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02

Dec

Chin straps for Snoring: Safe, Effective or Dangerous? (Sleep-expert Review 2021)

Estimated reading time: 11 minutes

So your mouth opens and you snore when you fall asleep…

If during the night, when you fall asleep your mouth opens and you start snoring, then it’s easy (but perhaps mistaken) to think a chin strap to stop it doing so, would be a simple solution.

So, if you’re wondering:

Do chin straps work? Are they safe and effective?

Then read this independent sleep-industry expert (no affiliate links!) review. 

Adrian Zacher MBA

Author, Snoring and Sleep Apnoea Care Navigator

I teach healthcare professionals how to help their patients stop snoring; sleep and breathe at the same time.

Snoring and mouth-opening: The case for a chin strap

As you breathe IN (inhale) the soft tissue in your throat and sometimes nose, together with your uvula (the dangly bit hanging from the roof of your mouth) may vibrate as the air passes.

This makes the snoring noise

If your mouth is closed while you sleep (sounds positive for the chin strap – for a moment) then assuming you can… your breathing has to occur through your nose, which is what your nose is designed for.

Sounds good in principle…

And if you Google “chin straps for snoring” you will see there are plenty to choose from. With lovely colours, different length straps and sizes etc. etc.

But almost all cup your chin and have straps that go around the back of your head.

So its a reasonable question to ask:

Do chin straps make snoring better or worse? 

Do chin straps make snoring better or worse?

When your airway gets narrower the air you breathe must travel faster. As the air speeds up, it makes floppy tissue in your airway vibrate and this makes the snoring noise.

If you sleep on your back…

The problem is NOT that your mouth falls open, its because as your mouth opens your jaw moves backwards, which allows your tongue to reduce the size of the airway in your throat.

A chin strap exaggerates this backwards movement of your jaw, making your airway smaller and your snoring worse.

It’s now commonplace to see news articles where couples inflict various stop snoring gadgets or sprays upon each other, including perhaps a pillow and a chin strap (sometimes called a ‘jaw strap’).

Here’s a quote from currently the second most popular UK newspaper:

Even less successful is the [name removed] jaw strap….. a good solid snore resonating from her throat.

What happens in your throat when you use a chinstrap?

The three airway diagrams below (used with permission from Elsevier Press1) and taken from our FREE How to choose a Mouthpiece Guide illustrate the negative consequence of this backward jaw movement, created by gravity and aggravated by a chinstrap.

Three airway

In the left of the three images the airway is normal and open.

Breathing occurs freely and quietly.

The middle image shows how the jaw and tongue have moved backwards and no breathing is possible.

This is technically known as ‘mandibular retrusion’ and it is not safe. It is dangerous.

The third image on the right illustrates how a ‘Mouthpiece’ protrudes the jaw and helps the individual sleep and breathe at the same time.

More about them later in this post.

How do you keep your mouth closed when sleeping?

Now you’re thinking, if chin straps move my jaw in the ‘wrong‘ direction:

What will keep my mouth closed while sleeping – and perhaps move my jaw the ‘right‘ way?

Enter custom-made Mandibular Advancement Devices (MADs). More about them later.

Keep reading… 

The X-ray images on the left have red highlighted areas, that indicate the size of the airway behind the tongue.

The right-hand one illustrates how airway volume increases with protrusion.

A chinstrap moves your jaw the wrong way. 

What does the clinical research say about chin straps?

Since I first published this post (2017) I have seen some vendors of chin straps misquote a case study2 (which means ONE patient) to make out that clinical research proves chin straps are a valid option for snoring and obstructive sleep apnoea (OSA).

Which is not the case at all

The key things to know about chin straps:

  1. Clinical research has proved chin straps are not effective for snoring
  2. If you use Positive Airway Pressure therapy for sleep apnoea / apnea then a chin strap may help avoid mouth leak

Since the case study (2007) found one patient experienced an improvement with a chin strap, Bhat, et al,3 (2014) established chin straps had no place in treating sleep-disordered breathing and snoring. Indeed the original case study authors also published a paper4 (2014) trying to clear things up:

We learned that entrepreneurs were advertising high priced (to our mind) chin straps for treatment of snoring and OSAS, and that information from our case report was used to bolster claims of chin strap effectiveness.

They continued:

The lead author spent considerable time answering emails and phone calls to state unequivocally that we at Eastern Virginia Medical School Sleep Medicine did not support the use of the chin strap for the treatment of OSAS, and that more investigation was warranted.

Here’s the pertinent extract:

We thus applaud Bhat et al. for their work in investigating the potential utility of the chin strap for treatment of snoring and OSAS.

They demonstrated that the chin strap appears to be an i

neffective treatment for a typical apnea population.

Which means that chin straps for snoring are not safe nor effective, and they also delay diagnosis and effective treatment.

Good to know:

Snorer.com is independent. We don’t sell anti-snoring devices, chin straps or whatever! And we don’t benefit from affiliate deals.

For the sake of a balanced argument, in the next paragraph I will explain how some patients using Positive Airway Pressure (PAP) therapy for obstructive sleep apnoea (OSA) may find certain chin straps do have a role.

I use Positive Airway Pressure (PAP):  Will a chin strap help with mouth leak?

A chin strap may help if you use a nasal mask and air is escaping from your mouth5.

However, the real solution if you use PAP and have mouth leak, is a full face mask.

Grab our free ‘How to Choose Positive Airway Pressure (PAP) Guide‘ to learn more.

I would add, that if you’re fixed on buying a chin strap, then find one that is designed to just close the mouth and NOT pull your lower jaw backwards

How to choose positive airway pressure (PAP) therapy

When snoring is a problem…

You can’t ‘fix’ something if you don’t know what is wrong.

Start with some self-help ways to stop snoring.

Grab our completely free Overview of Snoring and Sleep Apnoea Guide and then consult a sleep-trained pharmacist to get signposted to the most appropriate professional to help you.

What about ‘Mouthpieces’ or ‘Gumshields for snoring’?

I mentioned ‘protrusion‘ earlier and how a ‘mouthpiece’ technically known as a Mandibular (jaw) Advancement Device (MAD) also stops your mouth falling open while sleeping.

There are two basic groups of MAD:

The first group you can buy in shops and on-line, the second group of MAD is custom-made exclusively for you, and prescribed by a dentist with a special interest in sleep-related breathing disorders from snoring to sleep apnoea.

Be careful not to confuse custom-made with customised (customised means a ‘gumshield’ adapted or customised to you).

These prescription anti-snoring devices have a substantial and growing body of clinical evidence to support their place on the market.

The best MADs adhere to 2 specific design principles:

  • 1

    They advance the lower jaw, which increases the tone and size of your airway behind your tongue

  • 2

    They specifically limit how much your mouth can open while you sleep

And I am expressly NOT referring to Over-the-Counter (OTC) ‘gumshields’ for snoring.

Radio frequency ablation surgery for snoring

What about Surgery to Stop Snoring?

Although surgeries are rarely performed, surgical approaches have been largely confined to:

  • Reduction of the soft palate and uvula (dangly bit at the back of the mouth)
  • Removal of nasal polyps (‘lumps’ inside your nasal airway)
  • Septum straightening (correcting a crooked nose)
  • Advancing the upper and lower jaws which advances the soft palate and tongue, opening up the airway, known as an MMA (MMA = Maxilla (upper jaw) Mandible (lower jaw)

If you want to know more about safe and effective ways to stop snoring and treat obstructive sleep apnoea/apnea, then grab our free, evidence-based Information Guide:

Things to discuss when considering surgery for snoring and obstructive sleep apnoea

Summary

Chin straps do not stop snoring and may well be dangerous. 

I implore you NOT to waste your money, harm yourself, your loved one or I pray your children.

Chin straps have been clinically proven to be neither safe nor effective.

And they could mask symptoms of obstructive sleep apnoea / apnea (OSA) and/or delay your eventual OSA diagnosis and effective treatment.

OSA if left untreated may:

  • Reduce your life expectancy
  • Increase your risk of stroke
  • Increase your risk of a fatal heart attack
  • Predispose you to type II diabetes, depression, impotence and driving or work place accidents to name but a few!

My advice is to start with some self-help options and then consult a sleep-trained pharmacist or your GP.

Thanks for reading. Now share this with your long suffering friends. (If you dare!) or let me know what you think by entering a quick comment below. I read every one.

Created by Adrian Zacher. Last updated 7th April 2021.

Glossary

Airway Volume The volume is the amount of space that a exists in your throat to breathe through.
Information Standard NHS England’s Information Standard. Organisations that join The Information Standard are showing their commitment to producing good quality health and care information.
MAD Mandibular Advancement Device Jaw advancing device, worn at night while asleep to hold forward the lower jaw to stop snoring and prevent obstructive sleep apnoea / apnea.
Mandibular Retrusion Backwards movement of your jaw
MMA Surgery to move both jaws. MMA = Maxilla (upper jaw) Mandible (lower jaw).
OSA Obstructive Sleep Apnoea When an individual is unable to sleep and breathe at the same time. Visually, a repetitive pattern of breathing interruptions (apnoeas) occurring while the individual sleeps, due to a physical obstruction in the airway. Apnoea is spelt Apnea in the US.
Palate Roof of your mouth.
Polyps Refers to nasal polyps in this Guide. These are ‘lumps’ inside your nasal airway.
Protrusion Forwards movement of your jaw.
Septum is the tissue that separates the left and right airways in the nose, dividing the two nostrils.
Sleep-trained Dentist A dentist that has undergone special interest training in sleep. As such they are able to obtain professional indemnity insurance.
Soft-palate Soft tissue behind your palate (roof of your mouth).
Uvula ‘Dangly’ bit at the back of the mouth.

References

1. Sleep-disordered Breathing, Adrian Zacher & Michael McDevitt, Carranza’s Clinical Periodontology – E-Book: Expert Consult: Online, Elsevier Health Sciences, 2017. Accessible here: https://www.elsevier.com/books/carranzas-clinical-periodontology/newman/978-0-323-18824-1 new window [accessed 24th May 2018]

2. Vorona RD, Ware JC, Sinacori JT, Ford ML, Cross JP. Treatment of severe obstructive sleep apnea syndrome with a chin strap. J Clin Sleep Med. 2007;3:729–30. Accessible here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2556917/ new window [accessed 8th May 2020]

3. The Efficacy of a Chinstrap in Treating Sleep Disordered Breathing and Snoring, Bhat, S, et al, 2014, Journal of Clinical Sleep Medicine, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4106943/ new window [accessed 24th May 2018]

4. Vorona RD, Ware JC. Use of a chin strap in treating sleep-disordered breathing and snoring. J Clin Sleep Med. 2014;10(12):1361. Published 2014 Dec 15. doi:10.5664/jcsm.4304 Available here: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4237533/new window [accessed 4th Nov 2018]

5. Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP. Bachour, Adel et al. 2004, Sleep Medicine, Volume 5, Issue 3, 261 – 267 https://doi.org/10.1016/j.sleep.2003.11.004 new window [accessed 24th May 2018]

9 Comments

  1. Maryjo ward

    I have mild sleep apnea & had a dental device made by sleep dentist. In testing it needed to be more forward to work. I felt pressure on two lower teeth & needed two root canals done & am afraid to go back to using it, plus it no longer fits. I have been using CareFusion chin strap & as long as I sleep on my side it seems to work. The sleep apnea store at the hospital no longer carries them. My friends say I do not snore. I hate the machine & the chin strap is wearing out. With mild apnea is it so bad to do nothing? Can exercise for the throat & chin help? I am 77 years old.

    Reply
    • Adrian Zacher

      Hi Maryjo. Thanks for commenting.

      I cannot give medical advice – because I am not medically qualified! 🙂

      I would urge you to consult your Primary Care Practitioner or at the very least the dentist that made the dental device for you (get a new one after a sleep study).

      Mild sleep apnoea is not something to be ignored.

      It means you are experiencing breathing interruptions during sleep up to 14 times per hour. The length of these apneaic episodes could be as long as two minutes. During each apneaic episode your blood oxygen level plummets, your body responds with surges in blood pressure and hormones that disrupt your metabolism and as a consequence you may find weight management difficult. You are more at risk of a stroke and there is good evidence linking untreated OSA with type II diabetes.

      In short, do something about your sleep apnoea/apnea as mild may become moderate as you age and gain weight.

      This article (I hope) has clearly shown that chinstraps are NOT valid for snoring nor sleep apnoea. Some particular types ‘may’ help keep your mouth closed if you were to use positive airway pressure (PAP) therapy and this may help with leakage of air from your mouth. However, the real solution in this particular circumstance is a different PAP mask (full face). I would imagine the hospital no longer carry chinstraps as they recognise they have no valid role to play.

      You also ask about exercise for the throat and chin. My view on this is that exercise is unlikely to do you harm (!) so there is little to lose in trying.

      As you have mild (perhaps moderate) sleep apnoea / apnea its not really sufficient to judge how effectively treated you are, through friends reports of you “not snoring” as they most likely did not listen to you sleep and breathe all night… (they went to sleep themselves – did you snore and have OSA episodes while they slept?)

      Hope this helps.

      Cheers

      Adrian

      Reply
  2. Andrew

    Chin straps make the problem worse. My name is Andrew and I have really bad sleep apnea due to my jaw sliding back while i sleep. I have modified a chin strap so that it now actually pulls my jaw forward (toward the tip of my nose. The problem with chin straps is that most if not all of them, pull back around the back of your head. Anyone who suggests this kind of strap is simply trying to sell a product. For a chin strap to work, the pulling of the chin must come from the center of your forehead or out in front of your forehead. This however would (and mine does) look like a Frankenstein design that would most surly scare anyone you may sleep next to. My design is scary, ugly and bulky, but it works – period. I use it with a molded mouth piece to hold my jaw closed and the mouth piece locks my jaw in position. Not pretty but a great alternative to the slow death of dementia (which killed my father) that sleep apnea causes. If anyone ever finds a good looking chin strap that pulls the mouth forward, please let me know phungi at gmail. com.

    Reply
    • Adrian Zacher

      Can’t say fairer than that Andrew. I only hope that you have a diagnosis and are not just treating the symptom. Appreciate you taking the time to comment.

      Reply
  3. Aditya

    Hi Adrian. I am very well happy to read this article which i often asking my self on hwy should i wear chin straps when it is actually push my jaw further back while i actually feel that is the main cause of my OSA.

    I had my surgery few years ago. They took my flabby tiny part that dangling in my inner mouth (whats the name again)….

    Yet i do still snore and stops breathing during my sleep.

    Now about the tools to push the jaw to the front, do you know by any chance where should i buy them in Indonesia or ASIA. Does all dentist understand about this treatment if i asked them to make the tools? Coz they are not the specialists for OSA right?

    I hope you can assist me coz this OSA thing has caused me sleepless night and im most often tired during day time.

    Thanks

    Reply
    • Adrian Zacher

      Hi Aditya. Thanks for commenting. Sorry, but I am not able to offer you medical advice as I am not a Doctor. You say you are tired during the day and experiencing sleepless nights so please consult a Doctor. I also noted your remark about having had palatal surgery to remove your uvula (known as a uvulopalatoplasty). Although you’ve had this operation there is more information about surgical options here.

      Regarding dental appliances (known as mandibular advancement devices there is more about them here). Sadly no, most dentists do not know how to provide such devices. I would urge you NOT to consider a treatment option until you have a diagnosis. The Doctor will then prescribe the most appropriate therapy for your condition, which may or may not be Positive Airway Pressure (PAP) therapy, a mandibular advancement device or surgery. They have your medical history to hand and your sleep test results – so they can help you best.

      I hope I have helped and I wish you every success. Sleep is something we all take for granted until it eludes us.

      Cheers

      Adrian

      Reply
  4. Kath Hope - Hope2Sleep

    Excellent article thanks and I couldn’t have written in better myself! Chin straps can be of enormous benefit to CPAP users when attaching the chin straps on gently to ‘encourage’ their mouths to stay closed to help with nasal breathing and prevent dry mouth. However, it is very wrong to promote chin straps to cure sleep apnoea, as even if it silences the snoring, this does not mean the apnoeas/hypopnoeas have gone away, so the person’s health is still at risk!
    I totally agree with the fact that chin straps normally force a person’s jaw backwards as they slip into deep sleep, thus minimising the space at the airways.
    The most important advice is that a person’s snoring should ALWAYS be investigated further to check that it’s not sleep apnoea (which is very dangerous untreated) before trying to self treat with chin straps and other snoring remedies!

    Reply
    • Cheryl

      Hello, I have Seen a lot of articles about mouth taping to keep mouth closed so you have to breath out of your nose. Apparently it will stop you from snoring. Any advice on that?

      Reply
      • Adrian K Zacher

        Hi Cheryl. Thanks for taking a moment. I think that ‘mouth taping’ is a very bad idea because there are a number of assumptions being made, not least that the individual can breathe through their nose adequately when sleeping. Without going into a long-winded answer, the best advice is to consult a sleep-trained healthcare professional. Trying to ‘cure the snore’ without understanding WHY someone is snoring is a recipe for disaster. Why leads to How. Hope this helps.

        Reply

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