Mouth Taping During Sleep

Sree Roy: Hello and welcome. I’m Sree Roy with Sleep Review, and I’m thrilled to be here with clinical sleep educator, Teresa Power DeNike, BS, CCSH, the founder of Sleep Better NYC. Her expertise is in sleep apnea, sleep hygiene, and mindset for sleep and overall wellbeing. After 14 years in healthcare sales and consulting, Teresa witnessed countless family, friends, and patients struggle through the typical pathways for sleep support. Her coaching company was founded as a solution. Teresa has served as a subject matter expert for the AAST, BRPT, AASM, and DentistryIQ.

We are chatting about mouth taping during sleep.

Teresa, what exactly is mouth taping during sleep? Are there certain products designed for it or do people use just any kind of tape?

Teresa Power DeNike:
That is a great question. It sounds so simple too, but this has been coming up so much and I’d say especially in the last two years, not just from consumers and patients but also on the clinical side because there is so much talk about it.

In short, mouth tape is exactly what it sounds like. It’s using tape to keep your lips closed during sleep, to improve healthy breathing, and to reduce snoring that’s caused by mouth breathing. The goal of mouth tape is to encourage nasal breathing, to optimize oxygen consumption, increase production of nitric oxide, not to mention of course the oral health benefits of keeping your mouth closed during sleep.Now it’s not just using scotch tape, certainly not duct tape or anything like that, although people have asked. There are a lot of different products on the market. Some people will simply use medical tape, which seems to be fine. Of course there are some things to note about these products and the materials. I would always recommend medical-grade tape to make sure that you’re not going to have an allergic reaction to the adhesive. You don’t want to use an adhesive that’s so strong that’s going to pull your skin or cause damage.

Typically products that are specifically designed for mouth taping will fit passively. They might even have an air hole. I actually really like this one brand that has an H-shape to it and this will allow for some air, some movement, to make it a little more comfortable to reduce that trapped feeling or claustrophobia, for example.

Sree Roy: How has the practice of mouth taping evolved in popularity over the years? It seems to be a sleep trend on social media nowadays, but I suspect you may have heard of it long before.

Teresa Power DeNike:
It is trending. I feel like it comes in waves too. Every few months there’s a new TikTok or something about it. It has changed a bit over the years. I have a love-hate relationship with the idea of mouth taping for sleep.

Aside from sleep, I have seen it used in various forms, mouth taping to be used for myofunctional therapy, in breath work exercises, even during exercise or yoga practice to in theory increase oxygen and help with focus. For that reason, that’s cheap, quick fix. I do like it because it generates a lot of conversation around healthy breathing and healthy sleep habits, which in my opinion is always a good thing.

On the other hand, especially now with you being able to say pretty much anything you want on social media, I see a lot of products that are saying that they can cure snoring, or people might be using it to cover up mouth breathing snoring, which we know is often a sign of sleep apnea. So obviously that can be really dangerous for people, especially if they haven’t been tested or if they don’t even have the ability to breathe properly through their nose.

Sree Roy: Is there any evidence that mouth taping during sleep is useful for healthy sleepers, that is, people without any sleep disorders?

Teresa Power DeNike:
Yes, a little bit. So there is a ton of anecdotal information out there and success stories and testimonials. I do tend to believe that most of these reports are true given the idea that these people are breathing through their nose and not their mouth. In general, they’re healthy or they are not having sleep disorders.
There are several studies and legitimate research papers on the health benefits of nasal breathing and regarding nitric oxide filtration, oxygen levels, things like that. But they don’t always directly correlate to using the mouth tape. I did come across a study that confirmed a little bit of an increase of deep sleep in healthy people and another study back in, I believe it was 1999, that showed a little bit of an increase in REM sleep. From what I’ve seen and maybe it’s a little bias because it is more relevant to my practice, I actually see a little bit more research on using mouth tape as a supplement to other OSA treatments.

Sree Roy: Let’s talk about that. What evidence if any, is there that mouth taping is useful for people with any sleep disorders, including perhaps as an add-on to a device such as an oral appliance for sleep apnea?

Teresa Power DeNike:
I really like this idea. I do feel like people are a little uncomfortable sometimes mixing consumer products and medical devices. But again, it’s there and people are asking about it so we have to keep an open mind. I think that mouth tape and airway exercises and even nasal strips or sprays, these can all be helpful for increasing the success of these OSA therapies that are proven to be effective.

There is a study from 2020 that showed a reduction in AHI and leakage due to mouth opening during nasal CPAP therapy when they were using a tape-like product. I think it was technically called a shield but it was some sort of mouth tape. And that same study actually showed an increase in the amount of deep sleep as well in these subjects when they were using a nasal mask and mouth taping versus a full face mask without tape.

There is another one, I believe it was 2022, so it’s even more recent. This involved patients with mild sleep apnea. So these patients experienced a significant reduction in snoring. About 65% of them had a decrease in their AHI of about 50%, which is pretty significant but again they were mild. So we have to remember that’s like an AHI of 8 going down to 4. Now, if you start as a mild patient, your bed partner is appreciating that snoring reduction and maybe your symptoms improve even though those are low numbers. But that study did indicate in the results that it should be considered an option for mild patients if for whatever reason they can’t tolerate CPAP or oral appliance therapy, or they don’t want some kind of surgery.

So for mild, there is definitely some research that can be beneficial for using mouth tape.

Sree Roy: What, if any, dangers are associated with mouth taping during sleep?

Teresa Power DeNike:
I mentioned a little bit before and I feel like this might be obvious to clinicians. But the biggest danger I see is really in those who use mouth tape to cover up the signs of sleep apnea, which means that they’re going to continue to go undiagnosed and untreated. Dr. Weiss in Buffalo recently advised that mouth taping can actually worsen sleep apnea by making breathing more difficult. By holding the mouth closed, even if it’s passively, we might be reducing that patient’s ability to gasp for air during these apneic events. Especially if the patient can’t breathe properly through their nose, this will put an incredible strain on their cardiopulmonary system. So there’s that.

Clearly we want people to be diagnosed with sleep apnea, these are signs of sleep apnea and then of course there’s temporary concerns about allergic reactions or the feeling of claustrophobia.

Sree Roy: And I keep seeing this come up more and more frequently these days. So what is your advice to sleep techs for how to handle the situation when they’re doing an in-lab sleep study and they have a patient who wants to use mouth tape during an in-lab sleep study? Does it make a difference to you whether it’s a diagnostic study or a titration sleep study that they want to use the mouth tape for?

Teresa Power DeNike:
I think that’s such a good question. I’ve actually spoken to a few sleep techs recently about this. I think for the most part we all agree that we’re looking for the most typical night of sleep during testing. So if a typical night for a patient includes mouth tape almost every single night, then yes it definitely makes sense to use mouth tape during the study.

If we’re trying to relate it to something else, just like having a side sleeper sleep on their back in an in-lab study, we might find more apneic events if they don’t use mouth tape and they typically do. Then again those scenarios are not indicative of a typical night for this patient. I think it’s really just a decision to discuss with your medical director.

But in regards to in-lab testing, techs are using chin straps all the time. Even though it’s a different product, it’s the same general mechanism to keep the mouth closed during sleep and breathing. In fact, if you really think about it, mouth tape will most likely be more effective at keeping the mouth and the lips closed. You won’t have that puffing and that strong exhalation where their lips vibrate if you’re using mouth tape versus a chin strap.

Sree Roy: And what is your advice to sleep medicine professionals if their patients confide in them that they use mouth tape either with or without their prescribed device to treat a sleep disorder?

Teresa Power DeNike:
I would say first and foremost, make sure that the patient has a healthy nasal passageway. I think all forms of sleep breathing therapy benefit from proper nasal breathing, especially when the mouth is taped closed. If that patient is seeing you as a sleep professional, I’m assuming you’ve already considered their oral health and airways.

So you really just need to be clear in the expectations with the patient. Be clear that mouth tape is a supportive accessory and not a treatment product or a form of therapy even though it can work. And there again is some data to back it up. You just don’t want your oral appliance patient to see it as a substitute, or your CPAP patient to go on vacation and leave it at home because they have some mouth tape in their bag.

Sree Roy: Great points. Do you have any social media handles, links, or any other resources that you’d like to share with our audience?

Teresa Power DeNike:
Yeah, I have a social media Instagram that is very patient-facing. It breaks down a lot of things to make it easier for patients and consumers to understand. That is @sleepbetternyc, no dots or spaces or underlines. And then you can find our page on LinkedIn. Again, it’s Sleep Better NYC and that is definitely more of what we do in the clinical world.

Sree Roy: Fantastic. Well thank you so much for chatting with us about mouth taping during sleep.
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