Mouth taping is one of many approaches marketed aggressively for snoring and obstructive sleep apnea without careful scientific evaluation. There is some evidence that mouth breathing can be associated with increased overall airway resistance and narrowing, both of which are unfavorable. The more-important question is whether closure of the mouth – possibly with mouth taping or chin straps – is helpful to treat snoring or obstructive sleep apnea.

It depends…and mouth closure can make things worse

A recent research study published in JAMA Otolaryngology – Head and Neck Surgery from Phillip Huyett, MD and teams at Mass Eye and Ear and Brigham and Women’s Hospital suggests that the impact of mouth closure on breathing in patients with obstructive sleep apnea depends on how much mouth breathing they are doing.

They examined 54 study participants during drug-induced sleep endoscopy, using masks to separate breathing through the nose vs. mouth and then connecting sensors to measure airflow separately. They closed the mouth and allowed it to open on alternating breaths, comparing breathing through the nose and mouth separately as well as the total airflow (nose plus mouth). On average, there was an increase in airflow with mouth closure, but the findings were much more interesting than just that. Study participants who had their mouth open but little airflow through their mouth did not have a change in airflow with mouth closure. Those with a moderate amount of airflow through their mouth had an increase in total airflow with mouth closure, whereas those with a high amount of airflow through their mouth had a decrease in total airflow with mouth closure!

Why exactly would the effect of mouth closure vary so much?

The answer came down to the degree and type of blockage behind the soft palate: what I call the Palate Region on my website. Those with substantial blockage in the Palate Region were more likely to have little nasal breathing and mainly mouth breathing before mouth closure. For them, closing the mouth blocked their main pathway for breathing, reducing total airflow. The only potential exception occurred if the blockage was related to enlarged tissues along the sides of the throat, as mouth closure seemed to stabilize the sides of the throat somewhat.

Those without substantial blockage in the Palate Region had improvement in total airflow with mouth closure, as mouth closure opened the airway more fully. Finally, if there was less blockage of breathing in the Palate Region had no change in total airflow with mouth closure.

When should mouth taping or a chin strap be helpful?

The short answer is that we do not know. However, there are a couple of key takeaways”

• Mouth taping or chin straps should not be recommended for all patients with obstructive sleep apnea, as it could be harmful. Their use in obstructive sleep apnea should be based on patient evaluation and discussion with a health care provider.
• Mouth taping or chin straps can be tried in patients with snoring who have sleep studies showing no obstructive sleep apnea, as the likelihood of harm seems low.
• Mouth taping or chin straps may have a role in treatment of snoring and obstructive sleep apnea, either alone or in combination with other therapies. Further research can enhance our understanding and identification of optimal treatment strategies.