Fat body, fat tongue?
The idea that sleep apnea and snoring is at least partly caused by an increase in the size of the tongue in obese people has been around for some time. This makes perfect sense because an increase in tongue size would mean a blockage in the air passages and hence a reduced airway flow, thus resulting in the vibrating sound of snoring and reduced oxygen intake.
Pathologists carrying out autopsies however have often said they fail to find increases in tongue size in fat corpses. Does this mean the theory is wrong? And if so, how else do we explain the big increases in snoring and sleep apnea in the overweight? There are a couple of lines of evidence here: In the first place a recent study published in the journal Laryngoscope reporting the autopsies on 122 medical examiner cases, not only found a high correlation between tongue weight and Body Mass Index (BMI), but a close link between fat content of the tongue and BMI. This was particularly so in men, perhaps explaining why snoring is generally more of a problem amongst the male gender.
But how do we explain the lean snorers and the obese individuals who don’t snore (although there’s not many of the latter)? The answer seems to lie in the concept of inflammation again (see GI News, November 2008). Inflammatory markers appear to occur in the airways passages of people whose lifestyle may pre-dispose them to obesity, but who, for some reason may not become obese. Some obese individuals on the other hand may be obese for genetic reasons, not lifestyle, and may not have developed the inflammatory processes of those with the poor lifestyle. Inflammation, like tongue enlargement, can amplify upper airway narrowing and hence result in the same type of airways restriction as a fat tongue itself.
In any case, the main cure for snoring – and sleep apnea – remains a healthy diet and lots of exercise, even if body weight loss is only minimal. In the few cases where this still exists alongside a healthy lifestyle, anatomical structures in the airways may need to be checked.
Dr Garry Egger aka Prof Trim
For more information on weight loss for men, check out Professor Trim.