Medical professionals raised concerns about the recent social media trend promoting mouth taping for sleep-related issues. An invited commentary published in JAMA Otolaryngology–Head & Neck Surgery highlighted potential risks associated with this practice, particularly for individuals with obstructive sleep apnea.

Study authors Jeffrey W. Chadwick, DDS, MSc, PhD, and Andrew T. Huang, MD, emphasized the need for regulation and evidence-based protocols surrounding mouth taping and other obstructive sleep apnea (OSA) therapies. Their commentary accompanied a nonrandomized clinical trial conducted by Yang et al, which examined the effects of mouth closure on airflow in patients with OSA.

The authors noted several critical aspects:

• Social media impact: Over 7,000 posts with 7 million views on TikTok used the hashtag #mouthtape, promoting various claimed benefits.
• Limited evidence: The commentary highlighted the sparse literature supporting or disproving mouth taping benefits, especially in the context of OSA.
• Potential risks: Undiagnosed upper airway obstructions, including structural abnormalities of the sinonasal cavity, neoplastic processes, and inflammatory conditions could contraindicate mouth closure therapies.
• Variability in outcomes: The accompanying study found that while mouth closure increased overall inspiratory airflow in most participants, 22% of them experienced a significant decrease.
• Need for comprehensive evaluation: The authors stressed the importance of proper diagnosis and assessment of anatomical factors before recommending mouth closure therapies.

The commentary referenced a study, which provided the following data:

• 54 patients with varying OSA severities participated in the trial.
• Drug-induced sleep endoscopy was used to evaluate inspiratory airflow in open and closed mouth positions.
• Independent nasal and oral pneumotachometers measured airflow.
• 22% (n = 12) of the participants showed significantly decreased inspiratory airflow with mouth closure.
• Velopharyngeal obstruction (anteroposterior or concentric) was associated with decreased total inspiratory airflow during forced mouth closure.

The commentary noted that preliminary work by other groups demonstrated statistically significant but relatively modest reductions in apnea-hypopnea index values with mouth taping. However, these studies were limited to individuals diagnosed with mild OSA and had small sample sizes.

Drs. Chadwick and Huang outlined several necessary steps:

• Conducting well-designed studies to evaluate the mechanisms, safety, and utility of mouth taping.
• Developing comprehensive, multidisciplinary treatment pathways for OSA.
• Establishing consensus-driven, evidence-based guidelines for OSA-related therapies.

The authors emphasized the importance of integrating advancements judiciously while ensuring patient safety and treatment efficacy. They called on the sleep medicine and surgical communities to create robust, data-driven protocols to guide clinical decision-making for OSA management.

The authors declared having no competing interests.