What is the safety and efficacy of mouth tape for Obstructive Sleep Apnea (OSA)?

From the Guidelines

Mouth taping for obstructive sleep apnea (OSA) is not recommended as a primary treatment due to limited evidence supporting its safety and efficacy. The current evidence base, as outlined in the American College of Physicians' clinical practice guideline 1, emphasizes the importance of established treatments such as continuous positive airway pressure (CPAP) therapy and mandibular advancement devices (MADs) for managing OSA. These treatments have a stronger evidence base for improving outcomes such as the Apnea-Hypopnea Index (AHI), sleepiness, and quality of life.

Key Considerations

• The gold standard treatment for OSA remains CPAP therapy, which has robust evidence supporting its ability to maintain airway patency during sleep 1.
• MADs are recommended as an alternative therapy to CPAP for patients who prefer them or experience adverse effects from CPAP, based on low-quality evidence 1.
• Lifestyle modifications, including weight loss, avoiding alcohol before bedtime, and sleeping on your side, may also help manage OSA symptoms alongside medical treatments 1.

Risks Associated with Mouth Taping

• Potential risks of mouth taping include skin irritation, allergic reactions to adhesives, and the possibility of restricting breathing if nasal passages become blocked during sleep, which could worsen respiratory distress in OSA patients.
• Given these risks and the lack of strong evidence supporting its efficacy, mouth taping is not a recommended treatment approach for OSA.

Clinical Recommendations

• Patients diagnosed with OSA should be encouraged to lose weight if they are overweight or obese, as part of a comprehensive management plan 1.
• CPAP therapy should be recommended as the initial treatment for patients diagnosed with OSA, given its strong evidence base and recommendation grade 1.
• For patients who cannot tolerate CPAP or prefer alternative treatments, MADs may be considered, taking into account individual patient factors and the severity of OSA 1.

From the Research

Safety and Efficacy of Mouth Tape for OSA

• The use of mouth tape in patients with mild obstructive sleep apnea (OSA) has been studied as a potential treatment option 2.
• A preliminary study found that mouth-taping during sleep improved snoring and the severity of sleep apnea in mouth-breathers with mild OSA, with the apnea/hypopnea index (AHI) and snoring index (SI) being reduced by about half 2.
• The study defined a "responder" as a patient who experienced a reduction from the baseline snoring index of at least 50% under mouth-taping, and found that 65% of patients were responders 2.
• The median AHI decreased significantly from 8.3 to 4.7 event/h, and the median SI was also improved by 47% 2.
• Improvements in the oxygen desaturation index and the lowest saturation were also noted, although there was no significant difference in the mean saturation 2.

Comparison to Other Treatments

• Oral appliance therapy, including mandibular advancement devices, has been shown to be effective in reducing the severity of OSA, although it is generally less effective than continuous positive airway pressure (CPAP) therapy 3, 4, 5.
• However, oral appliance therapy may be more tolerable and have better compliance than CPAP therapy, which can be cumbersome and uncomfortable for some patients 3, 4, 5.
• Mouth-taping may be an alternative treatment option for patients with mild OSA who are unable to tolerate CPAP therapy or oral appliance therapy 2.

Potential Benefits and Limitations

• The use of mouth tape may be a simple and non-invasive treatment option for patients with mild OSA, and may be particularly beneficial for mouth-breathers 2.
• However, further studies are needed to fully evaluate the safety and efficacy of mouth-taping as a treatment for OSA, and to determine the potential long-term benefits and limitations of this treatment option 2.