightsnoring.com that testimonials could be used as expressions of subjective opinion but could not be used to make or imply factual claims which were not supported by sufficient evidence. References such as ‘it worked for me’ or ‘I slept better’ were rejected from earlier drafts as viewers were likely to interpret those claims as indicative of the Good Night Ring’s efficacy. Words such as ‘stop’, anti’, ‘treat’ and ‘reduce’, etc. were also rejected for the same reason. Clearcast asked Goodnightsnoring.com to concentrate instead on perceptive claims such as ‘I feel …’ or ‘It seemed …’.
The ASA noted that the ad began with a clear indication that the data was based on a user trial of 136 couples. We considered that consumers would therefore understand that the claims that followed were based on the responses of the user trial.
We noted that the ad contained two “recommended” claims: that “80% of snorers would recommend the ring to other snorers” and that “79% of partners would recommend it”. We considered such recommendations were clearly related to the opinions of the participants in the user trial. However, as the only advertised purpose of the ring was to prevent snoring, we considered that those claims also implied that the ring was effective in the treatment of snoring.
We considered that the on-screen claim “82% of partners felt more refreshed after 14 days” would also be interpreted as a reference to the effectiveness of the product in treating snoring, i.e. that they had slept better and were more rested because their partner had been snoring less or not at all.
We noted the results of the user trial, but considered that self-assessment studies did not include control data, bias or recall bias, therefore were unlikely to be acceptable support for claims related to physiological action in humans.
The clinical trial the advertiser submitted involved 39 participants who were equipped with a unit to monitor their normal sleep and measure “baseline” data. Participants were later split into two groups – an active and a placebo. The active group wore the acupressure ring on their index finger (where it was meant to be placed) while the placebo group was told to wear the ring on their little finger. Their sleep was monitored and data was collected from both groups. Twenty participants took part in the active phase while 19 took part in both active and placebo phases.
The subjects also completed questionnaires based on their sleep. The study concluded there was no difference in the placebo and baseline measurements with a statistically significant reduction in the number of “snoring events” and “the average snoring volume in a snoring event” among the active group.
However, we did not consider this was sufficient evidence to demonstrate the product’s efficacy. We considered the number of participants was too small to make conclusions about a larger population; we could not assess how the test result’s statistical significance was calculated; data for only 19 of 39 participants compared placebo and active results; and no discussion was included to assess the limitations or flaws of the test. As the test was conducted among a crossover group as well, we also did not consider it was truly blind. We therefore concluded that the study did not provide sufficient evidence showing that the acupressure ring could be used to treat snoring.
The Mori telephone survey found that 78% of those who participated (153 respondents) claimed the ring had a positive effect on their snoring, a third claimed the ring stopped their snoring completely, the effect was felt quickly, and the benefit appeared to be universal among varying demographics). However, we considered that a telephone survey was not sufficient to substantiate such efficacy claims.
Because we had not seen adequate substantiation to show that the product was effective in the treatment of snoring, we concluded the ad was misleading.
The ad breached BCAP Code rules 3.1 (Misleading advertising), 3.9 (Substantiation) and 11.2 (Medicines, medical devices, treatments and health).
The ad must not appear again in its current form. We told Goodnightsnoring.com not to imply the Good Night Anti Snoring Ring could help treat snoring.