Research & Publications

Tongue Size, Fat Implicated As Potential Causes Of Obstructive Sleep Apnea (OSA)

Date Posted: Friday, October 9th, 2015 by Alan Berger

Obesity has become a public health epidemic.  Many health conditions have been linked to obesity---high blood pressure, diabetes, heart disease, stroke, sleep apnea and sexual dysfunction.  According to the Centers for Disease Control and Prevention, 34.9 percent of U.S. adults – 78.6 million people - are obese, based on nationally representative survey data from 2011 – 2012.  It has been well documented that obesity is a risk factor for snoring and sleep apnea.  However, new research published in the Journal of Sleep demonstrates that fat deposits in the tongue may be a risk factor for developing sleep apnea.

The study used MRI scans to examine the fat deposits in the subjects’ tongues.  Researchers compared obese patients with confirmed sleep apnea to obese individuals without sleep apnea.  Interestingly, the obese patients with sleep apnea had significantly larger tongue volumes, tongue fat and percentage of tongue fat than obese patients without sleep apnea.  Furthermore, the fat deposits in the sleep apnea patients tended to be concentrated in the base of the tongue.  This is important, since an enlarged tongue base is associated with airway obstruction.  This may be the key difference in obese patients that predisposes them to sleep apnea----the location of the tongue where fat is deposited.  In addition, besides narrowing the airway, it is hypothesized that the fat deposits may inhibit the activity of the muscles of the tongue that dilate or enlarge the airway, thus contributing to obstruction of the airway during sleep.

This is the first study to demonstrate that fat deposits are increased in the tongue of obese patients with obstructive sleep apnea.  Physicians should include examination of tongue size in screening exams of patients, as this may be a risk factor for sleep apnea.  Earlier recognition and diagnosis of patients at risk for sleep apnea can lead to resolution of sleep apnea and a reduction of health problems.  The study did not examine treatment options for fat deposits in the tongue; further investigation is needed.   However, new treatment options are being evaluated to treat the large fat deposits in the tongues of obese sleep apnea patients.  Weight loss, physical therapy and tongue reduction surgery are being reviewed as possible options. 

Resources

1. WebMD: Could a 'Fat Tongue' Be a Factor in Sleep Apnea?
2. AASM: Study shows that tongue size and fat may predict sleep apnea risk in obese adults

Authors:
Alan S. Berger, M.D.
Donald M. Sesso,M.D.