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Chin Straps: Safe and Effective or Dangerous?

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 expert (no affiliate links!) review of the concept upon which they’re based. 

Lets do this…

I’m a sleep-industry insider (learn more about me: Adrian Zacher) with a quarter of century of sleep medicine experience. Adrian Zacher MBA

Author, Dental Sleep Medicine Instructor and Sleep Apnoea Evangelist, Snorer.com

Are Chinstraps for Snoring Safe and Effective?

In this post I answer these questions:

why-do-we-snore  Why do we snore?
Do chin straps make snoring better or worse?  Do chin straps make snoring better or worse?
are-chinstrap-safe-effective-or-dangerous  Are chin straps for snoring safe and effective?
what if your snoring is because you have obstructive sleep apnoea  What does the clinical research say about them?
I use PAP - will a chin strap help with 'mouth leak'  I use PAP – will a chin strap help with ‘mouth leak’?

Why do we snore?

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…

Sadly, a chin strap on its own is unlikely to be sufficient to stop snoring…

And it could even be dangerous… Yet, 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.

In this post, using video, diagrams and X-rays, I will examine whether chin straps work and if they’re safe and effective.

I welcome your review.

Do chin straps make snoring better or worse?

If you sleep on your back, the problem is not just that your mouth falls open, its because your jaw moves backwards, which allows your tongue to narrow the space at the back of your throat.

A chin strap will exaggerate this backwards movement making your snoring worse.

Its gravity and simple physics they pull your jaw backwards while you sleep.

The diagram below (used with permission from Elsevier Press3) and taken from our FREE How to Choose a Mouthpiece Guide illustrates the negative consequence of backward jaw movement.

Three airway examples: normal, with apnea, restored.

On the far left the airway is normal and open.

Breathing occurs freely and quietly.

The jaw and tongue have moved backwards and no breathing is possible.

This backwards jaw movement is not safe. Its technically known as ‘mandibular retrusion’ and it is not safe. It is dangerous!

This is what Chin Straps Do.

The third diagram on the right illustrates how a custom made, prescription oral appliance or ‘Mouthpiece’ restores the airway safely by protruding the jaw, and enables the individual to sleep and breathe at the same time.

More about them later in this post.

 

Video – How Airway Volume Dimensions Increase with Jaw Protrusion


Video length = 26 seconds

Hit play to see how the space in your throat to breathe (the airway volume) increases with protrusion of your lower jaw.

A chin strap does the reverse.

If you snore now because the space behind your tongue is insufficient to quietly breathe and sleep at the same time, then it will only be made worse or COLLAPSE completely with a chin strap.

You are in effect, creating obstructive sleep apnoea/apnea.

airway volume change with protrusion
The X-ray images on the left are from our Snorer.training, KnowSleep™ Academy for dentists.

The red highlighted area, indicates the size of the airway behind the tongue.

On the right, the image shows how the airway volume increases with protrusion.

‘Mandibular Retrusion‘ (which is backwards movement of your jaw – as would be created by a chin strap) narrows your airway. Error!

Verdict on chin straps

Chin straps for snoring are not safe nor effective, and they also delay diagnosis and effective treatment.

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

My point is, that a chinstrap moves your jaw backwards instead of forwards while attempting to keep your mouth closed. If anything, you may need jaw protrusion to stop snoring / treat OSA.

 

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. Bhat, S, et al, 2014. Journal of Clinical Sleep Medicine

The Efficacy of a Chinstrap in Treating Sleep Disordered Breathing and Snoring (2014)

I use Positive Airway Pressure (PAP) for OSA – Will a chin strap help with Mouth leak?

I promised to explain how some diagnosed obstructive sleep apnoea (OSA) users of PAP (positive airway pressure) therapy may find a chin strap helps avoid ‘mouth leak’. 

A chin strap can help if you use a nasal mask and air is escaping from your mouth. However, the real solution if you have mouth leak, is a full face mask.

Grab our freeHow 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… The big PAP companies sell these.

No, I do not have, or want, an affiliate link! Thank you.

Don't buy a chinstrap if you want to stop snoring!

If snoring is a problem, you need to know what you’re dealing with.

You can’t ‘fix’ something if you don’t know what is wrong. So, see your Doctor/Primary Care Physician (and/or a sleep-trained dentist if you’re in the UK) and have a review of your medical history before you decide to ‘treat’ yourself to anything.

Grab our free, British Medical Association Patient Information Awards, winning Overview of Snoring and Sleep Apnoea Guide

What about Mouthpieces?

I mentioned ‘protrusion‘ earlier and this is what a ‘mouthpiece’ technically known as a mandibular (jaw) advancement device (MAD) does.

There are two basic groups of MAD. They work by holding your jaw more forwards and this opens your airway behind your tongue.

The first group you can buy in shops and online, they are the so called “one-size-fits-all” type also variously known as non-custom, ‘self-fit’, ‘boil and bite’, or ‘gumshield’.

The second group of MAD is custom-made exclusively for you by a dentist with a special interest in sleep apnoea. Be careful not to confuse custom-made with customised (customised means a ‘gumshield’ adapted or customised to you).

There are many different types, with different mechanisms to connect the two jaws and hold your lower jaw forwards.

But this is not a definitive guide to choosing a dental device (Mandibular Advancement Device – MAD) to stop snoring. This is.

chinstrap or dental device for snoring?

What about Surgery?

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

What about surgery for snoring?

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.

Think of snoring as a signal like a fire alarm going off. While it might be a false alarm and just irritating noise – it could be serious. Self-diagnosing and ‘treating’ your snoring with gadgets like chin straps, not only wastes your money, but may well do you serious harm.

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!

Thanks for reading. Now share this with your long suffering friends. (If you dare!)

Grab our free, NHS England Information Standard accredited, award-winning Overview of Snoring and Obstructive Sleep Apnoea Guide and learn without jargon about evidence-based ways to stop snoring.

Created by Adrian Zacher. Last updated 4th Oct 2018.

Related posts

Here are some more of our high quality posts about snoring and sleep apnoea / apnea, ‘cures’, assessment, diagnosis and treatments.

Dental Appliances for Sleep Apnoea | Snorer.com

Dental appliances for sleep apnoea are an appealing option. But how do you know if they will work without buying one? This post explores how predictor or titration dental appliances for sleep apnoea came to be and the vital role they may play building trust between medical and dental sleep professionals.

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. Mouth closing device (chinstrap) reduces mouth leak during nasal CPAP. Bachour, Adel et al. 2004, Sleep Medicine, Volume 5, Issue 3, 261 – 267 https://www.sleep-journal.com/article/S1389-9457(03)00252-1/abstract [accessed 24th May 2018]

2. 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]

3. 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]

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I found this document clear, understandable with no jargon and recommend the advice given to any sufferers.

Sylvia Explanation of subject May 26, 2018

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