While most people think sleep apnea is a breathing problem, there are physical signs, including some tongue signs, that may give you important information regarding a potential sleep disorder. So, if you’ve been struggling with poor sleep, disruptive snorting, or extreme daytime tiredness and wondering if there are other signals of sleep apnea, read on.
The Connection Between Your Tongue and Sleep Apnea
Yes, there are tongue signs of sleep apnea. In fact, our tongue plays a more significant role in obstructive sleep apnea (OSA) than you might realize.
What’s interesting is that if we’re looking at two patients of equal weight and height where one person has sleep apnea and the other doesn’t, the person with sleep apnea frequently has a larger tongue. And it’s not just genetics; it’s because of the deposition of fat within the tongue musculature itself.
Here’s an MRI of the tongue in two different people. The image on the left is someone with sleep apnea. On the right, this person has the same BMI but does not have sleep apnea. The difference between the two is the amount of fat in the tongue shown in yellow. The muscle is red-brown.
Why Does Tongue Size Matter for Sleep Apnea?
Let’s look at basic human anatomy to understand the relationship between one’s tongue size and sleep apnea. Humans aren’t like snakes: your throat doesn’t grow larger to fit a larger tongue. So, if your tongue gets enlarged by fat deposits it’s going to take up more space in a space that’s already pretty small. When you’re sleeping your muscles naturally relax, and that’s when an oversized tongue can fall backwards in your mouth and block your airway, which is what causes OSA.
The obstructed airway is what leads to repeated breathing interruptions that characterize sleep apnea, causing:
- Drops in blood oxygen levels
- Fragmented sleep as your brain briefly wakes you to restore breathing
- Loud snoring as air fights to pass through the narrowed airway
- Daytime exhaustion and other health complications
Visual Tongue Signs to Look For
Other than thickness, there are a few tongue signs that you may be able to detect that could point to sleep apnea:
- Scalloped or wavy edges: If you can see indentations on the sides of your tongue and they seem to mirror the shape of your teeth, this can indicate that your tongue has been pressing against your teeth–possibly because it’s too big for your mouth.
- Large tongue in proportion to mouth size: If your tongue seems to fill your mouth or your mouth seems crowded when you open wide, you may be at increased risk for OSA.
- Redness or inflammation: While not specific to sleep apnea, a red or inflamed tongue sometimes accompanies breathing disorders.
Do Tongues Really Get Fatter When a Person Gains Weight?
Yes, people who gain weight can see a change in their tongues. However, you might not see a big change in your tongue if you’ve gained weight, as the difference in fat proportion is greatest at the tongue base. The good news? Weight loss can decrease fat deposits in the tongue, possibly opening more space in the airway.
I’d like to point out that sleep apnea’s not exclusively a weight-related issue. People of all body types can have OSA, and factors like jaw structure, tonsil size, and nasal congestion are part of the consideration.
What Should You Do if You Notice these Tongue Signs?
If you’re worried you have sleep apnea due to snoring, gasping for air while sleeping, morning headaches, or extreme fatigue, it’s time to talk to a sleep apnea doctor. While tongue signs may be present, they aren’t always, so it’s more important to think about the quality of your sleep than the size of your tongue.
A diagnosis will usually involve:
- A detailed medical history review and physical exam
- Assessment of your sleep symptoms
- And could include a sleep study to monitor your breathing, oxygen levels, and sleep patterns.
Treatment Options
If you’re concerned you might have sleep apnea, here’s the good news: it’s treatable. Depending on your exact situation, treatment options could include:
- Lifestyle modifications: Weight loss, sleep position changes, avoiding certain foods/beverages in the evenings.
- CPAP therapy: Continuous Positive Airway Pressure (CPAP) devices can keep airways open during sleep
- Oral appliances: Custom devices to reposition your jaw and tongue to keep your airway open
- Surgical therapies: Therapies such as Inspire or Nyoxah Genio or may be the best option for some.
The Bottom Line on Your Tongue and Sleep Apnea
If you’re wondering if your tongue is signalling that you may have sleep apnea, it might well be. Tongue signs of sleep apnea are real and provide insights about possible airway blockage. The thickness and size of your tongue, especially when caused by fat deposits within the muscle tissue, can interrupt your breathing during sleep.
If you think you might have sleep apnea based on this and/or other symptoms, don’t put off calling your doctor. Sleep apnea is more than a nuisance. It’s associated with serious health issues including high blood pressure, heart disease, stroke, and diabetes. A consultation with a medical doctor can get you the diagnosis and treatment you need for better health—and better sleep!
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This post is for educational purposes only. Every patient is unique, so please consult with Dr. Weiner or your healthcare provider for personalized medical advice tailored to your specific needs.