Sleep apnea and tongue strength

Continuous Positive Airway Pressure (CPAP) was first successfully used in the early 1980s. It is said that the participants in the first CPAP study slept so well with the device that they asked to take the device home with them. However, as you may know, CPAP treatment is not for everyone. For some, sleeping with the CPAP mask is very uncomfortable and sometimes makes sleep worse. That’s why, for many years, researchers and physicians have been looking for CPAP alternatives. Recently, people have been examining the airway from a different viewpoint. Many have recently attempted to find ways of “tightening” the airway by strengthening muscles in and around it. It has been theorized that tightening the airway may decrease excess tissue, which may minimize blockages, which may reduce apneas. A recent area of investigation in the airway has been the tongue – can making the tongue “less floppy” decrease apneas?

A group of researchers from Canada and France set out to test this theory. But how do you make a tongue less floppy? You make it exercise! Participants in this study performed a tongue training task (TTT) for 1 hour each day for 1 week. The task consisted of pressing the tongue with a medium force against a pressure gauge for 2 seconds, followed by a 10 second break. This was repeated 300 times in the hour. (If you think this doesn’t sound fun, I agree.) To gauge the strength of the tongue before and after these training sessions, tongue protruding force and endurance were performed using the pressure gauge. Participants also underwent overnight polysomnography (a sleep study) twice – once before training and once after training. Sleep apnea severity was compared between these two nights to see if the TTT exercises actually worked.

When comparing the force and endurance capabilities of the tongue before and after TTT sessions, there were no differences found, meaning the tongues had not increased force and endurance due to the training sessions. However, when comparing sleep apnea severity between sessions, participants had an average of 5 fewer apneas per hour after training – a 26% decrease. Interestingly, this decrease was most significant during REM sleep, which is when people typically have the greatest sleep apnea severity.

First and foremost, it must be stated that this study badly needs a control group for comparison. However, here’s the good news for those who hate CPAP: you may someday be able to work out your tongue to alleviate your sleep apnea! The bad news: tongue strengthening (at least at this magnitude) does not fully treat sleep apnea, as CPAP typically does. Perhaps someday a tongue training regimen will be developed that can fully prevent apneas from occurring. But in the meantime, tongue strengthening in conjunction with CPAP may maximize treatment effectiveness. Stay tuned for more exploration of this topic! 

Source: Rousseau, E., Silva, C., Gakwaya, S., & Sériès, F. (2015). Effects of one-week tongue task training on sleep apnea severity: A pilot study. Canadian respiratory journal: journal of the Canadian Thoracic Society.

Janna Mantua


Janna is a PhD Student / Graduate Research Assistant at University of Massachusetts Amherst with a background in clinical sleep research and psychology. Janna Mantua is a PhD student in the Behavioral Neuroscience department at the University of Massachusetts. Her research focuses on sleep and aging, with specific projects on cognitive health, inflammation, memory formation, and neuroimaging. Prior to her PhD work, Janna was involved in research on sleep apnea and cognitive decline at the NYU Sleep Disorders Center.

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