Study Finds Tongue Fat Can Lead to Sleep Apnea


Study Finds Tongue Fat Can Lead to Sleep Apnea
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A new study finds that losing fat in the tongue can alleviate symptoms of sleep apnea. Getty Images
  • Losing fat in your tongue can alleviate symptoms of obstructive sleep apnea (OSA).
  • Researchers used an MRI to see how weight loss affected the upper airway.
  • Experts say understanding the link to tongue fat may help them treat people with OSA.

Losing weight can help your sleep, according to a new study that found tongue fat can increase your risk of sleep apnea.

The study says that losing fat in your tongue can alleviate symptoms of obstructive sleep apnea (OSA). The condition occurs when people stop and start breathing during sleep. Patients wake up randomly during sleep and often snore. The condition can increase the risk for stroke and high blood pressure. Obesity is a risk factor, but so is having a recessed jaw or large tonsils.

According to a report in the American Journal of Respiratory and Critical Care Medicine, a team led by Dr. Richard Schwab, the chief of sleep medicine at the Perelman School of Medicine at the University of Pennsylvania, used MRI scans to look at how weight loss affected the upper airway. They say that lowering tongue fat is a primary factor to ease the severity of OSA.

Though we already knew weight loss can improve symptoms, Schwab said research hasn’t looked at fat loss in the tongue.

“Now that we know tongue fat is a risk factor and that sleep apnea improves when tongue fat is reduced, we have established a unique therapeutic target that we’ve never had before,” he said in a statement.

In 2014, Schwab conducted research that found patients with obesity and OSA had larger tongues and higher percentages of tongue fat compared to those without sleep apnea.

The American Academy of Sleep Medicine recommended that doctors examine it during screenings.

“Fat deposition within the tongue — and potentially other structures surrounding the upper airway — may transform our understanding of the link between weight gain and OSA, with wide-ranging implications for diagnosis and treatment,” Dr. Eric J. Kezirian, a professor in otolaryngology-head and neck surgery at the University of Southern California, wrote in an accompanying editorial to Schwab’s 2014 work.

In the current study, Schwab’s team evaluated 67 participants with obesity and mild to severe OSA. They had MRI scans in their pharynx and abdomen prior to losing weight. Patients lost about 10 percent of their body weight via diet or weight loss surgery over a 6-month span. After losing weight and having another MRI, the team quantified changes in their weight loss, as well as reductions of the volume in the upper airway structures. Their sleep apnea scores improved by 31 percent, and tongue fat loss was the biggest link between weight loss and OSA improvement.

Losing weight also reduced the volume between the pterygoid (a jaw muscle that controls chewing) and pharyngeal lateral wall (the muscles on the sides of the airway). That improved OSA, but not as effectively or to the extent of tongue fat loss.

“To see the real benefits of weight loss in reducing tongue fat, the patients that would benefit the most are those who have substantial tongue fat to begin with,” Kezirian told Healthline. People store their body weight differently, meaning that there are people who are very heavy and have increased body fat but do not have much tongue fat and often do not have sleep apnea, he explained.

Now that he knows tongue fat loss could help some of the 22 million Americans battling OSA, Schwab hopes it will trigger more research into new methods to reduce tongue fat.

Schwab would like to know if certain low fat diets can work better than others in tongue fat reduction, or whether cold therapies currently used to reduce stomach fat could do the same in our tongues.

Exercises can be beneficial to reduce fat in the tongue. He cited a study that found people who played the didgeridoo were able to ease symptoms.

Tongue liposuction may sound like a potential solution, but Schwab said tongue fat doesn’t present the same way as it does in other parts of the body, so it may not be in development anytime soon.

“Tongue fat does not exist in specific areas that would be amenable to typical liposuction, unfortunately,” Kezirian said.

There’s no way to lose weight and focus the fat loss solely on the tongue — you have to lose weight throughout your body to see results in the tongue, added Michael W. Calik, PhD, an assistant professor at the University of Illinois at Chicago Center for Sleep and Health Research. He is studying dronabinol, a cannabinoid that may be able to improve tongue activation if ingested before going to sleep.

Schwab also wants to find out if patients who are not obese but still have fatty tongues may be predisposed to having OSA and are less likely to be diagnosed with it. Ethnicity may also play a role in the severity of OSA. When comparing the upper airway anatomy of Chinese and Icelandic patients who have OSA, he noted that Chinese patients had smaller airways and soft tissues, but bigger soft palate volume with more bone restrictions. As such, people of Asian descent could have a higher risk for OSA.

Anyone who experiences snoring or sleepiness should be screened for OSA, even if they aren’t in a typical high-risk category, such as having obesity.

People should also know that having OSA doesn’t mean you have to use a CPAP (continuous positive airway pressure) machine for relief. Though the machine helps OSA in about 75 percent of patients, many have a hard time tolerating the machine. There are other treatment options, Schwab emphasized.

“Many patients get turned off by CPAP and they won’t come and see their doctor,” Schwab said. “There’s other options out there and you should investigate those options with your physician. There are serious consequences of not having your OSA treated.”

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