A variably automated tissue retention system generally comprises an oral appliance retractably coupled to a covering which is secured to an anterior portion of the tongue. As the subject moves their tongue naturally or sleeps and the tongue becomes hypotonic, the subject's tongue may move posteriorly. As the covering pulls the tongue anteriorly or maintains a position of the tongue, the base of the tongue may be inhibited or prevented from collapsing posteriorly against the pharyngeal tissue walls and thereby allow the subject to breathe normally by automatically increasing the suction pressure on the tongue to maintain securement of the covering to the tongue as the tongue moves posteriorly.