Original Article | UChicago Medicine | by Esra Tesali, MD

From counting sheep to white noise and weighted blankets, people have tried innumerable ways to get a good night’s sleep. Sleep disruptions can have far-reaching negative consequences, impacting cardiovascular and metabolic health, memory, learning, productivity, mood regulation, interpersonal relationships and more.

It turns out that an important tool for improving sleep quality may have been hiding in plain sight…in the produce aisle. A new study led by researchers at the University of Chicago Medicine and Columbia University found that eating more fruits and vegetables during the day was associated with sleeping more soundly later that same night.

“Dietary modifications could be a new, natural and cost-effective approach to achieve better sleep,” said co-senior author Esra Tasali, MD, director of the UChicago Sleep Center. “The temporal associations and objectively-measured outcomes in this study represent crucial steps toward filling a gap in important public health knowledge.”

Uncovering the connection between diet and sleep

Studies have shown that inadequate sleep can cause people to gravitate towards unhealthier diets higher in fat and sugar. However, despite the far-reaching effects of sleep on public health and even economic productivity, doctors and scientists know far less about how diet can affect sleep patterns.

In previous observational studies, high fruit and vegetable intakes were associated with better self-reported overall sleep quality, but this new study was the first to draw a temporal connection between a given day’s dietary choices and objectively-measured sleep quality that same night.

Healthy young adults who participated in the study reported their food consumption each day with an app and wore a wrist monitor that allowed the researchers to objectively measure their sleep patterns. The researchers specifically looked at “sleep fragmentation,” an index that reflects how often someone awakens or shifts from deep to light sleep throughout the night.

Promising findings support dietary guidelines

The researchers found that each day’s diet was correlated with meaningful differences in the subsequent night’s sleep. Participants who ate more fruits and vegetables during the day tended to have deeper, more uninterrupted sleep that same night, as did those who consumed more healthy carbohydrates like whole grains.

Based on their findings and statistical modeling, the researchers estimate that people who eat the CDC-recommended five cups of fruits and veggies per day could experience a 16 percent improvement in sleep quality compared to people who consume no fruits or vegetables.

“16 percent is a highly significant difference,” Tasali said. “It’s remarkable that such a meaningful change could be observed within less than 24 hours.”

Future studies will help establish causation, broaden the findings across diverse populations, and examine the underlying mechanisms of digestion, neurology, and metabolism that could explain the positive impact of fruits and vegetables on sleep quality. But based on current data, the experts confidently advise that regularly eating a diet rich in complex carbohydrates, fruits, and vegetables is best for long-term sleep health.

“People are always asking me if there are things they can eat that will help them sleep better,” said co-senior author Marie-Pierre St-Onge, PhD, director of the Center of Excellence for Sleep & Circadian Research at Columbia. “Small changes can impact sleep. That is empowering — better rest is within your control.”

“Higher daytime intake of fruits and vegetables predicts less disrupted nighttime sleep in younger adults” was published in Sleep Health: The Journal of the National Sleep Foundation in June 2025. Co-authors include Hedda L. Boege (Columbia), Katherine D. Wilson (University of California San Diego), Jennifer M. Kilkus (UChicago), Waveley Qiu, (Columbia), Bin Cheng (Columbia), Kristen E. Wroblewski (UChicago), Becky Tucker (UChicago), Esra Tasali, (UChicago), and Marie-Pierre St-Onge (Columbia). The work was supported by grants from the National Institutes of Health (R01HL142648, R35HL155670, UL1TR001873, CTSA-UL1TR0002389, UL1TR002389, R01DK136214, T32HL007605), and the Diabetes Research and Training Center at the University of Chicago.

Untreated sleep apnea during pregnancy is associated with several increased health risks for both the mother and the baby. Sleep apnea is characterized by repeated interruptions in breathing during sleep, leading to poor oxygenation and fragmented sleep. Below is a summary of the risks:

Maternal Risks

1. Preeclampsia: Sleep apnea is linked to a higher risk of preeclampsia, a condition marked by high blood pressure and damage to organs such as the liver and kidneys.

2. Gestational Hypertension: Increased risk of elevated blood pressure during pregnancy.

3. Gestational Diabetes: Sleep apnea may impair glucose metabolism, leading to a higher incidence of gestational diabetes.

4. Cardiovascular Strain: Recurrent oxygen deprivation can stress the cardiovascular system, potentially leading to arrhythmias or heart issues.

5. Fatigue and Depression: Chronic sleep disruption can exacerbate pregnancy-related fatigue and increase the risk of depression or mood disorders.

6. AND, weight gain, hormonal changes and fluid retention can place you at a higher risk of having sleep apnea when you are pregnant.

Fetal Risks

1. Low Birth Weight: Poor oxygenation in the mother can restrict fetal growth.

2. Preterm Birth: Sleep apnea may increase the likelihood of delivering before 37 weeks of gestation.

3. Fetal Hypoxia: Reduced oxygen levels in the mother can lead to inadequate oxygen delivery to the fetus, affecting development.

4. Neonatal Complications: Babies born to mothers with untreated sleep apnea may face a higher risk of requiring neonatal intensive care.

Long-Term Considerations

Both the mother and the child may face long-term health implications if sleep apnea remains untreated. Early intervention, including the use of an oral appliance or continuous positive airway pressure (CPAP) therapy, weight management, and proper prenatal care, can mitigate many of these risks.

If you suspect sleep apnea during pregnancy, it is crucial to consult a healthcare provider for evaluation and management.

Obstructive sleep apnea (OSA) is a prevalent sleep disorder that affects millions of people worldwide. Characterized by repeated interruptions in breathing during sleep, OSA can lead to a variety of health complications, including cardiovascular issues, fatigue, cognitive decline, and a diminished quality of life. While Continuous Positive Airway Pressure (CPAP) therapy remains the gold standard for treating OSA it is too often intolerable to use.  I am not against the use of CPAP, it can be a great treatment for many people, but unfortunately half the people that try CPAP cannot sleep with it for a variety of reasons.  If you can’t sleep with CPAP, you are not the “world’s biggest looser” – you are a member of a big club!  In addition, we understand there are thousands of people (maybe more) that will not even get tested for OSA because CPAP is the only treatment know and they do not want to try it.  In terms of the ability to open the airway during sleep, the next best treatment for OSA is Oral Appliance Therapy (OAT) – and it’s another non-surgical approach that is far more tolerable than CPAP. For most patients OAT treats their OSA as well as CPAP, but for others it reduces their OSA but leaves some residual OSA and/or symptoms untreated.  To optimize treatment with OAT other modalities can be added based on patient preference, problems and medical necessity to optimize treatment. Today’s blog will discuss adding Mouth Taping to OAT – we will talk about other adjunctive modalities, like nasal patency, lateral sleep aides, etc in another blog.

Oral Appliance Therapy (OAT)

What is Oral Appliance Therapy?

Oral Appliance Therapy involves wearing a custom-fitted device in the mouth during sleep. These devices are designed to keep the airway open by repositioning the jaw and tongue forward during sleep. OAT is more effective for people with mild to moderate OSA but can also be used for those with severe OSA if they cannot tolerate CPAP or refuse to try one.  For others, it’s a great alternative treatment for travel, or when they are in places that make their CPAP difficult to use. Sometimes the more tools in the toolbox the better!

How Does OAT Work?

The primary mechanism behind OAT is the advancement of the lower jaw (mandible) and the stabilization of the tongue in a more forward position. By moving the jaw and tongue forward, oral appliances prevent the soft tissues in the throat from collapsing and blocking the airway during sleep. This leads to a more unobstructed breathing pathway, reducing apneas (total closures) and hypopneas (partial closures).

Benefits of OAT:

• Comfort and Convenience: Oral appliances are small, portable, and easy to wear, making them more comfortable than bulky CPAP machines.
• Improved Compliance: Studies show higher long-term adherence rates with OAT compared to CPAP, largely due to its non-invasive nature and increased comfort
• Non-Invasive: Unlike surgery, OAT does not involve any permanent alterations to the airway structure, making it a low-risk option.
• Custom-Fit: These appliances are tailored to fit each patient, ensuring a snug and effective treatment.

Mouth Taping for OSA

What is Mouth Taping?

Mouth taping is a technique where a piece of hypoallergenic tape is placed over the mouth to encourage nasal breathing during sleep. If you Google mouth taping you will find hundreds of specifically designed tapes. The theory behind mouth taping is simple: by keeping the mouth closed, individuals are forced to breathe through their nose, which can help reduce airway collapse.  In addition, it can also help prevent that dry mouth feeling during the night (because breathing through your mouth creates that dry mouth).

Mouth Taping alone rarely treats OSA

However, mouth taping can be a useful adjunctive therapy to use with your oral appliance or with CPAP.  Please only use mouth taping under the guidance of your healthcare practitioner.

How Does Mouth Taping Help?

Mouth taping helps mitigate sleep apnea symptoms by promoting nasal breathing. Breathing through the nose has multiple benefits for OSA sufferers:

• Nasal breathing activates the diaphragm, which leads to deeper, more stable breaths.
• The nose filters and humidifies air, making breathing smoother and less prone to obstruction.
• Mouth breathing can lead to snoring and throat relaxation, which may exacerbate OSA symptoms.
• By keeping your mouth closed and breathing through your nose your airway will stay slightly more “inflated” during sleep – thus helping to reduce airway collapse which is the “apnea”.

It is important to note that mouth taping should be done cautiously and under professional guidance.  Mouth taping needs to be done using a relatively weak adhesive that so that it is easily removed and it always has to be done so that you can still breathe through you mouth if your nose gets clogged during sleep.

Benefits of Mouth Taping:

• Non-Invasive: No equipment or devices are needed other than a small piece of tape.
• Inexpensive: Mouth taping is a low-cost option compared to other treatments.
• Improves Sleep Quality: Promoting nasal breathing can lead to fewer sleep interruptions and better overall sleep quality.

Downsides:

• Not a Standalone Solution for OSA: Studies show mouth taping alone is unlikely to treat sleep apnea effectively, even mild OSA.
• Risk of Nasal Obstruction: Those with nasal congestion or structural issues, like a deviated septum, may struggle with mouth taping.
• Discomfort: Some users may find the sensation of having their mouth taped shut uncomfortable or claustrophobic.

Combining OAT and Mouth Taping: A Holistic Approach

As we discussed above, for some patients, although the use of oral appliance therapy improves their OSA, residual OSA or symptoms persist.  This dual approach can potentially improve the effectiveness of treatment by addressing multiple factors that contribute to OSA.

A study performed in our office in conjunction with the Brigham and Women’s’ Hospital/Harvard Medical School showed that the use of both together can improve the efficacy of treatment for some patient (https://www.atsjournals.org/doi/10.1513/AnnalsATS.202109-1050OC). You will not know until you try!          

Before combining treatments, however, it is crucial to consult with a healthcare provider or sleep specialist. They can help determine the best course of action based on the severity of the apnea and individual needs.

Conclusion

Oral Appliance Therapy and mouth taping represent two alternative treatment options for people struggling with OSA, especially for those who cannot tolerate CPAP. While OAT is backed by robust clinical evidence and is widely recognized as an effective treatment for OSA, mouth taping is still relatively new in the OSA treatment space but shows promise as an adjunct therapy. Both options have their benefits and potential downsides, and individual results will vary. Consulting with a healthcare provider is essential to determine the most appropriate treatment based on the severity of your condition.

If you or a loved one suffer from sleep apnea, consider exploring these alternatives as part of a comprehensive treatment plan that can improve your sleep quality and overall health.

Disclaimer: Always consult with a licensed healthcare provider before making any changes to your sleep apnea treatment plan.