How Does Neck Size Affect Sleep and Contribute to Snoring and Apnea?

Excessive Weight May Cause the Airway to Collapse During Sleep

A large neck size may increase the risk of having sleep apnea and weight loss may help
A large neck size may increase the risk of having sleep apnea and weight loss may help. Getty Images

It may seem like an odd question, but how does neck size affect sleep? Women often don't know their neck size, and men may use the measurement to buy collared dress shirts. Surprisingly, the size of your neck may be useful in determining your risk for various sleep disorders, including snoring and sleep apnea. This is likely true for a few reasons. Learn about the role of your neck size in the anatomy associated with sleep-disordered breathing disorders like obstructive sleep apnea.

Neck Size and the Link to Obstructive Sleep Apnea

Why might your neck size increase your risk of having sleep apnea? First, as an individual becomes more overweight or obese, one area of the body that becomes larger in circumference is the neck. Therefore, a large neck likely corresponds to increased fat tissue elsewhere in the body, including at the base of the tongue and lining the airway. Aside from having a large stomach, there will also be tissue crowding along the airway, especially in the throat.

When the airway becomes narrowed, it is more likely to partially collapse causing hypopneas or, with vibration, the sound of snoring. It may also completely close off during sleep, causing obstructive sleep apnea.

If an individual has enlarged tissues in the back of the mouth and throat — such as big tonsils, adenoids, or tongue — this will likewise contribute. A smaller lower jaw may push the tongue back into the throat.

The weight of the neck tissue itself may also lead the soft airway to collapse, especially if gravity contributes when the person is sleeping on his or her back.

When Is the Neck Size Too Big and What Can Be Done?

Men may know their collar size from wearing dress shirts or suits, but women don't usually measure their necks for clothing.

To evaluate your risk of breathing problems in sleep, the circumference, or distance around the neck, is typically measured with a paper or plastic measuring tape at the doctor's office. In general, this is considered to be a risk factor for snoring and sleep apnea when the circumference is greater than 17 inches (43.2 centimeters) for men and greater than 16 inches (40.6 centimeters) in women.

For the reasons described above, neck size can have a significant impact on your ability to sleep. Sleep physicians will often measure neck circumference since it can be as useful as height and weight to determine your risk of having breathing problems during sleep. In the right context of symptoms and other signs, it may be additional evidence suggesting the need for further evaluation.

What can be done if your neck size is too large? As a general rule, weight loss will help to decrease the size of the neck. In some cases, evaluation by a plastic surgeon may be necessary to pursue treatments that may reduce excessive tissue, including fat or skin stabilization or removal.

A Word from Verywell

If you are concerned about snoring or sleep apnea, meet with a sleep physician to pursue further testing and treatment options, including the use of an oral appliance or continuous positive airway pressure (CPAP).

If needed, these therapies can help to relieve the condition and help you to sleep and feel better.

By simply measuring your neck size, you may go down a path that leads to better long-term health.

Sources:

Katz I, et al. "Do patients with obstructive sleep apnea have thick necks?" Am Rev Respir Dis. 1990 May;141(5 Pt 1):1228-31.

Davies RJ and Stradling JR. "The relationship between neck circumference, radiographic pharyngeal anatomy, and the obstructive sleep apnoea syndrome." Eur Respir J. 1990 May;3(5):509-514.

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