Tongue retaining devices for obstructive sleep apnea: A systematic review and meta-analysis

Objective: Tongue Retaining Devices (TRD) anteriorly displace the tongue with suction forces while patients sleep. TRD provide a non-surgical treatment option for patients with Obstructive Sleep Apnea (OSA). Our objective was to conduct a systematic review of the international literature for TRD outcomes as treatment for OSA. Methods: Three authors independently and systematically searched four databases (including PubMed/MEDLINE) through June 26, 2016. We followed guidelines set within the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA). Results: Sixteen studies with 242 patients met criteria. The overall means +/- standard deviations (M +/- SD) for apnea-hypopnea index (AHI) decreased from 33.6 +/- 21.1/h to 15.8 +/- 16.0/h (53% reduction). Seven studies (81 patients) reported lowest oxygen saturation (LSAT), which improved from 79.8 +/- 17.5% to 83.9 +/- 8.6%. Four studies (93 patients) reported Epworth sleepiness scale (ESS), which decreased from 10.8 +/- 4.8 to 8.2 +/- 4.5, p <0.0001. Four studies (31 patients) reported Oxygen Desaturation Index (ODI) which decreased from 29.6 +/- 32.1 to 12.9 +/- 8.7, a 56.4% reduction. Conclusion: Current international literature demonstrates that tongue retaining devices reduce apnea-hypopnea index by 53%, increase lowest oxygen saturation by 4.1 oxygen saturation points, decrease oxygen desaturation index by 56% and decrease Epworth sleepiness scale scores by 2.8 points. Tongue retaining devices provide a statistically effective alternative treatment option for obstructive sleep apnea. Published by Elsevier Inc.