- KILLER IN YOUR BEDROOM
Estimated reading time: 12 minutes
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.
I specifically address these points. Click to jump to each section:
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?
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.
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 chinstrap exaggerates this backwards movement of your jaw, making your airway smaller and your snoring worse.
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.
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.
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.
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.
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.
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
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.
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
ineffective treatment for a typical apnea population.
Which means that
chin straps for snoring are not safe nor effective,
and they delay diagnosis and effective treatment.
A chinstrap alone is not an effective treatment for OSA. It does not improve sleep disordered breathing, even in mild OSA, nor does it improve the AHI in REM sleep or supine sleep. It is also ineffective in improving snoring.
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.
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…
You can’t ‘fix’ something if you don’t know what is wrong.
Start with some self-help ways to stop 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.
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:
They advance the lower jaw, which increases the tone and size of your airway behind your tongue
They specifically limit how much your mouth can open while you sleep
Be sure to bookmark my review of the features of the best anti-snoring devices.
Image used with consent from SomnoMed Ltd.
And I am expressly NOT referring to Over-the-Counter (OTC) ‘gumshields’ for snoring.
Although surgeries are rarely performed, surgical approaches have been largely confined to:
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:
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:
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.
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.
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 [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/ [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/ [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/ [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 [accessed 24th May 2018]