How resting tongue position may influence airway function, facial development, and breathing patterns — and why the science is still evolving.
Breathing does not occur in isolation. It is shaped by posture, muscle tone, and the subtle positioning of structures within the mouth and airway.
Among these, tongue posture — the position of the tongue at rest — gained increasing attention in clinical and research settings. While commonly discussed in orthodontics, speech therapy, and sleep medicine, its role in healthy breathing remains a topic of ongoing scientific discussion.
Emerging evidence suggests that tongue posture may influence breathing route, airway stability, and craniofacial development. At the same time, questions of causality and clinical significance remain open. This balance between growing insight and scientific uncertainty makes tongue posture a particularly important subject for thoughtful, evidence-based exploration.
Understanding Tongue Posture
At rest, the tongue can assume different positions within the oral cavity. In many clinical descriptions, a high resting posture refers to the tongue resting gently against the palate with lips closed and breathing occurring through the nose. A low or posterior posture places the tongue closer to the floor of the mouth or further back toward the airway.
Rather than a conscious action, tongue posture is typically habitual. It’s influenced by nasal patency, muscle tone, craniofacial structure, and early developmental patterns. For this reason, it is increasingly studied as both a potential contributor to breathing patterns and a reflection of underlying airway conditions.
Proposed Mechanisms Supporting High Tongue Posture
Several lines of clinical and theoretical evidence suggest that a high, palatal tongue posture may support nasal breathing and upper airway stability.
Orofacial myofunctional therapy (OMT) is commonly described as a form of neuromuscular retraining that targets the tongue and orofacial muscles. Clinical reports associate OMT with improvements in swallowing patterns, resting tongue posture, oral competence, and breathing route, especially when used in combination with orthodontic or sleep-related interventions.
Educational and clinical sources also describe a functional relationship between tongue-on-palate posture, lip seal, and nasal breathing. In this configuration, the tongue may help maintain oral cavity structure and reduce airway collapse during sleep by supporting a more anterior and stable tongue position.
While these mechanisms are biologically plausible, much of the supporting data remains observational or based on surrogate outcomes rather than large randomized controlled trials.
Low Tongue Posture and Disordered Breathing
Low or posterior tongue posture is frequently observed in individuals who breathe predominantly through the mouth, particularly in the presence of nasal obstruction.
Imaging and sleep studies have shown that mouth breathing can be associated with posterior displacement of the tongue, reduced retropalatal and retroglossal airway dimensions, and increased collapsibility of the pharyngeal airway during sleep. These patterns are commonly discussed in the context of sleep-disordered breathing.
Some clinical models propose that low resting tongue posture may contribute to a progressive sequence, from snoring and upper airway resistance to obstructive sleep apnea. This is additionally linked to combined craniofacial narrowing or reduced neuromuscular tone. Whether tongue posture acts as a primary driver or an adaptive response remains an active area of investigation.
Craniofacial Growth and Airway Development
Research on craniofacial development offers indirect support for a relationship between tongue posture and long-term airway health.
In nasal breathers, the resting tongue is typically described at the roof of the mouth, where it may exert gentle, continuous forces that support palatal width. In contrast, oral breathing requires the tongue to lower from the palate, a posture that has been associated with narrower maxillary arches, altered jaw growth, and changes in facial morphology during development.
Over time, these structural adaptations may reduce airway volume and increase susceptibility to breathing disturbances during sleep. While craniofacial growth is influenced by multiple genetic and environmental factors, tongue posture is increasingly considered one modifiable element within this complex system.
Interventional Evidence and Clinical Outcomes
Interventional studies exploring tongue posture and function provide encouraging but preliminary findings.
Programs incorporating myofunctional therapy report improvements in tongue elevation strength, resting posture, maxillary constriction, and markers of sleep-disordered breathing. In adult populations, structured tongue and throat exercises have been associated with reductions in snoring intensity and obstructive sleep apnea severity.
However, many of these interventions are delivered alongside orthodontic treatment, speech therapy, or medical management, making it difficult to isolate the independent effect of tongue posture alone. Larger, well-controlled trials are still needed to define the magnitude and durability of these outcomes.
Questions That Continue to Shape the Field
Despite growing interest, several key questions remain central to scientific discussion:
- Causality versus adaptation: Is low tongue posture a primary contributor to airway compromise, or does it arise secondary to nasal obstruction and craniofacial anatomy?
- Clinical relevance: How meaningful are the breathing and sleep improvements associated with correcting tongue posture in otherwise healthy children?
- Screening and intervention: Should tongue posture assessment become a routine component of pediatric and sleep-related evaluations, and if so, under what clinical criteria?
Addressing these questions will require interdisciplinary research spanning orthodontics, sleep medicine, pediatrics, and neuroscience.
A Measured Perspective
Tongue posture represents a compelling intersection between structure, function, and breathing behaviour. While current evidence supports its relevance to airway health, the field continues to evolve, guided by cautious interpretation and ongoing inquiry.
Rather than viewing tongue posture as a single solution, it may be most appropriately understood as one element within a broader system — influenced by nasal breathing, muscle tone, facial growth, and overall health.
As research advances, this nuanced perspective allows families and clinicians alike to remain informed, curious, and grounded in evidence.
Selected References for Further Reading
Camacho, M., Certal, V., Abdullatif, J., Zaghi, S., Ruoff, C.M., Capasso, R., et al. (2015) Myofunctional therapy to treat obstructive sleep apnea: a systematic review and meta-analysis, Sleep, 38(5), pp. 669–675. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC4402674/ (Accessed: 16 December 2025).
Liu, Y. (2023) The effects of orofacial myofunctional therapy on children with obstructive sleep apnea syndrome, PMC. Available at: https://pmc.ncbi.nlm.nih.gov/articles/PMC10136844/ (Accessed: 16 December 2025).
SingHealth (2025) Myofunctional therapy and nasal breathing exercises, SingHealth. Available at: https://www.singhealth.com.sg/tests-procedures/myofunctional-therapy-and-nasal-breathing-exercises (Accessed: 16 December 2025).