The position of the tongue during sleep is an important factor that can impact sleep quality and health. Many people are unaware of their tongue position while sleeping, but this can have significant effects on breathing, sleep disorders, and oral health. Understanding normal tongue position and causes for deviation can help improve sleep.
Quick Answers
– The ideal tongue position during sleep is up and forward, resting on the roof of the mouth. This helps maintain an open airway.
– When the tongue falls back into the airway, it can block breathing and cause snoring and sleep apnea.
– Tongue position is influenced by anatomy, sleep position, alcohol use, muscle tone, and other factors.
– Abnormal tongue positions like pressing on the teeth can lead to tooth shifting or temporomandibular joint dysfunction.
– Treatments like oral appliances or special pillows aim to keep the tongue forward during sleep.
What Is Considered Normal Tongue Position During Sleep?
The most normal and ideal tongue position during sleep is up and forward in the mouth. More specifically, the tip of the tongue should rest lightly on the ridge right behind the upper front teeth. The rest of the tongue presses up against the hard palate, or roof of the mouth.
This optimal tongue position serves important functions:
– It keeps the airway open and unobstructed. When the tongue falls back, it can block airflow and cause snoring or sleep apnea. Keeping it forward prevents this.
– It allows for normal swallowing and protection of the airway. With the tongue forward, you can easily swallow as needed overnight and avoid choking or aspiration.
– It gives the jaw, mouth, and tongue a restful position. The tongue isn’t straining or pushing against anything unnaturally. This prevents pain, discomfort, and dental side effects.
– It may promote restful sleep. Poor tongue position can impair sleep quality, while proper tongue posture may make sleep more restful.
This ideal forward tongue position should be maintained whenever possible during sleep. However, the tongue is made of muscle and is not rigid, so its position often changes dynamically throughout the night.
What Causes the Tongue to Deviate from Normal Position During Sleep?
There are many possible reasons why the tongue may drift out of its normal forward position during sleep:
– Anatomical factors – Jaw structure, size of the tongue, size of tonsils/adenoids, and other anatomical traits make some people more prone to backward tongue positioning.
– Sleeping on back – Gravity makes the tongue fall back more easily in this position. Side or stomach sleeping reduces this effect.
– Alcohol – Alcohol intake before bed causes muscles like the tongue to relax more, allowing it to fall back under gravity.
– Reduced muscle tone – With aging or conditions like sleep apnea, the tongue muscles have lower tone and cannot maintain forward position.
– Sedatives or medicines – Like alcohol, some drugs cause muscular relaxation and tongue to drift backward.
– Sleep stage – The tongue may slide backward when transitioning to deeper stages of non-REM or REM sleep.
– Dry mouth – Saliva helps hold the tongue forward. Dry mouth at night allows it to slip back.
– An open mouth – Breathing through the mouth often drops the tongue down over time.
– Medical conditions – Hypothyroidism, tumors, stroke, etc. can directly impair tongue muscle control.
– Habit – Sometimes people develop a habit of incorrect tongue placement during the day or night.
What Are the Effects of Abnormal Tongue Positioning During Sleep?
When the tongue strays from its normal forward posture during sleep, it can have adverse effects:
– Snoring – The tongue falling back narrows the airway and causes turbulence and snoring.
– Sleep apnea – Serious backward positioning causes blockage of airflow (obstructive sleep apnea) with breathing pauses.
– Tooth issues – Pressing on the front teeth can shift teeth or cause temporomandibular joint problems.
– Speech problems – Changes in dental alignment from tongue pressure can affect speech.
– Dry mouth and bad breath – Open-mouth breathing dries the mouth and causes halitosis.
– Restless sleep – Light or disrupted sleep may result from difficulties breathing.
– Daytime fatigue – Sleep apnea and fragmentation from poor tongue position causes daytime tiredness.
– Headache – Sleep apnea and TMJ dysfunction are associated with increased headache prevalence.
The most serious consequence is increased risk for obstructive sleep apnea when the tongue totally blocks the airway during sleep, leading to oxygen deprivation.
What Is Considered an Abnormal Tongue Position During Sleep?
Any tongue position that strays significantly from the ideal forward posture is regarded as abnormal. The main problematic positions are:
– Retracted tongue – The tongue falls backward toward the throat, partially obstructing breathing.
– Downward tongue – The tongue drops down lower in the mouth, blocking the airway.
– Open-mouth tongue – An open mouth lets the tongue fall back under gravity during sleep.
– Teeth-pressing tongue – The tongue pushes against or rests between the teeth, possibly shifting their alignment.
– Sideways tongue – The tongue may involuntarily move or fall to one side or the other during sleep.
– Protruded tongue – Rarely, neurological conditions may cause the tongue to abnormally protrude from the mouth during sleep.
These abnormal tongue positions during sleep have negative health consequences. They also simply indicate that the tongue is not supporting the airway properly for restful, high-quality sleep.
What Factors Affect Tongue Position During Sleep?
Tongue position during sleep is influenced by:
– Mouth breathing – Chronic nasal congestion often leads to mouth breathing during sleep, which directly affects the tongue.
– Sleep position – Back sleeping allows the tongue to fall back under gravity most easily. Side or stomach position help avoid this.
– Alcohol – Alcohol is a muscle relaxant that can cause the tongue to drift backward during sleep.
– Neurological diseases – Conditions like stroke and Parkinson’s disease affect the tongue muscles.
– Normal aging – With age, the tongue loses muscle tone and is more likely to fall back when supine.
– Sleep stages – The tongue may slide backward during transitions to deeper non-REM and REM sleep.
– Anatomical factors – Jaw and airway anatomy can determine someone’s tendency for backward tongue positioning during sleep.
– Medications – Sedatives, muscle relaxants, and alcohol can all influence tongue position at night.
– Medical conditions – From tonsil hypertrophy to hypothyroidism, some disorders make the tongue more likely to obstruct during sleep.
– Oral appliances – Devices like mandibular advancement devices mechanically hold the tongue forward.
How Does Sleep Position Affect Tongue Position?
Sleeping position has a major impact on where the tongue falls during sleep. This is due to gravity’s actions on the tongue:
– On the back – Tongue easily falls backward to block the throat. This is the worst sleep position for tongue positioning.
– On the side – Less impact of gravity on the tongue, so it usually remains more forward.
– On the stomach – Gravity pulls the tongue forward, away from the throat.
– Inclined positions – Sleeping propped up similarly pulls the tongue forward through gravity’s effect.
To control backward tongue positioning during sleep, side or stomach sleep positions are recommended. Even inclining the head of the bed 30 degrees can help by using gravity beneficially.
Back sleeping makes it very difficult to maintain normal forward tongue posture. Those who sleep supine should use other techniques to keep the tongue from blocking the airway.
How Does Alcohol Affect Tongue Position During Sleep?
Alcohol has a profoundly negative effect on tongue position during sleep. This occurs for several reasons:
– Alcohol is a muscle relaxant. By relaxing the tongue, it predisposes it to falling backward under gravity during sleep.
– Alcohol leads to increased deep sleep. During deep sleep, the muscles relax even more, further dropping the tongue.
– Alcohol causes nasal congestion. This leads to mouth breathing during sleep, which affects tongue position.
– Alcohol relaxes the throat muscles. This allows the tongue to collapse the airway when it falls back.
– Alcohol exacerbates sleep apnea. Relaxed throat muscles let the tongue totally block the airway.
For those with risks for obstructive sleep apnea, alcohol can be especially problematic. Just a few drinks before bed can turn mild snoring into sleep apnea as the tongue slides backward onto the airway.
Avoiding alcohol for 3-4 hours before bed is advised, especially in those prone to posterior tongue positioning when supine.
Can You Train Yourself to Maintain Proper Tongue Position When Sleeping?
It is possible to train the tongue to stay in a proper forward position during sleep through conscious practice and special equipment:
– Use daytime oral posture practice to get used to proper tongue placement. Keep the tongue tip on the ridge behind upper front teeth whenever possible.
– Do exercises like pressing the entire tongue to the palate or sliding the tongue forward. These strengthen the tongue so it resists falling back during sleep.
– Avoid positions that let the tongue drop back, like open-mouth posture. Keep lips gently together whenever possible.
– Try a tongue retaining device. These hold the tongue forward mechanically during sleep.
– Some myofunctional therapy techniques specifically target improving tongue posture and strength.
– Get an oral appliance to facilitate forward tongue posture at night. A mandibular advancement device can be highly effective.
With diligent practice of proper oral and tongue posture during the day, these positions can partially carry over to sleep. But devices, therapy, and avoiding sleep positions that drop the tongue back are likely still needed.
What Kind of Doctor Treats Tongue Positioning During Sleep?
There are several medical specialties that may treat tongue position during sleep:
– Sleep doctors – Sleep physicians are experts in sleep disorders like sleep apnea that are affected by the tongue. They may prescribe oral sleep apnea appliances or mouthpieces to control tongue position.
– Dentists – Many dentists now treat sleep disorders. They can provide oral appliances and recommend ways to train the tongue muscles.
– Otolaryngologists – ENT doctors treat airway issues and may recommend interventions for obstructive sleep apnea related to the tongue.
– Speech therapists – Speech language pathologists provide myofunctional therapy to strengthen the tongue so it better maintains forward posture.
– Oral surgeons – Oral surgeons may perform surgery if anatomical issues like a large tongue or tonsils obstruct breathing.
Training the tongue muscles for proper forward sleep position is emerging as an important therapy goal for airway health and restful sleep. Several medical specialties can now provide this type of treatment.
Conclusion
The tongue plays an important yet underappreciated role in sleep quality and health. Allowing the tongue to fall back into the airway during sleep can lead to problems like sleep apnea, restless sleep, and tooth alignment changes.
Keeping the tongue forward is the ideal position for unobstructed breathing and a more restful night’s sleep. This position can be achieved through awareness of posture, certain sleep positions, oral appliances, and specific strengthening exercises. Various doctors now have expertise in helping patients control their tongue positioning during sleep.
Given its impacts on breathing, sleep quality, and oral health, proper tongue position is a key consideration during sleep. With a few simple adjustments, the tongue can be oriented in a way that maximizes airway patency and allows for a deeper, healthier rest.