Sleep apnea, scientifically known as obstructive sleep apnea-hypopnea syndrome (OSAHS) is a condition that involves involuntary breathing stops during the night because air no longer passes normally through the lungs. These breaks last more than 10 seconds and occur several times a night at a variable frequency. In severe cases, they can occur up to 30 times an hour. They can then result in fatigue upon waking, headaches and drowsiness during the day. Ultimately, this affliction may cause cardiovascular disease, lack of alertness responsible for accidents, depression or even complications during operations under general anesthesia. Among the main risk factors: large tonsils or a receding jaw but especially obesity. Today, a surprising study has appeared on the subject. According to work published on January 10 in theAmerican Journal of Respiratory and Critical Care Medicine, a loss of fat in the tongue would improve sleep apnea in obese patients.
In 2014, the team of Doctor Schwab of the Perelman School of Medicine at the University of Pennsylvania (United States) had already noticed that obese patients suffering from sleep apnea had languages with a higher percentage of fat. than the others. Here, they followed 67 participants with mild to severe and obese sleep apnea for six months. Through diet or weight loss surgery, patients have lost almost 10% of their average body weight.
Before and after the weight loss, they underwent MRI scans of the pharynx and abdomen. They then found that the participants’ sleep apnea results improved by 31% after the weight loss and that this was mainly due to the reduction in the volume of tongue fat.
A unique therapeutic target
Scientists have also discovered that losing weight decreases the volume of the pterygoids (jaw muscles that control chewing) and the side wall of the pharynx (muscles located on the sides of the airways). These two changes also improved sleep apnea to a lesser extent.
“Most clinicians, and even sleep apnea experts, have generally not focused on fat in the tongue. Now that we know that 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 have never had before ” , comments Dr. Richard Schwab.
Also, the fat of the tongue could be a new therapeutic target. New studies should now be done to see if certain low-fat diets are more effective than others at reducing tongue fat and if cold therapy, like the one used to reduce stomach fat , may be helpful in reducing tongue fat, researchers say.
Asian patients more at risk
In the meantime, they are examining the causes and effects behind this mechanism in more detail. They are also trying to understand if some patients who are not obese but have a “greasy” tongue may be predisposed to sleep apnea but less likely to be diagnosed.
Recently, Dr. Schwab’s team also discovered that ethnicity may play a role in the severity of the disease. Its results suggest that Asian patients are more likely to experience severe symptoms. Also, obese or not, all patients with snoring or drowsiness should be screened for this disease, say the researchers.
“Primary care physicians, and perhaps even dentists, should ask about snoring and drowsiness in all patients, even those with a normal body mass index, because according to our data, they may also be at risk for sleep apnea, ”concludes Schwab.
Braces to relieve symptoms?
Currently, most patients are treated with CPAP (continuous positive airway pressure) devices, but 25% of them find it hard to tolerate this sleep gear. They are then offered oral devices or upper airway surgery, more complicated processes. Recently, a study published in Annals of the American Thoracic Society argued that some patients could be treated effectively with a much less bulky dental appliance.
In France, 5% of the adult population is affected by sleep apnea.
Interested in this topic ? Come and discuss it on our forum!
–
–
