Can mouth tape help improve snoring and apnea treatment?

Today we’ll review what mouth taping is and its effects on improving snoring and apnea treatment.

We will also discuss when it may be best not to use it.

Today’s information is for general educational purposes only. It is always best to consult with your sleep medical provider before any new treatment.

If you are currently using a dental sleep device or CPAP mask to treat obstructive sleep apnea, you may find your mouth dropping open. 

I am often asked – Can mouth tape improve my sleep apnea treatment results or stop my snoring?

This article has been long overdue. I’ve been wanting to share this topic of mouth taping for quite some time. 

What is mouth tape?

Mouth taping, as it sounds, is using some form of tape over the mouth to encourage a mouth to stay closed during sleep.

There are many different types of mouth tapes readily available today.

Now, let’s start when using mouth tape is not a good idea. 

Is mouth tape safe to use?

Many people wrongly assume that if you sleep with your mouth open, it is the cause of your snoring or obstructive sleep apnea (OSA).

Although this may be a common occurrence and may add some validity, many patients who snore and have apnea sleep with their mouths closed.  

On the flip side, many people sleep with their mouths open who do not have obstructive sleep apnea or snore.

Mouth taping is a very controversial topic amongst many professionals that work with sleep breathing disorders. 

Unfortunately, there aren’t many scientific studies on the topic of mouth taping. As a result, many physicians, several sleep organizations, and some myofunctional therapists advise against using mouth tape and do not support its use.

Myofunctional therapists use exercise-based therapy to exercise the muscles of the mouth, tongue and face. The exercises a patient performs are designed specifically to improve breathing, speaking, chewing, and swallowing. 

Yet still, other myofunctional therapists, some dentists, and other medical professionals support mouth taping in various situations. 

I discourage the use of mouth taping in individuals who often snore or sleep poorly but have not been medically evaluated by a medical professional. 

Snoring remains one of the most common symptoms of patients with obstructive sleep apnea. The last thing you want to do is mask a condition that can take years off your life. 

Sleep apnea is an easily treatable condition that, left undiagnosed, can lead to many serious health consequences, including death. 

Talk to a medical provider knowledgeable in sleep disorder evaluations if you snore, have sleep apnea or have had consistent sleep quality issues. They can advise you on if mouth tape is suitable for you.

These articles may be helpful:

What Kind of Physician Should I Seek to Find Out if I Have Apnea? 

What Should You Know BEFORE Getting Medically Evaluated or Scheduled for a Sleep Test?

Why is it important to breathe through your nose? 

Nasal breathing is extremely beneficial in general health and well-being. Whether during awake hours or sleep, it is best to keep your mouth closed and channel air through your nasal passages if possible. 

Why is it better to breathe through your nose?

Breathing through your nose helps filter dust and allergens before entering your body. Your overall oxygen uptake is increased, and your mouth can stay more moist, which helps decrease negative dental health consequences.

Chronic mouth breathing can lead to:

• Dry mouth (which can lead to bad breath, cavities and gum problems)
• Poor CPAP effectiveness
• Decreased effectiveness of oral appliance therapy
• Increase in snoring (with or without associated apnea)

The topic of nasal breathing and mouthtape has been very common because of James Nestor, best-selling author of Breath – The New Science of a Lost Art  

It has stirred up a flurry of discussions on the importance of nasal breathing and the negative impacts of mouth breathing during sleep and when awake.  

(More to come on this fascinating book in an upcoming article.)

How does mouth breathing affect oral appliance therapy?

Regarding my area of expertise, oral appliance therapy for the treatment of snoring and apnea, nasal breathing has been found to increase treatment success rates in a fairly large percentage of individuals. I encourage my patients to try to breathe through their noses when wearing an oral appliance if possible.

For some, nasal breathing will help improve the results of oral appliance therapy. For others, nasal breathing does not influence the outcome of using a dental sleep device.

Why do people breathe through their mouths?

Many individuals who find themselves mouth breathing do so usually because of these reasons:

1. They have difficulty breathing through their noses, and it’s simply easier to breathe through their mouths

The why behind this can vary, often with an airway obstruction somewhere along the air passage by enlarged adenoids, tonsils, nasal polyps, or allergies, sleep apnea and more.

2. They have turned to mouth breathing as a habit
3. When some oral appliances are inserted and the lower jaw is moved forward, it may cause space between the lips
4. When wearing CPAP, it can occur due to positive airway pressure challenges 

Is nasal breathing a necessity for dental sleep appliances?

If you are an individual with difficulty breathing through your nose, a good place to start is to seek medical consultation with your primary care physician.  

Other evaluations may be necessary, such as with an ENT (otolaryngologist) or an allergist or other medical specialist.

Although breathing through your nose is helpful in any treatment for obstructive sleep apnea, including oral appliance therapy, many patients find success with dental sleep mouthguards and breathe only through their mouth during sleep.  

On this note, I don’t require a patient to seek medical consultation before treatment. I mention that a nasal medical evaluation may benefit them down the road as part of a more successful treatment plan if needed.

Again, make sure to talk to your sleep medicine specialist to determine how mouth breathing will impact your treatment plan.

When should I consider using mouth tape?

Mouth Taping with Oral Appliance Patients

For my patients that have already been diagnosed with OSA and do wear an oral appliance successfully, increased or improved results can occur by keeping and sleeping with your mouth closed.

In many individuals, before advancing the oral appliance more protrusive (lower jaw more forward), it may be prudent to address any mouth opening occurring when using the oral appliance. In some of these individuals, keeping their mouths closed can improve their dental sleep device results.

If you currently wear an oral appliance or sleep apnea mouthguard and believe your mouth drops open during sleep or you awaken with a very dry mouth, consider talking with your dental sleep professional regarding using elastics with your device.

Small orthodontic elastics can often be worn with your oral appliance to help keep your mouth closed. The dental mouth guards may have small hooks or clasps that can accommodate these elastics.

In most cases, it’s easiest to place the elastics onto your device before inserting the oral appliance into your mouth. 

Here are a few samples of oral appliances with elastics inserted:

For oral appliance elastics to work in keeping your mouth closed, the oral appliance must fit quite snugly onto your teeth. Otherwise, the elastics may cause your device to lift off your teeth.

In some cases, a patient may need to use heavy gauge elastics or even double them up to keep the mouth from opening.

If a patient does not feel comfortable with this level of oral appliance tightness, or if it is not possible to add elastic accommodating hooks onto your device, mouth tape may be a helpful tool to keep your mouth closed during oral appliance therapy.

Mouth tape can be a helpful, comfortable tool to help keep your mouth more closed when wearing a dental sleep appliance.  

In some situations, when deeper snoring is eliminated, the person sleeping can have a different “tune” like purring or puffing. Mouth tape can help decrease these lighter snoring or purring sounds in some individuals.

Mouth Taping with PAP/CPAP Apnea Patients

Sleep apnea patients using nasal-type masks while their mouths open may be prescribed a full face mask. Full face masks cover the nose and mouth.

Another option to help keep mouths closed with nasal masks is to add the use of a chin strap.

As an alternative to both of these situations, a patient may be encouraged to try using mouth tape.

For those apnea patients already using a full face mask, mouth taping may be useful when performing nasal mask trials.

Mouth taping may also alleviate dry mouth symptoms in full-face mask wearers who have already maximized humidity settings.

How do I know if I sleep with my mouth open out of habit or need?

Here’s a simple exercise recommended by several sleep medicine health providers.

During the day, set a timer for 10 minutes keeping your mouth closed and purposely breathing through your nose. 

If you do not have a difficult time breathing through your nose in the daytime, and you’re being treated at night with either an oral appliance or CPAP, mouth taping may be an excellent option to try if you feel you are opening your mouth during sleep.

Suppose you find it difficult during the day to experiment with breathing through your nose. In that case, you may have physical obstructions that would be best to have medically evaluated before mouth taping.

What is the best mouth tape to use during sleep?

There are many options available for this purpose. It may be best to try several and see which are most comfortable.

Some considerations in choosing mouth tape often include:

• How your skin around the mouth feels after removal (redness, soreness?)
• Sensitivity to adhesives or latex allergies
• Does it make you feel claustrophobic?
• Facial hair: mustaches and beards may add challenges to  mouth taping

Mouth tape products that my patients or colleagues have liked and suggested:

Somnifix Mouth Strips

Somnifix mouth tape is made of hypoallergenic material, latex-free with central vented area

Somnifix offers a money back guarantee through their main site

Approximate cost per box: $21.99, 28 strips or $0.79 per strip as of 11/2021

Myotape

• Myotape is made using cotton and hypoallergenic, skin-friendly glue.
• In a recent interview with Dr. Nancy Addy, former president of the American Academy of Dental Sleep Medicine, highlighted that she herself uses this type of mouth tape nightly along with her oral appliance.
• 1 packet of 90 strips, approx $25 per box or $0.28 /per strip

3. Snorless Strips 

• Sheets will need to be cut, and mouth tape can be applied in many ways. 
• Made with hypoallergenic surgical quality tape 
• Snorless strips are often used with trainers of the Buteyko Breathing Method
• Can be worn horizontally, diagonally, or vertically over the lips depending on the person and their breathing ability
• For an easier start, a person may need to start with wearing the tape vertically, then move diagonally and, when ready, horizontally  
• Adhesion is so strong can be used multiple times
• Moisture resistant even if lips are wet
• Directions recommend they are so sticky that place on hand and remove several times prior to placing onto mouth, and for easier removal fold in edge slightly
• The cost of Snorless strips are around $14 for 25 strips. The sheets are 4” x 6” and can be trimmed to fit your needs. Most people are able to get 8, 3”x1” strips out of each sheet. This equals to about 200 strips, $.07 per strip.

Nexcare – Sensitive Skin First Aid Tape

• Approximate cost is 1 roll 1 inch by 144 inches for $7.00. May be cut and applied many ways. 
• This tape can be cut into different sizes and used vertically, horizontally and vertically. 
• For easier mouth tape removal, fold in the edge for a removing tab. 

5. 3M Micropore Tape 1530 

• Approximate cost -2 rolls of 1 inch x 10 yards = $4.85, also an inexpensive choice .
• This surgical tape option has been recommended by Dr. Steven Park, a sleep medicine physician, author and podcast host. For more details with Dr. Park discussing this option, read his article.
• Gentle to the skin
• Latex-free and hypoallergenic for sensitive patients
• Highly breathable to maintain skin integrity
• It may be cut and applied many ways.
• This was definitely the least “sticky” of the mouth tapes mentioned in this article. It may be a good choice to start with, especially if you have any anxiety or looking for a very easy to remove option. 

How to put mouth tape on your mouth

To see how to place mouth tape, read the accompanying directions of the product you choose if made specifically for mouth taping.

For many mouth tapes made specifically for this purpose, most will direct you to place them across the lips horizontally. 

For some of the basic surgical adhesive tapes, some clinicians suggest vertically or horizontally across the lips. You may need to try several ways to determine what works best for you. For many, it is easiest to start vertically and slowly move to horizontal placement if you have any apprehension about mouth taping.

It’s always best if your skin is clean and void of lotions in the event it will cause the mouth tape not to stick.

Most instructions do recommend you tuck your lips in slightly before placing the mouth tape on.

Also, if you feel that the mouth tape is too sticky, you may want to adhere the tape onto your hand or forearm and then remove the tape several times to make it less tacky. 

Benefits of using mouth taping to help with snoring and sleep apnea treatment

Pros

• Success has been noted in many people studying and participating in mouth breathing and airway issues challenges, including mouth breathing, snoring and apnea
• Inexpensive to try
• Easy to use
• Can decrease the risk of cavities and other mouth-related problems
• Can improve result or oral appliance therapy and CPAP therapy
• It can help break the habit of day and night time breathing

Issues that are commonly seen with mouth taping

Cons

• Minimal scholarly scientific studies on the topic of mouth taping
• May mask serious underlying disorders such as obstructive sleep apnea by creating a quiet non-snoring apnea patient
• May not address the actual underlying reason why one may prefer to breathe through their mouth, in which case mouth taping may be a band aid type of approach
• May leave skin or lip irritations after removing the tape
• Disrupted sleep or anxiety due to newness of feeling and limitation of mouth opening

To help gain insight on the pros and cons of mouth taping to help improve nasal breathing and stop mouth breathing, I’ve included a variety of articles and podcasts on the topic at the end of this article.

If you are currently sleeping with your mouth open while using an oral appliance or CPAP/PAP mask, mouth taping may help improve your apnea treatment results.

As always, it is best to ask your sleep medical/dental professional for more details and guidance.

IMPORTANT: Many doctor-patient parameters are considered as to which oral appliance therapy is best suited for an individual.

Your oral appliance dentist or sleep medicine physican can help decide which course of theraphy is most appropriate for you and your dental/oral condition.

These helpful resources are general in nature and for educational purposes only. Please consult with your sleep health provider before using mouth tape. The resources include scientific research articles as well as articles and podcasts by clinicians with experience with mouth / lip taping.

More Resources:

• Park MD, Steven: The Mouth Taping Controversy
• Steven Park MD of the Breathe Better Sleep Better Live Better Podcast interviews author James Nestor Author of best-selling book, Breath: The New Science of a Lost Art Episode #92
• Zaghi, S., Peterson, C., Shamtoob, S., & Fung, B. (2020, January). Assessment of Nasal Breathing Using Lip Taping: A Simple and Effective Screening Tool. Author List: International Journal of Otorhinolaryngology 2020; X(X): XX-XX Levels of Evidence: 2b -Cross sectional cohort study. Retrieved November 23, 2021 from https://www.researchgate.net/publication/341341629_Assessment_of_Nasal_Breathing_Using_Lip_Taping_A_Simple_and_Effective_Screening_Tool_Author_List_International_Journal_of_Otorhinolaryngology_2020_XX_XX-XX_Levels_of_Evidence_2b_-Cross_sectional_cohor
• Tsung-Wei Huang, T.-H. Y. (2014, December 1). Novel porous oral patches for patients with mild obstructive sleep apnea and Mouth Breathing: A pilot study – Tsung-Wei Huang, Tai-Horng Young, 2015. SAGE Journals. Retrieved November 23, 2021, from https://journals.sagepub.com/doi/abs/10.1177/0194599814559383?journalCode=otoj&.
• Untethered Podcast host Hallie Bulcan M.A. Episode 116: The 411 on Lip Taping with Autumn R Henning, speech pathologist- The two discuss the topic from a myofunctional perspective and the masking of root causes.
• Zeng B, Ng AT, Qian J, Petocz P, Darendeliler MA, Cistulli PA. Influence of nasal resistance on oral appliance treatment outcome in obstructive sleep apnea. Sleep. 2008;31(4):543-547. doi:10.1093/sleep/31.4.543 from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2279749/
• Sutherland K, Vanderveken OM, Tsuda H, et al. Oral appliance treatment for obstructive sleep apnea: an update. J Clin Sleep Med. 2014;10(2):215-227. Published 2014 Feb 15. doi:10.5664/jcsm.3460 from https://pubmed.ncbi.nlm.nih.gov/24533007/
• Huang T-W, Young T-H. Novel Porous Oral Patches for Patients with Mild Obstructive Sleep Apnea and Mouth Breathing: A Pilot Study. Otolaryngology–Head and Neck Surgery. 2015;152(2):369-373. doi:10.1177/0194599814559383 from https://journals.sagepub.com/doi/abs/10.1177/0194599814559383?journalCode=otoj&.
• Stupak, H. (2020, May 6). Strategies for Addressing Mouth-Breathing Treatment with an “Adequate” Nose. Retrieved November 23, 2021, from https://link.springer.com/chapter/10.1007/978-3-030-44674-1_3.