Using a Tongue Stabilizing Device for Sleep Apnea

This oral appliance may improve breathing by pulling the tongue forward

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Oral appliances are sometimes recommended for managing obstructive sleep apnea (OSA). A tongue stabilizing device (TSD) is one that can help sleep apnea by pulling the tongue forward, improving breathing and reducing waking up throughout the night due to low oxygen levels.

This article describes how a tongue stabilizing device works for sleep apnea, who it may be appropriate for, how to use one, and possible issues with using this appliance.

The Aveo tongue stabilizing device
Brandon Peters, M.D.

What Is a Tongue Stabilizing Device?

A TSD is a small piece of plastic that sits at your lips and resembles a large pacifier with a hole into which you can insert your tongue.

When placed in the mouth, it can hold your tongue forward, which might alleviate snoring or sleep apnea that occurs with an obstructed airway.

Two of the popular models are the AveoTSD and Good Morning Snore Solution devices.

A TSD device must be properly fitted by a medical professional, typically your healthcare provider or dentist.

Treatments for OSA are aimed at opening the airway to prevent snoring and maintain oxygen levels. The goal is to avoid waking episodes and to feel more rested throughout the day. OSA is also known to cause many health complications.

Who Might Use a TSD (and Who Shouldn't)

You might consider using a tongue stabilizing device if you:

  • Have been unable to tolerate standard treatments for sleep apnea, such as continuous positive airway pressure (CPAP).
  • Your airway is obstructed due to a large tongue (called macroglossia).

A tongue stabilizing device should not be used by:

  • People who cannot stick their tongue out past their teeth, which is needed to secure the device in place
  • People with central sleep apnea, which has different causes than OSA
  • Children, who often have different causes of breathing issues during sleep, such as allergies, tonsil enlargement, and facial anatomy that might contribute to the problems

How to Use a Tongue Stabilizing Device

A tongue stabilizing device must be rinsed with hot water before it is applied to your tongue. This will make the plastic more flexible and the fit more secure.

To use it, place the device in your mouth every night before sleeping and remove it in the morning when you wake up.

Possible Problems With Tongue Stabilizing Devices

The tongue stabilizing device isn't always effective and it can have some side effects.

Issues that some users report include:

  • The device coming off during the night, especially if it fits poorly
  • A disagreeable sensation on the tip of the tongue
  • Increased salivation and possibly drooling
  • Dry mouth
  • Difficulties swallowing, which relates to the altered positioning of the tongue
  • A slight discoloration of the tongue

If you have difficulty breathing with the device in place, you should not use it.

Care and Cleaning of a TSD

It is very important that you clean your TSD every day with hot water to prevent infection and minimize unpleasant odors. You may find it helpful to clean it with a denture-cleaning solution on a weekly or monthly basis.

You should not clean your tongue stabilizing device with mouthwash that contains alcohol, as it may dry out the plastic and damage the appliance.

When you are not using your device, store it in a cool and dry environment within its container.

A Word From Verywell

If treating your snoring and sleep apnea with continuous positive airway pressure (CPAP) isn't working for you, you may be looking for another option.

If you have struggled with OSA and are interested in trying alternative oral appliances, talk to your healthcare provider about the possibility of trying the tongue-stabilizing device. It might also be advisable to have a sleep study with the device in place to determine whether your condition is adequately treated by the mouthpiece.

3 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Pavwoski P, Shelgikar AV. Treatment options for obstructive sleep apnea. Neurol Clin Pract. 2017;7(1):77-85. doi:10.1212/CPJ.0000000000000320

  2. Alshhrani WM, Kohzuka Y, Okuno K, Hamoda MM, Fleetham JA, Almeida FR. Compliance and side effects of tongue stabilizing device in patients with obstructive sleep apnea. Cranio. 2021 Apr 25:1-14. doi:10.1080/08869634.2021.1917900

  3. Alshhrani WM, Hamoda MM, Okuno K, Kohzuka Y, Fleetham JA, Ayas NT, Comey R, Almeida FR. The efficacy of a titrated tongue-stabilizing device on obstructive sleep apnea: a quasi-experimental study. J Clin Sleep Med. 2021 Aug 1;17(8):1607-1618. doi:10.5664/jcsm.9260

By Brandon Peters, MD
Brandon Peters, MD, is a board-certified neurologist and sleep medicine specialist.