The Efficacy of a Novel Tongue-Stabilizing Device on Polysomnographic Variables in Sleep-Disordered Breathing: A Pilot Study


The polysomnographic efficacy of a novel tongue-stabilizing device (TSD) in the treatment of snoring and sleep-disordered breathing (SDB) was evaluated in this pilot study. Six current users of the TSD with SDB underwent polysomnography with and without the TSD in situ in a randomized crossover design. The TSD significantly lowered the frequency of snores per hour slept (61- to 70-dB range) (no TSD: mean = 41/h slept ± 52 SD; TSD: 8/h slept ± 16 SD; P = 0.046) but did not alter snoring in the other decibel ranges (all Ps > 0.1). Trends were found for reductions in the frequency of apneas plus hypopneas (no TSD: 26/h slept ± 17/h slept; TSD: 15/h slept ± 13; P = 0.06) and oxygen desaturations of 4% or more (no TSD: 10/h slept ± 10; TSD: 5/h slept ± 5; P = 0.09). Significant improvements in microarousal frequency with the TSD were found (no TSD: 34/h slept ± 16; TSD: 22/h slept ± 14; P = 0.004). Significant reductions in percentage of Stage 1 sleep with the TSD were also demonstrated (no TSD: 10 ± 3%; TSD: 8 ± 2%; P = 0.03). The results of this small pilot study indicate that the TSD may be effective in reducing snoring severity and microarousals, with favorable trends for reducing SDB severity in selected individuals. Additional larger prospective studies are required to identify suitable candidates for TSD use in the treatment of snoring and SDB.

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  1. 1.

    Lugaresi E, Mondini S, Zucconi M, Montagna P, Cirignotta F. Staging of heavy snorers’ disease: a proposal. Bull Eur Physiopathol Respir 1983;19:590–594

    Google Scholar 

  2. 2.

    Sullivan CE, Berthon-Jones M, Issa FG, Eves L. Reversal of obstructive sleep apnoea by continuous positive airway pressure applied through the nares. Lancet 1981;1:862–865

    Google Scholar 

  3. 3.

    McArdle N, Devereux G, Heidarnejad H, et al. Long-term use of CPAP therapy for sleep apnea/hypopnea syndrome. Am J Respir Crit Care Med 1999;159:1108–1114

    CAS  PubMed  Google Scholar 

  4. 4.

    Lowe AA. Dental appliances for the treatment of snoring and obstructive sleep apnea. In: Kryger MA, Roth T, Dement WC, eds. Principles and Practice of Sleep Medicine. 2nd ed. Philadelphia, PA: WB Saunders; 1994:722–735

    Google Scholar 

  5. 5.

    Schmidt-Nowara W, Lowe AA, Wiegand L, et al. Oral appliances for the treatment of snoring and obstructive sleep apnea: a review. Sleep 1995;18:501–510

    Google Scholar 

  6. 6.

    Ferguson KA, Ono T, Lowe AA, Keenan SP, Fleetham JA. A randomized crossover study of an oral appliance vs. nasal continuous positive airway pressure in the treatment of mild-moderate obstructive sleep apnea. Chest 1996;109:1269–1275

    Google Scholar 

  7. 7.

    Cartwright RD, Samelson CF. The effects of a nonsurgical treatment for obstructive sleep apnea. The tongue-retaining device. JAMA 1982;248:705–709

    Google Scholar 

  8. 8.

    Cartwright R, Ristanovic R, Diaz F, Caldarelli D, Alder G. A comparative study of treatments for positional sleep apnea. Sleep 1991;14:546–552

    Google Scholar 

  9. 9.

    Ferguson KA, Love LL, Ryan CF. Effect of mandibular and tongue protrusion on upper airway size during wakefulness. Am J Respir Crit Care Med 1997;155:1748–1754

    Google Scholar 

  10. 10.

    Ono T, Lowe AA, Ferguson KA, Pae EK, Fleetham JA. The effect of the tongue retaining device on awake genioglossus muscle activity in patients with obstructive sleep apnea. Am J Orthod Dentofacial Orthop 1996;110:28–35

    Google Scholar 

  11. 11.

    Douglas NJ, Thomas S, Jan MA. Clinical value of polysomnography. Lancet 1992;339:347–350

    Google Scholar 

  12. 12.

    Rechtschaffen A, Kales A. A Manual of Standardised Terminology, Techniques and Scoring System for Sleep Stages of Human Subjects Los Angeles: University of California, Los Angeles; 1968

    Google Scholar 

  13. 13.

    Gould GA, Whyte KF, Rhind G B et al. The sleep hypopnea syndrome. Am Rev Respir Dis 1988;137:895–898

    Google Scholar 

  14. 14.

    Atlas Task Force of the American Sleep Disorders Association. EEG arousals: scoring rules and examples. A preliminary report. Sleep 1992;15:174–184

    Google Scholar 

  15. 15.

    Hills M, Armitage P. The two-paired crossover trial. Br J Pharmacol 1979;8:7–20

    Google Scholar 

  16. 16.

    Bryman A, Cramer D. Quantitative Data Analysis with SPSS for Windows London: Routledge 1997

    Google Scholar 

  17. 17.

    Clark GA, Cartwright RD. A survey of treatment efficacy of patients fitted with tongue retaining device. Sleep Res 1995;24:213–213

    Google Scholar 

  18. 18.

    Stradling JR, Negus TW, Smith D. Mandibular advancement devices for the control of snoring. Eur Respir J 1998;11:447–450

    Google Scholar 

  19. 19.

    Cartwright RD. Predicting response to the tongue retaining device for sleep apnea syndrome. Arch Otolaryngol 1985;111:385–388

    Google Scholar 

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Correspondence to Christopher J. Robertson M.D.S..

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Kingshott, R.N., Jones, D.R., Taylor, D.R. et al. The Efficacy of a Novel Tongue-Stabilizing Device on Polysomnographic Variables in Sleep-Disordered Breathing: A Pilot Study. Sleep Breath 6, 69–76 (2002).

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  • Oral appliances
  • tongue retainers
  • sleep-disordered breathing
  • snoring