On This Page
Tongue-Retaining Devices (TRDs)
Our editorial process includes extensive measures to verify accuracy, provide clarity on complex topics, and present factual information. Read more
Key Takeaways
- Tongue-retaining devices are oral appliances that are used to treat snoring and mild to moderate obstructive sleep apnea.
- TRDs use suction to move the tongue forward and away from a person’s breathing passages, which helps make breathing easier.
- Some TRDs are available over-the-counter, but they’re usually basic models meant to stop snoring. Physicians can help with getting a custom-fitted device for treating sleep apnea.
What Is a Tongue-Retaining Device?
A tongue-retaining device (TRD) is an oral appliance that’s used to treat snoring and as an alternative to CPAP therapy for mild to moderate obstructive sleep apnea (OSA). It sits in your mouth like a mouthguard and uses a silicone bulb to hold your tongue forward in your mouth and away from your upper airway with gentle suction.
In pharmacies, you can find over-the-counter anti-snoring devices that are similar to TRDs, but people with an OSA diagnosis should consult their doctor and get a prescription for the right TRD for their anatomy and individual needs rather than buying one at a store.
Tongue-Retaining Device vs. Mandibular Advancement Device
TRDs and mandibular advancement devices (MADs) are both oral appliances used to treat OSA by keeping your upper airway clear of obstruction. But while TRDs hold your tongue forward in your mouth using suction, MADs move your lower jaw forward slightly. MADs are more popular and widely prescribed than TRDs.
MADs fit over your teeth and feel similar to a mouthguard used for sports. TRDs sit more at the front of your mouth and extend forward. The two devices take up similar amounts of space, and can feel a bit uncomfortable or strange at first. Despite their initial discomfort, many people find them easier to stick with than CPAP therapy, and there’s evidence showing that both devices work to decrease OSA severity of mild to moderate cases.
Don’t Just Test Your Sleep. Understand It.
Measure key sleep metrics and review your results with a licensed sleep-care provider. Discuss sleep issues and options to make restless nights a thing of the past.
How Do Tongue-Retaining Devices Work?
For some people, the position of the tongue during sleep can contribute to snoring and obstructive sleep apnea by blocking the upper airway. TRDs hold the tongue forward, which helps to keep their breathing passages open and prevents their tongue from obstructing their airway.
TRDs achieve this through gentle suction. Though devices can vary in design, they generally work similarly. There’s a silicone or plastic guard that fits over the front of the teeth and is attached to a hollow bulb that extends forward and out of their mouth. The user puts their tongue inside the bulb and suction keeps their tongue away from the back of their throat. To release their tongue, users squeeze the bulb.
What Are the Benefits of Tongue-Retaining Devices?
TRDs are an excellent option for people who don’t tolerate CPAP therapy well. When used as directed, they can decrease apneatic events like pauses in breathing by as much as 53%. They’re also small and easy to transport, which makes them ideal for travel. TRDs can also reduce snoring, and some people use over-the-counter options to treat snoring as a standalone issue.
What Are the Side Effects of Tongue-Retaining Devices?
Some people find TRDs awkward and uncomfortable to wear, especially at first. Other side effects include tongue irritation, drooling, and dry mouth. Tooth soreness and changes in bite could also be possible.
Is a Tongue-Retaining Device Right for You?
Tongue-retaining devices aren’t the right solution for everyone, but they can be a helpful option for certain people with snoring or sleep apnea. If you’re considering one, talk to your doctor. They’ll consider factors like the severity of your sleep apnea, comfort preferences, and ability to use the device consistently.
If you’re currently on CPAP therapy, it’s important to continue until discussing your alternative treatment options with your doctor. Not everyone tolerates CPAP therapy well, but stopping can have a serious impact on your health.
Who Should Consider a Tongue-Retaining Device?
TRDs can be particularly beneficial for some people, including:
- People with mild to moderate OSA
- Snorers
- CPAP-intolerant users
- People who cannot use MADs because of jaw pain or temporomandibular joint (TMJ) pain
- Those seeking a travel-friendly treatment option
Who Should Not Use a Tongue-Retaining Device?
Though TRDs are fairly non-invasive, there are particular groups of people who shouldn’t use them to treat OSA.
- Those with moderate to severe or severe OSA
- People with nasal obstructions
- Those who wear denture or braces, depending on the device design
- People who cannot tolerate tongue suction
- Anyone with severe gum disease
- People with central sleep apnea (CSA)
- Those who experience pain after wearing the device
- People with tongue-tie, or a short lingual frenulum
How Do You Use a Tongue-Retaining Device?
Using a TRD is relatively straightforward, but wearing it correctly is important.
- See your physician to get fitted for a device and have impressions made of your mouth.
- Brush and floss your teeth normally, as you would before bed.
- Run the TRD under the faucet to get it wet, which can help improve suction.
- Place the device against your lips with the guard against your teeth and the bulb sticking out of your mouth.
- Put your tongue into the bulb and squeeze the bulb with your fingers to activate the suction.
- Check that the device is seated correctly and comfortable, then go to sleep.
Cleaning your TRD is important. In the morning, brush it gently with a toothbrush and mild soap, which is a better, less harsh option than toothpaste. You can also soak your TRD in denture or retainer cleaner weekly to prevent bacteria growth and build up.
When to Talk to a Doctor
Treatment for sleep apnea requires diagnosis with an in-lab sleep study or at-home sleep test and a diagnosis from a doctor.
If you wake up regularly gasping or choking for air, or a partner tells you that you do, it may be time to take a home sleep test. You should also talk to a doctor if you have daytime fatigue, feel irritable, experience regular headaches, or are a loud, regular snorer.
If you already have an OSA diagnosis but want to try something other than CPAP therapy, it’s worth speaking to your doctor about switching to an oral appliance like an MAD or TRD, especially if you have a hard time adhering to CPAP treatment.
Frequently Asked Questions
Do tongue-retaining devices work?
One study shows that tongue-retaining devices can lower a person’s apnea-hypopnea index (AHI) score by up to 53%, which means they have a 53% reduction in the amount of times they pause or stop breathing during an hour of sleep.
That said, TRDs aren’t an effective sleep apnea treatment for everyone. They’re best for people who don’t tolerate CPAP therapy well and those with mild to moderate sleep apnea. They aren’t as effective for people with more severe OSA.
Do you need a prescription to buy a tongue-retaining device?
You don’t need a prescription to buy a TRD over-the-counter. However, these more basic TRDs are typically designed to prevent snoring and aren’t intended to treat sleep apnea. A physician can write you a prescription for a TRD that’s molded to your anatomy and more effective at treating OSA than the anti-snoring devices you’ll find at the store. Insurance plans may be more likely to cover prescribed TRDs as well.
Can you use a tongue-retaining device every night?
You can, and should, use a TRD every night if you have a sleep apnea diagnosis and it’s been prescribed as part of your treatment plan. Stopping OSA treatment, even short term, can lead to increased symptoms and health risks.
Is a tongue-retaining device better than CPAP?
CPAP therapy is the most effective treatment for sleep apnea, and it’s the most widely prescribed treatment in the U.S. However, not everyone is comfortable wearing a mask or breathing out against pressurized air. For those people, a TRD may be a suitable alternative treatment that helps maintain a clear airway.
TRDs are best for people with mild to moderate OSA, those with more severe OSA will likely need to stick with CPAP therapy or seek another option. Your doctor can give personalized advice on what type of sleep apnea treatment is best for your needs.
References
The Sleep Doctor Forum
Real Experiences, Real Connections
Continue the discussion on the Sleep Doctor Forum. Connect with experts and fellow forum members on CPAP, sleep apnea, and all things sleep. A priceless resource that’s free to join.
