Anti-snoring tongue devices: how tongue-retaining devices work and what the evidence says

An anti-snoring tongue device holds your tongue forward with gentle suction so it doesn't drop back toward your throat while you sleep. Small trials show these devices can reduce snoring, and one did about as well as a palate procedure. They also have a reputation for drool and a sore tongue, and many people stop using them. Here's what the research shows, and how they compare with jaw-advancing mouthpieces.

What is a tongue-retaining device?

A tongue-retaining device is an oral appliance that pulls the tongue forward using suction rather than moving the jaw. You'll also see it called a tongue sleeve, tongue-stabilizing device or anti-snoring tongue device. A 2017 systematic review describes these devices as moving the tongue forward with suction forces during sleep.

Ready-made versions are usually a soft silicone bulb with flanges that rest on the outside of the lips. In the 2009 randomized trial described below, people put their tongue into the bulb as far as was comfortable, then squeezed and released it to create suction. The researchers noted that current ready-made designs don't cover the teeth and are held in place by suction alone. Custom versions also exist. A 2009 French study describes a custom one-piece device that covers both the upper and lower teeth and holds the tongue forward through suction created in a front compartment.

The idea is simple. The NHS says snoring happens when parts of the airway relax and narrow during sleep, and it lists the tongue partly blocking the back of the throat as one cause of snoring. Holding the tongue forward aims to keep that space open.

Do anti-snoring tongue devices work?

Anti-snoring tongue devices do reduce snoring in some people, but the studies are few and small. The best snoring data comes from a 2008 randomized crossover trial of a ready-made suction device, which lowered the snoring index from about 215 to 133 snores an hour. A control device without suction made no significant difference.

That 2008 trial, published in Sleep and Breathing, also found the suction device reduced breathing events more than the control. Just over half of participants (54%) said they would keep using it. The authors called for larger studies.

Other evidence points the same way:

• A 2000 study in Laryngoscope compared 10 people using a tongue-retaining device with 10 who had radiofrequency treatment of the soft palate. Both groups spent much less of the night snoring loudly, and the difference between them wasn't significant. The authors concluded that the choice should rest on factors other than effectiveness.
• A 2002 pilot study of six regular users found the device cut the louder snores (61 to 70 decibels) from about 41 to 8 an hour. It didn't change snoring at other loudness levels.
• In the 2009 French study of people with sleep apnea, self-rated snoring intensity fell by 68% with the device.

The research on tongue devices for sleep apnea is larger but still limited. The 2017 review pooled 16 studies with 242 patients and found breathing events fell by about 53% on average. Even so, the American Academy of Sleep Medicine's 2015 oral appliance guideline treats tongue-retaining devices as separate from jaw-advancing appliances and says there was insufficient evidence to assess them for sleep apnea. So a tongue device isn't a do-it-yourself sleep apnea treatment.

How does a tongue device compare with a mandibular advancement device?

A tongue device and a mandibular advancement device both aim to keep the tongue from blocking the airway, but they get there differently and people tolerate them differently. In the only randomized head-to-head trial we found, both cut breathing events by similar amounts, yet most people preferred the jaw device.

That trial, published in Sleep in 2009, tested both devices in 27 people with sleep apnea. A complete or partial response was seen in 68% with the jaw device and 45% with the tongue device. Snoring and sleep quality improved with both, with better results from the jaw device. By three weeks, 63.6% had stopped using the tongue device, and about 91% preferred the jaw device overall.

The 2009 French study came to a gentler conclusion. It found the tongue device performed similarly to jaw-advancing devices in its patients and suggested it as an option where teams are trained to fit it. About half (52%) were still using it after five years.

Our guide to anti-snoring mouthpieces and oral appliances covers the jaw-advancing type in more depth.

What are the side effects of a tongue device?

The main side effects of a tongue device are drooling, a dry mouth and irritation of the tongue. In the 2009 randomized trial, 86.4% of people reported excess saliva with the tongue device, 59.1% a dry mouth and 50% soft tissue irritation. Some problems lasted three weeks or longer.

The same trial describes a few more specific complaints. Several people felt a temporary tingling in the tongue for 30 minutes to an hour after taking the device out. Some got a small sore on the band of tissue under the tongue, which the researchers fixed by widening the notch in the device. Some also said swallowing was harder because the device held the mouth slightly open.

In the 2009 French study, the people who kept using the device most often mentioned discomfort and excess saliva, and 30% reported no side effects at all. Among those who quit, the most common reasons were discomfort or a foreign-body feeling (49%) and pain (31%). Changes in the position of the front teeth or gum problems were reported by 16% of everyone treated, and patients described them as minor.

If you try one, expect a settling-in period, and stop if your tongue gets sore or stays numb. A dentist can check your teeth and gums if you use any oral device for months at a time.

Who might do well with a tongue device?

People who might do well with a tongue device are those whose snoring comes from the tongue falling back and who breathe easily through their nose. The 2009 French study found nasal obstruction was a strong predictor of giving up, and the authors suggested treating it as a reason not to use the device.

The reasoning is straightforward. A one-piece device that fills the front of the mouth means breathing almost entirely through the nose, which is hard if the nose is blocked. Try our nose test first, and see how to unblock your nose before bed if it feels tight.

The same study found people with a normal bite were more likely to stick with the device than people whose jaws were set further back or forward. Its authors also preferred patients to have at least six teeth in each jaw for their custom device, but noted that a tongue-retaining device is the only oral appliance that can be used by someone with no teeth. If you sleep mostly on your back, it's also worth trying a change of position first. Our guide to sleep position and snoring has practical tips.

Should you see a doctor or dentist first?

You should see a doctor before using a tongue device if there's any chance your snoring is sleep apnea. The AASM guideline says snoring without sleep apnea should be diagnosed by a sleep physician, not a dentist. The NHS lists daytime sleepiness, breathing that stops and starts, and gasping or choking at night as reasons to see a doctor.

A tongue device that quiets the snoring can hide those signs without fixing the cause. Our guide to snoring vs. sleep apnea explains the difference.

For ongoing use, dental advice helps too. The German snoring guideline recommends that jaw-advancing devices be fitted and monitored with dental and sleep medicine experts, and that long-term users watch for changes in their bite. The same caution makes sense for any oral device worn every night, since the French study also recorded tooth position changes with tongue devices.

What if your snoring starts in your nose or mouth?

If your snoring starts in your nose or mouth rather than your tongue, a different approach may fit better. The NHS matches a blocked or narrow nose to nasal strips or dilators, and a mouth that falls open in sleep to devices that keep the mouth closed. A tongue device doesn't address either.

Many snorers have more than one thing going on, so it helps to work out where your snoring comes from. Our article on reasons you snore walks through the common causes, and mouth tape and nasal strips together covers the nose-and-mouth combination. If that combination sounds like you, the Titan Sleep System pairs a nasal strip with mouth tape.

Mouth tape is only for adults who can breathe comfortably through the nose with the mouth closed. We don't recommend mouth tape for children.

Our pick (paid partner): Titan Sleep System

For people whose snoring seems to come from a stuffy nose or a mouth that falls open, our pick is the Titan Sleep System. It isn't a tongue device and doesn't do what one does. It's a different approach for nose and mouth breathers, and we haven't tested or ranked products ourselves.

Titan says the system combines TitanAir Nasal Strips and Titan Mouth Tape as one nightly routine. Titan describes the strips as drug-free external nasal dilators with flexible spring-loaded bands, and the tape as a bamboo silk strip with an adhesive made to grip through stubble and beards. Titan says every batch is third-party tested and certified PFAS-free, and that its 30-night guarantee refunds you if your sleep isn't better after 30 nights.

Read next

• Anti-snoring mouthpieces and oral appliances
• Mouth and tongue exercises for snoring
• How to stop snoring

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.