Tongue Retaining Device for Obstructive Sleep Apnea: Does It Work?

There are many variations of oral appliances to treat snoring and obstructive sleep apnea, but one variation that you may not have heard of is the tongue retaining device (TRD). There are also different variations of TRDs, from suction bulbs to hybrid mandibular advancement device-TRDs. Here’s one example and here’s another. Here’s a good review of the science behind tongue retaining devices.


In this month’s issue to Journal of Clinical Sleep Medicine, French researchers reported complete or partial responses in 71% of cases, with the mean AHI dropping from 38 to 14. Snoring dropped by 68%, and subjective sleepiness dropped significantly as well.


What I had in mind when I saw the paper’s title was the suction cup-like device that sits between your teeth and lips, with a bulb protruding out your mouth. Your tongue sits inside the suction cup, keeping it from falling back. A simple and novel idea. However, when I looked more closely at the study it turns out that what they call a tongue retaining device is actually a hybrid mandibular advancement device and TRD. We know that mandibular advancement devices, by pushing your jaw forward can significantly push your tongue base forward, improves the space behind your tongue. The researchers set the mandibular protrusion at 50 to 75% of maximal protrusion, which can definitely improve your sleep quality.


Although my experience is limited, I’ve had mixed results in people who have tried tongue retaining devices. In general, they’re not as expensive as the formal mandibular advancement devices, so there’s less of a barrier for people to try it out. 


Just out of curiosity, I have patients stick out their tongue whenever I examine the space behind the tongue while they’re lying flat on their backs. This is a rough estimate, but only in about one out of 4 times, do I see any significant improvement in the posterior airway space. This may explain why many patients don’t see any benefits. Drooling, discomfort and an inability to swallow are some of the more common complaints.


Have you tried tongue retaining devices and if so, what’s been your experience? Please enter your responses below.

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9 thoughts on “Tongue Retaining Device for Obstructive Sleep Apnea: Does It Work?

  1. I have been using an appliance designed by Jonathan Greenburg DDS Southern CA). It is effective as long as I can breathe through my nose, which is not always possible because of nasal polyps. I experienced REM sleep for the first time in many, many years. My AH went down from 67 to 42 and I feel better rested, but not entirely. I have been moderately pleased although I would be interested in learning more about your program.

  2. I have had OSA since at least age 15, not diagnosed until much later. CPAP never helped, even at high pressure. Had extensive surgery at age 36 (U3P, septoplasty, turbinectomy, genioglossus advancement, and hyoid suspension. I estimate a 60% improvement in sleep quality (no follow-up sleep study done because health insurance lapsed). 60% improvement was welcome, but I still suffer greatly.

    The point: I have come to realize that much of my problem is caused by my “upper” tongue (the visible, in-the-mouth part) blocking EXHALATION. My fat tongue takes up my whole mouth and often protrudes between my upper and lower teeth all-the-way-round from molar to molar. Often, when I wake at night, i find myself making a ‘Thhh’ or ‘Chhh’ sound as I push air out around my tongue. Occasionally, I even wake myself up because I have bitten my tongue!

    Of course, this implies that something is blocking my nasal airway at the same time. I suspect that my tongue is also the culprit here too.

    How does this relate to Tongue Retaining Devices? Well, I have fashioned my own device. It is more of a bypass that a retainer. It is the mouth piece cut-off from a swimming snorkel, with 2 pieces of clear plastic tube extending through the middle and over my tongue. the tubes are long enough to allow air past most of my tongue, but not long enough to induce gag reflex.

    When I use this device, my sleep is imperfect, but noticeably better. I might only wake up a half-dozen times per night and I will have very long dreams while I sleep that I can remember after i wake (almost unheard of for me).

    I’ve never found any mention of “upper tongue-induced, exhaling apnea” on any site. Is my anatomy so unique, or has this condition been overlooked? Or, perhaps more likely, is it just that I have failed to find it with my amateur research skills?

    Your opinion/advice would be very welcome.

  3. Mr. McIntyre,

    What you’re proposing is certainly possible, but yet to be documented. Another possibility is that your soft palate is flapping back into the opening into your nose, causing a sudden exhalational breathing pauses, with air leaking out through the mouth.

  4. Hi everyone!
    I bought one of these anti-snoring first aid from It is a simple black and blue jaw strap for $119. I got it for 90 dollars after the usual discount given at the website. Anyways, I used it for several nights. It was very painful experience and I woke up both in the middle of the night and in the morning with painful jaws and mouth! My wife compalined as always from my snoring. This time just the jaws pain added. That’s why I decided to return it back. Yet could not find an address to retirn it!
    Now, I am going to try one of these tounge retaining devices and let you know about my experince once I tried it. Wish me luck!

  5. I started using the Good Morning Snore Solution with the cpap. The GMSS is the only TSD I’m able to use with my nasal pillows mask because the wings extend farther out than the other TSDs on the market. Air does not leak from the corners of my mouth like the other TSDs, whose wings are more narrow. Since not only my tongue is an obstruction but also my narrow airway is prone to collapse, I have to use both the GMSS with the cpap and this also allows me to use a much lower pressure than with the cpap alone. The GMSS has been a godsend to me to use with the cpap. Hope this info helps others.

  6. I have tried the tongue retaining device.
    It seems to fit very well at first.
    But it does not stay in place for more than an hour.
    How can I prevent it falling out?

  7. Dr Steven, I think your rationale is wrong. When a person wears a tongue retaining device it prevents or resists the tongue to go back obstructing posterior airway during sleep. To be effective it is not necassary to provide significant improvement in the posterior airway space, particularly in an awake person. It only needs to resist backward movement of the tongue when the person sleeps.

  8. Dr. Toprak,

    Thanks for commenting. Unfortunately, when a person sleeps, especially on the back and in REM sleep, the tongue can fall back much more easily. Having the patient stick out the tongue will give inconsistent results: The space behind the tongue improves in some, stays the same in some and worsens in others.

    Due to the pliability of the tongue muscles, pulling on the tip of the tongue doesn’t always lead to movement of the tongue base. From what I see during drug induced sleep endoscopy, tongue collapse can be very significant. However, many patents who snore have no significant tongue collapse and will have mostly soft palate collapse. In these situations, TRDs won’t help.