Continuous tongue suction as a potential therapy for obstructive sleep apnea: A feasibility study

During wakefulness, apneic events, even in patients with severe obstructive sleep apnea (OSA), rarely occur regardless of the presence or absence of such episodes while asleep, because the augmented activity of the genioglossus muscle acts to patent the upper airway by maintaining the tongue in position. Hence, it is reasonable to hypothesize that OSA could be alleviated if the awake tongue position is maintained despite a sleep-related reduction in genioglossus muscle activity. The median (interquartile range) respiratory event index was significantly reduced with continuous tongue suction (23 [16-27] to 8 [7-14] events/h, P = 0.043) in 5 patients who successfully completed the protocol. Because this approach does not require either positive airway pressure or mandibular advancement, it makes it possible to completely avoid the adverse effects associated with the use of nasal continuous positive airway pressure and/or mandibular advancement devices in patients for whom nasal continuous positive airway pressure and mandibular advancement devices are contraindicated.