HI Jon--FWIW--At least for my turkey mouth calls...It helps me if I concentrate on breathing through my nose....not my mouth. It seems to greatly help extend the time I can keep a call in my mouth. I remove it for a few minutes periodically to relax the gag reflex. If I can avoid reaching the gag point at all by frequently taking it out, I can continue using them a lot longer. I usually take them out while moving from place to place to give it a rest. Also...conditioning the reflex by practicing with the call at home for short periods, but working to extend the time as I do helps me. Seems some of it is mental...when you get to the point where you sort of forget about it..it becomes much easier. Good luck. Joe