Fat Got Your Tongue?
Twenty-two million Americans stop breathing in their sleep without knowing. Snuggling up under their covers and swirling to the beautiful chaos of a new dream, their upper airway muscles stealthily relax, pinching off any aperture to oxygen. As breathing momentarily cuts off and reflexes violently kick in, their bodies unconsciously embark on a workout of raucous snoring, sporadic wake-ups and high blood pressure. For many struggling to get sufficient rest after a full night of what is known as obstructive sleep apnea, or O.S.A., their troubles may be attributed to one key culprit: fat tongues.
When you stick your tongue all the way out while looking in a mirror, can you see your entire uvula? If not, you may suffer from bearing an unusually large tongue, which falls back against the back of your throat as you sleep, effectively closing the airway and suspending respiratory activity for more than ten seconds.
While this increasingly common condition occasionally affects slim folks, overweight people make up around 70 percent of those with sleep apnea, according to a study published by Surendra Kumar Sharma in the journal Chest. With obesity continuing its unrelenting climb among adults today, weight loss is key for treating apnea.
Supporting this idea is a recent study published in the American Journal of Respiratory and Critical Care Medicine, where researchers gathered 67 people suffering from obesity and severe sleep apnea. Taking MRI scans of each participant’s pharynx as they lost around 10 percent of their body weight, the analysts observed tongue fat reduction to be the primary link between weight loss and apnea relief.
“No one really understands the relationship of obesity to sleep apnea, and no one knows much about tongue fat in general,” said Dr. Richard Schwab, senior author of the study. “But the correlation between the three is significant.” In his final statistical report, Dr. Schwab disclosed how losing weight reduced tongue fat by an average of 20 percent — a change greater than that of any other airway structure — and consequently, a 31 percent improvement in sleep apnea scores. Essentially, the slimmer the tongue, the more the disorder’s symptoms improved.
Acknowledging the agent and solution to this condition is critical in improving the quality of many lives, as apnea left untreated is a serious matter, according to Jonathan Jun, a sleep medicine specialist at Johns Hopkins. “We’re talking about car accidents in the daytime, lost productivity at work, mood swings, and falling asleep in class,” he said. In a more long-term perspective, sleep apnea also instigates heart disease, stroke and metabolic issues like diabetes.
The scariest part? You might not even know you have this prevalent disorder. With nine in 10 patients still undiagnosed, as reported by the American Academy of Sleep Medicine, Dr. Jun encourages everyone to simply avoid trouble by maintaining a healthy weight.
“It’s nothing new, really, to ask people to keep an eye on their weight,” he said. “But now, we know tongue fat is a risk factor for O.S.A., giving us a unique therapeutic target for future testing that we’ve never had before.”
Brody, Jane E. “Sleep Apnea Can Have Deadly Consequences.” The New York Times, 27 May 2019.
Lanese, Nicoletta. “A Fat Tongue May Be Blocking Your Airways While You Sleep.” LiveScience, 10 Jan. 2020.
“Losing Tongue Fat Improves Sleep Apnea.” ScienceDaily, 10 Jan. 2020.
Seppa, Nathan. “Wake-up Call for Sleep Apnea.” ScienceNews, 31 July 2008.
Wang et al. “Effect of Weight Loss on Upper Airway Anatomy and the Apnea Hypopnea Index: The Importance of Tongue Fat.” American Journal of Respiratory and Critical Care Medicine, 10 Jan. 2020.