Common warning signs for sleep apnea include snoring and choking, gasping, or silent breathing pauses during sleep.

Obese adults with sleep apnea had significantly greater tongue volumes, tongue fat and percentage of tongue fat than obese controls without sleep apneea, the findings showed.

"This is the first study to show that fat deposits are increased in the tongue of obese patients with obstructive sleep apnea," said principal investigator Richard Schwab, a professor at University of Pennsylvania Medical Center in Philadelphia, US.

Further analysis found that tongue fat percentage in participants with sleep apnea was site-specific, with increased fat toward the base of the tongue in the retroglossal region.

"Tongue size is one of the physical features that should be evaluated by a physician when screening obese patients to determine their risk for obstructive sleep apnea," said Timothy Morgenthaler, president, American Academy of Sleep Medicine.

The study involved 90 obese adults with sleep apnea and 31 obese controls without sleep apnea.

All participants underwent high resolution upper airway magnetic resonance imaging (MRI).

In addition to enlarging the size of the tongue, increased tongue fat may impair the functioning of the muscles that attach the tongue to the bone, preventing these muscles from positioning the tongue away from the airway, the authors proposed.

The study appeared in the journal Sleep.

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