In fact, slimmer tongues explained about 30% of the benefit of patients’ weight loss.
People who lost weight also showed reductions in certain jaw and airway muscles — and those changes, too, seemed to improve apnea symptoms. But tongue fat was a more important factor.
The results were published Jan. 10 in the American Journal of Respiratory and Critical Care Medicine.
The findings are “not really surprising,” said Dr. Sabra Abbott, an assistant professor of sleep medicine at Northwestern University’s Feinberg School of Medicine in Chicago. She was not part of the study.
Given the nature of sleep apnea, she said, it makes sense that such changes in the anatomy of the upper airways would improve symptoms.
“This shouldn’t take away from the importance of overall weight loss,” Abbott said. Not only will it ease apnea symptoms, she noted, but it should also be a boon to a person’s general health.
Plus, Abbott pointed out, there’s no way to “spot reduce” tongue fat. “Until someone comes up with a tongue-selective form of fat loss, you have to lose overall body weight,” she said.
Schwab said that tongue liposuction is not in the cards. For one, the tongue does not hold big depots of fat that can easily be removed.
“It’s more like a steak that’s marbled,” he explained.
But Schwab does not discount the possibility of tongue-targeting therapies. One question, he said, is whether specific diet compositions affect the amount of fat, or fat loss, in the tongue.
He also noted that certain upper-airway exercises can improve sleep apnea — which he said raises the question, does tongue fat change when you do these exercises?
Finally, Schwab said studies might investigate noninvasive “cold therapy,” which is sometimes used to reduce small pockets of body fat by “freezing” and breaking down fat cells.
But Abbott was skeptical about cold therapy for the tongue. “I wouldn’t want to be the first person to have that,” she said.
Both doctors, however, said the findings underscore the value of weight loss for obese patients with OSA.
There are various treatments for the condition, including CPAP breathing machines and oral appliances worn during sleep. “But weight loss is the only way we have to cure it,” Abbott said.