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Mouth taping, a growing trend on social media channels like TikTok, carries serious health risks, especially for those with sleep-disordered breathing and obstructive sleep apnea, according to a paper published in PLOS One.

The study from Lawson Research Institute (Lawson) of St. Joseph’s Health Care London, London Health Sciences Centre Research Institute (LHSCRI) and Western University’s Schulich School of Medicine & Dentistry also found no strong evidence of health benefits.

The trend involves placing tape over the mouth to stop ‘mouth breathing’ and promote breathing through the nose during sleep. It has been recommended by many social media influencers and celebrities who claim it can lead to better sleep, enhanced oral health and anti-aging results.

“It was concerning to us that celebrities and influencers are endorsing mouth taping without scientific evidence,” says Dr. Brian Rotenberg, researcher at Lawson, LHSCRI and Schulich Medicine & Dentistry. “In the language of social media influencers, it seemed a bit ‘sus,’ so we examined what science is telling us about this trend and whether or not it is safe.”

Rotenberg collaborated with Dr. Elise Graham, paediatric otolaryngologist head and neck surgeon at IWK Health and Jess Rhee a Schulich School of Medicine & Dentistry resident who is training at London Health Sciences Centre (LHSC) on the research. He and his team examined 86 existing scientific studies on the topic, including an in-depth review of 10 studies representing the experience of 213 patients. The team found mouth taping:

• Has no strong scientific evidence of health benefits, contradicting claims on social media.
• Can make existing sleep-disorder breathing worse by restricting airflow, putting additional stress on the respiratory system and increasing risk of suffocation when patients experience a nasal obstruction.

“Our research shows that taping the mouth shut during sleep is dangerous, especially among those who may not be aware they have sleep apnea,” adds Rotenberg, who is also an otolaryngologist and sleep surgeon at St. Joseph’s Health Care London and London Health Sciences Centre (LHSC). “These individuals are unknowingly making their symptoms worse and putting themselves at greater risk for serious health complications like heart disease.”

Rotenberg and his team point to the importance of health research in combatting misinformation and pseudoscience.

“It’s easy for misinformation to run rampant on social media; we’ve seen this countless times over the past few years,” says Rhee. “We need to make health decisions based on strong scientific evidence. Our hope is that people stop taping their mouths during sleep and recognize it is dangerous.”

A new study by researchers at ICES, Lawson Health Research Institute and Western University finds that virtual care during the COVID-19 pandemic led to a significant reduction in carbon dioxide emissions and patient travel-related expenses, such as gasoline, parking or public transit costs.

Prior to the pandemic, less than two per cent of patient visits with physicians took place virtually. The beginning of the pandemic (April-June 2020) triggered a rapid transition to virtual visits, which soared to 70 to 80 per cent, and then stabilized at 50 to 60 per cent of all physician visits.

This cross-sectional study published in JAMA Network Open used healthcare administrative data from Ontario, Canada to identify all patients with at least one virtual care visit between March 2020 and December 2021. 

“Virtual care has become an important part of the healthcare system in Ontario, and in addition to improved patient convenience, it results in significant environmental and financial benefits for patients,” says lead author Dr. Blayne Welk, associate professor of surgery at Western's Schulich School of Medicine & Dentistry, urologist at St. Joseph’s Health Care London, associate scientist at Lawson, and adjunct scientist at ICES Western. “The financial and environmental benefits of virtual care will likely continue beyond the pandemic and are particularly relevant for some patients who were frequent recipients of virtual care.”

Findings show that for more than 10 million patients with at least one appointment during the study period (63 million visits in total), virtual care was associated with estimated savings of:
•    3.2 billion kilometres of patient travel;
•    545 to 658 million kilograms of carbon dioxide (CO2) emissions; and
•    $569 to $733 million (Canadian [US $465-$599 million]) in expenses for gasoline, parking, or public transit.

The avoidance of carbon dioxide emissions during the pandemic due to virtual visits represented approximately 0.2 per cent of the total annual carbon dioxide emissions (150 megatons) from Ontario. 

The number of virtual care visits was greater for those aged 65 and older, individuals with multiple health conditions, and those living in urban areas. Due to distance travelled, virtual care may offer more potential environmental benefits and patient cost savings for rural residents. Other factors, such as decreased time off work (given that some virtual visits can be done during the day with little interruption to work) may have had additional benefits for some working adults and parents of young children.

“Virtual visits should not replace all in-person visits, but they are an important option that can enhance the care that physicians provide for patients,” says Dr. Alexandra Zorzi, a Paediatric Oncologist at Children’s Hospital at London Health Sciences Centre and Associate Scientist at Lawson. “Our findings suggest that physicians should continue to offer virtual care appointments when appropriate, especially for patients living in more remote areas and those that have barriers to accessing in-person health care.”

The study, “Association of virtual care expansion with environmental sustainability and reduced patient costs during the COVID-19 pandemic in Ontario, Canada” was published in JAMA Network Open.

Author block: Welk B, McArthur E, Zorzi AP.

As ICES Western recruits a new Site Director, Dr. Amit Garg, who currently holds the position, sat down to talk about the importance of the work being done. Dr. Garg is also a Scientist at Lawson Health Research Institute, Nephrologist at London Health Sciences Centre (LHSC) and Professor at Western University’s Schulich School of Medicine & Dentistry.

What is your role with ICES Western?

Starting in 2009, I supervised the team responsible for the ICES Western build over an approximately three-year period. Since then, I have spent the last decade serving as the inaugural Site Director for ICES Western. 

Can you briefly describe the work that ICES Western does?

For those people who don't know, ICES is a province-wide non-profit research institute, founded in 1992, that is focused on translating data into trusted evidence. Our community is comprised of world-class research, data and clinical experts who evaluate health care delivery and population outcomes. 

ICES scientists and staff (currently about 570 in Ontario) and trainees (currently about 700) access a vast and secure array of Ontario’s demographic and administrative health-related data. ICES currently has 108 linked data holdings (with over one trillion data points), and the amount of data that ICES has available for use in research grows each year. The linked data include vital statistics, hospital services, physician claims, drug benefits, laboratory results, biosamples and immigration records. Our research, including 1,200 active investigator-initiated projects, is focused on making health policy and health care better, and people healthier.  

ICES Western is physically located at LHSC’s Victoria Hospital and is one of seven ICES satellite sites across Ontario. The site’s development is an ongoing partnership between LHSC, St. Joseph’s Health Care London, Lawson, the Academic Medical Organization of Southwestern Ontario (AMOSO) and Western. 

How does ICES’ work impact research being done in Ontario and across Canada?

ICES Western is a core facility that researchers use for research, training and decision support. Organizations such as our local hospitals and public health agencies make requests for decision support through a procedural mechanism called Applied Health Research Questions. 

Over the last two years, our researchers have conducted a great deal of COVID-19 research. Several projects at ICES Western have examined vaccine effectiveness and spread of the virus. Investigators have used a data-driven approach to help protect people experiencing homelessness in Ontario. Another study quantified the impact of COVID infections on physicians, including how many of them became ill, were hospitalized and received care in the intensive care unit. 

Research done through ICES Western has led to important changes in health care. For example, Health Canada instituted labeling requirement changes based on drug safety studies done through ICES.

Why is this work so important?

We all want better health outcomes for citizens, both in Ontario and throughout the world. Ideally, we want people to live longer, healthier lives without needing many health care resources, and we want that to be done in an equitable fashion. There is a substantial amount of research needed in multiple areas to achieve this goal. ICES provides a cutting edge infrastructure to enable this work.  

What kind of researchers are involved with ICES?

At ICES Western we support a whole host of individuals and entities as they conduct research. Health care delivery organizations and health agencies including LHSC, the Ontario Renal Network and Trillium Gift of Life Network use knowledge received through reports completed at ICES. Our typical individual investigators include both basic science and clinical investigators. We also support trainees in the areas of epidemiology and statistics, as well as many other fields of study, such as computer science and geography. These are all students who have an interest in working with ‘big’ data. Finally, we have personnel that work with privacy, data, analysis, epidemiology and more.

What do you see in the future for the organization?

We've made a lot of progress in the last 10 years and I can't wait to see what's going to happen in the future. We're still just scratching the surface in terms of what's possible. While what we have done in building this site and supporting important research is impressive, in terms of the possibilities – the sky's the limit. There is so much opportunity around new research and trial methodologies, new insights and new evaluation techniques. I expect ICES Western will continue to develop, enabling a growing number of people to make a large impact. I see ICES continuing to contribute to a world where people live longer, healthier lives. 

What is the most important thing people should know about ICES?

How enabling it is. It's time well spent to really understand what is and is not possible with ICES data and research expertise. Once you invest in it – really spend your time and energy to understand the potential– you start realizing all of these opportunities that would not be possible otherwise. With more than a thousand research studies underway across all ICES sites, we have great discoveries ahead to shape the future of health care in Ontario.