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.

35 Responses to “Chin straps are not a solution for most patients with snoring or sleep apnea”

  1. John Micelli

    I use a chin strap to stop snoring, highly effective, and is true that is not helping so much against sleep apnea. Also when I go to sleep I like to drink chamomile tea to relax and sleep better.

    Reply
  2. Michael Wall

    OMG, Why would a chinstrap alone ease symptoms of sleep apnea? I use one to discourage mouth breathing at night, but that is as a part of breathing therapy I am doing or I use one with my CPAP mask depending on which one I use, to avoid dry mouth the next morning. My particular full face mask, of course not only covers my mouth, but (I think) helps to keep it shut. At best a chin strap will just cause you to breathe through your nose, which seems unlikely to treat sleep apnea in my opinion.

    Reply
    • Dr. Kezirian

      Nose breathing is usually better for snoring and sleep apnea, and chin straps can help certain patients. However, that is really the exception and not something where chin straps should be a routine approach to consider for most patients.

      Reply
      • david

        I use a tegaderm film to cover my mouth before I go to sleep–this and the chin strap have helped my sleep apnea immensely

        Reply
        • Kelleen

          Could you use this film in conjunction with a full face mask with cpap machine? I am still snoring because my mouth opens at night. I fear the snore chin strap will be in the way of the cushion on the mask.

          Reply
          • Dr. Kezirian

            Absolutely. You would need to be careful in not interfering with the seal of your mask, however.

        • Kim

          How do you use trader film over your mouth for sleep apnea? How does it work, what do you do?

          Reply
          • Dr. Kezirian

            I am not familiar with this and do not use various approaches to taping the mouth shut. The key really is having your jaw closed and in a position whether the teeth are touching, so it is more than just taping the lips together.

  3. Dan

    >These suggest a possible role for chin straps, often in combination with opening the nose with medications or a procedure.

    No side effects or risk with Breathe Right strips.

    Reply
    • Dr. Kezirian

      There are ways to evaluate whether these would make sense for someone to consider. There are no major risks with these, other than irritation of the skin or nuisance (and some cost). The real issue is that people want to move forward with something that has a reasonable chance of working, especially when we are discussing a potentially serious medical condition like obstructive sleep apnea. We have to look at research and not just marketing materials.

      Reply
  4. ADELE F NEWSOME

    Adele
    i have severe Sleep Apnea and was prescribed a c pap machine. It is bulky and inconvenient for travel, would the chin strap be suitable for travel ?

    Reply
    • Dr. Kezirian

      I have responded to others with a similar question. I would not recommend wearing a chin strap as a stand-alone treatment for sleep apnea.

      Reply
  5. john

    is using only a chin strap safe when you have sleep apnea? is it possible that you stop breathing if you wear a chin strap and breathing through you nose stops due to apnea?

    Reply
    • Dr. Kezirian

      I would not recommend wearing a chin strap as a stand-alone treatment for sleep apnea. What you have described is one of the many reasons. Another reason is that, even if you do not have trouble breathing through your nose, chin straps have not been shown to work in sleep apnea.

      Reply
  6. Peter

    Hi Dr Kezirian,
    I appreciate this post, and your responsiveness to these questions. It’s hard to find a website that ISN’T spruiking these ‘devices’ (that are usually no more than a piece of fabric, but costed $30-200).
    I am a ‘natural’ mouth breather due to my first 18 years of life in a dust-full home (I have dust/mite allergies) – I have taught myself to breathe through my nose during the day (although at times e.g. in Spring can only breathe through 1 nostril) – but my natural position is to breathe through my mouth. At nights I mouth breathe, with dry mouth every morning; and if I drink any alcohol, I often snore (I think due to its relaxant properties?)
    I read that aforementioned study ~2 years ago so decided not to try a chin strap – and I am wary of it giving me sleepless nights due to breathing difficulties – are there any studies on these for non-sleep-apnea snorers, that you know of?
    Thanks in advance,
    Peter.

    Reply
    • Dr. Kezirian

      You probably want to be treated for the allergies or other causes of nasal blockage and then try to do what you can to breathe through your nose rather than your mouth. I do not know of good studies evaluating chin straps for snoring without obstructive sleep apnea, but they might work–if your nose is open for breathing.

      Reply
  7. Barb

    I use a full face mask with memory foam (couldn’t stand the gel) and still find it irritating. I have started wearing a chin strap also b/c my mouth gets very dry so must still be dropping my jaw. The mask itself pushes my cheeks together so the natural tendency is for my mouth to open. The fabric of the chin strap irritates my skin and makes it itchy & red. On the nights that I can get to sleep & stay there–or go quickly back–the combo works well for sleep even though my skin is still irritated in the morning. When it doesn’t work, I can lay awake for hours which is certainly counter productive so eventually I remove it all.

    I would like to know if a natural fabric chin strap combined with nasal pillow will work for me. I am definitely a mouth breather–do so even during the day at times.

    Reply
    • Dr. Kezirian

      You would probably benefit from opening the space for breathing in your nose. As for fabrics, I am not an expert in this. I would recommend looking online or contacting a medical equipment company.

      Reply
  8. Carroll Seigars

    I can tell you after 20 years of severe obstructive sleep apnea ( good doctors bad doctors, sleep study after sleep study) that there is no cure except possible throat surgery with a long recuperative time and with no guaranty of success. All you can do is safely manage it by trial and error. My jaw falls open as well and gives me terrible dry mouth which forces me to drink about 10 times per night and it affects your sleep cycles terribly. The C-pap or C-flex machines run out of humidified water vapor within 3 hours. All that I have tried, (at an absurd price)share that same problem of inadequate water supply. Also, one doctor told me I had central brain apnea and the other said obstructive apnea. I know that it is obstructive because I can feel and hear it catch on the exhale. Not my brain. I have found that a chin straps combined with your c-pap will work fairly well. The problem is that purchased chin straps do not have enough elastic holding power to keep my jaw from falling open. Answer: I have had to have my wife sew extra wide elastic material to make the chin strap powerful enough to hold my jaw closed. It’s not 100% perfect, but it the best solution I have found.

    Reply
    • Charles Graham

      I have not slept in years i am 29 and because of the lack of sleep i feel like im in my 70’s the way i nod off in front of company i feel like a drug addict… ive had countless issues with my CPAP machine and being the rebel that I am I just wouldn’t wear it so they finally got me to use the nostril pillows but my mouth kept opening I noticed so once again I just stopped wearing it but now it’s getting to the point where every night I’m waking up gasping for air I can’t sleep in the bed with my girlfriend because I feel like I’m disturbing her sleep and I’m just pretty much fed up at this point I’ve went on so many different articles online WebMD everywhere and it’s all about marketing finally I come here and I read through most of the comments and I come across this one I’ve always wondered if chin straps would work along with the nostril pillows for the CPAP machine and I’m not a rocket scientist but I figured common sense would show that if the jaw would stop opening while there’s a constant flow of air being pushed through your nostrils there would be nowhere for the air to escape end result you will have if not a perfect night sleep at least a decent night and it would be beneficial towards your sleep apnea treatment now the only issue with that is to find a chin strap that is not only strong enough to hold the jaw shut but also not too much to break your pockets hearing that you have tried this has given me some hope that maybe I can actually get some sleep again…..
      Thank you.
      Charles

      Reply
  9. Deborah Tapper

    A simple test for everyone. Mouth open, easy to make the snoring sounds. Shut your mouth, impossible or very difficult to make the snoring sounds. Mouth breathing develops in children who suffer allergies that block their noses and sinuses. That was me. I am watching my 15 yr old boy closely. Asthma, allergies. My own father had all teeth removed by 28, and dentures. Big allergy sufferer, hayfever, mould, dust, cats. I would watch his subconscious jaw clenching as a child when he read the paper. Mouth breathers allow oxygen in that feeds the cavity making bacteria. Growing faces develop differently. Narrow arches, crowded back teeth. I suffered tooth decay, root canals, 3 teeth implants….all this from mouth breathing. Through my youth, 20’s, 30’s, 40’s often waking with headaches from teeth grinding. Disturbed sleep. Some say grinding teeth is a way to jolt the sleeper to breathe again….it’s all connected. Now I mouth tape AND wear a chin strap. A lifetime of clenching means my jaw sometimes still aches, like a biofeedback thing, but I sleep soundly, never stir, my anxiety has diminished, my mouth is ‘sweet’ when I remove the tape. There is a different exchange of gases happening with air intake through the nasal passages that requires less oxygen in the lungs through the long night. Mouths are for eating. Noses for breathing. None of my ‘issues’ are around excess weight. I’m a petite 5’2 EX mouth breather. Magnesium glycinate also helps me relax the jaw and to sleep.

    Reply
    • Dr. Kezirian

      I am so glad you are doing much better now with the mouth tape and chin strap. I believe I mentioned in the post that I think chin straps have a definite role for selected patients. In fact, I recommend them to certain patients. However, the idea that they are a cure-all for most patients with snoring or obstructive sleep apnea has been disproven pretty clearly.

      Reply
  10. Alan

    I find the CPAP very uncomfortable and experiance a Common problem that I have read in these Comments being the irritation from the mask and dry mouth, surly the manufactures of the CPAP can come up with a better face or Nasal mask, as I have often heard it describerd ( the dreaded CPAP).
    I have found that using a bed wedge combined with a chin strap has worked wonders for me, the bed wedge seems to stop the closing of the muscels in the throat by elevating my upper body at an angle and the Chin strap stops the dry mouth.

    Reply
    • nicky melville

      I too use a wedge pillow and put a special anti-snoring pillow on top of the wedge and it does seem to work. Imean, I haven’t been tested, but before I did this I used to wake every night gasping for air and had the most horrible nightmares that I was under water and couldn’t breathe and horrid things like that. I haven’t had that since I have used the wedge pillow etc. I tried gamely for two whole years with a CPAP machine and it drove me totally demented! I am afraid that I used to crudely call it my CRAP machine! it was SO uncomfortable and my sleep got worse and worse and I actually started to get claustraphobic even though I am normally a very placid and calm person. I think that I might try the chin strap as occasionally I find that I have turned onto my back in my back in my sleep and am not quite sure if my airway is being blocked or not. Do you think a chin strap as well might help a bit, just to make sure?

      Reply
      • Dr. Kezirian

        Chin straps may help if you are mouth breathing at night – but only use them if breathing through your nose is relatively open! Of course, you do want to be sure that these are helping you feel better and also conrolling your sleep apnea, so I would remain in contact with your doctor to see if you might need a sleep study using these treatments.

        Reply
      • Norma

        Nicky
        Could you please tell me the name of the special anti-snoring pillow?
        Thank you.

        Reply
        • Dr. Kezirian

          There is no special anti-snoring pillow. I would never buy a pillow specifically for this. If you want, you can use any pillow in a position that tilts your head back slightly.

          Reply
  11. Inge Bock

    I am only new to sleep apnea , coming up 12 months. At the beginning it worked wonders for me , but now I find I wake up a lot through the night and feel tired throughout the day , not as bad as I use to be , but I know it has declined . My biggest problem is my chin strap , I find the chin strap sits in the grove under my lip but does not keep my mouth from opening . If I pull it up a bit and really tight I get headaches , and now the top of my head feels like it is bruised . I have been trying to design a better chinstrap , but have not been successful , I have an idea but am not smart enough to make it , but will keep trying ..

    Reply
  12. JOHN HALL

    I HAVE BEEN USING CPAP FOR 25 YEARS AT PRESENT IAM HAVING TROUBLE WITH MY MOUTH DROPPING OPEN . I HAVE USED ALL DIFFERENT CHIN STRAPS THAT ARE NOT HELPING. CAN SOMEONE PLEASE OFFER A BETTER SOLUTION. JOHN H

    Reply
  13. Rick

    I have been diagnosed with OSA and have had terrible sleeping patterns and chainsaw snoring so bad that moving to another room was not enough for my partner to get any sleep. About 3 weeks ago, I quit smoking. My partner and I were talking about the snoring and gasping during my sleep and it was pointed out that when I breathe through my nose and not my mouth, I make no noise and do not gasp for air. I started using Flonase every night before bed and the Breathe Right strips. These in addition to my no longer smoking has in effect cured my sleep apnea. I no longer wake my partner during the night, I have so much energy now and I no longer feel the need to nap during the weekends or after coming home from work. I do believe the key was to cease with the cigarettes, first and foremost.

    Reply
    • Dr. Kezirian

      I am so glad that you quit smoking and that it improved your breathing during the day and night so much. Congratulations! This is fantastic.

      Reply
  14. David W

    Hello Dr. Keririan, Over the past year I’ve been dealing with waking up tired and significant fatigue though-out the day. After having many blood test done, I also completed two sleep studies. Both coming back with mild sleep apnea. However, my oxygen level did drop to 84% occasionally thought out the night. My question is, I’ve been using a cpap machine for a few weeks at a very low advised setting 4.0-6.5. Using only the nasal mask. At such a low setting would a chin strip help with a cpap machine or could I possibly use it without the machine. And, if the cpap therapy isn’t working do you have any advice on who to see to advance my issues. Thx you very much for your help.

    Reply
    • Dr. Kezirian

      If CPAP is not working for you, then seeing a sleep surgeon to consider alternatives can make complete sense. You are asking some specific medical questions. Answering them properly would require an evaluation and discussion of what be helpful for you. I do provide online consultations (for example, using Skype), but an in-person evaluation would be even better if that is straightforward for you. Please feel free to e-mail me directly if you are interested in an evaluation.

      Reply

Leave a Reply

Your email address will not be published. Required fields are marked *