The Takeaway 

Obesity, large neck, large tongue, short lower jaw, and a reduction in the size of the airway behind the tongue are frequently observed in people with obstructive sleep apnea. 


Crowd of Overweight People
Both prescription and over-the-counter medications can worsen OSA

About two-thirds of all people with OSA are overweight or obese. It doesn't matter if a person has been heavy his or her entire life, or if the weight gain occurred in recent years. A large neck circumference (for men, a collar size greater than 17 inches) is also a common characteristic of OSA, as it often is an indicator of fat tissue surrounding the airway. In some studies, neck size was a stronger predictor of OSA than the severity of obesity. 

Head & Face 

There are a number of head and facial characteristics that are associated with OSA. One that is obvious from simple external inspection is a lower jaw (mandible) that is “short,” where the chin does not protrude past the upper jaw and is notably behind it. This is often called retrognathia. Other findings that are apparent only with more detailed examination or special studies include: 

  • Large tongue 
  • Small airway behind the tongue
  • Large tonsils
  • Longer and thicker soft palate
  • Low position of the hyoid bone 
  • Brachycephaly (head is wider than it is longer)
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