Pitagora's Tongue

Sleep Apnea: Do We Need Leaner Tongues?

Sleep apnea is a serious problem with serious consequences for life and health. With this condition, people have shorter lives and more cardiovascular disease. Because obesity is the primary risk factor for sleep apnea, it’s growing just as obesity is. That’s why we’re hearing so many ads for CPAP machines and supplies. More and more people need this treatment to protect their health. But new research suggest another approach: leaner tongues.

An Observational Study

In the American Journal of Respiratory and Critical Care Medicine, Stephen Wang and colleagues published a study of how weight loss affects the upper airway. They wanted to know what changes were bringing improvements in sleep apnea. So they followed the outcomes of patients losing weight through bariatric surgery or behavioral therapy. They carefully measured the changes in upper airways using MRIs. In addition, they quantified both abdominal fat and tongue fat.

It was no surprise to find that losing weight slimmed down the size of soft tissue in the upper airway. But simply reducing tongue size is not especially effective for treating sleep apnea. Common techniques for doing this take away both muscle and fat. Wang et al see this as a problem. That’s because their data suggests it’s fat in the tongue that is the real problem.

The patients with the biggest improvement in sleep apnea were the ones who lost the most fat from their tongues. In fact, mediation analysis attributes almost a third of the improvements of apnea in this study to reductions in tongue fat – not tongue size. So perhaps the goal should be leaner tongues, not just slimmer tongues.

A New Target for Treating Sleep Apnea

Senior author Richard Schwab is quite enthusiastic about the insight this offers:

Now that we know tongue fat is a risk factor and that sleep apnoea improves when tongue fat is reduced, we have established a unique therapeutic target that we’ve never had before.

Will this lead to CoolSculpting for our tongues? We have our doubts. However, it might bring us a pathway to better treatments for sleep apnea.

Click here for the study and here for a sample of reporting on it.

Pitagora’s Tongue, photograph © zaser / flickr

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January 12, 2020

One Response to “Sleep Apnea: Do We Need Leaner Tongues?”

  1. January 13, 2020 at 3:36 am, Mary-Jo said:

    I would have never given tongue fat a thought until seeing this research. It makes me wonder about where fat can actually deposit in the body and what effects it has depending on location. We always think about effects of abdominal and visceral fat, for sure, but it may be helpful to have other locations of where fat accumulates in the body better identified and effects better delineated.