Largest Neck Circumference Associated With Obstructive Sleep Apnea: A Case Report

Obstructive sleep apnea (OSA) is a sleep-related breathing disorder associated with obesity markers such as neck circumference (NC), waist circumference (WC), and body mass index (BMI). A greater NC has been linked to a higher risk of OSA. To date, the largest reported NC has been 20.5 inches. We present a case of a patient who came to our clinic for OSA management and was found to have an NC of 25 inches, the largest reported to date. The primary objective of this case is to stimulate discussion and research on the specific limits of NC that indicate a higher risk of OSA, the impact of extreme obesity on the severity of the condition and its treatment challenges, and the importance of basic physical measurements of NC in assessing a patient's level of risk and providing appropriate care. This case highlights an extreme clinical observation of a common medical problem. It illustrates the importance of physical examination findings and their relevance in OSA.