From the Guidelines
A neck circumference of ≥ 15.5 inches in women is associated with an increased risk for sleep apnea. This measurement is a significant clinical indicator because excess fat deposition around the neck can compress the upper airway during sleep, leading to partial or complete obstruction of breathing, as noted in the study by the American Academy of Sleep Medicine 1. The larger the neck circumference, the more soft tissue is present that can potentially block the airway when muscle tone decreases during sleep. Key factors that increase the risk of sleep apnea in women with a neck circumference of ≥ 15.5 inches include:
- Hypertension, especially if resistant
- Type 2 diabetes, particularly if accompanied by obesity
- Cardiovascular disease
- Hypothyroidism (untreated)
- Age 42 years or older
- Family history of OSA
- Postmenopausal status Healthcare providers often include neck circumference as part of sleep apnea risk assessment alongside other factors such as body mass index (BMI), presence of snoring, observed breathing pauses during sleep, and daytime sleepiness, as outlined in the recommendations of the AASM Sleep and Transportation Safety Awareness Task Force 1. Women with neck measurements exceeding this threshold should consider discussing sleep apnea screening with their healthcare provider, especially if they experience symptoms like chronic fatigue, morning headaches, or unrefreshing sleep. Weight loss can help reduce neck circumference and potentially improve sleep apnea symptoms in those who are overweight or obese.
From the Research
Neck Circumference and Sleep Apnea in Women
- The relationship between neck circumference and sleep apnea in women is not as well-studied as in men, but research suggests that a larger neck circumference is associated with an increased risk of sleep apnea 2.
- A study of 3,942 patients (2,753 men and 1,189 women) found that sleep apnea was less frequent and severe in women than in men, but that women with larger neck circumferences were more likely to have sleep apnea 2.
- The study found that the difference in neck circumference between men and women became less pronounced when normalized to body height, suggesting that other factors may contribute to the gender difference in sleep apnea risk 2.
- Another study reported a case of a patient with a neck circumference of 25 inches, which is the largest reported to date, and highlighted the importance of physical examination findings in assessing the risk of sleep apnea 3.
Specific Neck Circumference Measurements
- Unfortunately, there is no specific information available on the exact neck circumference measurement that is associated with an increased risk of sleep apnea in women.
- However, the study by 2 suggests that a larger neck circumference is associated with an increased risk of sleep apnea, and that other factors such as body mass index (BMI) and age may also contribute to this risk.
- Further research is needed to determine the specific neck circumference measurement that is associated with an increased risk of sleep apnea in women.
Treatment Options for Sleep Apnea
- Oral appliances, such as mandibular advancement devices, are a treatment option for sleep apnea, and may be effective in reducing the severity of the condition 4, 5, 6.
- However, the effectiveness of oral appliances may vary depending on the individual patient and the severity of their sleep apnea.
- Other treatment options, such as continuous positive airway pressure (CPAP) therapy, may also be effective in reducing the severity of sleep apnea.