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.
Yes, I have a TSD (tongue stablizing device, the bulb type thzt operates on a passive vacuum.) I have used it consistently, but I am dissatisfied with it. Along with the common complaints mentioned already (drooling, inability to swallow, and discomfort), I also found that it is difficult to keep on my tongue through the night. If I increase the vacuum pressure it is too uncomfortable, if I don't have enough vacuum, it slips off during my sleep.
There may be some people for which this device works fine, like people with mild to moderate OSA, but my AHI (apnea-hyponeia index) is 40. For someone like me, MMA, MA and/or orthodontic treament, or a combination of these is the best way to go. My blockage is due to a retrognathic manible, which means the anterior to posterior measurement of the lower jaw is too short. It falls back on my airway taking my tongue with it shutting off my airway.