We know that it can be a challenge to find information about tongue retaining devices and we would like to help.

This blogpost was written by an Ear, Nose and Throat surgeon also fellowship trained in Sleep Medicine.

As part of the background for this blogpost, we searched the internet for frequently asked questions and answered them.

The goal of the blogpost is to educate you on what snoring and obstructive sleep apnea are and how tongue retaining devices can help improve breathing during sleep.

This blogpost provides illustrations that shows the anatomy behind tongue retaining devices and why it is that they can help improve snoring and OSA.

Upper airway obstruction at the level of the tongue. The obstruction makes it so that oxygen cannot get into the airway and carbon dioxide cannot leave. The light blue arrow points to the obstructed tongue. CamachoMD.com
Upper airway obstruction at the level of the tongue. The obstruction makes it so that oxygen cannot get into the airway and carbon dioxide cannot leave. The light blue arrow points to the obstructed tongue.

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Summary for Tongue Retaining Devices for Snoring and Obstructive Sleep Apnea:

Tongue retaining devices basically using suction forces on the tongue and pull it forward and out of the mouth.

Tongue retaining devices are then worn during sleep.

Snoring and obstructive sleep apnea are caused by the soft tissues that are in the throat and narrow the airway during sleep.

Devices that treat snoring and obstructive sleep apnea either push airway structures out of the way, or they pull structures forward (which also helps to keep the airway more open).

Because the tongue is attached to the soft palate, when patients wear a tongue retaining device, both the tongue and soft palate (and uvula) move forward.

Overall, tongue retaining devices have reduced obstructive sleep apnea by approximately 50%, increased lowest oxygen saturation by 4% and also have significantly decreased sleepiness.

Background

Who uses tongue retaining devices?

People who snore or have obstructive sleep apnea might use tongue retaining devices.

What are tongue retaining devices?

Tongue retaining devices are also known as tongue stabilization devices. Tongue retaining devices are made out of soft material, such as silicone. They are then placed onto the tip of the tongue so that the suction forces can hold the tongue forward.

Tongue retaining device woman lying down. Note that the device pulls the tongue forward, which opens the upper airway. CamachoMD.com
Tongue retaining device woman lying down. Note that the device pulls the tongue forward, which opens the upper airway.

When is it appropriate to explore tongue retaining devices as treatment for snoring and obstructive sleep apnea?

If a patient snores or has obstructive sleep apnea, then the sleep medicine specialist will provide treatment recommendations. Generally, continuous positive airway pressure (CPAP) are tried first. If a patient cannot tolerate CPAP after working with their sleep medicine physician to improve any problems, then alternatives may be explored.

Where are tongue retaining devices sold?

Tongue retaining devices are sold on Amazon and on the internet by simply typing “tongue retaining devices” on google. We are not affiliated with any company that sells tongue retaining devices and cannot provide any guidance or reviews on specific products.

How do tongue retaining devices work?

When the tongue is pulled forward by the suction forces of the device, the size of the upper airway increases. The increased size of the upper airway allows for better airflow during sleep.

Upper airway that is open with normal breathing. Note that the oxygen goes into the airway and the carbon dioxide leaves the airway. CamachoMD.com
Upper airway that is open with normal breathing. Note that the oxygen goes into the airway and the carbon dioxide leaves the airway.
Upper airway obstruction at the level of the soft palate and the tongue. Note that since the airflow is blocked, the oxygen cannot get into the airway and carbon dioxide cannot leave. The light blue arrow points to the obstructed palate and the obstructed tongue. CamachoMD.com
Upper airway obstruction at the level of the soft palate and the tongue. Note that since the airflow is blocked, the oxygen cannot get into the airway and carbon dioxide cannot leave. The light blue arrow points to the obstructed palate and the obstructed tongue.

How do you use a tongue retaining device?

The tongue retaining device is placed onto the tip of the tongue. There are parts of the tongue retaining devices that stick out and prevent them from falling into the mouth.

Why should patients use tongue retaining devices?

Tongue retaining devices should only be used if they are recommended by a sleep medicine physician or a healthcare provider who treats obstructive sleep apnea patients.

How are snoring and obstructive sleep apnea diagnosed?

Snoring is due to the vibration of the soft tissues of the upper airway. If the tissues obstruct the airway in a manner that is repeated (at least 5 times per hour, lasting 10 seconds each time), then this is known as obstructive sleep apnea.

How effective are tongue retaining devices in treating snoring and obstructive sleep apnea?

Dr. Chang and colleagues performed a review and found that retaining devices have reduced obstructive sleep apnea by approximately 53%, increased lowest oxygen saturation by 4% and also have significantly decreased sleepiness.[1]

Tongue retaining device woman lying down. Note that the device pulls the tongue forward, which opens the upper airway. Note: oxygen (blue) is able to come into her airway and carbon dioxide (green) is able to go out of the airway. CamachoMD.com
Tongue retaining device woman lying down. Note that the device pulls the tongue forward, which opens the upper airway. Note: oxygen (blue) is able to come into her airway and carbon dioxide (green) is able to go out of the airway.

How long does it take for tongue retaining devices to start working?

Tongue retaining devices can take a while to get used to. Having the tongue sticking out of the mouth is an unnatural sensation. Drooling can be a problem since the tongue is sticking out and that can make it difficult to swallow.

Testing

Are there tests that can be performed to show how effective tongue retaining devices are for patients who have obstructive sleep apnea?

Yes, once the sleep medicine physician has determined that the tongue retaining device may be working well, then they may recommend that a new sleep study be performed (with the device being worn) to ensure that it worked.

Side Effects and Complications of No Treatment

What are the side effects associated with tongue retaining devices?

Drooling, dry mouth, tongue pain, tongue soreness and other potential side effects.

Has the FDA (Food and Drug Administration) provided guidance about tongue retaining devices?

The FDA has provided information a “Class II Special Controls Guidance Document: Intraoral Devices for Snoring and/or Obstructive Sleep Apnea.

Can you make your own tongue retaining device?

Patients should not make their own tongue retaining devices. If the tongue retaining devices are purchased from a company that has properly designed and tested their products, then it is more likely that they will function better. 

Government Disclaimer: The views expressed in this website are those of the author(s) and do not reflect the official policy or position of the Department of the Army, Department of Defense, or the US Government.

References:

1.            Chang ET, Fernandez-Salvador C, Giambo J, et al. Tongue retaining devices for obstructive sleep apnea: A systematic review and meta-analysis. Am J Otolaryngol. 2017;38(3):272-278.