Losing weight is an effective treatment for Obstructive Sleep Apnea (OSA), but why exactly this is the case has remained unclear. Now, researchers at the University of Pennsylvania have discovered that improvements in sleep apnea symptoms appear to be linked to the reduction of fat in one unexpected body part — the tongue.
Using magnetic resonance imaging (MRI) to measure the effect of weight loss on the upper airway in obese patients, researchers found that reducing tongue fat is a primary factor in lessening the severity of OSA.
“Most clinicians, and even experts in the sleep apnea world, have not typically focused on fat in the tongue for treating sleep apnea,” said Richard Schwab, MD, chief of Sleep Medicine. “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.”
Twenty-two million Americans are diagnosed with sleep apnea, a serious health condition in which breathing repeatedly stops and starts, causing patients to wake up randomly throughout their sleep cycles. The condition, which is usually marked by loud snoring, can increase your risk for high blood pressure and stroke. While obesity is the primary risk factor for developing sleep apnea, there are other causes, such as having large tonsils or a recessed jaw. CPAP (continuous positive airway pressure) machines improves sleep apnea in about 75 percent of patients, studies suggest, but for the other 25 percent — those who may have trouble tolerating the machine — alternative treatment options, such as oral appliances or upper airway surgery, are more complicated.
A 2014 study led by Schwab compared obese patients with and without sleep apnea, and found that the participants with the condition had significantly larger tongues and a higher percentage of tongue fat when compared to those without sleep apnea. The researchers next step was to determine if reducing tongue fat would improve symptoms and to further examine cause and effect.
The authors believe that tongue fat is a potential new therapeutic target for improving sleep apnea. They suggest that future studies could be designed to explore whether certain low-fat diets are better than others in reducing tongue fat and whether cold therapies — like those used to reduce stomach fat — might be applied to reducing tongue fat. However, Schwab notes, these types of interventions have not yet been tested.
Schwab’s team is also examining new interventions and other risk factors for sleep apnea, including whether some patients who are not obese but who have “fatty” tongues could be predisposed to sleep apnea, but are less likely to be diagnosed.
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