The Link Between Sleep Apnea and Neck Size

There can be a higher risk of Obstructive Sleep Apnea (OSA) for those people with a larger neck size. This is, of course, not always the case but it can play a role if any form of sleep apnea is suspected.

Sleep experts believe that any neck circumference greater than 17 inches for males -- or 16 inches for females -- can play a role in the onset of obstructive sleep apnea. 

With OSA, the muscles in the neck and throat relax during sleep which allows the soft tissues to shift position -- and block the regular air flow. This causes the brain to react by temporarily awakening the sleeper until normal breathing is resumed, a process that can occur dozens (even hundreds) of times during the night.

This is disruptive as it becomes increasingly difficult to get the necessary, restorative, quality sleep necessary for proper functioning but there are also associated health risks.

Oxygen levels in the blood can drop during these short breathing pauses which increases blood pressure and places strain on the heart and cardiovascular system.  

Upper Airway Resistance Syndrome (UARS) is part of the spectrum of obstructive sleep apnea and causes the patient to have repetitive arousals during sleep without a concurrent drop in oxygen levels.

If left untreated for a long period of time, obstructive sleep apnea can have severe health complications including:

Hypertension (high blood pressure)

Heart conditions

Heart failure

Apart from these serious medical conditions, untreated sleep apnea lowers the quality of life as sufferers can also suffer from:

Lack of concentration

Daytime drowsiness

Morning headaches




Although the size of one's neck may seem a trivial matter, it should be noted that a larger neck indicates more fat in the area. This contributes to crowding and compression of the air passage making blockages and obstructions more likely.

Risk Assessment

A doctor or sleep specialist investigating possible OSA will often use neck measurements as part of the risk assessment procedure. Apart from taking physical measurements, a series of questions may be asked such as the patient's:

Normal sleeping position

Snoring habits

Overall physical health and general well-being

A patient will also be assessed for obesity and blood pressure is checked. Other risk factors to be considered are whether the patient drinks alcohol or uses tobacco products. 

An overnight home study to check oxygen levels during sleep is quite common and this may be followed by a sleep study to be carried out either at home or in a specialist sleep laboratory.

Examining Neck Size 

Having a larger neck size does not necessarily increase the risk of developing obstructive sleep apnea -- but there is some correlation between the two. The reasons why are mainly physical as a thicker neck:

Usually means a narrower air passage

Can indicate excess fatty deposits and tissue

May be due to obesity

In all these cases, it is typical to find that the air passage is narrower than it should be -- which makes breathing more difficult. Because the air has to force its way through a constricted airway, wheezing and shortness of breath are possible -- as is an increased tendency to snore during sleep.

If a large neck size is natural because of the person’s physique, there is nothing that can be done about it --and there is little need to worry. If, however, it is due to being overweight, or obese, it may be necessary to consider a change of lifestyle and diet. 

Regular physical exercise and following a balanced but healthy diet should soon make a significant difference, not just to the circumference of the neck but to overall good health.


A larger neck size does not automatically imply that OSA is inevitable, but it is something that bears consideration. Every individual is different and larger, taller people will likely have a bigger neck circumference than their smaller counterparts. 

What is important is the size of the neck in comparison to the rest of the body. If shortness of breath, wheezing or snoring are evident, and the neck size seems bigger than it was or should be, it would be prudent to consult a doctor who can determine the cause of the problem and decide on the appropriate course of action to rectify matters.

Medical or surgical solutions are unlikely as the problem is often due to lifestyle and dietary issues. 

Maintaining good general fitness, while eating and drinking sensibly, is often all that is required to bring an increased neck size back to normal. While this can never guarantee that obstructive sleep apnea will never become an issue it will at least eliminate one more contributory factor.