Your tongue is a major component of your upper airway, and its size, structure, and function can be affected by — and contribute to — sleep apnea.

Sleep apnea conditions cause pauses in your breathing while you’re asleep.

Most people with sleep apnea experience obstructive sleep apnea (OSA), in which relaxation of the muscles at the back of the throat causes the airway to collapse or become blocked.

Central sleep apnea (CSA) is less common and occurs when communication between the brain and the breathing muscles becomes disrupted.

It’s possible to experience a mixture of OSA and CSA.

As an important part of your upper airway, your tongue can both contribute to and hint at the presence of sleep apnea. Airway obstruction can cause tissue swelling, irregular movement, and changes in your tongue’s appearance.

Not everyone with sleep apnea notices tongue symptoms, but changes to your tongue’s appearance are possible.

You may notice your tongue looks swollen or enlarged, especially on waking. This occurs when pressure on the tongue during airway obstruction causes the tissue to swell.

Some people report “scalloping” or the development of ridges, indentations, or grooves. Scalloping is caused by prolonged pressing of the tongue against your teeth while your airway is restricted.

Scalloped tongue is also considered a risk factor for OSA because it can indicate your tongue is larger than ideal for the space in your mouth. A too-large tongue can contribute to sleep apnea by crowding your airway and making it more prone to obstruction when muscles relax during sleep.

Some people notice sleep apnea is drying to the tongue because it promotes mouth-breathing while sleeping. A dry tongue surface can appear rough, dull in color, or have a shriveled appearance.

In addition to physical changes in your tongue’s appearance, you may notice tongue pain, discomfort, or frequent tongue thrusting at night as your body attempts to reposition for better airflow.

In addition to tongue symptoms, sleep apnea can cause a variety of clinical mouth signs, such as:

Not everyone with sleep apnea will develop noticeable changes in their mouth health.

How do you fix ‘sleep apnea tongue’

Sleep apnea tongue, as a secondary complication of sleep apnea, can be treated by addressing the underlying condition of sleep apnea.

If you have OSA, CSA, or a mixture of both, doctors will recommend management through breathing or oral devices, healthy lifestyle changes, facial therapy, and surgery, if necessary.

If your tongue is a factor in sleep apnea, oral devices, and sleeping position training can help prevent your tongue from contributing to airway obstruction during sleep. These strategies can also relieve any pressure on the tongue that may be causing pain, swelling, or appearance changes.

You can learn more about treating sleep apnea by reading:

During sleep apnea, it’s possible to experience a choking-like sensation as the muscles of your upper airway relax and your tongue falls back into your throat.

This relaxation and repositioning of your tongue can sometimes trigger your pharyngeal reflex, also known as your gag reflex.

This involuntary response can occur anytime the base of your tongue, tonsil area, or upper airway walls become stimulated, and it’s a natural reaction to help prevent airway blockage and expel foreign objects lodged in the throat.

There are two primary reasons you may feel like your tongue is blocking your airway.

First, differences in your mouth anatomy, like a too-large tongue, smaller mouth cavity, stiff tongue muscles, or a narrow airway, could contribute to the sensation that your tongue is in the way of your breathing.

It’s also possible that a medical condition like sleep apnea is causing your tongue to swell, enlarge, or reposition in your mouth so that it limits air movement as you breathe.

Other conditions that may feature changes to your tongue associated with this sensation include:

Sleep apnea conditions can affect your tongue, and your tongue can affect sleep apnea conditions. While not everyone will notice changes to the function or appearance of their tongue, a variety of mouth symptoms are possible in sleep apnea.

Treating sleep apnea can help if you notice changes in your tongue, such as swelling or scalloping. Your doctor can send you home with oral devices and coach you on the best sleeping positions to ward off the sensation of choking.