In this latest video from MedCram, Dr. Seheult discusses using tape for the mouth for treating obstructive sleep apnea.
What is sleep apnea?
When a person is sleeping, we know that as we breath, oxygen needs to go in and carbon dioxide needs to come out. As individuals age and get older, especially in men, the tongue start to fall backwards and can obstruct the area in the back of the throat. This can lead to issues with breathing at night and is known as obstructive sleep apnea. As the lungs are attempting to take a breath in, air is not able to get in and because of this oxygen levels drop and the brain senses this decline in oxygen and the sympathetic nervous system becomes activated to arouse us out of our sleep so we can take a breath in. When this happens our heart rate and blood pressure go up. If this recurs repeatedly, the sympathetic nervous system can become hyper amped up. This hyperactive sympathetic nervous system can cause a multitude of problems. It is commonly found in patients with OSA, that between the hours of midnight and 6 AM they have the highest death rates because of the huge swings in the oxygen and the sympathetic nervous system. In contrast, individuals without obstructive sleep apnea are noted to have the most common time of death between 6 AM and noon, which is when the cortisol levels are typically the highest.
Best treatment of sleep apnea?
The tried-and-true treatment for obstructive sleep apnea is a CPAP machine which is basically air pressure being pushed into the back of the respiratory tract to allow relief of the obstruction. Other mechanisms include mandibular advancement device or a dental device that moves the jar forward, bringing the tongue off the back and opens up the airway in the back. Another device is called Inspire which is a hypoglossal nerve stimulator. This causes a portion of the tongue to contract and essentially causes a shortening of it. Essentially in OSA, this is a physical problem and it needs a physical solution to help open the airway. There are surgical treatments for this, including breaking the jaw and moving it forward or a tracheostomy which is just bypassing everything and breathing through a tube in the trachea, but these are done only in extreme circumstances and are not realistic solutions for the average person.
Does mouth tape work?
In 2014 there was a prospective study done in Otolaryngology-Head and Neck Surgery which looked at putting on a porous oral patch or tape to keep the mouth closed. These patients had mild sleep apnea and habitual open-mouth breathing. These patients had to have had a sleep study done prior to the study. This study had no control. The conclusion was that the porous oral patch was a useful device to treat patients with mild OSA. The key takeaway from the study was that the study was done on patients that had mild sleep apnea and did not evaluate any patients with moderate to severe obstructive sleep apnea. It is important to note that without a sleep study a person can’t determine whether they have mild, moderate or severe sleep apnea.
In 2022 there was an article by Larbarca that was published looking at mouth breathing and it was hypothesized that using a mandibular advancement device can increase mouth breathing so that using an adhesive mouthpiece of tape could improve the treatment efficacy. This was a prospective cross over study and involved patients with mild, moderate and severe apnea. They concluded that a combination of an adhesive mouthpiece and a mandibular advancement device was more effective therapy than just a mandibular device alone.
Another study done in 2022 on mouth taping by Yi-chieh Lee again looked at the impact of mouth taping in mouth breathers with mild OSA. This was a retrospective design. The mouth tape used in this particular study was 3M silicone hypoallergenic tape that spanned the upper and lower lips so as to seal the mouth during sleep. There were some limitations due to the small sample size without a control group. However there was some evidence that it may have been helpful.
In review overall, using tape may be something to consider in someone with mild sleep apnea who uses a dental device.
LINKS / REFERENCES:
Novel Porous Oral Patches for Patients with Mild Obstructive Sleep Apnea and Mouth Breathing: A Pilot Study (Sage Journals) | https://journals.sagepub.com/doi/abs/…
Mouth Closing to Improve the Efficacy of Mandibular Advancement Devices in Sleep Apnea (ATS) | https://www.atsjournals.org/doi/epdf/…
The Impact of Mouth-Taping in Mouth-Breathers with Mild Obstructive Sleep Apnea: A Preliminary Study (Healthcare) | https://www.ncbi.nlm.nih.gov/pmc/arti…
Sleep Apnea Explained Clearly (MedCram) | https://www.medcram.com/courses/sleep..