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Clinical features of obstructive sleep apnea (OSA)

Clinical features of obstructive sleep apnea (OSA)
Examination findings
  • Narrow or "crowded" airway
  • Obesity
  • Large neck circumference
  • Craniofacial abnormalities (eg, retrognathia)
Symptoms
  • Daytime sleepiness
  • Nonrestorative sleep
  • Loud snoring
  • Witnessed apneas by bed partner
  • Awakening with choking or gasping
  • Nocturnal restlessness
  • Insomnia with frequent awakenings
  • Lack of concentration
  • Cognitive deficits
  • Changes in mood
  • Morning headaches
  • Vivid, strange, or threatening dreams
  • Nocturia
Associated conditions
  • Obesity hypoventilation syndrome
  • Systemic hypertension
  • Cardiovascular disease (eg, heart failure)
  • Cerebrovascular disease (eg, stroke, transient ischemic attacks)
  • Cardiac dysrhythmias (eg, atrial fibrillation)
  • Pulmonary hypertension
  • Cor pulmonale
  • End-stage kidney disease
  • Type 2 diabetes mellitus
  • Chronic lung disease
  • Pregnancy
  • Acromegaly
  • Hypothyroidism
  • Gastroesophageal reflux
  • Secondary polycythemia
  • Floppy eyelid syndrome
  • Polycystic ovary syndrome
  • Parkinson disease
Other medical conditions that may have an association with OSA include fibromyalgia, gastroesophageal reflux disease, and secondary polycythemia. For further information refer to UpToDate content on clinical evaluation of obstructive sleep apnea.
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