My doc said that at 18" you have a 75% chance of having apnea, and at 19" everyone has it. Or close to that statement. OTOH, a fat neck isn’t required to have apnea, as the structure of your soft palette is a primary driver of obstructive sleep apnea.
W/o intervention of some sort, it can shorten your life or straight up kill you. It’s not just loud snoring and coughing. Man, one time I had an event that was so bad, my body coughed to clear the obstruction so hard that it woke me and simultaneously knocked the wind out of me. That was fucking terrifying.
I’ve been around and around and investigated all sorts of treatments. I had a real tough time with CPAP’s, b/c I felt claustrophobic and felt like I wasn’t getting enough air as in I felt like I was suffocating. After a year of wrestling with the CPAP and desperate for a solution, I flew to the clinic in Ohio that did the FDA trials for the Winx machine from Apnicare (It uses suction to pull tongue forward rather than positive pressure to keep passages open), and look into the surgically implanted ‘pacemaker’ known as Inspire (used electrodes attached to your tongue to drive tongue forward upon onset of an apnea event). I was fitted with it and qualified with the Winx, but the doc who did the trials still said the CPAP was the gold standard. He gave me some advice: fix my deviated septum, use the Navage thing to clear out sinuses, use OTC medications for clearing up nasal passages, and modify machine settings. But most of all, I switched from a full face mask to nose pillows.
Voila. I’m now mostly compliant except when i fall asleep w/o putting the mask on.
My bloodwork is now better and I have more energy.
For you big guys, you might recall Eddie Hall documentary showing him putting his mask on. Whether you know it or not, probably most SHW’s have obstructive sleep apnea.