The lay press can be quick to jump on reports in the medical literature, especially when it comes to snoring and obstructive sleep apnea. This has positive and negative impacts, but one of the downsides is that the public can read an article and misunderstand the findings. Companies with products described in medical articles can exaggerate the findings, leading many patients astray in the search for a simple, cure-all.
Chin straps (shown below) are commonly used to treat patients with obstructive sleep apnea who open their mouth during use of positive airway pressure therapy. Opening the mouth allows air to escape from the mouth when a patient is wearing a mask over their nose or with inserts that extend into the nostril (nasal pillows). However, they are not used often as treatment by themselves. An article published in 2007 in the Journal of Clinical Sleep Medicine showed that a single patient with sleep apnea experienced resolution with wearing a chin strap (shown below). Since that time, I have seen a number of patients with sleep apnea come in and report that they have tried a chin strap after being unable to tolerate positive airway pressure therapy. This is in addition to many patients with snoring (but without sleep apnea) who have tried a chin strap unsuccessfully after searching on the Internet and looking for solutions.
Do chin straps improve sleep apnea? Unfortunately not so much.
The August 2014 issue of the Journal of Clinical Sleep Medicine included an article reporting results from a study of using chin straps to treat obstructive sleep apnea. In 26 patients with obstructive sleep apnea, there was no improvement in any measure of obstructive sleep apnea or snoring. The authors evaluated different components of sleep to see if certain patients might benefit. For example, a change in the degree of sleep apnea during rapid eye movement (REM) sleep or while sleeping on one’s back (supine) might suggest that patients with sleep apnea limited to these situations would be ideal candidates for a chin strap. Unfortunately, there were no improvements in these either.
The bottom line is that chin straps do not appear to be viable treatment treatment options for most patients with sleep apnea. This study did not include patients with snoring who did not have sleep apnea. My personal experience is that patients with snoring or, to a much lesser extent, sleep apnea who are mouth breathers during sleep (especially if the snoring occurs only when mouth breathing) can do well with chin straps as part of their overall treatment plan. However, those patients are less common than we might believe by looking at online advertisements. What is missing is that many patients are mouth breathers because they cannot physically breathe through their nose. This is where a comprehensive approach is required, requiring that we open the passageways for breathing in the nose. As in all of medicine, talking to patients (and their bed partners) about their snoring and breathing patterns during sleep can identify those who have substantially worse problems when mouth breathing or especially bad blockage of breathing in the nose. These suggest a possible role for chin straps, often in combination with opening the nose with medications or a procedure.