SherbyNet - /page/wikibook/entry.mu

Micron Document

<!DOCTYPE html>

<title>Obstructive sleep apnea</title>

</head>

Obstructive sleep apnea

</h1>

</header>

/* start https://en.wikipedia.org/ */

.mw-parser-output .infobox-subbox{padding:0;border:none;margin:-3px;width:auto;min-width:100%;font-size:100%;clear:none;float:none;background-color:transparent}.mw-parser-output .infobox-3cols-child{margin:auto}.mw-parser-output .infobox .navbar{font-size:100%}@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-full-data:not(.notheme)>div:not(.notheme)[style]{background:#1f1f23!important;color:#f8f9fa}}@media(min-width:640px){body.skin--responsive .mw-parser-output .infobox-table{display:table!important}body.skin--responsive .mw-parser-output .infobox-table>caption{display:table-caption!important}body.skin--responsive .mw-parser-output .infobox-table>tbody{display:table-row-group}body.skin--responsive .mw-parser-output .infobox-table th,body.skin--responsive .mw-parser-output .infobox-table td{padding-left:inherit;padding-right:inherit}}

/* end https://en.wikipedia.org/ */

</style><table class="infobox infobox-has-images-with-white-backgrounds"><tbody><tr><th colspan="2" class="infobox-above" style="background:#ccc">Obstructive sleep apnea</th></tr><tr><th scope="row" class="infobox-label">Other names</th><td class="infobox-data">Obstructive sleep apnoea</td></tr><tr><td colspan="2" class="infobox-full-data"></td></tr><tr><td colspan="2" class="infobox-full-data">Obstructive sleep apnea: As <a href="Soft_tissue" title="Soft tissue">soft tissue</a> falls to the back of the throat, it impedes the passage of air (blue arrows) through the <a href="Trachea" title="Trachea">trachea</a>.</td></tr><tr><th scope="row" class="infobox-label"><a href="Medical_specialty" title="Medical specialty">Specialty</a></th><td class="infobox-data"><a href="Sleep_medicine" title="Sleep medicine">Sleep medicine</a></td></tr></tbody></table><style data-mw-deduplicate="TemplateStyles:r1236303919">

/* start https://en.wikipedia.org/ */

@media screen{html.skin-theme-clientpref-night .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .infobox-has-images-with-white-backgrounds img{background:white}}

/* end https://en.wikipedia.org/ */

</style>

Obstructive sleep apnea (OSA) is the most common <a href="Sleep-related_breathing_disorder" title="Sleep-related breathing disorder">sleep-related breathing disorder</a>. It is characterized by recurrent episodes of complete or partial <a href="Airway_obstruction" title="Airway obstruction">obstruction</a> of the <a href="Respiratory_tract#Upper_respiratory_tract" title="Respiratory tract">upper airway</a> leading to reduced or absent breathing during <a href="Sleep" title="Sleep">sleep</a>.<a href="#cite_note-s719-1">[1]</a> These episodes are termed "<a href="Apnea" title="Apnea">apneas</a>" with complete or near-complete cessation of breathing, or "<a href="Hypopnea" title="Hypopnea">hypopneas</a>" when the reduction in breathing is partial. In either case, a fall in <a href="Oxygen_saturation_(medicine)" title="Oxygen saturation (medicine)">blood oxygen saturation</a>, a sleep disruption, or both, may result. A high frequency of apneas or hypopneas during sleep may interfere with the quality of sleep, which – in combination with disturbances in blood oxygenation – is thought to contribute to negative consequences to health and quality of life.<a href="#cite_note-2">[2]</a> The terms obstructive sleep apnea syndrome (OSAS) or obstructive sleep apnea–hypopnea syndrome (OSAHS) may be used to refer to OSA when it is associated with symptoms during the daytime (e.g. excessive daytime sleepiness, decreased cognitive function).<a href="#cite_note-Barnes2009-3">[3]</a><a href="#cite_note-Young2004-4">[4]</a>

Most individuals with obstructive sleep apnea are unaware of disturbances in breathing while sleeping, even after waking up. A bed partner or family member may observe a person <a href="Snoring" title="Snoring">snoring</a> or appear to stop breathing, gasp, or choke while sleeping. People who live or sleep alone are often unaware of the condition. Symptoms may persist for years or even decades without identification. During that time, the person may become conditioned to the daytime sleepiness, headaches, and <a href="Fatigue_(medical)" class="mw-redirect" title="Fatigue (medical)">fatigue</a> associated with significant levels of sleep disturbance. Obstructive sleep apnea has been associated with neurocognitive morbidity, and there is a link between snoring and neurocognitive disorders.<a href="#cite_note-5">[5]</a>

/* start https://en.wikipedia.org/ */

.mw-parser-output .toclimit-2 .toclevel-1 ul,.mw-parser-output .toclimit-3 .toclevel-2 ul,.mw-parser-output .toclimit-4 .toclevel-3 ul,.mw-parser-output .toclimit-5 .toclevel-4 ul,.mw-parser-output .toclimit-6 .toclevel-5 ul,.mw-parser-output .toclimit-7 .toclevel-6 ul{display:none}

/* end https://en.wikipedia.org/ */

</style><div class="toclimit-2"><meta property="mw:PageProp/toc"></div>

<div class="mw-heading mw-heading2"><h2 id="Classification">Classification</h2></div>

In the third edition of the <a href="International_Classification_of_Sleep_Disorders" title="International Classification of Sleep Disorders">International Classification of Sleep Disorders</a> (ICSD-3), obstructive sleep apnea is classified amongst the sleep-related breathing disorders and is divided in two categories, namely adult OSA and pediatric OSA.<a href="#cite_note-AASM3rd-6">[6]</a> Obstructive sleep apnea is differentiated from <a href="Central_sleep_apnea" title="Central sleep apnea">central sleep apnea</a> (CSA), which is characterized by episodes of reduction or cessation in breathing attributable to decreased effort, rather than upper airway obstruction.<a href="#cite_note-Tung2017-7">[7]</a> The respiratory effort must then be assessed in order to correctly classify the apnea as obstructive given the specificity of the diaphragmatic activity in this condition:<a href="#cite_note-Stoohs2005-8">[8]</a> the inspiratory effort is continued or increased through the entire episode of absent airflow.<a href="#cite_note-AASMManual-9">[9]</a>

When <a href="Hypopnea" title="Hypopnea">hypopneas</a> are present alongside apneas, the term obstructive sleep apnea-hypopnea is used. If it is associated with daytime sleepiness and other daytime symptoms, it is known as obstructive sleep apnea-hypopnea syndrome.<a href="#cite_note-10">[10]</a> To be categorized as obstructive, the hypopnea must meet one or more of the following symptoms: (1) <a href="Snoring" title="Snoring">snoring</a> during the event, (2) increased oronasal flow flattening, or (3) <a href="Diaphragmatic_paradox" title="Diaphragmatic paradox">thoraco-abdominal paradoxical respiration</a> during the event.<a href="#cite_note-AASMManual-9">[9]</a> If none of them are present during the event, then it is categorized as central hypopnea.<a href="#cite_note-AASMManual-9">[9]</a>

<div class="mw-heading mw-heading2"><h2 id="Signs_and_symptoms">Signs and symptoms</h2></div>

Common symptoms of obstructive sleep disorder syndrome include unexplained daytime sleepiness, restless sleep, frequent awakenings and loud <a href="Snoring" title="Snoring">snoring</a> (with periods of silence followed by gasps).<a href="#cite_note-11">[11]</a> Less common symptoms are morning <a href="Headaches" class="mw-redirect" title="Headaches">headaches</a>; <a href="Insomnia" title="Insomnia">insomnia</a>; trouble concentrating; mood changes such as <a href="Irritability" title="Irritability">irritability</a>, <a href="Anxiety" title="Anxiety">anxiety</a>, and <a href="Depression_(mood)" title="Depression (mood)">depression</a>; bruxism (teeth grinding), forgetfulness; increased heart rate or <a href="Blood_pressure" title="Blood pressure">blood pressure</a>; erectile dysfunction, unexplained weight gain; increased urinary frequency or <a href="Nocturia" title="Nocturia">nocturia</a>; frequent heartburn or <a href="Gastroesophageal_reflux_disease" title="Gastroesophageal reflux disease">gastroesophageal reflux</a>; and heavy night sweats.<a href="#cite_note-cognition-12">[12]</a><a href="#cite_note-13">[13]</a><a href="#cite_note-14">[14]</a>

Many people experience episodes of OSA transiently, for only a short period. This can be the result of an upper respiratory infection that causes nasal congestion, along with swelling of the throat, or <a href="Tonsillitis" title="Tonsillitis">tonsillitis</a> that temporarily produces very enlarged tonsils.<a href="#cite_note-pmid22297210-15">[15]</a><a href="#cite_note-pmid23643333-16">[16]</a> The <a href="Epstein-Barr_virus" class="mw-redirect" title="Epstein-Barr virus">Epstein-Barr virus</a>, for example, is known to be able to increase the size of lymphoid tissue dramatically during acute infection, and OSA is fairly common in acute cases of severe <a href="Infectious_mononucleosis" title="Infectious mononucleosis">infectious mononucleosis</a>. Temporary spells of OSA syndrome may also occur in people who are under the influence of a drug (such as <a href="Ethanol" title="Ethanol">alcohol</a>) that may relax their body tone excessively and interfere with normal arousal from sleep mechanisms.<a href="#cite_note-17">[17]</a>

<div class="mw-heading mw-heading3"><h3 id="Adults">Adults</h3></div>

The hallmark symptom of OSA syndrome in adults is <a href="Excessive_daytime_sleepiness" title="Excessive daytime sleepiness">excessive daytime sleepiness</a>. Typically, an adult or adolescent with severe long-standing OSA will fall asleep for very brief periods in the course of usual daytime activities if allowed to sit or rest.<a href="#cite_note-18">[18]</a> This behavior may be quite dramatic, sometimes occurring during conversations with others at social gatherings.

The <a href="Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">hypoxia</a> (absence of oxygen supply) related to OSA may cause changes in the neurons of the <a href="Hippocampus" title="Hippocampus">hippocampus</a> and the right <a href="Frontal_cortex" class="mw-redirect" title="Frontal cortex">frontal cortex</a>. Research using neuroimaging revealed evidence of hippocampal atrophy in people with OSA. They found that OSA can cause problems in mentally manipulating non-verbal information, in <a href="Executive_functions" title="Executive functions">executive functions</a> and <a href="Working_memory" title="Working memory">working memory</a>.<a href="#cite_note-pmid14751008-19">[19]</a> OSA may also be associated with an increased risk of a person developing <a href="Alzheimer's_disease" title="Alzheimer's disease">Alzheimer's disease</a>.<a href="#cite_note-pmid14751008-19">[19]</a><a href="#cite_note-20">[20]</a>

Obesity is a major risk factor for OSA. In the severely obese, the risk for sleep apnea can be between 55 and 90%.<a href="#cite_note-21">[21]</a> However between 20 and 25% of patients with sleep apnea are not overweight.<a href="#cite_note-22">[22]</a> What is often unrecognized in primary care is that it is crucial to identify these patients because they are four times more likely to develop hypertension than obese individuals without OSA.<a href="#cite_note-23">[23]</a> And non-obese patients are at a higher risk for early atherosclerosis. In fact, approximately 2.7 times more than obese patients without OSA. This risk increases as the severity of the syndrome increases.<a href="#cite_note-24">[24]</a> Factors in this population may include inherited anatomical features, instability of ventilatory control, neuromuscular inefficiency of the dilator muscles of the upper airways, or a lower threshold for awakening in response to respiratory stimuli.<a href="#cite_note-25">[25]</a>

Diagnosis of obstructive sleep apnea is significantly more common among people in relationships, who are alerted to their condition by being informed by their sleeping partner, since individuals with obstructive sleep apnea are often unaware of the condition. There is a stigma associated with loud snoring. It is not considered a feminine trait. Consequently, females are less likely to be told by their partners that they snore, or to admit it to themselves or doctors. Furthermore, CPAP (continuous positive airway pressure) machines are also perceived negatively by females, and less likely to be utilized to their full extent in this group.<a href="#cite_note-26">[26]</a>

<div class="mw-heading mw-heading3"><h3 id="Children">Children</h3></div>

Although this so-called "hypersomnolence" (excessive sleepiness) may also occur in children, it is not at all typical of young children with sleep apnea. Toddlers and young children with severe OSA instead ordinarily behave as if "over-tired" or "<a href="Hyperactivity" class="mw-redirect" title="Hyperactivity">hyperactive</a>"; and usually appear to have behavioral problems like irritability, and an attention deficit.<a href="#cite_note-27">[27]</a><a href="#cite_note-28">[28]</a><a href="#cite_note-29">[29]</a>

Adults and children with very severe OSA also differ in typical <a href="Habitus_(sociology)#Body_habitus" title="Habitus (sociology)">bodily habitus</a>. Adults are generally heavy, with particularly short and heavy necks. Young children, on the other hand, are generally not only thin but may have "<a href="Failure_to_thrive" title="Failure to thrive">failure to thrive</a>", where growth is reduced. Poor growth occurs for two reasons: the work of breathing is intense enough that calories are burned at high rates even at rest, and the nose and throat are so obstructed that eating is both tasteless and physically uncomfortable. OSA in children, unlike adults, is often caused by obstructive <a href="Tonsil" title="Tonsil">tonsils</a> and <a href="Adenoid" title="Adenoid">adenoids</a> and may sometimes be cured with <a href="Tonsillectomy" title="Tonsillectomy">tonsillectomy</a> and <a href="Adenoidectomy" title="Adenoidectomy">adenoidectomy</a>.

This problem can also be caused by excessive weight in children. In this case, the symptoms are similar to those adults experience, such as restlessness and exhaustion. If adenotonsillar hypertrophy remains the most common cause of OSA in children,<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Jazi2011-31">[31]</a> <a href="Obesity" title="Obesity">obesity</a> can also play a role in the pathophysiology of upper airway obstruction during sleep which can lead to OSA, making obese children more likely to develop the condition.<a href="#cite_note-Capdevilaetal2008-32">[32]</a> The recent epidemic increase of obesity prevalence has thus contributed to changes in the prevalence and in the characteristics of pediatric OSA,<a href="#cite_note-Dayyat2008-33">[33]</a> the severity of OSA is proportional to the degree of obesity.<a href="#cite_note-Kalra2005-34">[34]</a><a href="#cite_note-Verhulst2009-35">[35]</a>

Obesity leads to the narrowing of upper airway structure due to fatty infiltration and fat deposits in the anterior <a href="Neck" title="Neck">neck</a> region and cervical structures.<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Dayyat2008-33">[33]</a> Alongside with the additional weight loading on the <a href="Respiratory_system" title="Respiratory system">respiratory system</a>, it increases the risk of pharyngeal collapsibility while reducing the intrathoracic volume and diaphragm excursion.<a href="#cite_note-Dayyat2008-33">[33]</a> Moreover, excessive daytime sleepiness resulting from sleep fragmentation can decrease physical activity and thus lead to weight gain (by sedentary habits or increased food intake to overcome <a href="Somnolence" title="Somnolence">somnolence</a>).<a href="#cite_note-Bower2000-36">[36]</a> The obesity-related obstruction of upper airway structure has led some authors to distinguish between two types of OSA in children:<a href="#cite_note-Capdevilaetal2008-32">[32]</a><a href="#cite_note-Dayyat2008-33">[33]</a> type I is associated with marked lymphadenoid <a href="Hypertrophy" title="Hypertrophy">hypertrophy</a> without obesity and type II is first associated with obesity and with milder upper airway lymphadenoid <a href="Hyperplasia" title="Hyperplasia">hyperplasia</a>. The two types of OSA in children can result in different morbidities and consequences.<a href="#cite_note-Capdevilaetal2008-32">[32]</a> Studies have shown that weight loss in obese adolescents can reduce <a href="Sleep_apnea" title="Sleep apnea">sleep apnea</a> and thus the symptoms of OSA.<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Verhulst2009-35">[35]</a>

<div class="mw-heading mw-heading2"><h2 id="Diagnosis">Diagnosis</h2></div>

The diagnosis of OSA syndrome is made when the patient shows recurrent episodes of partial or complete collapse of the upper airway during sleep, resulting in apneas or hypopneas, respectively.<a href="#cite_note-Obstructive_sleep_apnea_is_a_common-37">[37]</a> Criteria defining an apnea or a hypopnea vary. The <a href="American_Academy_of_Sleep_Medicine" title="American Academy of Sleep Medicine">American Academy of Sleep Medicine (AASM)</a> defines an apnea episode as a reduction in airflow of ≥ 90% lasting at least 10 seconds. A hypopnea is defined as a reduction in airflow of ≥ 30% lasting at least 10 seconds and associated with a ≥ 4% decrease in pulse oxygenation, or as a ≥ 30% reduction in airflow lasting at least 10 seconds and associated either with a ≥ 3% decrease in pulse oxygenation or with an arousal.<a href="#cite_note-38">[38]</a>

To define the severity of the condition, the Apnea-Hypopnea Index (AHI) or the <a href="Respiratory_Disturbance_Index" class="mw-redirect" title="Respiratory Disturbance Index">Respiratory Disturbance Index</a> (RDI) is used. While the AHI measures the mean number of apneas and hypopneas per hour of sleep, the RDI adds to this measure the respiratory effort-related arousals (RERAs).<a href="#cite_note-39">[39]</a> The OSA syndrome is thus diagnosed if the AHI is > 5 episodes per hour and results in daytime sleepiness and fatigue or when the RDI is ≥ 15 independently of the symptoms.<a href="#cite_note-40">[40]</a> Daytime sleepiness may be classified as mild, moderate, or severe depending on its impact on social life. Daytime sleepiness can be assessed with the <a href="Epworth_Sleepiness_Scale" title="Epworth Sleepiness Scale">Epworth Sleepiness Scale</a> (ESS), a self-reported questionnaire on the propensity to fall asleep or doze off during daytime.<a href="#cite_note-41">[41]</a> Screening tools for OSA itself comprise the STOP questionnaire, the Berlin questionnaire and the STOP-BANG questionnaire which has been reported as being a powerful tool to detect OSA.<a href="#cite_note-42">[42]</a><a href="#cite_note-43">[43]</a>

<div class="mw-heading mw-heading3"><h3 id="Polysomnography">Polysomnography</h3></div>

<th>Rating

</th>

<th><a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">AHI</a> (adult)</th>

<th><a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">AHI</a> (pediatrics)

</th></tr>

<tr>

<td>Normal

</td>

<td><1

</td></tr>

<tr>

<td>Mild

</td>

<td>≥1, <5

</td></tr>

<tr>

<td>Moderate

</td>

<td>≥5, <10

</td></tr>

<tr>

<td>Severe

</td>

<td>≥10

</td></tr></tbody></table>

Nighttime in-laboratory Level 1 polysomnography (PSG) is the gold standard test for diagnosis. Patients are monitored with EEG leads, <a href="Pulse_oximetry" title="Pulse oximetry">pulse oximetry</a>, temperature or pressure sensors to detect nasal and oral airflow, respiratory impedance plethysmography or similar resistance belts around the chest and abdomen to detect motion, an ECG lead, and EMG sensors to detect muscle contraction in the chin, chest, and legs.

An "event" can be either an apnea, characterized by complete cessation of airflow for at least 10 seconds, or a <a href="Hypopnea" title="Hypopnea">hypopnea</a> in which airflow decreases by 50 percent for 10 seconds or decreases by 30 percent if there is an associated decrease in the oxygen saturation or an arousal from sleep.<a href="#cite_note-:1-44">[44]</a> To grade the severity of sleep apnea, the number of events per hour is reported as the <a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">apnea-hypopnea index</a> (AHI). For adults, an AHI of less than 5 is considered normal, an AHI of [5–15) is mild, [15–30) is moderate, and ≥30 events per hour characterizes severe sleep apnea. For pediatrics, an AHI of less than 1 is considered normal, an AHI of [1–5) is mild, [5–10) is moderate, and ≥10 events per hour characterizes severe sleep apnea.

<div class="mw-heading mw-heading3"><h3 id="Home_sleep_test_(HST)_/_home_sleep_apnea_test_(HSAT)">Home sleep test (HST) / home sleep apnea test (HSAT)</h3></div>

Sleep apnea can also be diagnosed using an in-home testing kit.<a href="#cite_note-45">[45]</a> The main advantage is that these record in the usual sleep environment and thus are more representative of their natural sleep than staying overnight at a lab. Home sleep testing is more accessible and less expensive than polysomnography due to long waiting periods for in-lab tests.<a href="#cite_note-46">[46]</a>

<div class="mw-heading mw-heading3"><h3 id="Home_oximetry_and_peripheral_arterial_tone_measurement">Home oximetry and peripheral arterial tone measurement</h3></div>

Home <a href="Oximetry" class="mw-redirect" title="Oximetry">oximetry</a> (a non-invasive method of monitoring blood oxygenation) used in concert with <a href="Peripheral_Arterial_Tone" title="Peripheral Arterial Tone">Peripheral Arterial Tone</a> (PAT) technology has been approved by the FDA at-home sleep apnea diagnosis since November 2001 when <a rel="nofollow" class="external text" href="https://www.itamar-medical.com/">Itamar Medical</a> obtained <a href="510(k)" class="mw-redirect" title="510(k)">510(k)</a> clearance for the Watchpat-100.<a href="#cite_note-47">[47]</a> Althought PAT-based at-home sleep tests are not consider as accurate as polysomnography-based tests, their <a href="Apnea%E2%80%93hypopnea_index" title="Apnea–hypopnea index">AHI</a> or AHI-equivalent measurments are considered sufficient for coverage purposes in the United States by <a href="Medicare_(United_States)" title="Medicare (United States)">Medicare</a> and <a href="Health_insurance_in_the_United_States" title="Health insurance in the United States">private health insurance</a> companies.<a href="#cite_note-48">[48]</a><a href="#cite_note-49">[49]</a>

<div class="mw-heading mw-heading3"><h3 id="Criteria">Criteria</h3></div>

According to the <a href="International_Classification_of_Sleep_Disorders" title="International Classification of Sleep Disorders">International Classification of Sleep Disorders</a>, there are 4 types of criteria. The first one concerns sleep – excessive sleepiness, nonrestorative sleep, fatigue, or insomnia. The second and third criteria are about respiration – waking with breath holding, gasping, or choking; snoring, breathing interruptions, or both during sleep. The last criterion revolved around medical issues as hypertension, coronary artery disease, stroke, heart failure, atrial fibrillation, type 2 diabetes mellitus, mood disorder, or cognitive impairment. Two levels of severity are distinguished: the first one is determined by polysomnography or a home sleep apnea test demonstrating five or more predominantly obstructive respiratory events per hour of sleep, and the higher levels are determined by 15 or more events. If the events occur fewer than five times per hour, no obstructive sleep apnea is diagnosed.<a href="#cite_note-50">[50]</a>

A considerable night-to-night variability further complicates the diagnosis of OSA. In unclear cases, multiple testing might be required to achieve an accurate diagnosis.<a href="#cite_note-51">[51]</a>

<div class="mw-heading mw-heading2"><h2 id="Pathophysiology">Pathophysiology</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .ambox{border:1px solid #a2a9b1;border-left:10px solid #36c;background-color:#fbfbfb;box-sizing:border-box}.mw-parser-output .ambox+link+.ambox,.mw-parser-output .ambox+link+style+.ambox,.mw-parser-output .ambox+link+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+style+.ambox,.mw-parser-output .ambox+.mw-empty-elt+link+link+.ambox{margin-top:-1px}html body.mediawiki .mw-parser-output .ambox.mbox-small-left{margin:4px 1em 4px 0;overflow:hidden;width:238px;border-collapse:collapse;font-size:88%;line-height:1.25em}.mw-parser-output .ambox-speedy{border-left:10px solid #b32424;background-color:#fee7e6}.mw-parser-output .ambox-delete{border-left:10px solid #b32424}.mw-parser-output .ambox-content{border-left:10px solid #f28500}.mw-parser-output .ambox-style{border-left:10px solid #fc3}.mw-parser-output .ambox-move{border-left:10px solid #9932cc}.mw-parser-output .ambox-protection{border-left:10px solid #a2a9b1}.mw-parser-output .ambox .mbox-text{border:none;padding:0.25em 0.5em;width:100%}.mw-parser-output .ambox .mbox-image{border:none;padding:2px 0 2px 0.5em;text-align:center}.mw-parser-output .ambox .mbox-imageright{border:none;padding:2px 0.5em 2px 0;text-align:center}.mw-parser-output .ambox .mbox-empty-cell{border:none;padding:0;width:1px}.mw-parser-output .ambox .mbox-image-div{width:52px}@media(min-width:720px){.mw-parser-output .ambox{margin:0 10%}}@media print{body.ns-0 .mw-parser-output .ambox{display:none!important}}

/* end https://en.wikipedia.org/ */

</style>

The transition from wakefulness to sleep (REM sleep or NREM sleep) is associated with a reduction in upper-airway muscle tone. During REM sleep, the muscle tone of the throat and neck, as well as that of the vast majority of skeletal muscles, is almost completely relaxed. This allows the tongue and soft palate/oropharynx to relax, reducing airway patency and potentially impeding or completely obstructing the flow of air into the lungs during inspiration, resulting in reduced respiratory ventilation. If reductions in ventilation are associated with sufficiently low blood-oxygen levels or with sufficiently high breathing efforts against an obstructed airway, neurological mechanisms may trigger a sudden interruption of sleep, called a neurological arousal. This arousal can cause an individual to gasp for air and awaken.<a href="#cite_note-52">[52]</a> These arousals rarely result in complete awakening but can have a significant negative effect on the restorative quality of sleep. In significant cases of OSA, one consequence is <a href="Sleep_deprivation" title="Sleep deprivation">sleep deprivation</a> resulting from the repetitive disruption and recovery of sleep activity. This sleep interruption in Stage 3 NREM sleep (also called <a href="Slow-wave_sleep" title="Slow-wave sleep">slow-wave sleep</a>) and in REM sleep can interfere with normal growth patterns, <a href="Healing" title="Healing">healing</a>, and <a href="Immune_response" title="Immune response">immune response</a>, especially in children and young adults.

The fundamental cause of OSA is a blocked upper airway, usually behind the tongue and epiglottis, whereby the otherwise patent airway, in an erect and awake patient, collapses when the patient lies on his or her back and loses muscle tone upon entering deep sleep.

At the beginning of sleep, a patient is in light sleep, and there is no loss of tone in the throat muscles. Airflow is laminar and soundless. As the upper airway collapse progresses, the obstruction becomes increasingly apparent by the initiation of noisy breathing as air turbulence increases, followed by gradually louder <a href="Snoring" title="Snoring">snoring</a> as a <a href="Venturi_effect" title="Venturi effect">Venturi effect</a> forms through the ever-narrowing air passage. The patient's blood-oxygen saturation gradually falls until cessation of sleep noises, signifying total airway obstruction of airflow, which may last for several minutes.

Eventually, the patient must at least partially awaken from deep sleep into light sleep, automatically regaining general muscle tone. This switch from deep to light to deep sleep can be recorded using <a href="Emission_computed_tomography" title="Emission computed tomography">ECT</a> monitors. In light sleep, muscle tone is near normal, the airway spontaneously opens, normal noiseless breathing resumes, and blood oxygen saturation rises. Eventually, the patient reenters deep sleep, upper <a href="Airway_tone" title="Airway tone">airway tone</a> is again lost, the patient enters the various levels of noisy breathing, and the airway blockage returns.

The cycle of muscle tone loss and restoration, coinciding with periods of deep and light sleep, repeats throughout the patient's period of sleep. The number of apnoea and hypopnoea episodes during any given hour is counted and given a score. If a patient has an average of five or more episodes per hour, mild OSA may be confirmed. An average of 30 or more episodes per hour indicates severe OSA.

<div class="mw-heading mw-heading3"><h3 id="Pathophysiological_models">Pathophysiological models</h3></div>

The causes of spontaneous upper airway blockage are strongly debated by clinical professionals. The areas of thought are divided mostly into three medical groups.

Some <a href="Pulmonology" title="Pulmonology">pulmonologists</a> and <a href="Neurology" title="Neurology">neurologists</a> believe the risk factors to be:

<ul><li>Advanced age, although OSA occurs in neonates, as with <a href="Pierre_Robin_syndrome" class="mw-redirect" title="Pierre Robin syndrome">Pierre Robin</a> syndrome, and in all age groups of people.</li>

<li>Brain injury (temporary or permanent), although this does not account for the 99% of OSA patients who have normal brains and normal lives.</li>

<li>Decreased muscle tone caused by drugs or alcohol, or caused by neurological disorders. This also would not account for the majority of people with OSA.</li>

<li>Long-term snoring, which is postulated to potentially induce local nerve lesions in the soft tissues of the <a href="Pharynx" title="Pharynx">pharynx</a>. Snoring may produce traumatic vibrations that may give rise to nerve injuries in the upper airway muscles, further contributing to OSA.<a href="#cite_note-53">[53]</a></li>

<li>Increased soft tissue around the airway, often resulting from obesity, though not seen in all patients with OSA.</li></ul>

Some <a href="Otorhinolaryngology" title="Otorhinolaryngology">otorhinolaryngologists</a> believe the risk factors to be structural features that give rise to a narrowed airway, such as enlarged <a href="Tonsils" class="mw-redirect" title="Tonsils">tonsils</a>, an enlarged posterior tongue, or fat deposits in the neck. Further factors leading to OSA can be impaired nasal breathing, floppy soft palate, or a collapsible <a href="Epiglottis" title="Epiglottis">epiglottis</a>.

Some <a href="Oral_and_maxillofacial_surgery" title="Oral and maxillofacial surgery">oral and maxillofacial surgeons</a> believe the risk factors to be several primary forms of <a href="Micrognathism" title="Micrognathism">mandibular hypoplasia</a>, which offers a primary anatomical basis to the development of OSA through <a href="Glossoptosis" title="Glossoptosis">glossoptosis</a>. Some maxillofacial surgeons who offer <a href="Orthognathic_surgery" title="Orthognathic surgery">orthognathic</a> surgery for treatment of OSA believe that their treatments offer superior guarantees of cure of OSA.

<div class="mw-heading mw-heading2"><h2 id="Risk_factors">Risk factors</h2></div>

<div class="mw-heading mw-heading3"><h3 id="Obesity">Obesity</h3></div>

It is well known that children, adolescents, or adults with OSA are often <a href="Obese" class="mw-redirect" title="Obese">obese</a>. People with obesity show an increase in neck fat tissue, which potentiates respiratory obstruction during sleep.<a href="#cite_note-54">[54]</a>

However, people of all ages and sexes with normal body mass indices (BMIs) can also demonstrate OSA – and these people do not have significant measures of subdermal or intra-neck fat as shown on <a href="DEXA" class="mw-redirect" title="DEXA">DEXA</a> scans. It is speculated that they may have increased muscle mass, or alternatively have a tendency to decreased muscle tone, potentiating airway collapse during sleep.

However, loss of muscle tone is a key feature of deep sleep, and whilst obesity seems a common association, it is not an invariable state of OSA.

Sleeping supine (on one's back) is also represented as a risk factor for OSA. Gravity and loss of tongue and throat tone as a person enters deep sleep are clear factors contributing to OSA development. But this explanation is also confounded by the presence of neck obesity.

The use of CPAP primarily expands a collapsed upper airway, allowing for nasal breathing. A positive response to CPAP confirms that airway collapse is the cause of OSA.

Throat lesions, particularly enlarged tonsils, are well recognized as aggravators of OSA, and removal may provide full, partial, or semi-permanent relief from OSA, which also indicates that enlarged tonsils may play a role in the pathogenesis of OSA.

Old age is often accompanied by muscular and neurological loss of muscle tone of the upper airway. Decreased muscle tone is also temporarily caused by chemical depressants; alcoholic drinks and sedative medications are the most common. Permanent premature muscular tonal loss in the upper airway may be precipitated by <a href="Traumatic_brain_injury" title="Traumatic brain injury">traumatic brain injury</a>, <a href="Neuromuscular_disorders" class="mw-redirect" title="Neuromuscular disorders">neuromuscular disorders</a>, or poor adherence to chemical and or speech therapy treatments.

<div class="mw-heading mw-heading3"><h3 id="Muscle_tone">Muscle tone</h3></div>

Individuals with decreased muscle tone and increased soft tissue around the airway, and structural features that give rise to a narrowed airway, are at high risk for OSA. Men, in whom the anatomy is typified by increased mass in the torso and neck, are at increased risk of developing sleep apnea, especially in middle age and later. Typically, women experience this condition less frequently and to a lesser degree than do men, owing partially to physiology, but possibly also to differential levels of <a href="Progesterone" title="Progesterone">progesterone</a>. Prevalence in <a href="Menopause" title="Menopause">post-menopausal</a> women approaches that of men in the same age range. Women are at greater risk for developing OSA during <a href="Pregnancy" title="Pregnancy">pregnancy</a>.<a href="#cite_note-55">[55]</a>

<div class="mw-heading mw-heading3"><h3 id="Medication_and_lifestyle">Medication and lifestyle</h3></div>

Lifestyle factors such as smoking may also increase the chances of developing OSA, as the chemical irritants in smoke tend to inflame the soft tissue of the upper airway and promote fluid retention, both of which can result in narrowing of the upper airway. Cigarettes may also have an impact due to a decline in blood nicotine levels, which alters sleep stability.<a href="#cite_note-Young2004-4">[4]</a> Smokers thus show a higher risk of developing OSA, but the effect of cigarettes on increased OSA is reversible with the cessation of smoking.<a href="#cite_note-Young2004-4">[4]</a> Children exposed to cigarette smoke may also develop OSA, as the lymphoid tissue will proliferate excessively in contact with the irritants.<a href="#cite_note-Dayyat2008-33">[33]</a> An individual may also experience or exacerbate OSA with the consumption of alcohol, sedatives, or any other medication that increases sleepiness as most of these drugs are also muscle relaxants.<a href="#cite_note-56">[56]</a> Allergic rhinitis and asthma have also been shown to be implicated in the increased prevalence of adenotonsillar hypertrophy and OSA.<a href="#cite_note-57">[57]</a><a href="#cite_note-58">[58]</a>

<div class="mw-heading mw-heading3"><h3 id="Genetic">Genetic</h3></div>

OSA also appears to have a genetic component; those with a family history of it are more likely to develop it themselves. This could be the result of both direct genetic contributions to OSA susceptibility. Or it could be from indirect contributions via ‘intermediate’ phenotypes such as obesity, craniofacial structure, neurological control of upper airway muscles, and of sleep and <a href="Circadian_rhythm_sleep_disorder" title="Circadian rhythm sleep disorder">circadian rhythm sleep problems.</a><a href="#cite_note-59">[59]</a>

Several genes connected with sleep apnea have been identified, including <a href="DLEU1" title="DLEU1">DLEU1</a>, DLEU7 CTSF, MSRB3, <a href="FTO_gene" title="FTO gene">FTO</a>, and TRIM66.<a href="#cite_note-Campos2023-60">[60]</a>

<div class="mw-heading mw-heading3"><h3 id="Craniofacial_syndromes">Craniofacial syndromes</h3></div>

Of substantial recent interest is the idea that there is a general human tendency towards developing short lower jaws (<a href="Neoteny" title="Neoteny">neoteny</a>) is a major cause of OSA through a combined condition called <a href="Glossoptosis" title="Glossoptosis">glossoptosis</a>. The posterior "normal" tongue is displaced backwards by a smaller "abnormal" anterior tongue and lower jaw. In much the same way, a narrow upper jaw will also contribute to OSA due to its relation to airway volume. A narrower upper jaw results in narrower nasal passages and a narrower throat; this also appears to be why so many OSA patients experience nasal congestion, especially while lying down.

<a href="Maxillofacial_surgeon" class="mw-redirect" title="Maxillofacial surgeon">Maxillofacial surgeons</a> see many effects of small lower jaws, including crowded teeth, malocclusions, as well as OSA – all of which are treatable by surgical operations that increase and normalise jaw size. Operations such as custom BIMAX, GenioPaully, and IMDO (in adolescence) offer a valid medical option that replaces all traditional forms of OSA treatment – including <a href="CPAP" class="mw-redirect" title="CPAP">CPAP</a>, <a href="Mandibular_advancement_splint" title="Mandibular advancement splint">Mandibular Advancement Splints</a>, <a href="Tonsillectomy" title="Tonsillectomy">tonsillectomy</a> and <a href="Uvulopalatopharyngoplasty" title="Uvulopalatopharyngoplasty">UPPP</a>. There are patterns of unusual facial features that occur in recognizable syndromes. Some of these craniofacial syndromes are genetic, and others are from unknown causes. In many craniofacial syndromes, the features that are unusual involve the nose, mouth, and jaw, or resting muscle tone, and put the individual at risk for OSA syndrome.

<a href="Down_syndrome" title="Down syndrome">Down syndrome</a> is one such syndrome. In this <a href="Chromosome" title="Chromosome">chromosomal</a> abnormality, several features combine to make the presence of obstructive sleep apnea more likely. The specific features of Down syndrome that predispose to obstructive sleep apnea include relatively low muscle tone, a narrow <a href="Nasopharynx" class="mw-redirect" title="Nasopharynx">nasopharynx</a>, and a large tongue. Obesity and enlarged tonsils and adenoids, conditions that occur commonly in the western population, are much more likely to be obstructive in a person with these features than without them. Obstructive sleep apnea occurs even more frequently in people with Down syndrome than in the general population. A little over 50% of all people with Down syndrome experience obstructive sleep apnea,<a href="#cite_note-61">[61]</a> and some physicians advocate routine testing of this group.<a href="#cite_note-62">[62]</a>

In other craniofacial syndromes, the abnormal feature may improve the airway, but its correction may put the person at risk for obstructive sleep apnea after surgery when it is modified. <a href="Cleft_palate" class="mw-redirect" title="Cleft palate">Cleft palate</a> syndromes are such an example. During the newborn period, all humans are <a href="Obligate_nasal_breathing" title="Obligate nasal breathing">obligate nasal breathers</a>. The palate is both the roof of the mouth and the floor of the nose. Having an open palate may make feeding difficult, but generally, it does not interfere with breathing; if the nose is very obstructed, then an open palate may relieve breathing. There are several clefting syndromes in which the open palate is not the only abnormal feature; additionally, there is a narrow nasal passage, which may not be obvious. In such individuals, closure of the cleft palate – whether by surgery or a temporary oral appliance – can cause the onset of obstruction.

Skeletal advancement to physically increase the <a href="Human_pharynx" class="mw-redirect" title="Human pharynx">pharyngeal</a> airspace is often an option for craniofacial patients with upper airway obstruction and small lower jaws (<a href="Human_mandible" class="mw-redirect" title="Human mandible">mandibles</a>). These syndromes include <a href="Treacher_Collins_syndrome" title="Treacher Collins syndrome">Treacher Collins syndrome</a> and <a href="Pierre_Robin_sequence" title="Pierre Robin sequence">Pierre Robin sequence</a>. <a href="Mandibular_advancement_surgery" class="mw-redirect" title="Mandibular advancement surgery">Mandibular advancement surgery</a> is one of the modifications needed to improve the airway; others may include reduction of the tongue, <a href="Tonsillectomy" title="Tonsillectomy">tonsillectomy</a> or modified <a href="Uvulopalatoplasty" title="Uvulopalatoplasty">uvulopalatoplasty</a>.

<div class="mw-heading mw-heading3"><h3 id="Post-operative_complication">Post-operative complication</h3></div>

OSA can also occur as a serious post-operative complication that seems to be most frequently associated with <a href="Pharyngeal_flap_surgery" title="Pharyngeal flap surgery">pharyngeal flap surgery</a> as compared to other procedures for the treatment of <a href="Velopharyngeal_inadequacy" title="Velopharyngeal inadequacy">velopharyngeal inadequacy</a> (VPI).<a href="#cite_note-Sloan-63">[63]</a> In OSA, recurrent interruptions of <a href="Respiration_(physiology)" title="Respiration (physiology)">respiration</a> during sleep are associated with temporary <a href="Airway_obstruction" title="Airway obstruction">airway obstruction</a>. Following pharyngeal flap surgery, depending on size and position, the flap itself may have an "<a href="https://en.wiktionary.org/wiki/obturator" class="extiw external" title="wikt:obturator">obturator</a>" or obstructive effect within the <a href="Human_pharynx" class="mw-redirect" title="Human pharynx">pharynx</a> during sleep, blocking ports of airflow and hindering effective <a href="Respiration_(physiology)" title="Respiration (physiology)">respiration</a>.<a href="#cite_note-Pugh-64">[64]</a><a href="#cite_note-Liao2004-65">[65]</a> There have been documented instances of severe airway obstruction, and reports of post-operative OSA continues to increase as healthcare professionals (i.e. physicians, <a href="Speech_and_language_pathology" class="mw-redirect" title="Speech and language pathology">speech language pathologists</a>) become more educated about this possible dangerous condition.<a href="#cite_note-PetersonFalzone-66">[66]</a> Subsequently, in clinical practice, concerns of OSA have matched or exceeded interest in speech outcomes following pharyngeal flap surgery.

The surgical treatment for velopalatal insufficiency may cause obstructive sleep apnea syndrome. When velopalatal insufficiency is present, air leaks into the nasopharynx even when the soft palate should close off the nose. A simple test for this condition can be made by placing a tiny mirror on the nose and asking the subject to say "P". This p sound, a plosive, is normally produced with the nasal airway closed off – all air comes out of the pursed lips, none from the nose. If it is impossible to say the sound without fogging a nasal mirror, there is an air leak, reasonable evidence of poor palatal closure. Speech is often unclear due to the inability to pronounce certain sounds. One of the surgical treatments for velopalatal insufficiency involves tailoring the tissue from the back of the throat and using it to purposefully cause partial obstruction of the opening of the <a href="Nasopharynx" class="mw-redirect" title="Nasopharynx">nasopharynx</a>. This may actually cause OSA syndrome in susceptible individuals, particularly in the days following surgery, when swelling occurs (see below: Special Situation: Anesthesia and surgery).

Finally, patients with OSA are at an increased risk of many perioperative complications when they are present for surgery, even if the planned procedure is not on the head and neck. Guidelines to reduce the risk of perioperative complications have been published.<a href="#cite_note-67">[67]</a>

<div class="mw-heading mw-heading2"><h2 id="Consequences">Consequences</h2></div>

There are 3 levels of consequences: physiologic, intermediate, and clinical.<a href="#cite_note-OSA-68">[68]</a> The physiologic consequences include hypoxia, sleep fragmentation, autonomic nervous system dysregulation, or hyperoxia.<a href="#cite_note-OSA-68">[68]</a> The intermediate results regroup inflammation, pulmonary vasoconstriction, general metabolic dysfunction, oxidation of proteins and lipids, or increased adiposity.<a href="#cite_note-OSA-68">[68]</a> The clinical repercussions include pulmonary hypertension, accidents, obesity, diabetes, different heart diseases, and hypertension.<a href="#cite_note-OSA-68">[68]</a>

<div class="mw-heading mw-heading3"><h3 id="In_children">In children</h3></div>

Obstructive sleep apnea is the most common Sleep-Disordered Breathing (SDB) and affects up to 11% of children born at term – it is even more common (3 to 6 times more) in children born pre-term.<a href="#cite_note-Walter2018-69">[69]</a> As a SDB, OSA in children can lead to several adverse consequences, also in the long-term with consequences lasting into adulthood.<a href="#cite_note-Dehlink2016-30">[30]</a> The implications of OSA in children are complex and cover a large scope of consequences: when it is left untreated, OSA can lead to morbidity affecting many different domains of life (organs, body systems, behavioral disturbance, <a href="Depression_(mood)" title="Depression (mood)">depression</a>, decreased <a href="Quality_of_life" title="Quality of life">quality of life</a>, etc.).<a href="#cite_note-Dayyat2008-33">[33]</a> Therefore, nocturnal symptoms indicating the presence of OSA (e.g. <a href="Snoring" title="Snoring">snoring</a>, gasping, restless sleep and excessive energy used to breathe during sleep) are associated with daytime symptoms such as concentration and learning difficulties and irritability, neurocognitive development impairment, decreased school performance and behavioral difficulties.<a href="#cite_note-Dehlink2016-30">[30]</a> For example, SDB such as OSA contributes to hyperactive behavior that can lead to the diagnosis and treatment of <a href="Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">attention deficit hyperactivity disorder</a> (ADHD). However, once the SDB is treated, the hyperactive behavior can improve, and the treatment can be stopped.<a href="#cite_note-Chervin2001-70">[70]</a> <a href="Obesity" title="Obesity">Obesity</a> also has an impact on the consequences of OSA and lead to different manifestations or severity.<a href="#cite_note-Dayyat2008-33">[33]</a> Studies have shown that, contrary to adults, children with obstructive sleep-disordered breathing can maintain cerebral oxygenation. However, the condition still has effects on the brain and can lead to adverse neurocognitive and behavioral sequelae. It is particularly concerning as those consequences happen while the brain is still developing.<a href="#cite_note-Walter2018-69">[69]</a> The degree to which the sleep is disturbed and fragmented has been significantly linked to the severity of the consequences, the latter having the possibility to decrease once the sleep is improved.<a href="#cite_note-Capdevilaetal2008-32">[32]</a> It is more the disruption of sleep processes than the total amount of sleep the child experience that generates the adverse consequences on the child's daytime functioning;<a href="#cite_note-Capdevilaetal2008-32">[32]</a> it contributes to the hyperactivity for example.<a href="#cite_note-Chervin2001-70">[70]</a>

Children with OSA may experience learning and memory deficits, and OSA has been linked to lowered childhood IQ scores.<a href="#cite_note-71">[71]</a> Untreated OSA may prevent children from reaching their height potential.<a href="#cite_note-Nieminen2002-72">[72]</a>

<div class="mw-heading mw-heading4"><h4 id="Neurocognitive_and_behavioral_consequences">Neurocognitive and behavioral consequences</h4></div>

Nocturnal sleep fragmentation has been linked to neurocognitive impairments, therefore, the identification of SDB such as OSA is crucial in children, those impairments having the possibility to be reversible with the appropriate treatment for the sleep disorder.<a href="#cite_note-O'Brien2004-73">[73]</a> The neurocognitive and behavioral dysfunctions commonly present in children with OSA include the following: hyperactivity, <a href="Impulsivity" title="Impulsivity">impulsivity</a>, aggressive behaviors,<a href="#cite_note-Dayyat2008-33">[33]</a><a href="#cite_note-Capdevilaetal2008-32">[32]</a> low social and communication abilities and reduced adaptive skills.<a href="#cite_note-Dehlink2016-30">[30]</a>

Children with OSA commonly show cognitive deficits, resulting in attention and <a href="Attentional_control" title="Attentional control">concentration</a> difficulties, as well as lower academic performance and <a href="Intelligence_quotient" title="Intelligence quotient">IQ</a>.<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Capdevilaetal2008-32">[32]</a> Poor academic performances have been linked to OSA and suggested to result from cortical and sympathetic arousals and <a href="Hypoxemia" title="Hypoxemia">hypoxemia</a> which affects <a href="Memory_consolidation" title="Memory consolidation">memory consolidation</a>.<a href="#cite_note-Goyal2018-74">[74]</a> A study with Indian children affected by OSA has shown poor school grades, including mathematics, science, language, and physical education. This study allowed us to see the overall impact of OSA on learning abilities associated with language or numeracy skills and physical development.<a href="#cite_note-Goyal2018-74">[74]</a> It has been suggested that the deficits in academic performance related to OSA could be mediated through reduced <a href="Executive_functions" title="Executive functions">executive functions</a> or language skills,<a href="#cite_note-Galland2015-75">[75]</a> those domains contributing highly to learning abilities and behavior. The deficits in school performance can nevertheless be improved if <a href="Tonsillectomy" title="Tonsillectomy">adenotonsillectomy</a> is performed on children to treat the OSA.<a href="#cite_note-Galland2015-75">[75]</a> It is thus crucial to identify the OSA for children with school difficulties; many cases remain unnoticed.<a href="#cite_note-Galland2015-75">[75]</a>

As studies have shown that learning skills and behaviors can be improved if the OSA is treated,<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Capdevilaetal2008-32">[32]</a> the neurocognitive and behavioral deficits are thus at least partly reversible.<a href="#cite_note-Dayyat2008-33">[33]</a> This reversible dimension has been postulated to be negatively correlated to the duration of the symptoms, which would mean that the longer the OSA is left untreated, the less reversible are the consequences.<a href="#cite_note-Capdevilaetal2008-32">[32]</a>

<div class="mw-heading mw-heading4"><h4 id="Somatic_and_metabolic_consequences">Somatic and metabolic consequences</h4></div>

Similarly to adults, OSA in children is linked to a higher risk for <a href="Cardiovascular_disease" title="Cardiovascular disease">cardiovascular diseases</a>,<a href="#cite_note-Dayyat2008-33">[33]</a><a href="#cite_note-Capdevilaetal2008-32">[32]</a> due to increased <a href="Sympathetic_nervous_system" title="Sympathetic nervous system">sympathetic</a> activity and impaired cardiac autonomic control.<a href="#cite_note-Walter2018-69">[69]</a> Amongst the cardiovascular dysfunctions resulting from OSA, we can find systemic <a href="Hypertension" title="Hypertension">hypertension</a><a href="#cite_note-Capdevilaetal2008-32">[32]</a> and <a href="Blood_pressure" title="Blood pressure">blood pressure</a> dysregulation<a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Amin2008-76">[76]</a> (elevated blood pressure, or variability of the blood pressure for example<a href="#cite_note-Walter2018-69">[69]</a>). The variability of the blood pressure has been shown to be correlated with the severity of the symptoms such as the frequency of the <a href="Apnea" title="Apnea">apnea</a> and <a href="Hypopnea" title="Hypopnea">hypopnea</a>.<a href="#cite_note-Amin2008-76">[76]</a> <a href="Pulmonary_hypertension" title="Pulmonary hypertension">Pulmonary hypertension</a> is also common amongst the cardiovascular problems resulting from OSA.<a href="#cite_note-Dehlink2016-30">[30]</a> Children with obstructive sleep-disordered breathing also show a faster heart rate during wakefulness and during sleep.<a href="#cite_note-Amin2008-76">[76]</a>

In adult patients, OSA is associated with <a href="Insulin_resistance" title="Insulin resistance">insulin resistance</a>.<a href="#cite_note-Ip2002-77">[77]</a> In children, <a href="Metabolism" title="Metabolism">metabolic</a> consequences of OSA are complicated to assess as they can also be associated to <a href="Puberty" title="Puberty">puberty</a> and <a href="Obesity" title="Obesity">obesity</a> (if present).<a href="#cite_note-Dehlink2016-30">[30]</a> However, when OSA is associated with obesity, the interaction of the two conditions can lead to metabolic disturbances such as insulin resistance and altered <a href="Hyperlipidemia" title="Hyperlipidemia">lipidemia</a>,<a href="#cite_note-Dayyat2008-33">[33]</a> <a href="Liver_disease" title="Liver disease">liver disease</a>, <a href="Abdominal_obesity" title="Abdominal obesity">abdominal adiposity</a> and <a href="Metabolic_syndrome" title="Metabolic syndrome">metabolic syndrome</a>. Obesity interacts with those effects.<a href="#cite_note-Amin2008-76">[76]</a>

<div class="mw-heading mw-heading4"><h4 id="Nocturnal_enuresis">Nocturnal enuresis</h4></div>

Children with OSA also show a higher risk for <a href="Nocturnal_enuresis" title="Nocturnal enuresis">nocturnal enuresis</a><a href="#cite_note-Dehlink2016-30">[30]</a><a href="#cite_note-Basha2009-78">[78]</a> and it is hypothesized to be caused by an excessive production of <a href="Urine" title="Urine">urine</a>,<a href="#cite_note-Goyal2018-74">[74]</a><a href="#cite_note-Barone2009-79">[79]</a> impaired performance of the <a href="Bladder" title="Bladder">bladder</a> and <a href="Urethra" title="Urethra">urethra</a><a href="#cite_note-Brooks2003-80">[80]</a> or an inability to suppress the nocturnal bladder contraction, due to a failure to arouse.<a href="#cite_note-Barone2009-79">[79]</a><a href="#cite_note-Brooks2003-80">[80]</a> The risk for nocturnal enuresis increases with the severity of the sleep-disordered breathing: the more respiratory events per hour of sleep, the higher the risk for nocturnal enuresis.<a href="#cite_note-Brooks2003-80">[80]</a> Obesity may also play a role, as it is associated with OSA and with nocturnal <a href="Diuresis" title="Diuresis">diuresis</a> (due to an unhealthy diet). The interaction between OSA and obesity might thus result in nocturnal enuresis.<a href="#cite_note-Barone2009-79">[79]</a> Considering the high prevalence of nocturnal enuresis amongst children with sleep-disordered breathing, it is important to consider the latter in the <a href="Differential_diagnosis" title="Differential diagnosis">differential diagnosis</a> of nocturnal enuresis as the treatment of the sleep disorder might have a favourable therapeutic effect on the enuresis.<a href="#cite_note-Weissbach2006-81">[81]</a><a href="#cite_note-Basha2009-78">[78]</a><a href="#cite_note-Brooks2003-80">[80]</a> For example, an <a href="Tonsillectomy" title="Tonsillectomy">adenotonsillectomy</a> performed to reduce OSA has a positive impact on nocturnal enuresis.<a href="#cite_note-Weissbach2006-81">[81]</a><a href="#cite_note-Goyal2018-74">[74]</a> A study has shown that this surgery has a 60–75% chance to resolve the nocturnal enuresis completely, and an 80–85% chance to reduce its symptoms alongside other symptoms of OSA.<a href="#cite_note-Basha2009-78">[78]</a>

<div class="mw-heading mw-heading4"><h4 id="Stunted_growth">Stunted growth</h4></div>

Untreated OSA in children can also lead to <a href="Stunted_growth" title="Stunted growth">stunted growth</a>. When sleep is disrupted in children who are still growing, there can be significant consequences. <a href="Human_growth_hormone" class="mw-redirect" title="Human growth hormone">Human growth hormone</a> (HGH) is secreted during the night, especially during deep, non-REM sleep. If this is disrupted, growth hormone secretion may be compromised; thus, growth may not occur normally, and children may become shorter than their peers.<a href="#cite_note-Nieminen2002-72">[72]</a>

<div class="mw-heading mw-heading4"><h4 id="Other_consequences">Other consequences</h4></div>

In contrast to adults, <a href="Excessive_daytime_sleepiness" title="Excessive daytime sleepiness">excessive daytime sleepiness</a> (EDS) is not the most commonly reported symptoms in children with OSA.<a href="#cite_note-O'Brien2004-73">[73]</a> However, using objective questionnaires, it is possible to notice that the frequency of EDS in children is higher than what is reported by the parents or caretakers (40–50%).<a href="#cite_note-Capdevilaetal2008-32">[32]</a> And the risk for EDS is even increased when OSA is associated with <a href="Obesity" title="Obesity">obesity</a>.<a href="#cite_note-Capdevilaetal2008-32">[32]</a><a href="#cite_note-Dayyat2008-33">[33]</a>

Due to all the consequences and symptoms it generates, OSA in children leads to a significant decrease in the <a href="Quality_of_life" title="Quality of life">quality of life</a>,<a href="#cite_note-Capdevilaetal2008-32">[32]</a> the decrease being even higher when obesity is present.<a href="#cite_note-Dayyat2008-33">[33]</a> The quality of life can however be improved with the treatment of OSA.<a href="#cite_note-Dayyat2008-33">[33]</a> SDB have also been linked to a higher rate of <a href="Internalizing_disorder" title="Internalizing disorder">internalizing disorders</a> such as <a href="Anxiety" title="Anxiety">anxiety</a> and <a href="Depression_(mood)" title="Depression (mood)">depression</a>.<a href="#cite_note-Carotenuto2012-82">[82]</a> Indeed, depressive symptoms have shown to be higher in children with OSA,<a href="#cite_note-Carotenuto2012-82">[82]</a> especially in males.<a href="#cite_note-Yilmaz2013-83">[83]</a> Once again, the severity of depressive symptoms is positively correlated with the severity of the SDB.<a href="#cite_note-Carotenuto2012-82">[82]</a> It also interacts with obesity as obese children have higher risk to show depressive symptoms and obesity can cause OSA.<a href="#cite_note-Yilmaz2013-83">[83]</a> The link can also go the other way around with the depression inducing obesity (due to <a href="Overeating" title="Overeating">overeating</a>) which worsens the OSA. <a href="Tonsillectomy" title="Tonsillectomy">Adenotonsillectomy</a> can decrease the intensity of the depressive symptoms.<a href="#cite_note-Yilmaz2013-83">[83]</a>

Other consequences of a disturbed sleep in children with OSA comprise <a href="Anhedonia" title="Anhedonia">anhedonia</a><a href="#cite_note-Crabtree2004-84">[84]</a><a href="#cite_note-Carotenuto2012-82">[82]</a> increased <a href="Fatigue" title="Fatigue">fatigue</a> and decreased interest in daily activities, which in turn can affect the child's social relationships.<a href="#cite_note-Dayyat2008-33">[33]</a>

<div class="mw-heading mw-heading3"><h3 id="In_adults">In adults</h3></div>

While there are some similarities between adults and children, OSA does not have the same consequences in both populations.<a href="#cite_note-Alsubie-85">[85]</a> Examples of similarities are the <a href="Snoring" title="Snoring">snoring</a> – which is the most common complaint in both pediatric OSA and OSA in adults<a href="#cite_note-Alsubie-85">[85]</a> – variability of <a href="Blood_pressure" title="Blood pressure">blood pressure</a> and <a href="Cardiovascular_disease" title="Cardiovascular disease">cardiovascular morbidities</a>.<a href="#cite_note-Young2004-4">[4]</a> A major difference is the <a href="Excessive_daytime_sleepiness" title="Excessive daytime sleepiness">excessive daytime sleepiness</a> (EDS) which is commonly reported in adult OSA,<a href="#cite_note-McNicholas2008-86">[86]</a> while it is not very common in pediatric OSA.<a href="#cite_note-Alsubie-85">[85]</a> Nevertheless, OSA in adults also implies a large scope of adverse and serious consequences,<a href="#cite_note-Stranks2016-87">[87]</a> the latter leading to higher mortality amongst OSA patients.<a href="#cite_note-Robichaud-Hallé2012-88">[88]</a> Those consequences are even worsened by common morbidities such as <a href="Obesity" title="Obesity">obesity</a>.<a href="#cite_note-Romero-Corral-89">[89]</a>

<div class="mw-heading mw-heading4"><h4 id="Neurocognitive_consequences">Neurocognitive consequences</h4></div>

Similarly to children, OSA affects <a href="Cognition" title="Cognition">cognitive functions</a> in adults.<a href="#cite_note-Alsubie-85">[85]</a> <a href="Meta-analysis" title="Meta-analysis">Meta-analysis</a> have shown that the most common cognitive impairments happen in the domains of <a href="Attention" title="Attention">attention</a>, verbal and visual delayed <a href="Long-term_memory" title="Long-term memory">long-term memory</a>,<a href="#cite_note-Fulda2003-90">[90]</a> visuospatial/constructional abilities and <a href="Executive_functions" title="Executive functions">executive functions</a>,<a href="#cite_note-Bucks2012-91">[91]</a> such as <a href="Cognitive_flexibility" title="Cognitive flexibility">mental flexibility</a>.<a href="#cite_note-Fulda2003-90">[90]</a> The executive functioning – mainly dominated by the <a href="Prefrontal_cortex" title="Prefrontal cortex">prefrontal cortex</a><a href="#cite_note-92">[92]</a> – being significantly impaired in patients with OSA, it is believed that the prefrontal region and its connectivity are affected by sleep disorders.<a href="#cite_note-Beebe2003-93">[93]</a>

Regarding memory deficits, <a href="Verbal_memory" title="Verbal memory">verbal memory</a> is significantly impaired as patients show difficulties in recalling verbal information immediately as well as with a delay. While meta-analyses have shown no deficits in retention of information for patients with OSA, those impairments in verbal memory may be linked to problems in <a href="Encoding_(memory)" title="Encoding (memory)">encoding information</a>.<a href="#cite_note-Wallace2013-94">[94]</a> This deficit in encoding of information is also noticed in visuo-spatial memory; however, the <a href="Visual_memory" title="Visual memory">visual memory</a> seems to be intact in OSA patients.<a href="#cite_note-Wallace2013-94">[94]</a>

The cognitive impairments have been suggested to result from sleep fragmentation and <a href="Sleep_deprivation" title="Sleep deprivation">sleep deprivation</a>, as well as the excessive daytime sleepiness associated with them.<a href="#cite_note-Bucks2012-91">[91]</a> More precisely, attention and memory deficits seem to result from sleep fragmentation, while deficits in global cognitive function (executive function, psychomotor function, language abilities) are more related to <a href="Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">hypoxia</a> or hypercarbia which accompanies the obstructive events during sleep.<a href="#cite_note-Bucks2012-91">[91]</a><a href="#cite_note-Olaithe2017-95">[95]</a> However, no consistent correlation has been found between the degree of cognitive impairment and the severity of the sleep disturbance or hypoxia.<a href="#cite_note-Wallace2013-94">[94]</a><a href="#cite_note-Olaithe2017-95">[95]</a>

These impairments may improve with an effective treatment for OSA, such as <a href="Continuous_positive_airway_pressure" title="Continuous positive airway pressure">continuous positive airway pressure</a> (CPAP) therapy.<a href="#cite_note-Bucks2012-91">[91]</a> Driving a motor vehicle is an example of a complex task that relies on driver's cognitive abilities, such as attention, reaction time and vigilance.<a href="#cite_note-Rizzo2019-96">[96]</a> Very brief moments of inattention called microsleep events could be an indicator for daytime vigilance impairment, although these may not be present in all drivers with obstructive sleep apnea.<a href="#cite_note-Morrone2020-97">[97]</a>

<div class="mw-heading mw-heading4"><h4 id="Behavioral_consequences">Behavioral consequences</h4></div>

The <a href="Attention_deficit_hyperactivity_disorder" title="Attention deficit hyperactivity disorder">hyperactivity</a> and difficulties in <a href="Emotional_self-regulation" title="Emotional self-regulation">emotional regulation</a> found in pediatric patients (children) are not reported in adults.<a href="#cite_note-Alsubie-85">[85]</a> OSA in adults is nevertheless associated with <a href="Personality_changes" class="mw-redirect" title="Personality changes">personality changes</a> and <a href="Automatic_behavior" class="mw-redirect" title="Automatic behavior">automatic behavior</a>.<a href="#cite_note-McNicholas2008-86">[86]</a> The biggest impact of OSA is the excessive daytime sleepiness (EDS), reported in approximately 30% of OSA patients.<a href="#cite_note-Cori2018-98">[98]</a> EDS can be caused by the disturbance of sleep quality, the insufficient sleep duration or the sleep fragmentation<a href="#cite_note-Slater2012-99">[99]</a> and it is responsible for further complications as it may lead to <a href="Depression_(mood)" title="Depression (mood)">depressive symptoms</a>,<a href="#cite_note-LaGrotte2016-100">[100]</a> impairments of social life and decreased effectiveness at work.<a href="#cite_note-Mulgrew2007-101">[101]</a><a href="#cite_note-Guilleminault2001-102">[102]</a> Studies have shown that those consequences of EDS can be improved following a CPAP treatment.<a href="#cite_note-Jackson2018-103">[103]</a>

<div class="mw-heading mw-heading4"><h4 id="Physiological_and_metabolic_consequences">Physiological and metabolic consequences</h4></div>

OSA in adults is associated with a higher risk for cardiovascular morbidities, <a href="Diabetes" title="Diabetes">diabetes</a>, <a href="Hypertension" title="Hypertension">hypertension</a>, <a href="Coronary_artery_disease" title="Coronary artery disease">coronary artery disease</a> and <a href="Stroke" title="Stroke">stroke</a><a href="#cite_note-Alsubie-85">[85]</a><a href="#cite_note-McNicholas2008-86">[86]</a> – OSA might have a role in the <a href="Etiology" title="Etiology">etiology</a> of these conditions. Those conditions may lead to increased mortality<a href="#cite_note-Alsubie-85">[85]</a><a href="#cite_note-McNicholas2008-86">[86]</a> that an appropriate treatment for OSA may reduce.<a href="#cite_note-McNicholas2008-86">[86]</a> OSA is often linked with hypertension as it induces an increase in <a href="Sympathetic_nervous_system" title="Sympathetic nervous system">sympathetic activity</a> that can lead to the elevation of blood pressure. The OSA-related <a href="Hypercapnia" title="Hypercapnia">hypercapnia</a> has been suggested to be related to the development of hypertension.<a href="#cite_note-Eskandari2017-104">[104]</a> Treating the OSA may prevent the development of hypertension.<a href="#cite_note-Drager2013-105">[105]</a>

The relationship between OSA and excess body weight is complex, as obesity is more prevalent amongst OSA patients but can also be a <a href="Risk_factor" title="Risk factor">risk factor</a> for the development of OSA<a href="#cite_note-McNicholas2008-86">[86]</a> – it accounts for 58% of adult cases.<a href="#cite_note-Ashrafian2015-106">[106]</a> Thus, both OSA and obesity (when present) may work synergistically and lead to <a href="Hyperlipidemia" title="Hyperlipidemia">hyperlipidemia</a>, diabetes, <a href="Insulin_resistance" title="Insulin resistance">insulin resistance</a> and other symptoms of the <a href="Metabolic_syndrome" title="Metabolic syndrome">metabolic syndrome</a>.<a href="#cite_note-Young2004-4">[4]</a><a href="#cite_note-McNicholas2008-86">[86]</a> The metabolic syndrome itself is often associated with OSA: 74–85% of OSA patients are diagnosed with it. CPAP therapy can lead to an improvement of some of the cardiovascular component of the metabolic syndrome<a href="#cite_note-Drager2013-105">[105]</a> while <a href="Weight_loss" title="Weight loss">weight loss</a> is also recommended for its positive effects on OSA consequences and metabolic dysfunctions.<a href="#cite_note-Ashrafian2015-106">[106]</a> An intervention comprising exercise and diet is thus effective for the treatment of OSA as it positively impacts the severity of both obesity symptoms and OSA symptoms.<a href="#cite_note-Dobrosielski2015-107">[107]</a>

Individuals with Type 2 diabetes are often co-diagnosed with OSA, where Type 2 diabetes prevalence rates range between 15% and 30% within the OSA population.<a href="#cite_note-pmid28527878-108">[108]</a> The relationship between OSA and Type 2 diabetes could be explained by the fact that OSA-characteristic fragmented sleep and irregular hypoxemia lead to the dysregulated metabolism of glucose in the blood.<a href="#cite_note-pmid28527878-108">[108]</a> In particular, many polysomnography studies showed that OSA left untreated worsens glycemic control in individuals with Type 2 diabetes.<a href="#cite_note-pmid28527878-108">[108]</a> However, it is possible that the relationship between OSA and Type 2 diabetes is bidirectional since diabetes-related nerve dysfunction may affect the respiratory system and induce breathing disturbances during sleep.<a href="#cite_note-pmid28527878-108">[108]</a>

<div class="mw-heading mw-heading4"><h4 id="Psychological_consequences">Psychological consequences</h4></div>

Sleep is of major importance for <a href="Mental_health" title="Mental health">psychological and emotional health</a>.<a href="#cite_note-Guglielmi2018-109">[109]</a> As it is greatly impaired in OSA, this condition is associated with <a href="Mood_disorder" title="Mood disorder">mood disorders</a><a href="#cite_note-Olaithe_2015-110">[110]</a> and several psychological outcomes,<a href="#cite_note-Guglielmi2018-109">[109]</a> especially depression and <a href="Anxiety_disorder" title="Anxiety disorder">anxiety</a>.<a href="#cite_note-Garbarino2018-111">[111]</a> Therefore, <a href="Mental_disorder" title="Mental disorder">psychological disorders</a> are commonly observed in OSA patients who show a higher <a href="Prevalence" title="Prevalence">prevalence</a> of <a href="Mental_distress" title="Mental distress">psychological distress</a>, mostly due to the impaired sleep quality and structure and the repeated episodes of <a href="Hypoxia_(medical)" class="mw-redirect" title="Hypoxia (medical)">hypoxia</a>.<a href="#cite_note-Guglielmi2018-109">[109]</a><a href="#cite_note-Xiao2016-112">[112]</a> The presence of psychological disorders may also worsen the sleep disorders which implies that the <a href="Psychopathology" title="Psychopathology">psychopathology</a> may either be a <a href="Risk_factor" title="Risk factor">factor</a> or a consequence of the OSA.<a href="#cite_note-Garbarino2018-111">[111]</a> The adverse consequences of OSA such as cardiovascular comorbidities and <a href="Metabolic_disorder" title="Metabolic disorder">metabolic disturbances</a> also play a role on the development of mental disorders,<a href="#cite_note-Garbarino2018-111">[111]</a> and patients with <a href="Chronic_condition" title="Chronic condition">chronic condition</a> have also been reported to have higher risk to experience depression.<a href="#cite_note-Olaithe_2015-110">[110]</a> In OSA patients with psychiatric disorders, it is crucial to treat the OSA as it may reduce the psychiatric symptoms.<a href="#cite_note-Gupta2015-113">[113]</a>

Some cases of OSA are caused by <a href="Nasal_congestion" title="Nasal congestion">nasal obstruction</a>, which has also been related to psychological problems due to an altered <a href="Ratio" title="Ratio">ratio</a> of <a href="Calcium" title="Calcium">calcium</a> and <a href="Magnesium" title="Magnesium">magnesium</a> in <a href="Neuron" title="Neuron">brain cells</a>. Nasal obstruction can thus aggravate the psychological health of OSA patients. <a href="Nasal_surgery" title="Nasal surgery">Nasal surgery</a> for those patients might decrease the OSA severity and improve the psychological symptoms.<a href="#cite_note-Xiao2016-112">[112]</a>

<div class="mw-heading mw-heading4"><h4 id="Other_consequences_2">Other consequences</h4></div>

Untreated OSA also leads to a decreased quality of life, difficulties in <a href="Social_skills" title="Social skills">social functioning</a>,<a href="#cite_note-McNicholas2008-86">[86]</a> occupational problems and <a href="Work_accident" title="Work accident">accidents</a><a href="#cite_note-Beebe2003-93">[93]</a> and a greatly increased rate of <a href="Traffic_collision" title="Traffic collision">vehicle accidents</a>.<a href="#cite_note-McNicholas2008-86">[86]</a><a href="#cite_note-Jonas2017-114">[114]</a><a href="#cite_note-Charokopos2018-115">[115]</a> Those serious outcomes of OSA are mostly related to the excessive daytime sleepiness resulting from the sleep fragmentation and highlight the need to provide the patients with appropriate treatment.<a href="#cite_note-McNicholas2008-86">[86]</a> Effective treatment majorly improves those adverse consequences, including quality of life.<a href="#cite_note-McNicholas2008-86">[86]</a>

OSA patients also frequently report <a href="Pain_disorder" title="Pain disorder">pain disorders</a> such as <a href="Headache" title="Headache">headache</a> or <a href="Fibromyalgia" title="Fibromyalgia">fibromyalgia</a>, OSA patients showing an increased pain intensity alongside a decreased <a href="Pain_tolerance" title="Pain tolerance">pain tolerance</a>.<a href="#cite_note-Charokopos2018-115">[115]</a>

<div class="mw-heading mw-heading3"><h3 id="Polysomnography_2">Polysomnography</h3></div>

<th>Rating

</th>

<th><a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">AHI</a> (adult)</th>

<th><a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">AHI</a> (pediatrics)

</th></tr>

<tr>

<td>Normal

</td>

<td><1

</td></tr>

<tr>

<td>Mild

</td>

<td>≥1, <5

</td></tr>

<tr>

<td>Moderate

</td>

<td>≥5, <10

</td></tr>

<tr>

<td>Severe

</td>

<td>≥10

</td></tr></tbody></table>

An "event" can be either an apnea, characterized by complete cessation of airflow for at least 10 seconds, or a <a href="Hypopnea" title="Hypopnea">hypopnea</a> in which airflow decreases by 50 percent for 10 seconds or decreases by 30 percent if there is an associated decrease in the oxygen saturation or an arousal from sleep.<a href="#cite_note-:1-44">[44]</a> To grade the severity of sleep apnea, the number of events per hour is reported as the <a href="Apnea-hypopnea_index" class="mw-redirect" title="Apnea-hypopnea index">apnea-hypopnea index</a> (AHI). For adults, an AHI of less than 5 is considered normal, an AHI of [5–15) is mild, [15–30) is moderate, and ≥30 events per hour characterizes severe sleep apnea. For pediatrics, an AHI of less than 1 is considered normal, an AHI of [1–5) is mild, [5–10) is moderate, and ≥10 events per hour characterizes severe sleep apnea.

<div class="mw-heading mw-heading3"><h3 id="Home_oximetry">Home oximetry</h3></div>

In people who are highly likely to have OSA, home <a href="Oximetry" class="mw-redirect" title="Oximetry">oximetry</a> (a non-invasive method of monitoring blood oxygenation) may be adequate and easier to obtain than formal polysomnography.<a href="#cite_note-pmid17283346-116">[116]</a> High probability patients may be identified by an <a href="Epworth_Sleepiness_Scale" title="Epworth Sleepiness Scale">Epworth Sleepiness Scale</a> (ESS) score of 10 or greater and a Sleep Apnea Clinical Score (SACS) of 15 or greater.<a href="#cite_note-pmid7952553-117">[117]</a> However, home oximetry does not measure apneic events or respiratory event-related arousals and thus does not produce an AHI value.

<div class="mw-heading mw-heading2"><h2 id="Management">Management</h2></div>

Numerous treatment options are used in obstructive sleep apnea.<a href="#cite_note-Friedman2008-118">[118]</a> Avoiding alcohol and smoking is recommended,<a href="#cite_note-Aza2012-119">[119]</a> as is avoiding medications that relax the central nervous system (for example, sedatives and muscle relaxants). <a href="Weight_loss" title="Weight loss">Weight loss</a> is recommended in those who are <a href="Overweight" title="Overweight">overweight</a>. <a href="Continuous_positive_airway_pressure" title="Continuous positive airway pressure">Continuous positive airway pressure</a> (CPAP) and <a href="Mandibular_advancement_device" class="mw-redirect" title="Mandibular advancement device">mandibular advancement devices</a> are often used and found to be equally effective.<a href="#cite_note-Qa2013-120">[120]</a><a href="#cite_note-Brat2015-121">[121]</a> Physical training, even without weight loss, improves sleep apnea.<a href="#cite_note-122">[122]</a> There is insufficient evidence to support widespread use of medications.<a href="#cite_note-Qa2013-120">[120]</a> In selected patients, e.g. with tonsillar hyperplasia, tonsillectomy is recommended. In patients failing CPAP and oral appliances, surgical treatment with conservative uvulopalatopharyngoplasty (UPPP) as <a href="Salvage_surgery" class="mw-redirect" title="Salvage surgery">salvage surgery</a> is recommended. UPPP has a positive effect on nocturnal respiration and excessive daytime sleepiness.<a href="#cite_note-123">[123]</a><a href="#cite_note-pmid30056286-124">[124]</a>

<div class="mw-heading mw-heading3"><h3 id="Physical_intervention">Physical intervention</h3></div>

The most widely used therapeutic intervention is positive airway pressure whereby a breathing machine pumps a controlled stream of air through a mask worn over the nose, mouth, or both. The additional pressure holds open the relaxed muscles. There are several variants:

<ul><li><a href="Continuous_positive_airway_pressure" title="Continuous positive airway pressure">Continuous positive airway pressure</a> (CPAP) is effective for both moderate and severe disease.<a href="#cite_note-Gil2006-125">[125]</a> It is the most common treatment for obstructive sleep apnea.<a href="#cite_note-:2-126">[126]</a></li>

<li><a href="Variable_positive_airway_pressure" class="mw-redirect" title="Variable positive airway pressure">Variable positive airway pressure</a> (VPAP) (also known as bilevel (BiPAP or BPAP)) uses an electronic circuit to monitor the patient's breathing and provides two different pressures, a higher one during <a href="Inhalation" title="Inhalation">inhalation</a> and a lower pressure during <a href="Exhalation" title="Exhalation">exhalation</a>. This system is more expensive and is sometimes used with patients who have other coexisting respiratory problems or who find breathing out against an increased pressure to be uncomfortable or disruptive to their sleep.</li>

<li><a href="Nasal_EPAP" title="Nasal EPAP">Nasal EPAP</a>, which is a bandage-like device placed over the nostrils that utilizes a person's own breathing to create positive airway pressure to prevent obstructed breathing.<a href="#cite_note-Riaz2015rev-127">[127]</a></li>

<li>Automatic positive airway pressure, also known as "Auto CPAP", incorporates pressure sensors and monitors the person's breathing.<a href="#cite_note-pmid15486338-128">[128]</a><a href="#cite_note-pmid11902424-129">[129]</a></li>

<li>A 5% reduction in weight among those with moderate to severe OSA may decrease symptoms similarly to CPAP.<a href="#cite_note-130">[130]</a></li></ul>

Encouraging people with moderate to severe OSA to use CPAP devices can be challenging, as their use often requires a behavioural change in sleeping habits.<a href="#cite_note-:2-126">[126]</a> 8% of people who use CPAP devices stop using them after the first night, and 50% of people with moderate to severe OSA stop using their devices in the first year.<a href="#cite_note-:2-126">[126]</a> Educational initiatives and supportive interventions to help improve compliance with CPAP therapy have been shown to improve the length of time people who need CPAP therapy use their devices.<a href="#cite_note-:2-126">[126]</a>

Many people benefit from sleeping at a 30-degree elevation of the upper body<a href="#cite_note-131">[131]</a> or higher, as if in a <a href="Recliner" title="Recliner">recliner</a>. Doing so helps prevent the gravitational collapse of the airway. <a href="Human_anatomical_terms" class="mw-redirect" title="Human anatomical terms">Sleeping on a side</a> as opposed to <a href="Supine_position" title="Supine position">sleeping on the back</a> ("supine position") is also recommended.<a href="#cite_note-132">[132]</a><a href="#cite_note-133">[133]</a><a href="#cite_note-134">[134]</a>

Some studies have suggested that playing a <a href="Wind_instrument" title="Wind instrument">wind instrument</a> (such a <a href="Didgeridoo" title="Didgeridoo">didgeridoo</a>, for example) may reduce snoring and apnea incidents.<a href="#cite_note-135">[135]</a><a href="#cite_note-136">[136]</a> This may be especially true of <a href="Double_reed_instrument" class="mw-redirect" title="Double reed instrument">double reed instruments</a>.<a href="#cite_note-137">[137]</a>

<div class="mw-heading mw-heading3"><h3 id="Medications">Medications</h3></div>

Evidence is insufficient to support the use of medications to treat obstructive sleep apnea directly.<a href="#cite_note-Qa2013-120">[120]</a><a href="#cite_note-138">[138]</a><a href="#cite_note-Gottlieb-139">[139]</a> This includes the use of <a href="Fluoxetine" title="Fluoxetine">fluoxetine</a>, <a href="Paroxetine" title="Paroxetine">paroxetine</a>, <a href="Acetazolamide" title="Acetazolamide">acetazolamide</a>, and <a href="Tryptophan" title="Tryptophan">tryptophan</a> among others.<a href="#cite_note-Qa2013-120">[120]</a><a href="#cite_note-Vea2003-140">[140]</a>

Recent studies are trying to investigate cannabinoids as a treatment for OSA, especially dronabinol, which is a synthetic form of THC (delta-9-tetrahydrocannabinol). Cannabis is known to influence sleep; for example, it can reduce sleep latency. However, results are not consistent.<a href="#cite_note-Babson2017-141">[141]</a> Studies about dronabinol have shown positive impact on the OSA, as they observed a reduced AHI (Apnea-Hypopnea Index) and an increased self-reported sleepiness (the objective sleepiness being unaffected).<a href="#cite_note-Carley2018-142">[142]</a> However, more evidence are needed as many effects of those substances remain unknown, especially the effects of a long-term intake.<a href="#cite_note-Ramar2018-143">[143]</a> The effects on sleepiness and weight gain are particularly of concern.<a href="#cite_note-Kolla2018-144">[144]</a> Due to uncertainty about its effects and a lack of consistent evidence, medical cannabis is not recommended for the treatment of OSA.<a href="#cite_note-Ramar2018-143">[143]</a><a href="#cite_note-145">[145]</a>

There are multiple drugs approved for managing the excessive daytime sleepiness associated with OSA, but not the underlying cause. These include <a href="Solriamfetol" title="Solriamfetol">solriamfetol</a>, <a href="Modafinil" title="Modafinil">modafinil</a>, and <a href="Armodafinil" title="Armodafinil">armodafinil</a>.<a href="#cite_note-146">[146]</a><a href="#cite_note-147">[147]</a><a href="#cite_note-148">[148]</a>

For adults with obesity and moderate-to-severe OSA, during a 52-week study <a href="Tirzepatide" title="Tirzepatide">tirzepatide</a> (brand name Zepbound) substantially reduced <a href="Apnea%E2%80%93hypopnea_index" title="Apnea–hypopnea index">apneic-hypopnic events</a>, body weight, hypoxic burden, <a href="C-reactive_protein" title="C-reactive protein">hsCRP</a> concentration, and <a href="Blood_pressure" title="Blood pressure">systolic blood pressure</a>, and improved sleep-related patient-reported outcomes, all presumably mediated via induced weight loss of 18–20% from baseline.<a href="#cite_note-149">[149]</a> Subsequently, the <a href="Food_and_Drug_Administration" title="Food and Drug Administration">FDA</a> approved the drug for treatment of OSA in December 2024, and <a href="Medicare_(United_States)" title="Medicare (United States)">Medicare</a> and many insurers began covering the drug specifically for treatment of OSA in 2025.<a href="#cite_note-150">[150]</a><a href="#cite_note-151">[151]</a>

<div class="mw-heading mw-heading3"><h3 id="Dental_appliances">Dental appliances</h3></div>

<a href="Mandibular_advancement_splint" title="Mandibular advancement splint">Mandibular advancement splints</a> (mandibular advancement devices) are designed to hold the lower jaw slightly down and forward relative to the natural, relaxed position. This position keeps the tongue farther away from the back of the airway and may be enough to relieve apnea or improve breathing. This device is a mouthguard similar to those used in sports to protect the teeth. Mandibular advancement splints are used for snoring and for mild to moderate obstructive sleep apnea.<a href="#cite_note-Deenadayal2022-152">[152]</a> They are most suitable for people with AHI < 25, <a href="Body_mass_index" title="Body mass index">BMI</a> < 30, and good <a href="Dentition" title="Dentition">dentition</a>.<a href="#cite_note-153">[153]</a>

Where appropriate, they are considered a good therapy choice as they are non-invasive, easily reversible, and quiet. They are generally well-tolerated because they are less uncomfortable. However, they may not be as effective as CPAP.<a href="#cite_note-Gil2006-125">[125]</a> Oral devices have been shown to treat OSA successfully. These include the polysomnographic indexes of OSA, subjective and objective measures of sleepiness, blood pressure, aspects of neuropsychological functioning, and quality of life.<a href="#cite_note-154">[154]</a> The focus of improvement in appliance design is in reducing bulk, permitting free jaw movement (i.e., yawning, speaking, and drinking), and allowing the user to breathe through their mouth (early "welded gum shield"-type devices prevented oral breathing).

Tongue repositioning (retaining) devices are made of soft acrylic and cover the upper and lower teeth, creating a seal with the lips. They have a "bulb" or "bubble" which sticks out of the front of the mouth. This creates negative suction pressure by holding the tongue in a forward position and increasing the airway space behind the tongue.<a href="#cite_note-Deenadayal2022-152">[152]</a> Hybrid devices combine mandibular advancement with the tongue restraint. These devices have been used for snoring and obstructive sleep apnea.<a href="#cite_note-155">[155]</a> Tongue retaining devices have not been well-received as a therapy choice since they are invasive, and the acclimation period is long. The devices have shown high success rates for therapy.<a href="#cite_note-156">[156]</a><a href="#cite_note-157">[157]</a>

Soft-palate lifters are devices that lift the soft palate. They are useful for people who have weak muscles in the region.<a href="#cite_note-Deenadayal2022-152">[152]</a>

Evidence to support oral appliances/functional orthopedic appliances in children is insufficient, with very low evidence of effect. However, the oral appliances/functional orthopedic appliances may be considered in specified cases as an auxiliary in the treatment of children with craniofacial anomalies, which are risk factors for apnea.<a href="#cite_note-158">[158]</a>

<div class="mw-heading mw-heading3"><h3 id="Rapid_Palatal_Expansion">Rapid Palatal Expansion</h3></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .hatnote{font-style:italic}.mw-parser-output div.hatnote{padding-left:1.6em;margin-bottom:0.5em}.mw-parser-output .hatnote i{font-style:normal}.mw-parser-output .hatnote+link+.hatnote{margin-top:-0.5em}@media print{body.ns-0 .mw-parser-output .hatnote{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div role="note" class="hatnote navigation-not-searchable">See also: <a href="Palatal_expansion" title="Palatal expansion">Palatal expansion</a></div>

In children, orthodontic treatment to expand the volume of the nasal airway, such as nonsurgical rapid <a href="Palatal_expansion" title="Palatal expansion">palatal expansion</a>, is common.

Since the palatal suture is fused in adults, regular RPE using tooth-borne expanders cannot be performed. Mini-implant-assisted rapid palatal expansion (MARPE) has been recently developed as a non-surgical option for the transverse expansion of the maxilla in adults. This method increases the volume of the nasal cavity and nasopharynx, leading to increased airflow and reduced respiratory arousals during sleep.<a href="#cite_note-159">[159]</a><a href="#cite_note-160">[160]</a> Changes are permanent with minimal complications.

<div class="mw-heading mw-heading3"><h3 id="Surgery">Surgery</h3></div>

<div role="note" class="hatnote navigation-not-searchable">Main article: <a href="Sleep_surgery" title="Sleep surgery">Sleep surgery</a></div>

<a href="Sleep_surgery" title="Sleep surgery">Sleep surgery</a> is a range of surgical treatments to modify airway anatomy. They are varied and are tailored to the specific location and nature of the airway obstruction for each individual. Surgery is not considered a first-line treatment for obstructive sleep apnea in adults. For people with obstructive sleep apnea who are unable or unwilling to comply with first-line treatment, surgical intervention is adapted to an individual's specific anatomy and physiology, personal preference, and disease severity.<a href="#cite_note-Friedman2008-118">[118]</a> <a href="Uvulopalatopharyngoplasty" title="Uvulopalatopharyngoplasty">Uvulopalatopharyngoplasty</a> (UPPP) with or without <a href="Tonsillectomy" title="Tonsillectomy">tonsillectomy</a> is the most common surgery for OSA. It is effective in selected patients failing conservative treatment.<a href="#cite_note-161">[161]</a><a href="#cite_note-pmid30056286-124">[124]</a> In Tonsillectomy, the benefit of the surgery increases with tonsil size.<a href="#cite_note-onlinelibrary.wiley.com-162">[162]</a> However, there is little randomized clinical trial evidence for other types of sleep surgery.<a href="#cite_note-Qa2013-120">[120]</a> There are many different procedures which may be performed, including:

<ul><li><a href="Septoplasty" title="Septoplasty">Septoplasty</a> is a corrective surgical procedure for <a href="Nasal_septum_deviation" title="Nasal septum deviation">nasal septum deviation</a> in which the <a href="Nasal_septum" title="Nasal septum">nasal septum</a> is straightened.</li>

<li><a href="Tonsillectomy" title="Tonsillectomy">Tonsillectomy</a><a href="#cite_note-onlinelibrary.wiley.com-162">[162]</a> or <a href="Adenoidectomy" title="Adenoidectomy">adenoidectomy</a> in an attempt to increase the size of the airway.</li>

<li><a href="Tonsillotomy" class="mw-redirect" title="Tonsillotomy">Tonsillotomy</a></li>

<li>Removal or reduction of parts of the <a href="Soft_palate" title="Soft palate">soft palate</a> and some or all of the <a href="Uvula" title="Uvula">uvula</a>, such as <a href="Uvulopalatopharyngoplasty" title="Uvulopalatopharyngoplasty">uvulopalatopharyngoplasty</a> (UPPP) or laser-assisted uvulopalatoplasty (LAUP). Modern variants of this procedure sometimes use <a href="Radiofrequency" class="mw-redirect" title="Radiofrequency">radiofrequency</a> waves to heat and remove tissue.</li>

<li><a href="Turbinectomy" title="Turbinectomy">Turbinectomy</a> is a surgical procedure in which all or some of the <a href="Turbinate" class="mw-redirect" title="Turbinate">turbinate</a> bones are removed to relieve <a href="Nasal_obstruction" class="mw-redirect" title="Nasal obstruction">nasal obstruction</a>.</li>

<li>Reduction of the tongue base, either with laser excision or <a href="Radiofrequency_ablation" title="Radiofrequency ablation">radiofrequency ablation</a>.</li>

<li><a href="Genioglossus_advancement" title="Genioglossus advancement">Genioglossus advancement</a>, in which a small portion of the lower jaw that attaches to the tongue is moved forward, to pull the tongue away from the back of the airway.</li>

<li><a href="Hyoid_suspension" title="Hyoid suspension">Hyoid suspension</a>, in which the <a href="Hyoid_bone" title="Hyoid bone">hyoid bone</a> in the neck, another attachment point for tongue muscles, is pulled forward in front of the <a href="Larynx" title="Larynx">larynx</a>.</li>

<li><a href="Maxillomandibular_advancement" title="Maxillomandibular advancement">Maxillomandibular advancement</a><a href="#cite_note-163">[163]</a></li>

<li><a href="Bariatric_surgery" title="Bariatric surgery">Bariatric surgery</a> (for morbid obesity)</li>

<li><a href="Hypoglossal_nerve_stimulation" title="Hypoglossal nerve stimulation">Hypoglossal nerve stimulation</a></li>

<li><a href="Radiofrequency_ablation" title="Radiofrequency ablation">Radiofrequency ablation</a></li></ul>

<div class="mw-heading mw-heading2"><h2 id="Prognosis">Prognosis</h2></div>

Stroke and other cardiovascular diseases are related to OSA, and those under the age of 70 have an increased risk of early death.<a href="#cite_note-Obstructive_sleep_apnea_is_a_common-37">[37]</a> Persons with sleep apnea have a 30% higher risk of <a href="Heart_attack" class="mw-redirect" title="Heart attack">heart attack</a> or death than those unaffected.<a href="#cite_note-164">[164]</a> In severe and prolonged cases, increased in pulmonary pressures are transmitted to the right side of the heart. This can result in a severe form of congestive heart failure known as <a href="Cor_pulmonale" class="mw-redirect" title="Cor pulmonale">cor pulmonale</a>. Diastolic function of the heart also becomes affected.<a href="#cite_note-pmid24445697-165">[165]</a> Elevated arterial pressure (i.e., <a href="Hypertension" title="Hypertension">hypertension</a>) can be a consequence of OSA syndrome.<a href="#cite_note-Sleep_Apnea-166">[166]</a> When OSA causes hypertension, it is distinctive in that, unlike most cases (so-called <a href="Essential_hypertension" title="Essential hypertension">essential hypertension</a>), the readings do not drop significantly when the individual is sleeping (non-dipper) or even increase (inverted dipper).<a href="#cite_note-167">[167]</a>

Without treatment, the <a href="Sleep_deprivation" title="Sleep deprivation">sleep deprivation</a> and lack of oxygen caused by sleep apnea increases health risks such as <a href="Cardiovascular_disease" title="Cardiovascular disease">cardiovascular disease</a>, aortic disease (e.g., <a href="Aortic_aneurysm" title="Aortic aneurysm">aortic aneurysm</a>),<a href="#cite_note-168">[168]</a> <a href="High_blood_pressure" class="mw-redirect" title="High blood pressure">high blood pressure</a>,<a href="#cite_note-169">[169]</a><a href="#cite_note-170">[170]</a> <a href="Stroke" title="Stroke">stroke</a>,<a href="#cite_note-171">[171]</a> <a href="Diabetes" title="Diabetes">diabetes</a>, <a href="Clinical_depression" class="mw-redirect" title="Clinical depression">clinical depression</a>,<a href="#cite_note-pmid15982424-172">[172]</a> weight gain, <a href="Obesity" title="Obesity">obesity</a>,<a href="#cite_note-OSA-68">[68]</a> and even death.

OSA is associated with cognitive impairment, including deficits in inductive and deductive reasoning, attention, vigilance, learning, executive functions, and episodic and working memory. OSA is associated with increased risk for developing <a href="Mild_cognitive_impairment" title="Mild cognitive impairment">mild cognitive impairment</a> and dementia, and has been associated with neuroanatomical changes (reductions in volumes of the hippocampus, and gray matter volume of the frontal and parietal lobes) which can however be at least in part reversed with CPAP treatment.<a href="#cite_note-173">[173]</a><a href="#cite_note-174">[174]</a>

<div class="mw-heading mw-heading2"><h2 id="Epidemiology">Epidemiology</h2></div>

Until the 1990s, little was known regarding the frequency of OSA.<a href="#cite_note-punjabi2008-175">[175]</a> A recent meta-analysis of 24 epidemiological studies on the <a href="Prevalence" title="Prevalence">prevalence</a> of OSA in the general population aged 18 and older revealed that for ≥ 5 apnea events per hour, OSA prevalence ranged from 9% to 38%, specifically ranging from 13% to 33% in men and 6% to 19% in women, while in the population aged 65 and older, OSA prevalence was as high as 84%, including 90% in men and 78% in women.<a href="#cite_note-:0-176">[176]</a> Nevertheless, for ≥ 15 apnea events per hour, OSA prevalence ranged from 6% to 17%, and almost 49% prevalence in the older population aged 65 and older.<a href="#cite_note-:0-176">[176]</a> Moreover, a higher <a href="Body_mass_index" title="Body mass index">BMI</a> is also linked to a higher prevalence of OSA, where a 10% increase in body weight led to a 6-fold risk of OSA in obese men and women.<a href="#cite_note-:0-176">[176]</a>

However, OSA is underdiagnosed as it is not always accompanied by daytime sleepiness which can leave the sleep-disordered breathing unnoticed.<a href="#cite_note-Olaithe_2015-110">[110]</a> The prevalence of OSA with daytime sleepiness is thus estimated to affect 3% to 7% of men and 2% to 5% of women, and the disease is common in both developed and developing countries.<a href="#cite_note-punjabi2008-175">[175]</a> OSA prevalence increases with age and is most commonly diagnosed in individuals over 65 years old, with estimations ranging from 22.1% to 83.6%.<a href="#cite_note-:0-176">[176]</a> The prevalence has drastically increased in recent decades due to the incidence of obesity.<a href="#cite_note-Drager2013-105">[105]</a>

Men are more affected by OSA than women, but the phenomenology differs between the genders.<a href="#cite_note-OSA-68">[68]</a> Snoring and witnessed apnea are more frequent among men but insomnia for example is more frequent among women.<a href="#cite_note-OSA-68">[68]</a> The OSA frequency increase with age for the women<a href="#cite_note-OSA-68">[68]</a>, and is in particular linked to the onset of menopause and assocatied hormonal changes.<a href="#cite_note-177">[177]</a> The mortality is higher for women.<a href="#cite_note-OSA-68">[68]</a>

If studied carefully in a sleep lab by polysomnography (formal "sleep study"), it is believed that approximately 1 in 5 American adults would have at least mild OSA.<a href="#cite_note-facial_phenotype-178">[178]</a> In the US, some studies report that it is more frequent among the Hispanic and African American population than among the white population.<a href="#cite_note-OSA-68">[68]</a>

<div class="mw-heading mw-heading2"><h2 id="Society_and_culture">Society and culture</h2></div>

<div class="mw-heading mw-heading3"><h3 id="United_States_of_America">United States of America</h3></div>

In the USA, home sleep testing is increasingly being preferred by private insurance carriers. For individuals who have high co-pays or deductibles, a home sleep test can be done for a fraction of the cost of polysomnography.

Radiofrequency ablation was recognized by the <a href="American_Academy_of_Otolaryngology-Head_and_Neck_Surgery" class="mw-redirect" title="American Academy of Otolaryngology-Head and Neck Surgery">American Academy of Otolaryngology</a><a href="#cite_note-AAO2013-179">[179]</a> as a somnoplasty treatment option in selected situations for mild to moderate OSA, but the evidence was judged insufficient for routine adoption by the American College of Physicians.<a href="#cite_note-Qa2013-120">[120]</a>

<div class="mw-heading mw-heading2"><h2 id="Research">Research</h2></div>

<a href="Neurostimulation" title="Neurostimulation">Neurostimulation</a> is being studied as a method of treatment.<a href="#cite_note-180">[180]</a> An implanted hypoglossal nerve stimulation system received European CE Mark (Conformité Européenne) approval in March 2012.<a href="#cite_note-181">[181]</a> Also being studied are exercises of the muscles around the mouth and <a href="Pharynx" title="Pharynx">throat</a> through activities such as playing the <a href="Didgeridoo" title="Didgeridoo">didgeridoo</a>.<a href="#cite_note-182">[182]</a><a href="#cite_note-Guimaraes_KC,_Drager_LF,_Genta_PR,_Marcondes_BF,_Lorensi-Filhol_G_2009_962–966-183">[183]</a>

/* start https://en.wikipedia.org/ */

.mw-parser-output .portalbox{padding:0;margin:0.5em 0;display:table;box-sizing:border-box;max-width:175px;list-style:none}.mw-parser-output .portalborder{border:1px solid var(--border-color-base,#a2a9b1);padding:0.1em;background:var(--background-color-neutral-subtle,#f8f9fa)}.mw-parser-output .portalbox-entry{display:table-row;font-size:85%;line-height:110%;height:1.9em;font-style:italic;font-weight:bold}.mw-parser-output .portalbox-image{display:table-cell;padding:0.2em;vertical-align:middle;text-align:center}.mw-parser-output .portalbox-link{display:table-cell;padding:0.2em 0.2em 0.2em 0.3em;vertical-align:middle}@media(min-width:720px){.mw-parser-output .portalleft{margin:0.5em 1em 0.5em 0}.mw-parser-output .portalright{clear:right;float:right;margin:0.5em 0 0.5em 1em}}

/* end https://en.wikipedia.org/ */

</style>

/* start https://en.wikipedia.org/ */

.mw-parser-output .div-col{margin-top:0.3em;column-width:30em}.mw-parser-output .div-col-small{font-size:90%}.mw-parser-output .div-col-rules{column-rule:1px solid #aaa}.mw-parser-output .div-col dl,.mw-parser-output .div-col ol,.mw-parser-output .div-col ul{margin-top:0}.mw-parser-output .div-col li,.mw-parser-output .div-col dd{page-break-inside:avoid;break-inside:avoid-column}

/* end https://en.wikipedia.org/ */

</style><div class="div-col div-col-small" style="column-width: 20em;">

<ul><li><a href="Congenital_central_hypoventilation_syndrome" class="mw-redirect" title="Congenital central hypoventilation syndrome">Congenital central hypoventilation syndrome</a></li>

<li><a href="Obesity_hypoventilation_syndrome" title="Obesity hypoventilation syndrome">Obesity hypoventilation syndrome</a></li>

<li><a href="Periodic_breathing" title="Periodic breathing">Periodic breathing</a></li>

<li><a href="Upper_airway_resistance_syndrome" title="Upper airway resistance syndrome">Upper airway resistance syndrome</a></li></ul>

</div>

<div class="mw-heading mw-heading2"><h2 id="References">References</h2></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .reflist{margin-bottom:0.5em;list-style-type:decimal}@media screen{.mw-parser-output .reflist{font-size:90%}}.mw-parser-output .reflist .references{font-size:100%;margin-bottom:0;list-style-type:inherit}.mw-parser-output .reflist-columns-2{column-width:30em}.mw-parser-output .reflist-columns-3{column-width:25em}.mw-parser-output .reflist-columns{margin-top:0.3em}.mw-parser-output .reflist-columns ol{margin-top:0}.mw-parser-output .reflist-columns li{page-break-inside:avoid;break-inside:avoid-column}.mw-parser-output .reflist-upper-alpha{list-style-type:upper-alpha}.mw-parser-output .reflist-upper-roman{list-style-type:upper-roman}.mw-parser-output .reflist-lower-alpha{list-style-type:lower-alpha}.mw-parser-output .reflist-lower-greek{list-style-type:lower-greek}.mw-parser-output .reflist-lower-roman{list-style-type:lower-roman}

/* end https://en.wikipedia.org/ */

</style><div class="reflist reflist-columns references-column-width" style="column-width: 30em;">

/* start https://en.wikipedia.org/ */

.mw-parser-output cite.citation{font-style:inherit;word-wrap:break-word}.mw-parser-output .citation q{quotes:"\"""\"""'""'"}.mw-parser-output .citation:target{background-color:rgba(0,127,255,0.133)}.mw-parser-output .id-lock-free.id-lock-free a{background:url("./mw/Lock-green.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-limited.id-lock-limited a,.mw-parser-output .id-lock-registration.id-lock-registration a{background:url("./mw/Lock-gray-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .id-lock-subscription.id-lock-subscription a{background:url("./mw/Lock-red-alt-2.svg")right 0.1em center/9px no-repeat}.mw-parser-output .cs1-ws-icon a{background:url("./mw/Wikisource-logo.svg")right 0.1em center/12px no-repeat}body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-free a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-limited a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-registration a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .id-lock-subscription a,body:not(.skin-timeless):not(.skin-minerva) .mw-parser-output .cs1-ws-icon a{background-size:contain;padding:0 1em 0 0}.mw-parser-output .cs1-code{color:inherit;background:inherit;border:none;padding:inherit}.mw-parser-output .cs1-hidden-error{display:none;color:var(--color-error,#d33)}.mw-parser-output .cs1-visible-error{color:var(--color-error,#d33)}.mw-parser-output .cs1-maint{display:none;color:#085;margin-left:0.3em}.mw-parser-output .cs1-kern-left{padding-left:0.2em}.mw-parser-output .cs1-kern-right{padding-right:0.2em}.mw-parser-output .citation .mw-selflink{font-weight:inherit}@media screen{.mw-parser-output .cs1-format{font-size:95%}html.skin-theme-clientpref-night .mw-parser-output .cs1-maint{color:#18911f}}@media screen and (prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .cs1-maint{color:#18911f}}

/* end https://en.wikipedia.org/ */

</style><cite id="CITEREFDesaiKhanBhatt2010" class="citation journal cs1">Desai, Tapan; Khan, Meena; Bhatt, Nitin Y. (2010). <a rel="nofollow" class="external text" href="https://linkinghub.elsevier.com/retrieve/pii/S1556407X10000524">"Positive Airway Pressure Treatment of Adult Patients with Obstructive Sleep Apnea"</a>. Sleep Medicine Clinics. 5 (3): 347–359. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jsmc.2010.05.003">10.1016/j.jsmc.2010.05.003</a>. Retrieved 2025-05-30. <q>Obstructive sleep apnea/hypopnea syndrome (OSA) is a disorder that is characterized by intermittent and recurrent upper airway closure during sleep that results in sleep fragmentation, intermittent hypoxemia/hypercapnia, and increased sympathetic nervous system activation.</q></cite>

</li>

<li id="cite_note-2"><a href="#cite_ref-2">^</a> <cite id="CITEREFPunjabiCaffoGoodwinGottlieb2009" class="citation journal cs1">Punjabi, Naresh M.; Caffo, Brian S.; Goodwin, James L.; Gottlieb, Daniel J.; Newman, Anne B.; O'Connor, George T.; Rapoport, David M.; Redline, Susan; Resnick, Helaine E.; Robbins, John A.; Shahar, Eyal; Unruh, Mark L.; Samet, Jonathan M. (18 August 2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722083">"Sleep-Disordered Breathing and Mortality: A Prospective Cohort Study"</a>. PLOS Medicine. 6 (8): e1000132. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pmed.1000132">10.1371/journal.pmed.1000132</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2722083">2722083</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19688045">19688045</a>.</cite>

</li>

<li id="cite_note-Barnes2009-3"><a href="#cite_ref-Barnes2009_3-0">^</a> <cite id="CITEREFBarnes_L2009" class="citation book cs1">Barnes L, ed. (2009). Surgical pathology of the head and neck (3rd ed.). New York: Informa healthcare. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-1-4200-9163-2</bdi>.</cite>: 226

</li>

<li id="cite_note-Young2004-4">^ <a href="#cite_ref-Young2004_4-0">a</a> <a href="#cite_ref-Young2004_4-1">b</a> <a href="#cite_ref-Young2004_4-2">c</a> <a href="#cite_ref-Young2004_4-3">d</a> <a href="#cite_ref-Young2004_4-4">e</a> <cite id="CITEREFYoungSkatrudPeppard2004" class="citation journal cs1">Young, Terry; Skatrud, J; Peppard, PE (28 April 2004). "Risk Factors for Obstructive Sleep Apnea in Adults". JAMA. 291 (16): 2013–2016. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.291.16.2013">10.1001/jama.291.16.2013</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15113821">15113821</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:12315855">12315855</a>.</cite>

</li>

<li id="cite_note-5"><a href="#cite_ref-5">^</a> <cite id="CITEREFBerryBudhirajaGottliebGozal2012" class="citation journal cs1">Berry, Richard B.; Budhiraja, Rohit; Gottlieb, Daniel J.; Gozal, David; Iber, Conrad; Kapur, Vishesh K.; Marcus, Carole L.; Mehra, Reena; Parthasarathy, Sairam; Quan, Stuart F.; Redline, Susan; Strohl, Kingman P.; Ward, Sally L. Davidson; Tangredi, Michelle M.; American Academy of Sleep Medicine (2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459210">"Rules for Scoring Respiratory Events in Sleep: Update of the 2007 AASM Manual for the Scoring of Sleep and Associated Events"</a>. Journal of Clinical Sleep Medicine. 08 (5): 597–619. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.2172">10.5664/jcsm.2172</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3459210">3459210</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23066376">23066376</a>.</cite>

</li>

<li id="cite_note-AASM3rd-6"><a href="#cite_ref-AASM3rd_6-0">^</a> <cite id="CITEREFAmerican_Academy_of_Sleep_Medicine2014" class="citation book cs1">American Academy of Sleep Medicine (2014). International Classification of Sleep Disorders, 3rd edition. Darien, IL: American Academy of Sleep Medicine.</cite>

</li>

<li id="cite_note-Tung2017-7"><a href="#cite_ref-Tung2017_7-0">^</a> <cite id="CITEREFTungLevitzkyWangWeng2017" class="citation journal cs1">Tung P, Levitzky YS, Wang R, Weng J, Quan SF, Gottlieb DJ, et al. (July 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586257">"Obstructive and Central Sleep Apnea and the Risk of Incident Atrial Fibrillation in a Community Cohort of Men and Women"</a>. Journal of the American Heart Association. 6 (7) e004500. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2Fjaha.116.004500">10.1161/jaha.116.004500</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5586257">5586257</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28668820">28668820</a>.</cite>

</li>

<li id="cite_note-Stoohs2005-8"><a href="#cite_ref-Stoohs2005_8-0">^</a> <cite id="CITEREFStoohsBlumKnaackButsch-von-der-Heydt2005" class="citation journal cs1">Stoohs RA, Blum HC, Knaack L, Butsch-von-der-Heydt B, Guilleminault C (March 2005). "Comparison of pleural pressure and transcutaneous diaphragmatic electromyogram in obstructive sleep apnea syndrome". Sleep. 28 (3): 321–329. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16173653">16173653</a>.</cite>

</li>

<li id="cite_note-AASMManual-9">^ <a href="#cite_ref-AASMManual_9-0">a</a> <a href="#cite_ref-AASMManual_9-1">b</a> <a href="#cite_ref-AASMManual_9-2">c</a> <cite id="CITEREFAmerican_Academy_of_Sleep_Medicine" class="citation web cs1">American Academy of Sleep Medicine. <a rel="nofollow" class="external text" href="https://aasm.org/clinical-resources/practice-standards/practice-guidelines/">"AASM Practice Guidelines"</a>. AASM. Retrieved 19 June 2019.</cite>

</li>

<li id="cite_note-10"><a href="#cite_ref-10">^</a> <cite id="CITEREFMbataChukwuka2012" class="citation journal cs1">Mbata, GC; Chukwuka, JC (2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507119">"Obstructive Sleep Apnea Hypopnea Syndrome"</a>. Annals of Medical and Health Sciences Research. 2 (1): 74–77. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4103%2F2141-9248.96943">10.4103/2141-9248.96943</a> (inactive 12 July 2025). <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3507119">3507119</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23209996">23209996</a>.</cite><code class="cs1-code">{{cite journal}}</code>: CS1 maint: DOI inactive as of July 2025 (link)

</li>

<li id="cite_note-11"><a href="#cite_ref-11">^</a> <cite id="CITEREFPatel2024" class="citation journal cs1">Patel, Sanjay R. (2024-10-03). <a rel="nofollow" class="external text" href="http://www.nejm.org/doi/10.1056/NEJMe2407117">"Entering a New Era in Sleep-Apnea Treatment"</a>. New England Journal of Medicine. 391 (13): 1248–1249. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMe2407117">10.1056/NEJMe2407117</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0028-4793">0028-4793</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38912659">38912659</a>.</cite>

</li>

<li id="cite_note-cognition-12"><a href="#cite_ref-cognition_12-0">^</a> <cite id="CITEREFCaporalePalmeriCoralloMuscarà2020" class="citation journal cs1">Caporale, Mina; Palmeri, Rosanna; Corallo, Francesco; Muscarà, Nunzio; Romeo, Laura; Bramanti, Alessia; Marino, Silvia; Lo Buono, Viviana (23 May 2020). "Cognitive impairment in obstructive sleep apnea syndrome: a descriptive review". Sleep and Breathing. 25 (1): 29–40. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11325-020-02084-3">10.1007/s11325-020-02084-3</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32447633">32447633</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:218835830">218835830</a>.</cite>

</li>

<li id="cite_note-13"><a href="#cite_ref-13">^</a> <cite id="CITEREFLiKuangLobbezoode_Vries2023" class="citation journal cs1">Li, Deshui; Kuang, Boyuan; Lobbezoo, Frank; de Vries, Nico; Hilgevoord, Antonius; Aarab, Ghizlane (March 2023). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978428">"Sleep bruxism is highly prevalent in adults with obstructive sleep apnea: a large-scale polysomnographic study"</a>. Journal of Clinical Sleep Medicine. 19 (3): 443–451. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.10348">10.5664/jcsm.10348</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1550-9389">1550-9389</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9978428">9978428</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36448332">36448332</a>.</cite>

</li>

<li id="cite_note-14"><a href="#cite_ref-14">^</a> <cite id="CITEREFGu2022" class="citation journal cs1">Gu, Yiwei (May 26, 2022). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178074">"Erectile Dysfunction and Obstructive Sleep Apnea: A Review"</a>. Frontiers in Psychiatry. 13 766639. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3389%2Ffpsyt.2022.766639">10.3389/fpsyt.2022.766639</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9178074">9178074</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/35693968">35693968</a>.</cite>

</li>

<li id="cite_note-pmid22297210-15"><a href="#cite_ref-pmid22297210_15-0">^</a> <cite id="CITEREFEzzeddiniDarabiGhasemiJabbari_Moghaddam2012" class="citation journal cs1">Ezzeddini R, Darabi M, Ghasemi B, Jabbari Moghaddam Y, Abdollahi SH, Rashtchizadeh N, Gharahdaghi A, Darabi M, Ansarin M, Shaaker M, Samadi A, Karamravan J (Apr 2012). <a rel="nofollow" class="external text" href="https://www.sciencedirect.com/science/article/abs/pii/S0165587612000055">"Circulating phospholipase-A2 activity in obstructive sleep apnea and recurrent tonsillitis"</a>. Int J Pediatr Otorhinolaryngol. 76 (4): 741–744. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijporl.2011.12.026">10.1016/j.ijporl.2011.12.026</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22297210">22297210</a>.</cite>

</li>

<li id="cite_note-pmid23643333-16"><a href="#cite_ref-pmid23643333_16-0">^</a> <cite id="CITEREFEzzediniDarabiGhasemiDarabi2013" class="citation journal cs1">Ezzedini R, Darabi M, Ghasemi B, Darabi M, Fayezi SH, Jabbari Moghaddam Y, Mehdizadeh A, Abdollahi SH, Gharahdaghi A (May 2013). <a rel="nofollow" class="external text" href="https://www.sciencedirect.com/science/article/abs/pii/S0165587613001511">"Tissue fatty acid composition in obstructive sleep apnea and recurrent tonsillitis"</a>. Int J Pediatr Otorhinolaryngol. 77 (6): 1008–1012. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijporl.2013.03.033">10.1016/j.ijporl.2013.03.033</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23643333">23643333</a>.</cite>

</li>

<li id="cite_note-17"><a href="#cite_ref-17">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.lecturio.com/concepts/obstructive-sleep-apnea/">"Obstructive Sleep Apnea"</a>. The Lecturio Medical Concept Library. 7 August 2020. Retrieved 21 August 2021.</cite>

</li>

<li id="cite_note-18"><a href="#cite_ref-18">^</a> <cite id="CITEREFLalWeaverBaeStrohl2021" class="citation journal cs1">Lal, Chitra; Weaver, Terri E.; Bae, Charles J.; Strohl, Kingman P. (2021). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086534">"Excessive Daytime Sleepiness in Obstructive Sleep Apnea. Mechanisms and Clinical Management"</a>. Annals of the American Thoracic Society. 18 (5): 757–768. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1513%2FAnnalsATS.202006-696FR">10.1513/AnnalsATS.202006-696FR</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2325-6621">2325-6621</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8086534">8086534</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33621163">33621163</a>.</cite>

</li>

<li id="cite_note-pmid14751008-19">^ <a href="#cite_ref-pmid14751008_19-0">a</a> <a href="#cite_ref-pmid14751008_19-1">b</a> <cite id="CITEREFGaleHopkins2004" class="citation journal cs1">Gale, Shawn D.; Hopkins, Ramona O. (January 2004). "Effects of hypoxia on the brain: Neuroimaging and neuropsychological findings following carbon monoxide poisoning and obstructive sleep apnea". Journal of the International Neuropsychological Society. 10 (1): 60–71. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1017%2FS1355617704101082">10.1017/S1355617704101082</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14751008">14751008</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:23745738">23745738</a>.</cite>

</li>

<li id="cite_note-20"><a href="#cite_ref-20">^</a> <cite id="CITEREFAndradeBubuVargaOsorio2018" class="citation journal cs1">Andrade, Andreia; Bubu, Omonigho M.; Varga, Andrew W.; Osorio, Ricardo S. (2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542637">"The relationship between Obstructive Sleep Apnea and Alzheimer's Disease"</a>. Journal of Alzheimer's Disease. 64 (Suppl 1): S255 – S270. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3233%2FJAD-179936">10.3233/JAD-179936</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6542637">6542637</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29782319">29782319</a>.</cite>

</li>

<li id="cite_note-21"><a href="#cite_ref-21">^</a> <cite id="CITEREFFrey2003" class="citation journal cs1">Frey, William (October 13, 2003). "Obstructive sleep-related breathing disorders in patients evaluated for bariatric surgery". Obesity Surgery. 13 (5): 676–683. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1381%2F096089203322509228">10.1381/096089203322509228</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14627460">14627460</a>.</cite>

</li>

<li id="cite_note-22"><a href="#cite_ref-22">^</a> <cite id="CITEREFGray2017" class="citation journal cs1">Gray, Emma (Jan 15, 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619">"Obstructive Sleep Apnea without Obesity Is Common and Difficult to Treat: Evidence for a Distinct Pathophysiological Phenotype"</a>. Journal of Clinical Sleep Medicine. 13 (1): 81–88. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.6394">10.5664/jcsm.6394</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5181619">5181619</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27655455">27655455</a>.</cite>

</li>

<li id="cite_note-23"><a href="#cite_ref-23">^</a> <cite id="CITEREFBixler2000" class="citation journal cs1">Bixler, E.O. (August 2000). "Association of hypertension and sleep-disordered breathing". Archives of Internal Medicine. 160 (15): 2289–2295. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchinte.160.15.2289">10.1001/archinte.160.15.2289</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10927725">10927725</a>.</cite>

</li>

<li id="cite_note-24"><a href="#cite_ref-24">^</a> <cite id="CITEREFLuyster2014" class="citation journal cs1">Luyster, Faith (Dec 1, 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252727">"Relation of obstructive sleep apnea to coronary artery calcium in non-obese versus obese men and women aged 45-75 years"</a>. American Journal of Cardiology. 114 (11): 1690–4. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.amjcard.2014.08.040">10.1016/j.amjcard.2014.08.040</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4252727">4252727</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25307200">25307200</a>.</cite>

</li>

<li id="cite_note-25"><a href="#cite_ref-25">^</a> <cite id="CITEREFEckert2013" class="citation journal cs1">Eckert, DJ (October 15, 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826282">"efining phenotypic causes of obstructive sleep apnea. Identification of novel therapeutic targets"</a>. American Journal Respiratory and Critical Care Medicine. 188 (81996–2004): 996–1004. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Frccm.201303-0448OC">10.1164/rccm.201303-0448OC</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3826282">3826282</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23721582">23721582</a>.</cite>

</li>

<li id="cite_note-26"><a href="#cite_ref-26">^</a> <cite id="CITEREFHenryRosenthal2013" class="citation journal cs1">Henry, Doug; Rosenthal, Leon (February 2013). "'Listening for his breath:' The significance of gender and partner reporting on the diagnosis, management, and treatment of obstructive sleep apnea". Social Science & Medicine. 79: 48–56. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.socscimed.2012.05.021">10.1016/j.socscimed.2012.05.021</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22770968">22770968</a>.</cite>

</li>

<li id="cite_note-27"><a href="#cite_ref-27">^</a> <cite id="CITEREFO'BrienHolbrookMervisKlaus2003" class="citation journal cs1">O'Brien, Louise M.; Holbrook, Cheryl R.; Mervis, Carolyn B.; Klaus, Carrie J.; Bruner, Jennifer L.; Raffield, Troy J.; Rutherford, Jennifer; Mehl, Rochelle C.; Wang, Mei; Tuell, Andrew; Hume, Brittany C.; Gozal, David (March 2003). "Sleep and Neurobehavioral Characteristics of 5- to 7-Year-Old Children With Parentally Reported Symptoms of Attention-Deficit/Hyperactivity Disorder". Pediatrics. 111 (3): 554–563. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.111.3.554">10.1542/peds.111.3.554</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12612236">12612236</a>.</cite>

</li>

<li id="cite_note-28"><a href="#cite_ref-28">^</a> <cite id="CITEREFSchechter2002" class="citation journal cs1">Schechter, Michael S. (April 2002). "Technical Report: Diagnosis and Management of Childhood Obstructive Sleep Apnea Syndrome". Pediatrics. 109 (4): e69. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.109.4.e69">10.1542/peds.109.4.e69</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11927742">11927742</a>.</cite>

</li>

<li id="cite_note-29"><a href="#cite_ref-29">^</a> <cite id="CITEREFRosenStorfer-IsserTaylorKirchner2004" class="citation journal cs1">Rosen, Carol L.; Storfer-Isser, Amy; Taylor, H. Gerry; Kirchner, H. Lester; Emancipator, Judith L.; Redline, Susan (December 2004). "Increased Behavioral Morbidity in School-Aged Children With Sleep-Disordered Breathing". Pediatrics. 114 (6): 1640–1648. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2004-0103">10.1542/peds.2004-0103</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15574628">15574628</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:7655711">7655711</a>.</cite>

</li>

<li id="cite_note-Dehlink2016-30">^ <a href="#cite_ref-Dehlink2016_30-0">a</a> <a href="#cite_ref-Dehlink2016_30-1">b</a> <a href="#cite_ref-Dehlink2016_30-2">c</a> <a href="#cite_ref-Dehlink2016_30-3">d</a> <a href="#cite_ref-Dehlink2016_30-4">e</a> <a href="#cite_ref-Dehlink2016_30-5">f</a> <a href="#cite_ref-Dehlink2016_30-6">g</a> <a href="#cite_ref-Dehlink2016_30-7">h</a> <a href="#cite_ref-Dehlink2016_30-8">i</a> <a href="#cite_ref-Dehlink2016_30-9">j</a> <a href="#cite_ref-Dehlink2016_30-10">k</a> <a href="#cite_ref-Dehlink2016_30-11">l</a> <cite id="CITEREFDehlinkTan2016" class="citation journal cs1">Dehlink E, Tan HL (February 2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739955">"Update on paediatric obstructive sleep apnoea"</a>. Journal of Thoracic Disease. 8 (2): 224–235. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3978%2Fj.issn.2072-1439.2015.12.04">10.3978/j.issn.2072-1439.2015.12.04</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4739955">4739955</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26904263">26904263</a>.</cite>

</li>

<li id="cite_note-Jazi2011-31"><a href="#cite_ref-Jazi2011_31-0">^</a> <cite id="CITEREFJaziBaratiKheradmand2011" class="citation journal cs1">Jazi SM, Barati B, Kheradmand A (December 2011). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434901">"Treatment of adenotonsillar hypertrophy: A prospective randomized trial comparing azithromycin vs. fluticasone"</a>. Journal of Research in Medical Sciences. 16 (12): 1590–1597. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3434901">3434901</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22973368">22973368</a>.</cite>

</li>

<li id="cite_note-Capdevilaetal2008-32">^ <a href="#cite_ref-Capdevilaetal2008_32-0">a</a> <a href="#cite_ref-Capdevilaetal2008_32-1">b</a> <a href="#cite_ref-Capdevilaetal2008_32-2">c</a> <a href="#cite_ref-Capdevilaetal2008_32-3">d</a> <a href="#cite_ref-Capdevilaetal2008_32-4">e</a> <a href="#cite_ref-Capdevilaetal2008_32-5">f</a> <a href="#cite_ref-Capdevilaetal2008_32-6">g</a> <a href="#cite_ref-Capdevilaetal2008_32-7">h</a> <a href="#cite_ref-Capdevilaetal2008_32-8">i</a> <a href="#cite_ref-Capdevilaetal2008_32-9">j</a> <a href="#cite_ref-Capdevilaetal2008_32-10">k</a> <a href="#cite_ref-Capdevilaetal2008_32-11">l</a> <a href="#cite_ref-Capdevilaetal2008_32-12">m</a> <a href="#cite_ref-Capdevilaetal2008_32-13">n</a> <cite id="CITEREFCapdevilaKheirandish-GozalDayyatGozal2008" class="citation journal cs1">Capdevila OS, Kheirandish-Gozal L, Dayyat E, Gozal D (February 2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645258">"Pediatric obstructive sleep apnea: complications, management, and long-term outcomes"</a>. Proceedings of the American Thoracic Society. 5 (2): 274–282. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1513%2Fpats.200708-138MG">10.1513/pats.200708-138MG</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645258">2645258</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18250221">18250221</a>.</cite>

</li>

<li id="cite_note-Dayyat2008-33">^ <a href="#cite_ref-Dayyat2008_33-0">a</a> <a href="#cite_ref-Dayyat2008_33-1">b</a> <a href="#cite_ref-Dayyat2008_33-2">c</a> <a href="#cite_ref-Dayyat2008_33-3">d</a> <a href="#cite_ref-Dayyat2008_33-4">e</a> <a href="#cite_ref-Dayyat2008_33-5">f</a> <a href="#cite_ref-Dayyat2008_33-6">g</a> <a href="#cite_ref-Dayyat2008_33-7">h</a> <a href="#cite_ref-Dayyat2008_33-8">i</a> <a href="#cite_ref-Dayyat2008_33-9">j</a> <a href="#cite_ref-Dayyat2008_33-10">k</a> <a href="#cite_ref-Dayyat2008_33-11">l</a> <a href="#cite_ref-Dayyat2008_33-12">m</a> <a href="#cite_ref-Dayyat2008_33-13">n</a> <a href="#cite_ref-Dayyat2008_33-14">o</a> <cite id="CITEREFDayyatKheirandish-GozalGozal2007" class="citation journal cs1">Dayyat E, Kheirandish-Gozal L, Gozal D (September 2007). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2084206">"Childhood Obstructive Sleep Apnea: One or Two Distinct Disease Entities?"</a>. Sleep Medicine Clinics. 2 (3): 433–444. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jsmc.2007.05.004">10.1016/j.jsmc.2007.05.004</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2084206">2084206</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18769509">18769509</a>.</cite>

</li>

<li id="cite_note-Kalra2005-34"><a href="#cite_ref-Kalra2005_34-0">^</a> <cite id="CITEREFKalraIngeGarciaDaniels2005" class="citation journal cs1">Kalra M, Inge T, Garcia V, Daniels S, Lawson L, Curti R, et al. (July 2005). <a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Foby.2005.139">"Obstructive sleep apnea in extremely overweight adolescents undergoing bariatric surgery"</a>. Obesity Research. 13 (7): 1175–1179. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Foby.2005.139">10.1038/oby.2005.139</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16076986">16076986</a>.</cite>

</li>

<li id="cite_note-Verhulst2009-35">^ <a href="#cite_ref-Verhulst2009_35-0">a</a> <a href="#cite_ref-Verhulst2009_35-1">b</a> <cite id="CITEREFVerhulstFranckxVan_GaalDe_Backer2009" class="citation journal cs1">Verhulst SL, Franckx H, Van Gaal L, De Backer W, Desager K (June 2009). <a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Foby.2008.673">"The effect of weight loss on sleep-disordered breathing in obese teenagers"</a>. Obesity. 17 (6): 1178–1183. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Foby.2008.673">10.1038/oby.2008.673</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19265797">19265797</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:205526401">205526401</a>.</cite>

</li>

<li id="cite_note-Bower2000-36"><a href="#cite_ref-Bower2000_36-0">^</a> <cite id="CITEREFBowerGungor2000" class="citation journal cs1">Bower CM, Gungor A (February 2000). "Pediatric obstructive sleep apnea syndrome". Otolaryngologic Clinics of North America. 33 (1): 49–75. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fs0030-6665%2805%2970207-3">10.1016/s0030-6665(05)70207-3</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10637344">10637344</a>.</cite>

</li>

<li id="cite_note-Obstructive_sleep_apnea_is_a_common-37">^ <a href="#cite_ref-Obstructive_sleep_apnea_is_a_common_37-0">a</a> <a href="#cite_ref-Obstructive_sleep_apnea_is_a_common_37-1">b</a> <cite id="CITEREFFranklinLindberg2015" class="citation journal cs1">Franklin KA, Lindberg E (August 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561280">"Obstructive sleep apnea is a common disorder in the population-a review on the epidemiology of sleep apnea"</a>. Journal of Thoracic Disease. 7 (8): 1311–1322. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3978%2Fj.issn.2072-1439.2015.06.11">10.3978/j.issn.2072-1439.2015.06.11</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4561280">4561280</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26380759">26380759</a>.</cite>

</li>

<li id="cite_note-38"><a href="#cite_ref-38">^</a> Berry RB, Quan SF, Abrue AR, et al.; for the American Academy of Sleep Medicine. The AASM Manual for the Scoring of Sleep and Associated Events: Rules, Terminology and Technical Specifications. Version 2.6. Darien, IL: American Academy of Sleep Medicine; 2020.

</li>

<li id="cite_note-39"><a href="#cite_ref-39">^</a> <cite id="CITEREFKapurAuckleyChowdhuriKuhlmann2017" class="citation journal cs1">Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG (March 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337595">"Clinical Practice Guideline for Diagnostic Testing for Adult Obstructive Sleep Apnea: An American Academy of Sleep Medicine Clinical Practice Guideline"</a>. Journal of Clinical Sleep Medicine. 13 (3): 479–504. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.6506">10.5664/jcsm.6506</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5337595">5337595</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28162150">28162150</a>.</cite>

</li>

<li id="cite_note-40"><a href="#cite_ref-40">^</a> <cite id="CITEREFThurnheer2007" class="citation journal cs1">Thurnheer, R. (September 2007). <a rel="nofollow" class="external text" href="https://www.minervamedica.it/en/journals/minerva-pneumologica/article.php?cod=R16Y2007N03A0191">"Diagnosis of the obstructive sleep apnea syndrome"</a>. Minerva Pneumologica. 46 (3): 191–204. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:52540419">52540419</a>.</cite>

</li>

<li id="cite_note-41"><a href="#cite_ref-41">^</a> <cite id="CITEREFCrookSieviBlochStradling2019" class="citation journal cs1">Crook S, Sievi NA, Bloch KE, Stradling JR, Frei A, Puhan MA, Kohler M (April 2019). <a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2018-211959">"Minimum important difference of the Epworth Sleepiness Scale in obstructive sleep apnoea: estimation from three randomised controlled trials"</a>. Thorax. 74 (4): 390–396. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2018-211959">10.1136/thoraxjnl-2018-211959</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30100576">30100576</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:51967356">51967356</a>.</cite>

</li>

<li id="cite_note-42"><a href="#cite_ref-42">^</a> <cite id="CITEREFChiuChenChuangChen2017" class="citation journal cs1">Chiu HY, Chen PY, Chuang LP, Chen NH, Tu YK, Hsieh YJ, et al. (December 2017). "Diagnostic accuracy of the Berlin questionnaire, STOP-BANG, STOP, and Epworth sleepiness scale in detecting obstructive sleep apnea: A bivariate meta-analysis". Sleep Medicine Reviews. 36: 57–70. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.smrv.2016.10.004">10.1016/j.smrv.2016.10.004</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27919588">27919588</a>.</cite>

</li>

<li id="cite_note-43"><a href="#cite_ref-43">^</a> <cite id="CITEREFAmraJavaniSoltaninejadPenzel2018" class="citation journal cs1">Amra B, Javani M, Soltaninejad F, Penzel T, Fietze I, Schoebel C, Farajzadegan Z (2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869953">"Comparison of Berlin Questionnaire, STOP-Bang, and Epworth Sleepiness Scale for Diagnosing Obstructive Sleep Apnea in Persian Patients"</a>. International Journal of Preventive Medicine. 9 (28): 28. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4103%2Fijpvm.IJPVM_131_17">10.4103/ijpvm.IJPVM_131_17</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5869953">5869953</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29619152">29619152</a>.</cite>

</li>

<li id="cite_note-:1-44">^ <a href="#cite_ref-:1_44-0">a</a> <a href="#cite_ref-:1_44-1">b</a> <cite class="citation journal cs1"><a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F22.5.667">"Sleep-related breathing disorders in adults: recommendations for syndrome definition and measurement techniques in clinical research. The Report of an American Academy of Sleep Medicine Task Force"</a>. Sleep. 22 (5): 667–689. August 1999. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F22.5.667">10.1093/sleep/22.5.667</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10450601">10450601</a>.</cite>

</li>

<li id="cite_note-45"><a href="#cite_ref-45">^</a> <cite id="CITEREFLuxBoehleckeLohr2004" class="citation book cs1">Lux, Linda; Boehlecke, Brian; Lohr, Kathleen N. (2004). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/books/NBK299250/">Effectiveness of Portable Monitoring Devices for Diagnosing Obstructive Sleep Apnea: Update of a Systematic Review</a>. AHRQ Technology Assessments. Rockville (MD): Agency for Healthcare Research and Quality (US). <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26065047">26065047</a>.</cite>

</li>

<li id="cite_note-46"><a href="#cite_ref-46">^</a> <cite id="CITEREFLeeSundar2021" class="citation journal cs1">Lee, Janet J.; Sundar, Krishna M. (April 2021). "Evaluation and Management of Adults with Obstructive Sleep Apnea Syndrome". Lung. 199 (2): 87–101. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00408-021-00426-w">10.1007/s00408-021-00426-w</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1432-1750">1432-1750</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33713177">33713177</a>.</cite>

</li>

<li id="cite_note-47"><a href="#cite_ref-47">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfpmn/pmn.cfm?ID=K010739">"510(k) Premarket Notification"</a>. www.accessdata.fda.gov. Retrieved 2025-07-31.</cite>

</li>

<li id="cite_note-48"><a href="#cite_ref-48">^</a> <cite id="CITEREFRöckenSchumannHerrmannVeitz2023" class="citation journal cs1">Röcken, Jonathan; Schumann, Desiree M.; Herrmann, Matthias J.; Veitz, Simon; Franchetti, Léo; Grize, Leticia; Strobel, Werner; Jahn, Kathleen; Tamm, Michael; Stolz, Daiana (2023-07-22). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362713">"Peripheral arterial tonometry versus polysomnography in suspected obstructive sleep apnoea"</a>. European Journal of Medical Research. 28 (1): 251. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1186%2Fs40001-023-01164-w">10.1186/s40001-023-01164-w</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2047-783X">2047-783X</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10362713">10362713</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/37481575">37481575</a>.</cite>

</li>

<li id="cite_note-49"><a href="#cite_ref-49">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.thedaybreak.com/resources/is-sleep-apnea-covered-by-insurance-a-comprehensive-guide">"Is Sleep Apnea Covered by Insurance? A Comprehensive Guide | Daybreak"</a>. www.thedaybreak.com. Retrieved 2025-07-31.</cite>

</li>

<li id="cite_note-50"><a href="#cite_ref-50">^</a> American Academy of Sleep Medicine. International classification of sleep disorders. 3rd ed. Darien, IL: American Academy of Sleep Medicine, 2014.

</li>

<li id="cite_note-51"><a href="#cite_ref-51">^</a> <cite id="CITEREFTschoppWimmerCaversaccioBorner2021" class="citation journal cs1">Tschopp, Samuel; Wimmer, Wilhelm; Caversaccio, Marco; Borner, Urs; Tschopp, Kurt (2021-03-30). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636340">"Night-to-night variability in obstructive sleep apnea using peripheral arterial tonometry: a case for multiple night testing"</a>. Journal of Clinical Sleep Medicine. 17 (9): 1751–1758. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.9300">10.5664/jcsm.9300</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1550-9389">1550-9389</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8636340">8636340</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/33783347">33783347</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:232420123">232420123</a>.</cite>

</li>

<li id="cite_note-52"><a href="#cite_ref-52">^</a> <cite id="CITEREFMillsKuohung2019" class="citation journal cs1">Mills, Jacqueline; Kuohung, Wendy (2019). "Impact of circadian rhythms on female reproduction and infertility treatment success". Current Opinion in Endocrinology, Diabetes & Obesity. 26 (6): 317–321. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2FMED.0000000000000511">10.1097/MED.0000000000000511</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31644470">31644470</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:204865937">204865937</a>.</cite>

</li>

<li id="cite_note-53"><a href="#cite_ref-53">^</a> <cite id="CITEREFSaboiskyButlerGandeviaEckert2012" class="citation journal cs1">Saboisky JP, Butler JE, Gandevia SC, Eckert DJ (15 June 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375463">"Functional role of neural injury in obstructive sleep apnea"</a>. Frontiers in Neurology. 3: 95. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3389%2Ffneur.2012.00095">10.3389/fneur.2012.00095</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3375463">3375463</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22715333">22715333</a>.</cite>

</li>

<li id="cite_note-54"><a href="#cite_ref-54">^</a> <cite id="CITEREFSchwabKimBagchiKeenan2015" class="citation journal cs1">Schwab RJ, Kim C, Bagchi S, Keenan BT, Comyn FL, Wang S, et al. (June 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476519">"Understanding the anatomic basis for obstructive sleep apnea syndrome in adolescents"</a>. American Journal of Respiratory and Critical Care Medicine. 191 (11): 1295–1309. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Frccm.201501-0169OC">10.1164/rccm.201501-0169OC</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4476519">4476519</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25835282">25835282</a>.</cite>

</li>

<li id="cite_note-55"><a href="#cite_ref-55">^</a> <cite id="CITEREFEdwardsSullivan2008" class="citation journal cs1">Edwards N, Sullivan CE (2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746354">"Sleep-Disordered Breathing in Pregnancy"</a>. Sleep Medicine Clinics. 3 (6): 81–95. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jsmc.2007.10.010">10.1016/j.jsmc.2007.10.010</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1746354">1746354</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12037233">12037233</a>.</cite>

</li>

<li id="cite_note-56"><a href="#cite_ref-56">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.mayoclinic.org/diseases-conditions/sleep-apnea/symptoms-causes/syc-20377631">"Sleep apnea – Symptoms and causes"</a>. Mayo Clinic.</cite>

</li>

<li id="cite_note-57"><a href="#cite_ref-57">^</a> <cite id="CITEREFLuPeatSullivan2003" class="citation journal cs1">Lu LR, Peat JK, Sullivan CE (August 2003). "Snoring in preschool children: prevalence and association with nocturnal cough and asthma". Chest. 124 (2): 587–593. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.124.2.587">10.1378/chest.124.2.587</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12907547">12907547</a>.</cite>

</li>

<li id="cite_note-58"><a href="#cite_ref-58">^</a> <cite id="CITEREFMcColleyCarrollCurtisLoughlin1997" class="citation journal cs1">McColley, Susanna A.; Carroll, John L.; Curtis, Shelly; Loughlin, Gerald M.; Sampson, Hugh A. (January 1997). <a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.111.1.170">"High Prevalence of Allergic Sensitization in Children With Habitual Snoring and Obstructive Sleep Apnea"</a>. Chest. 111 (1): 170–173. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.111.1.170">10.1378/chest.111.1.170</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/8996012">8996012</a>.</cite>

</li>

<li id="cite_note-59"><a href="#cite_ref-59">^</a> <cite id="CITEREFMukherjeeSaxenaPalmer2018" class="citation journal cs1">Mukherjee, Sutapa; Saxena, Richa; Palmer, Lyle J. (January 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308164">"The genetics of obstructive sleep apnoea"</a>. Respirology. 23 (1): 18–27. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fresp.13212">10.1111/resp.13212</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1440-1843">1440-1843</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7308164">7308164</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29113020">29113020</a>.</cite>

</li>

<li id="cite_note-Campos2023-60"><a href="#cite_ref-Campos2023_60-0">^</a> <cite id="CITEREFCamposIngoldHuangMitchell2023" class="citation journal cs1">Campos, AI; Ingold, N; Huang, Y; Mitchell, BL; Kho, PF; Han, X; García-Marín, LM; Ong, JS; 23andMe Research, Team; Law, MH; Yokoyama, JS; Martin, NG; Dong, X; Cuellar-Partida, G; MacGregor, S; Aslibekyan, S; Rentería, ME (9 March 2023). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995783">"Discovery of genomic loci associated with sleep apnea risk through multi-trait GWAS analysis with snoring"</a>. Sleep. 46 (3) zsac308. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2Fzsac308">10.1093/sleep/zsac308</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC9995783">9995783</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/36525587">36525587</a>.</cite><code class="cs1-code">{{cite journal}}</code>: CS1 maint: numeric names: authors list (link)

</li>

<li id="cite_note-61"><a href="#cite_ref-61">^</a> <cite id="CITEREFde_Miguel-DíezVilla-AsensiAlvarez-Sala2003" class="citation journal cs1">de Miguel-Díez J, Villa-Asensi JR, Alvarez-Sala JL (December 2003). "Prevalence of sleep-disordered breathing in children with Down syndrome: polygraphic findings in 108 children". Sleep. 26 (8): 1006–1009. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F26.8.1006">10.1093/sleep/26.8.1006</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14746382">14746382</a>.</cite>

</li>

<li id="cite_note-62"><a href="#cite_ref-62">^</a> <cite id="CITEREFShottAminChiniHeubi2006" class="citation journal cs1">Shott SR, Amin R, Chini B, Heubi C, Hotze S, Akers R (April 2006). "Obstructive sleep apnea: Should all children with Down syndrome be tested?". Archives of Otolaryngology–Head & Neck Surgery. 132 (4): 432–436. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Farchotol.132.4.432">10.1001/archotol.132.4.432</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16618913">16618913</a>.</cite>

</li>

<li id="cite_note-Sloan-63"><a href="#cite_ref-Sloan_63-0">^</a> <cite id="CITEREFSloan2000" class="citation journal cs1">Sloan, Gerald M. (March 2000). "Posterior Pharyngeal Flap and Sphincter Pharyngoplasty: The State of the Art". The Cleft Palate-Craniofacial Journal. 37 (2): 112–122. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1597%2F1545-1569_2000_037_0112_ppfasp_2.3.co_2">10.1597/1545-1569_2000_037_0112_ppfasp_2.3.co_2</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10749049">10749049</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:208150617">208150617</a>.</cite>

</li>

<li id="cite_note-Pugh-64"><a href="#cite_ref-Pugh_64-0">^</a> Pugh, M.B. et al. (2000). Apnea. Stedman's Medical Dictionary (27th ed.) Retrieved June 18, 2006 from STAT!Ref Online Medical Library database.

</li>

<li id="cite_note-Liao2004-65"><a href="#cite_ref-Liao2004_65-0">^</a> <cite id="CITEREFLiaoNoordhoffHuangChen2004" class="citation journal cs1">Liao YF, Noordhoff MS, Huang CS, Chen PK, Chen NH, Yun C, Chuang ML (March 2004). "Comparison of obstructive sleep apnea syndrome in children with cleft palate following Furlow palatoplasty or pharyngeal flap for velopharyngeal insufficiency". The Cleft Palate-Craniofacial Journal. 41 (2): 152–156. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1597%2F02-162">10.1597/02-162</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14989690">14989690</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:20976608">20976608</a>.</cite>

</li>

<li id="cite_note-PetersonFalzone-66"><a href="#cite_ref-PetersonFalzone_66-0">^</a> <cite id="CITEREFMcWilliamsPeterson-FalzoneHardin-JonesKarnell2001" class="citation book cs1">McWilliams BJ, Peterson-Falzone SJ, Hardin-Jones MA, Karnell MP (2001). <a rel="nofollow" class="external text" href="https://archive.org/details/cleftpalatespeec03edpete">Cleft palate speech</a> (3rd ed.). St. Louis: Mosby. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-0-8151-3153-3</bdi>.</cite>

</li>

<li id="cite_note-67"><a href="#cite_ref-67">^</a> <cite id="CITEREFGrossBachenbergBenumofCaplan2006" class="citation journal cs1">Gross JB, Bachenberg KL, Benumof JL, Caplan RA, Connis RT, Coté CJ, et al. (May 2006). "Practice guidelines for the perioperative management of patients with obstructive sleep apnea: a report by the American Society of Anesthesiologists Task Force on Perioperative Management of patients with obstructive sleep apnea". Anesthesiology. 104 (5): 1081–1093, quiz 1117–1118. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F00000542-200605000-00026">10.1097/00000542-200605000-00026</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16645462">16645462</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:14151958">14151958</a>.</cite>

</li>

<li id="cite_note-OSA-68">^ <a href="#cite_ref-OSA_68-0">a</a> <a href="#cite_ref-OSA_68-1">b</a> <a href="#cite_ref-OSA_68-2">c</a> <a href="#cite_ref-OSA_68-3">d</a> <a href="#cite_ref-OSA_68-4">e</a> <a href="#cite_ref-OSA_68-5">f</a> <a href="#cite_ref-OSA_68-6">g</a> <a href="#cite_ref-OSA_68-7">h</a> <a href="#cite_ref-OSA_68-8">i</a> <a href="#cite_ref-OSA_68-9">j</a> <cite id="CITEREFFoldvary-SchaeferWaters2017" class="citation journal cs1">Foldvary-Schaefer, Nancy R.; Waters, Tina E. (August 2017). "Sleep-Disordered Breathing". Continuum: Lifelong Learning in Neurology. 23 (4): 1093–1116. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1212%2F01.CON.0000522245.13784.f6">10.1212/01.CON.0000522245.13784.f6</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28777178">28777178</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:20852866">20852866</a>.</cite>

</li>

<li id="cite_note-Walter2018-69">^ <a href="#cite_ref-Walter2018_69-0">a</a> <a href="#cite_ref-Walter2018_69-1">b</a> <a href="#cite_ref-Walter2018_69-2">c</a> <a href="#cite_ref-Walter2018_69-3">d</a> <cite id="CITEREFWalterHorne2018" class="citation journal cs1">Walter LM, Horne RS (2018). <a rel="nofollow" class="external text" href="https://doi.org/10.4103%2Fprcm.prcm_16_18">"Obstructive Sleep-Disordered Breathing in Children; impact on the Developing Brain"</a>. Pediatric Respirology and Critical Care Medicine. 2 (4): 58–64. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4103%2Fprcm.prcm_16_18">10.4103/prcm.prcm_16_18</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:80862031">80862031</a>.</cite>

</li>

<li id="cite_note-Chervin2001-70">^ <a href="#cite_ref-Chervin2001_70-0">a</a> <a href="#cite_ref-Chervin2001_70-1">b</a> <cite id="CITEREFChervinArchbold2001" class="citation journal cs1">Chervin RD, Archbold KH (May 2001). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F24.3.313">"Hyperactivity and polysomnographic findings in children evaluated for sleep-disordered breathing"</a>. Sleep. 24 (3): 313–320. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F24.3.313">10.1093/sleep/24.3.313</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11322714">11322714</a>.</cite>

</li>

<li id="cite_note-71"><a href="#cite_ref-71">^</a> <cite id="CITEREFHalbowerDegaonkarBarkerEarley2006" class="citation journal cs1">Halbower, Ann C; Degaonkar, Mahaveer; Barker, Peter B; Earley, Christopher J; Marcus, Carole L; Smith, Philip L; Prahme, M. Cristine; Mahone, E. Mark (2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1551912">"Childhood Obstructive Sleep Apnea Associates with Neuropsychological Deficits and Neuronal Brain Injury"</a>. PLOS Medicine. 3 (8): e301. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1371%2Fjournal.pmed.0030301">10.1371/journal.pmed.0030301</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1551912">1551912</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16933960">16933960</a>.</cite>

</li>

<li id="cite_note-Nieminen2002-72">^ <a href="#cite_ref-Nieminen2002_72-0">a</a> <a href="#cite_ref-Nieminen2002_72-1">b</a> Nieminen P, Löppönen T, Tolonen U, Lanning P, Knip M, Löppönen H. <a rel="nofollow" class="external text" href="https://publications.aap.org/pediatrics/article/109/4/e55/64076/Growth-and-Biochemical-Markers-of-Growth-in">Growth and biochemical markers of growth in children with snoring and obstructive sleep apnea</a>. Pediatrics. 2002;109(4):e55. doi:10.1542/peds.109.4.e55

</li>

<li id="cite_note-O'Brien2004-73">^ <a href="#cite_ref-O'Brien2004_73-0">a</a> <a href="#cite_ref-O'Brien2004_73-1">b</a> <cite id="CITEREFO'BrienMervisHolbrookBruner2004" class="citation journal cs1">O'Brien LM, Mervis CB, Holbrook CR, Bruner JL, Smith NH, McNally N, et al. (June 2004). "Neurobehavioral correlates of sleep-disordered breathing in children". Journal of Sleep Research. 13 (2): 165–172. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1365-2869.2004.00395.x">10.1111/j.1365-2869.2004.00395.x</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15175097">15175097</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:25860827">25860827</a>.</cite>

</li>

<li id="cite_note-Goyal2018-74">^ <a href="#cite_ref-Goyal2018_74-0">a</a> <a href="#cite_ref-Goyal2018_74-1">b</a> <a href="#cite_ref-Goyal2018_74-2">c</a> <a href="#cite_ref-Goyal2018_74-3">d</a> <cite id="CITEREFGoyalPakhareBhattChoudhary2018" class="citation journal cs1">Goyal A, Pakhare AP, Bhatt GC, Choudhary B, Patil R (2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846262">"Association of pediatric obstructive sleep apnea with poor academic performance: A school-based study from India"</a>. Lung India. 35 (2): 132–136. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4103%2Flungindia.lungindia_218_17">10.4103/lungindia.lungindia_218_17</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5846262">5846262</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29487248">29487248</a>.</cite>

</li>

<li id="cite_note-Galland2015-75">^ <a href="#cite_ref-Galland2015_75-0">a</a> <a href="#cite_ref-Galland2015_75-1">b</a> <a href="#cite_ref-Galland2015_75-2">c</a> <cite id="CITEREFGallandSpruytDawesMcDowall2015" class="citation journal cs1">Galland B, Spruyt K, Dawes P, McDowall PS, Elder D, Schaughency E (October 2015). <a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2015-1677">"Sleep Disordered Breathing and Academic Performance: A Meta-analysis"</a>. Pediatrics. 136 (4): e934–946. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2015-1677">10.1542/peds.2015-1677</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26347434">26347434</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:20590026">20590026</a>.</cite>

</li>

<li id="cite_note-Amin2008-76">^ <a href="#cite_ref-Amin2008_76-0">a</a> <a href="#cite_ref-Amin2008_76-1">b</a> <a href="#cite_ref-Amin2008_76-2">c</a> <a href="#cite_ref-Amin2008_76-3">d</a> <cite id="CITEREFAminSomersMcConnellWillging2008" class="citation journal cs1">Amin R, Somers VK, McConnell K, Willging P, Myer C, Sherman M, et al. (January 2008). <a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FHYPERTENSIONAHA.107.099762">"Activity-adjusted 24-hour ambulatory blood pressure and cardiac remodeling in children with sleep disordered breathing"</a>. Hypertension. 51 (1): 84–91. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1161%2FHYPERTENSIONAHA.107.099762">10.1161/HYPERTENSIONAHA.107.099762</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18071053">18071053</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:1736152">1736152</a>.</cite>

</li>

<li id="cite_note-Ip2002-77"><a href="#cite_ref-Ip2002_77-0">^</a> <cite id="CITEREFIpLamNgLam2002" class="citation journal cs1">Ip, Mary S. M.; Lam, Bing; Ng, Matthew M. T.; Lam, Wah Kit; Tsang, Kenneth W. T.; <a href="Karen_Lam_(researcher)" title="Karen Lam (researcher)">Lam, Karen S. L.</a> (1 March 2002). "Obstructive Sleep Apnea Is Independently Associated with Insulin Resistance". American Journal of Respiratory and Critical Care Medicine. 165 (5): 670–676. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Fajrccm.165.5.2103001">10.1164/ajrccm.165.5.2103001</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11874812">11874812</a>.</cite>

</li>

<li id="cite_note-Basha2009-78">^ <a href="#cite_ref-Basha2009_78-0">a</a> <a href="#cite_ref-Basha2009_78-1">b</a> <a href="#cite_ref-Basha2009_78-2">c</a> <cite id="CITEREFBashaBialowasEndeSzeremeta2005" class="citation journal cs1">Basha, Suzanne; Bialowas, Christie; Ende, Kevin; Szeremeta, Wasyl (2005). "Effectiveness of Adenotonsillectomy in the Resolution of Nocturnal Enuresis Secondary to Obstructive Sleep Apnea". The Laryngoscope. 115 (6): 1101–1103. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.MLG.0000163762.13870.83">10.1097/01.MLG.0000163762.13870.83</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15933530">15933530</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:44686421">44686421</a>.</cite>

</li>

<li id="cite_note-Barone2009-79">^ <a href="#cite_ref-Barone2009_79-0">a</a> <a href="#cite_ref-Barone2009_79-1">b</a> <a href="#cite_ref-Barone2009_79-2">c</a> <cite id="CITEREFBaroneHansonDaJustaGioia2009" class="citation journal cs1">Barone JG, Hanson C, DaJusta DG, Gioia K, England SJ, Schneider D (July 2009). "Nocturnal enuresis and overweight are associated with obstructive sleep apnea". Pediatrics. 124 (1): e53–59. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1542%2Fpeds.2008-2805">10.1542/peds.2008-2805</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19564269">19564269</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:7324455">7324455</a>.</cite>

</li>

<li id="cite_note-Brooks2003-80">^ <a href="#cite_ref-Brooks2003_80-0">a</a> <a href="#cite_ref-Brooks2003_80-1">b</a> <a href="#cite_ref-Brooks2003_80-2">c</a> <a href="#cite_ref-Brooks2003_80-3">d</a> <cite id="CITEREFBrooksTopol2003" class="citation journal cs1">Brooks, Lee J.; Topol, Howard I. (May 2003). "Enuresis in children with sleep apnea". The Journal of Pediatrics. 142 (5): 515–518. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1067%2Fmpd.2003.158">10.1067/mpd.2003.158</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12756383">12756383</a>.</cite>

</li>

<li id="cite_note-Weissbach2006-81">^ <a href="#cite_ref-Weissbach2006_81-0">a</a> <a href="#cite_ref-Weissbach2006_81-1">b</a> <cite id="CITEREFWeissbachLeibermanTarasiukGoldbart2006" class="citation journal cs1">Weissbach A, Leiberman A, Tarasiuk A, Goldbart A, Tal A (August 2006). "Adenotonsilectomy improves enuresis in children with obstructive sleep apnea syndrome". International Journal of Pediatric Otorhinolaryngology. 70 (8): 1351–1356. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.ijporl.2006.01.011">10.1016/j.ijporl.2006.01.011</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16504310">16504310</a>.</cite>

</li>

<li id="cite_note-Carotenuto2012-82">^ <a href="#cite_ref-Carotenuto2012_82-0">a</a> <a href="#cite_ref-Carotenuto2012_82-1">b</a> <a href="#cite_ref-Carotenuto2012_82-2">c</a> <a href="#cite_ref-Carotenuto2012_82-3">d</a> <cite id="CITEREFCarotenutoEspositoParisiGallai2012" class="citation journal cs1">Carotenuto M, Esposito M, Parisi L, Gallai B, Marotta R, Pascotto A, Roccella M (2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430390">"Depressive symptoms and childhood sleep apnea syndrome"</a>. Neuropsychiatric Disease and Treatment. 8: 369–373. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2147%2FNDT.S35974">10.2147/NDT.S35974</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3430390">3430390</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22977304">22977304</a>.</cite>

</li>

<li id="cite_note-Yilmaz2013-83">^ <a href="#cite_ref-Yilmaz2013_83-0">a</a> <a href="#cite_ref-Yilmaz2013_83-1">b</a> <a href="#cite_ref-Yilmaz2013_83-2">c</a> <cite id="CITEREFYilmazSedkyBennett2013" class="citation journal cs1">Yilmaz E, Sedky K, Bennett DS (November 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805811">"The relationship between depressive symptoms and obstructive sleep apnea in pediatric populations: a meta-analysis"</a>. Journal of Clinical Sleep Medicine. 9 (11): 1213–1220. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.3178">10.5664/jcsm.3178</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3805811">3805811</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24235907">24235907</a>.</cite>

</li>

<li id="cite_note-Crabtree2004-84"><a href="#cite_ref-Crabtree2004_84-0">^</a> <cite id="CITEREFCrabtreeVarniGozal2004" class="citation journal cs1">Crabtree VM, Varni JW, Gozal D (September 2004). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F27.6.1131">"Health-related quality of life and depressive symptoms in children with suspected sleep-disordered breathing"</a>. Sleep. 27 (6): 1131–1138. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F27.6.1131">10.1093/sleep/27.6.1131</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15532207">15532207</a>.</cite>

</li>

<li id="cite_note-Alsubie-85">^ <a href="#cite_ref-Alsubie_85-0">a</a> <a href="#cite_ref-Alsubie_85-1">b</a> <a href="#cite_ref-Alsubie_85-2">c</a> <a href="#cite_ref-Alsubie_85-3">d</a> <a href="#cite_ref-Alsubie_85-4">e</a> <a href="#cite_ref-Alsubie_85-5">f</a> <a href="#cite_ref-Alsubie_85-6">g</a> <cite id="CITEREFAlsubieBaHammam2017" class="citation journal cs1">Alsubie HS, BaHammam AS (January 2017). "Obstructive Sleep Apnoea: Children are not little Adults". Paediatric Respiratory Reviews. 21: 72–79. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.prrv.2016.02.003">10.1016/j.prrv.2016.02.003</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27262609">27262609</a>.</cite>

</li>

<li id="cite_note-McNicholas2008-86">^ <a href="#cite_ref-McNicholas2008_86-0">a</a> <a href="#cite_ref-McNicholas2008_86-1">b</a> <a href="#cite_ref-McNicholas2008_86-2">c</a> <a href="#cite_ref-McNicholas2008_86-3">d</a> <a href="#cite_ref-McNicholas2008_86-4">e</a> <a href="#cite_ref-McNicholas2008_86-5">f</a> <a href="#cite_ref-McNicholas2008_86-6">g</a> <a href="#cite_ref-McNicholas2008_86-7">h</a> <a href="#cite_ref-McNicholas2008_86-8">i</a> <a href="#cite_ref-McNicholas2008_86-9">j</a> <a href="#cite_ref-McNicholas2008_86-10">k</a> <cite id="CITEREFMcNicholas2008" class="citation journal cs1">McNicholas WT (February 2008). "Diagnosis of obstructive sleep apnea in adults". Proceedings of the American Thoracic Society. 5 (2): 154–160. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1513%2Fpats.200708-118MG">10.1513/pats.200708-118MG</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18250207">18250207</a>.</cite>

</li>

<li id="cite_note-Stranks2016-87"><a href="#cite_ref-Stranks2016_87-0">^</a> <cite id="CITEREFStranksCrowe2016" class="citation journal cs1">Stranks EK, Crowe SF (March 2016). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Farclin%2Facv087">"The Cognitive Effects of Obstructive Sleep Apnea: An Updated Meta-analysis"</a>. Archives of Clinical Neuropsychology. 31 (2): 186–193. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Farclin%2Facv087">10.1093/arclin/acv087</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26743325">26743325</a>.</cite>

</li>

<li id="cite_note-Robichaud-Hallé2012-88"><a href="#cite_ref-Robichaud-Hallé2012_88-0">^</a> <cite id="CITEREFRobichaud-HalléBeaudryFortin2012" class="citation journal cs1">Robichaud-Hallé L, Beaudry M, Fortin M (September 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515504">"Obstructive sleep apnea and multimorbidity"</a>. BMC Pulmonary Medicine. 12 (60) 60. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1186%2F1471-2466-12-60">10.1186/1471-2466-12-60</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3515504">3515504</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23006602">23006602</a>.</cite>

</li>

<li id="cite_note-Romero-Corral-89"><a href="#cite_ref-Romero-Corral_89-0">^</a> <cite id="CITEREFRomero-CorralCaplesLopez-JimenezSomers2010" class="citation journal cs1">Romero-Corral A, Caples SM, Lopez-Jimenez F, Somers VK (March 2010). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364">"Interactions between obesity and obstructive sleep apnea: implications for treatment"</a>. Chest. 137 (3): 711–719. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.09-0360">10.1378/chest.09-0360</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3021364">3021364</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20202954">20202954</a>.</cite>

</li>

<li id="cite_note-Fulda2003-90">^ <a href="#cite_ref-Fulda2003_90-0">a</a> <a href="#cite_ref-Fulda2003_90-1">b</a> <cite id="CITEREFFuldaSchulz2003" class="citation journal cs1">Fulda S, Schulz H (2003). "Cognitive Dysfunction in Sleep-Related Breathing Disorders: A Meta-Analysis". Sleep Research Online. 5 (1): 19–51.</cite>

</li>

<li id="cite_note-Bucks2012-91">^ <a href="#cite_ref-Bucks2012_91-0">a</a> <a href="#cite_ref-Bucks2012_91-1">b</a> <a href="#cite_ref-Bucks2012_91-2">c</a> <a href="#cite_ref-Bucks2012_91-3">d</a> <cite id="CITEREFBucksOlaitheEastwood2013" class="citation journal cs1">Bucks RS, Olaithe M, Eastwood P (January 2013). "Neurocognitive function in obstructive sleep apnoea: a meta-review". Respirology. 18 (1): 61–70. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fj.1440-1843.2012.02255.x">10.1111/j.1440-1843.2012.02255.x</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22913604">22913604</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:27228461">27228461</a>.</cite>

</li>

<li id="cite_note-92"><a href="#cite_ref-92">^</a> <cite id="CITEREFNejatiSalehinejadNitsche2018" class="citation journal cs1">Nejati V, Salehinejad MA, Nitsche MA (January 2018). "Interaction of the Left Dorsolateral Prefrontal Cortex (l-DLPFC) and Right Orbitofrontal Cortex (OFC) in Hot and Cold Executive Functions: Evidence from Transcranial Direct Current Stimulation (tDCS)". Neuroscience. 369: 109–123. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.neuroscience.2017.10.042">10.1016/j.neuroscience.2017.10.042</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29113929">29113929</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:207258425">207258425</a>.</cite>

</li>

<li id="cite_note-Beebe2003-93">^ <a href="#cite_ref-Beebe2003_93-0">a</a> <a href="#cite_ref-Beebe2003_93-1">b</a> <cite id="CITEREFBeebeGroeszWellsNichols2003" class="citation journal cs1">Beebe DW, Groesz L, Wells C, Nichols A, McGee K (May 2003). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F26.3.298">"The neuropsychological effects of obstructive sleep apnea: a meta-analysis of norm-referenced and case-controlled data"</a>. Sleep. 26 (3): 298–307. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F26.3.298">10.1093/sleep/26.3.298</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12749549">12749549</a>.</cite>

</li>

<li id="cite_note-Wallace2013-94">^ <a href="#cite_ref-Wallace2013_94-0">a</a> <a href="#cite_ref-Wallace2013_94-1">b</a> <a href="#cite_ref-Wallace2013_94-2">c</a> <cite id="CITEREFWallaceBucks2013" class="citation journal cs1">Wallace A, Bucks RS (February 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543053">"Memory and obstructive sleep apnea: a meta-analysis"</a>. Sleep. 36 (2): 203–220. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5665%2Fsleep.2374">10.5665/sleep.2374</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3543053">3543053</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23372268">23372268</a>.</cite>

</li>

<li id="cite_note-Olaithe2017-95">^ <a href="#cite_ref-Olaithe2017_95-0">a</a> <a href="#cite_ref-Olaithe2017_95-1">b</a> <cite id="CITEREFOlaitheBucksHillmanEastwood2018" class="citation journal cs1">Olaithe, Michelle; Bucks, Romola S.; Hillman, David R.; Eastwood, Peter R. (April 2018). <a rel="nofollow" class="external text" href="https://api.research-repository.uwa.edu.au/files/34749496/Olaithe_et_al_2017_SMRV_D_16_651R2.pdf">"Cognitive deficits in obstructive sleep apnea: Insights from a meta-review and comparison with deficits observed in COPD, insomnia, and sleep deprivation"</a> (PDF). Sleep Medicine Reviews. 38: 39–49. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.smrv.2017.03.005">10.1016/j.smrv.2017.03.005</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28760549">28760549</a>.</cite>

</li>

<li id="cite_note-Rizzo2019-96"><a href="#cite_ref-Rizzo2019_96-0">^</a> <cite id="CITEREFRizzo2018" class="citation journal cs1">Rizzo D (August 2018). "Driving with obstructive sleep apnea policies, behaviors and screening measures".</cite> <code class="cs1-code">{{cite journal}}</code>: Cite journal requires <code class="cs1-code">|journal=</code> (help)

</li>

<li id="cite_note-Morrone2020-97"><a href="#cite_ref-Morrone2020_97-0">^</a> <cite id="CITEREFMorroneD'Artavilla_Lupo2020" class="citation journal cs1">Morrone E, D'Artavilla Lupo N (2020). "Microsleep as a marker of sleepiness in obstructive sleep apnea patients". Journal of Sleep Research. 29 (2) e12882. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1111%2Fjsr.12882">10.1111/jsr.12882</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31180173">31180173</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:182949124">182949124</a>.</cite>

</li>

<li id="cite_note-Cori2018-98"><a href="#cite_ref-Cori2018_98-0">^</a> <cite id="CITEREFCoriJacksonBarnesWestlake2018" class="citation journal cs1">Cori JM, Jackson ML, Barnes M, Westlake J, Emerson P, Lee J, et al. (June 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991942">"The Differential Effects of Regular Shift Work and Obstructive Sleep Apnea on Sleepiness, Mood and Neurocognitive Function"</a>. Journal of Clinical Sleep Medicine. 14 (6): 941–951. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.7156">10.5664/jcsm.7156</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5991942">5991942</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29852909">29852909</a>.</cite>

</li>

<li id="cite_note-Slater2012-99"><a href="#cite_ref-Slater2012_99-0">^</a> <cite id="CITEREFSlaterSteier2012" class="citation journal cs1">Slater G, Steier J (December 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506799">"Excessive daytime sleepiness in sleep disorders"</a>. Journal of Thoracic Disease. 4 (6): 608–616. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3978%2Fj.issn.2072-1439.2012.10.07">10.3978/j.issn.2072-1439.2012.10.07</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3506799">3506799</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23205286">23205286</a>.</cite>

</li>

<li id="cite_note-LaGrotte2016-100"><a href="#cite_ref-LaGrotte2016_100-0">^</a> <cite id="CITEREFLaGrotteFernandez-MendozaCalhounLiao2016" class="citation journal cs1">LaGrotte C, Fernandez-Mendoza J, Calhoun SL, Liao D, Bixler EO, Vgontzas AN (September 2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014694">"The relative association of obstructive sleep apnea, obesity and excessive daytime sleepiness with incident depression: a longitudinal, population-based study"</a>. International Journal of Obesity. 40 (9): 1397–1404. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1038%2Fijo.2016.87">10.1038/ijo.2016.87</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5014694">5014694</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27143032">27143032</a>.</cite>

</li>

<li id="cite_note-Mulgrew2007-101"><a href="#cite_ref-Mulgrew2007_101-0">^</a> <cite id="CITEREFMulgrewRyanFleethamCheema2007" class="citation journal cs1">Mulgrew AT, Ryan CF, Fleetham JA, Cheema R, Fox N, Koehoorn M, et al. (December 2007). "The impact of obstructive sleep apnea and daytime sleepiness on work limitation". Sleep Medicine. 9 (1): 42–53. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.sleep.2007.01.009">10.1016/j.sleep.2007.01.009</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17825611">17825611</a>.</cite>

</li>

<li id="cite_note-Guilleminault2001-102"><a href="#cite_ref-Guilleminault2001_102-0">^</a> <cite id="CITEREFGuilleminaultBrooks2001" class="citation journal cs1">Guilleminault C, Brooks SN (August 2001). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fbrain%2F124.8.1482">"Excessive daytime sleepiness: a challenge for the practising neurologist"</a>. Brain. 124 (Pt 8): 1482–1491. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fbrain%2F124.8.1482">10.1093/brain/124.8.1482</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11459741">11459741</a>.</cite>

</li>

<li id="cite_note-Jackson2018-103"><a href="#cite_ref-Jackson2018_103-0">^</a> <cite id="CITEREFJacksonMcEvoyBanksBarnes2018" class="citation journal cs1">Jackson ML, McEvoy RD, Banks S, Barnes M (January 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734892">"Neurobehavioral Impairment and CPAP Treatment Response in Mild-Moderate Obstructive Sleep Apneas"</a>. Journal of Clinical Sleep Medicine. 14 (1): 47–56. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.6878">10.5664/jcsm.6878</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5734892">5734892</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29198304">29198304</a>.</cite>

</li>

<li id="cite_note-Eskandari2017-104"><a href="#cite_ref-Eskandari2017_104-0">^</a> <cite id="CITEREFEskandariZouGroteSchneider2017" class="citation journal cs1">Eskandari D, Zou D, Grote L, Schneider H, Penzel T, Hedner J (June 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490198">"Independent associations between arterial bicarbonate, apnea severity and hypertension in obstructive sleep apnea"</a>. Respiratory Research. 18 (1) 130. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1186%2Fs12931-017-0607-9">10.1186/s12931-017-0607-9</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5490198">5490198</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28659192">28659192</a>.</cite>

</li>

<li id="cite_note-Drager2013-105">^ <a href="#cite_ref-Drager2013_105-0">a</a> <a href="#cite_ref-Drager2013_105-1">b</a> <a href="#cite_ref-Drager2013_105-2">c</a> <cite id="CITEREFDragerTogeiroPolotskyLorenzi-Filho2013" class="citation journal cs1">Drager LF, Togeiro SM, Polotsky VY, Lorenzi-Filho G (August 2013). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461232">"Obstructive sleep apnea: a cardiometabolic risk in obesity and the metabolic syndrome"</a>. Journal of the American College of Cardiology. 62 (7): 569–76. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jacc.2013.05.045">10.1016/j.jacc.2013.05.045</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4461232">4461232</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23770180">23770180</a>.</cite>

</li>

<li id="cite_note-Ashrafian2015-106">^ <a href="#cite_ref-Ashrafian2015_106-0">a</a> <a href="#cite_ref-Ashrafian2015_106-1">b</a> <cite id="CITEREFAshrafianTomaRowlandHarling2015" class="citation journal cs1">Ashrafian H, Toma T, Rowland SP, Harling L, Tan A, Efthimiou E, et al. (July 2015). "Bariatric Surgery or Non-Surgical Weight Loss for Obstructive Sleep Apnoea? A Systematic Review and Comparison of Meta-analyses". Obesity Surgery. 25 (7): 1239–1250. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11695-014-1533-2">10.1007/s11695-014-1533-2</a>. <a href="Hdl_(identifier)" class="mw-redirect" title="Hdl (identifier)">hdl</a>:<a rel="nofollow" class="external text" href="https://hdl.handle.net/10044%2F1%2F54731">10044/1/54731</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25537297">25537297</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:5284156">5284156</a>.</cite>

</li>

<li id="cite_note-Dobrosielski2015-107"><a href="#cite_ref-Dobrosielski2015_107-0">^</a> <cite id="CITEREFDobrosielskiPatilSchwartzBandeen-Roche2015" class="citation journal cs1">Dobrosielski DA, Patil S, Schwartz AR, Bandeen-Roche K, Stewart KJ (January 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246024">"Effects of exercise and weight loss in older adults with obstructive sleep apnea"</a>. Medicine and Science in Sports and Exercise. 47 (1): 20–26. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1249%2FMSS.0000000000000387">10.1249/MSS.0000000000000387</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4246024">4246024</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24870569">24870569</a>.</cite>

</li>

<li id="cite_note-pmid28527878-108">^ <a href="#cite_ref-pmid28527878_108-0">a</a> <a href="#cite_ref-pmid28527878_108-1">b</a> <a href="#cite_ref-pmid28527878_108-2">c</a> <a href="#cite_ref-pmid28527878_108-3">d</a> <cite id="CITEREFReutrakulMokhlesi2017" class="citation journal cs1">Reutrakul, Sirimon; Mokhlesi, Babak (November 2017). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812754">"Obstructive Sleep Apnea and Diabetes"</a>. Chest. 152 (5): 1070–1086. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.chest.2017.05.009">10.1016/j.chest.2017.05.009</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5812754">5812754</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28527878">28527878</a>.</cite>

</li>

<li id="cite_note-Guglielmi2018-109">^ <a href="#cite_ref-Guglielmi2018_109-0">a</a> <a href="#cite_ref-Guglielmi2018_109-1">b</a> <a href="#cite_ref-Guglielmi2018_109-2">c</a> <cite id="CITEREFGuglielmiMagnavitaGarbarino2018" class="citation journal cs1">Guglielmi O, Magnavita N, Garbarino S (May 2018). "Sleep quality, obstructive sleep apnea, and psychological distress in truck drivers: a cross-sectional study". Social Psychiatry and Psychiatric Epidemiology. 53 (5): 531–536. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00127-017-1474-x">10.1007/s00127-017-1474-x</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29285594">29285594</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:4914966">4914966</a>.</cite>

</li>

<li id="cite_note-Olaithe_2015-110">^ <a href="#cite_ref-Olaithe_2015_110-0">a</a> <a href="#cite_ref-Olaithe_2015_110-1">b</a> <a href="#cite_ref-Olaithe_2015_110-2">c</a> <cite id="CITEREFOlaitheNanthakumarEastwoodBucks2015" class="citation journal cs1">Olaithe M, Nanthakumar S, Eastwood PR, Bucks RS (2015). <a rel="nofollow" class="external text" href="http://research-repository.uwa.edu.au/en/publications/cognitive-and-mood-dysfunction-in-adult-obstructive-sleep-apnoea-osa-implications-for-psychological-research-and-practice(7590bb5c-cb4c-47ae-a09a-62fc73523aea).html">"Cognitive and Mood Dysfunction in Adult Obstructive Sleep Apnea (OSA): Implications for Psychological Research and Practice"</a>. Translational Issues in Psychological Science. 1 (1): 67–78. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1037%2Ftps0000021">10.1037/tps0000021</a>.</cite>

</li>

<li id="cite_note-Garbarino2018-111">^ <a href="#cite_ref-Garbarino2018_111-0">a</a> <a href="#cite_ref-Garbarino2018_111-1">b</a> <a href="#cite_ref-Garbarino2018_111-2">c</a> <cite id="CITEREFGarbarinoBardwellGuglielmiChiorri2018" class="citation journal cs1">Garbarino S, Bardwell WA, Guglielmi O, Chiorri C, Bonanni E, Magnavita N (2018). "Association of Anxiety and Depression in Obstructive Sleep Apnea Patients: A Systematic Review and Meta-Analysis". Behavioral Sleep Medicine. 18 (1): 35–57. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F15402002.2018.1545649">10.1080/15402002.2018.1545649</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30453780">30453780</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:53872339">53872339</a>.</cite>

</li>

<li id="cite_note-Xiao2016-112">^ <a href="#cite_ref-Xiao2016_112-0">a</a> <a href="#cite_ref-Xiao2016_112-1">b</a> <cite id="CITEREFXiaoHanZangWang2016" class="citation journal cs1">Xiao Y, Han D, Zang H, Wang D (June 2016). "The effectiveness of <a href="Nasal_surgery" title="Nasal surgery">nasal surgery</a> on psychological symptoms in patients with obstructive sleep apnea and nasal obstruction". Acta Oto-Laryngologica. 136 (6): 626–632. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.3109%2F00016489.2016.1143120">10.3109/00016489.2016.1143120</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26903174">26903174</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:10364903">10364903</a>.</cite>

</li>

<li id="cite_note-Gupta2015-113"><a href="#cite_ref-Gupta2015_113-0">^</a> <cite id="CITEREFGuptaSimpson2015" class="citation journal cs1">Gupta MA, Simpson FC (January 2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298774">"Obstructive sleep apnea and psychiatric disorders: a systematic review"</a>. Journal of Clinical Sleep Medicine. 11 (2): 165–175. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.4466">10.5664/jcsm.4466</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4298774">4298774</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25406268">25406268</a>.</cite>

</li>

<li id="cite_note-Jonas2017-114"><a href="#cite_ref-Jonas2017_114-0">^</a> <cite id="CITEREFJonasAmickFeltnerWeber2017" class="citation journal cs1">Jonas DE, Amick HR, Feltner C, Weber RP, Arvanitis M, Stine A, et al. (January 2017). "Screening for Obstructive Sleep Apnea in Adults: Evidence Report and Systematic Review for the US Preventive Services Task Force". JAMA. 317 (4): 415–433. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.2016.19635">10.1001/jama.2016.19635</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28118460">28118460</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:3656829">3656829</a>.</cite>

</li>

<li id="cite_note-Charokopos2018-115">^ <a href="#cite_ref-Charokopos2018_115-0">a</a> <a href="#cite_ref-Charokopos2018_115-1">b</a> <cite id="CITEREFCharokoposCardGundersonSteffens2018" class="citation journal cs1">Charokopos A, Card ME, Gunderson C, Steffens C, Bastian LA (September 2018). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fpm%2Fpny140">"The Association of Obstructive Sleep Apnea and Pain Outcomes in Adults: A Systematic Review"</a>. Pain Medicine. 19 (suppl_1): S69 – S75. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fpm%2Fpny140">10.1093/pm/pny140</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30203008">30203008</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:52182664">52182664</a>.</cite>

</li>

<li id="cite_note-pmid17283346-116"><a href="#cite_ref-pmid17283346_116-0">^</a> <cite id="CITEREFMulgrewFoxAyasRyan2007" class="citation journal cs1">Mulgrew AT, Fox N, Ayas NT, Ryan CF (February 2007). "Diagnosis and initial management of obstructive sleep apnea without polysomnography: a randomized validation study". Annals of Internal Medicine. 146 (3): 157–166. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7326%2F0003-4819-146-3-200702060-00004">10.7326/0003-4819-146-3-200702060-00004</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17283346">17283346</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:25693423">25693423</a>.</cite>

</li>

<li id="cite_note-pmid7952553-117"><a href="#cite_ref-pmid7952553_117-0">^</a> <cite id="CITEREFFlemonsWhitelawBrantRemmers1994" class="citation journal cs1">Flemons WW, Whitelaw WA, Brant R, Remmers JE (November 1994). "Likelihood ratios for a sleep apnea clinical prediction rule". American Journal of Respiratory and Critical Care Medicine. 150 (5 Pt 1): 1279–1285. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Fajrccm.150.5.7952553">10.1164/ajrccm.150.5.7952553</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/7952553">7952553</a>.</cite>

</li>

<li id="cite_note-Friedman2008-118">^ <a href="#cite_ref-Friedman2008_118-0">a</a> <a href="#cite_ref-Friedman2008_118-1">b</a> Friedman: Sleep Apnea and Snoring, 1st ed. 2008

</li>

<li id="cite_note-Aza2012-119"><a href="#cite_ref-Aza2012_119-0">^</a> <cite id="CITEREFAzagra-CaleroEspinar-EscalonaBarrera-MoraLlamas-Carreras2012" class="citation journal cs1">Azagra-Calero E, Espinar-Escalona E, Barrera-Mora JM, Llamas-Carreras JM, Solano-Reina E (November 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505711">"Obstructive sleep apnea syndrome (OSAS). Review of the literature"</a>. Medicina Oral, Patologia Oral y Cirugia Bucal. 17 (6): e925–929. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.4317%2Fmedoral.17706">10.4317/medoral.17706</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3505711">3505711</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22549673">22549673</a>.</cite>

</li>

<li id="cite_note-Qa2013-120">^ <a href="#cite_ref-Qa2013_120-0">a</a> <a href="#cite_ref-Qa2013_120-1">b</a> <a href="#cite_ref-Qa2013_120-2">c</a> <a href="#cite_ref-Qa2013_120-3">d</a> <a href="#cite_ref-Qa2013_120-4">e</a> <a href="#cite_ref-Qa2013_120-5">f</a> <cite id="CITEREFQaseemHoltyOwensDallas2013" class="citation journal cs1">Qaseem, Amir; Holty, Jon-Erik C.; Owens, Douglas K.; Dallas, Paul; Starkey, Melissa; Shekelle, Paul; Clinical Guidelines Committee of the American College of, Physicians. (1 October 2013). <a rel="nofollow" class="external text" href="https://doi.org/10.7326%2F0003-4819-159-7-201310010-00704">"Management of Obstructive Sleep Apnea in Adults: A Clinical Practice Guideline From the American College of Physicians"</a>. Annals of Internal Medicine. 159 (7): 471–483. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7326%2F0003-4819-159-7-201310010-00704">10.7326/0003-4819-159-7-201310010-00704</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24061345">24061345</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:6241714">6241714</a>.</cite>

</li>

<li id="cite_note-Brat2015-121"><a href="#cite_ref-Brat2015_121-0">^</a> <cite id="CITEREFBrattonGaislWonsKohler2015" class="citation journal cs1">Bratton DJ, Gaisl T, Wons AM, Kohler M (December 2015). <a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.2015.16303">"CPAP vs Mandibular Advancement Devices and Blood Pressure in Patients With Obstructive Sleep Apnea: A Systematic Review and Meta-analysis"</a>. JAMA. 314 (21): 2280–2293. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.2015.16303">10.1001/jama.2015.16303</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26624827">26624827</a>.</cite>

</li>

<li id="cite_note-122"><a href="#cite_ref-122">^</a> <cite id="CITEREFIftikharKlineYoungstedt2014" class="citation journal cs1">Iftikhar IH, Kline CE, Youngstedt SD (February 2014). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216726">"Effects of exercise training on sleep apnea: a meta-analysis"</a>. Lung. 192 (1): 175–184. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs00408-013-9511-3">10.1007/s00408-013-9511-3</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4216726">4216726</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24077936">24077936</a>.</cite>

</li>

<li id="cite_note-123"><a href="#cite_ref-123">^</a> <cite id="CITEREFBrowaldhNerfeldtLysdahlBring2013" class="citation journal cs1">Browaldh N, Nerfeldt P, Lysdahl M, Bring J, Friberg D (September 2013). <a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2012-202610">"SKUP3 randomised controlled trial: polysomnographic results after uvulopalatopharyngoplasty in selected patients with obstructive sleep apnoea"</a>. Thorax. 68 (9): 846–853. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2012-202610">10.1136/thoraxjnl-2012-202610</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23644225">23644225</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:27682387">27682387</a>.</cite>

</li>

<li id="cite_note-pmid30056286-124">^ <a href="#cite_ref-pmid30056286_124-0">a</a> <a href="#cite_ref-pmid30056286_124-1">b</a> <cite id="CITEREFStuckRaveslootEschenhagende_Vet2018" class="citation journal cs1">Stuck, Boris A.; Ravesloot, Madeline J. L.; Eschenhagen, Till; de Vet, H. C. W.; Sommer, J. Ulrich (1 October 2018). "Uvulopalatopharyngoplasty with or without tonsillectomy in the treatment of adult obstructive sleep apnea – A systematic review". Sleep Medicine. 50: 152–165. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.sleep.2018.05.004">10.1016/j.sleep.2018.05.004</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30056286">30056286</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:51878426">51878426</a>.</cite>

</li>

<li id="cite_note-Gil2006-125">^ <a href="#cite_ref-Gil2006_125-0">a</a> <a href="#cite_ref-Gil2006_125-1">b</a> <cite id="CITEREFGilesLassersonSmithWhite2006" class="citation journal cs1">Giles TL, Lasserson TJ, Smith BH, White J, Wright J, Cates CJ (July 2006). Giles T (ed.). "Continuous positive airways pressure for obstructive sleep apnoea in adults". The Cochrane Database of Systematic Reviews (3): CD001106. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD001106.pub3">10.1002/14651858.CD001106.pub3</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16855960">16855960</a>.</cite>

</li>

<li id="cite_note-:2-126">^ <a href="#cite_ref-:2_126-0">a</a> <a href="#cite_ref-:2_126-1">b</a> <a href="#cite_ref-:2_126-2">c</a> <a href="#cite_ref-:2_126-3">d</a> <cite id="CITEREFAsklandWrightWozniakEmmanuel2020" class="citation journal cs1">Askland, Kathleen; Wright, Lauren; Wozniak, Dariusz R; Emmanuel, Talia; Caston, Jessica; Smith, Ian (7 April 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137251">"Educational, supportive and behavioural interventions to improve usage of continuous positive airway pressure machines in adults with obstructive sleep apnoea"</a>. Cochrane Database of Systematic Reviews. 2020 (4): CD007736. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD007736.pub3">10.1002/14651858.CD007736.pub3</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7137251">7137251</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32255210">32255210</a>.</cite>

</li>

<li id="cite_note-Riaz2015rev-127"><a href="#cite_ref-Riaz2015rev_127-0">^</a> <cite id="CITEREFRiazCertalNigamAbdullatif2015" class="citation journal cs1">Riaz M, Certal V, Nigam G, Abdullatif J, Zaghi S, Kushida CA, Camacho M (2015). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699057">"Nasal Expiratory Positive Airway Pressure Devices (Provent) for OSA: A Systematic Review and Meta-Analysis"</a>. Sleep Disorders. 2015: 734798. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1155%2F2015%2F734798">10.1155/2015/734798</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4699057">4699057</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26798519">26798519</a>.</cite>

</li>

<li id="cite_note-pmid15486338-128"><a href="#cite_ref-pmid15486338_128-0">^</a> <cite id="CITEREFWhitelawBrantFlemons2005" class="citation journal cs1">Whitelaw, William A.; Brant, Rollin F.; Flemons, W. Ward (15 January 2005). "Clinical Usefulness of Home Oximetry Compared with Polysomnography for Assessment of Sleep Apnea". American Journal of Respiratory and Critical Care Medicine. 171 (2): 188–193. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Frccm.200310-1360OC">10.1164/rccm.200310-1360OC</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15486338">15486338</a>.</cite> Review in: <cite id="CITEREFCaples2005" class="citation journal cs1">Caples SM (2005). "The accuracy of physicians in predicting successful treatment response in suspected obstructive sleep apnea did not differ between home monitoring and polysomnography". ACP Journal Club. 143 (1): 21. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.7326%2FACPJC-2005-143-1-021">10.7326/ACPJC-2005-143-1-021</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15989309">15989309</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:219673066">219673066</a>.</cite>

</li>

<li id="cite_note-pmid11902424-129"><a href="#cite_ref-pmid11902424_129-0">^</a> <cite id="CITEREFLittnerHirshkowitzDavilaAnderson2002" class="citation journal cs1">Littner M, Hirshkowitz M, Davila D, Anderson WM, Kushida CA, Woodson BT, et al. (March 2002). "Practice parameters for the use of auto-titrating continuous positive airway pressure devices for titrating pressures and treating adult patients with obstructive sleep apnea syndrome. An American Academy of Sleep Medicine report". Sleep. 25 (2): 143–147. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F25.2.143">10.1093/sleep/25.2.143</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11902424">11902424</a>.</cite>

</li>

<li id="cite_note-130"><a href="#cite_ref-130">^</a> <cite id="CITEREFMcNicholasBonsignoreLévyRyan2016" class="citation journal cs1">McNicholas WT, Bonsignore MR, Lévy P, Ryan S (October 2016). "Mild obstructive sleep apnoea: clinical relevance and approaches to management". The Lancet. Respiratory Medicine. 4 (10): 826–834. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2FS2213-2600%2816%2930146-1">10.1016/S2213-2600(16)30146-1</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27245915">27245915</a>.</cite>

</li>

<li id="cite_note-131"><a href="#cite_ref-131">^</a> <cite id="CITEREFNeillAngusSajkovMcEvoy1997" class="citation journal cs1">Neill AM, Angus SM, Sajkov D, McEvoy RD (January 1997). "Effects of sleep posture on upper airway stability in patients with obstructive sleep apnea". American Journal of Respiratory and Critical Care Medicine. 155 (1): 199–204. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Fajrccm.155.1.9001312">10.1164/ajrccm.155.1.9001312</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/9001312">9001312</a>.</cite>

</li>

<li id="cite_note-132"><a href="#cite_ref-132">^</a> <cite id="CITEREFNakanoIkedaHayashiOhshima2003" class="citation journal cs1">Nakano H, Ikeda T, Hayashi M, Ohshima E, Onizuka A (March 2003). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F26.2.169">"Effects of body position on snoring in apneic and nonapneic snorers"</a>. Sleep. 26 (2): 169–172. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F26.2.169">10.1093/sleep/26.2.169</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/12683476">12683476</a>.</cite>

</li>

<li id="cite_note-133"><a href="#cite_ref-133">^</a> <cite id="CITEREFLoordHultcrantz2007" class="citation journal cs1">Loord H, Hultcrantz E (August 2007). "Positioner--a method for preventing sleep apnea". Acta Oto-Laryngologica. 127 (8): 861–868. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1080%2F00016480601089390">10.1080/00016480601089390</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17762999">17762999</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:323418">323418</a>.</cite>

</li>

<li id="cite_note-134"><a href="#cite_ref-134">^</a> <cite id="CITEREFSzollosiRoebuckThompsonNaughton2006" class="citation journal cs1">Szollosi I, Roebuck T, Thompson B, Naughton MT (August 2006). <a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F29.8.1045">"Lateral sleeping position reduces severity of central sleep apnea / Cheyne-Stokes respiration"</a>. Sleep. 29 (8): 1045–1051. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2F29.8.1045">10.1093/sleep/29.8.1045</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16944673">16944673</a>.</cite>

</li>

<li id="cite_note-135"><a href="#cite_ref-135">^</a> <cite id="CITEREFCaba2015" class="citation news cs1">Caba, Justin (16 April 2015). <a rel="nofollow" class="external text" href="https://www.medicaldaily.com/learning-play-wind-instrument-could-lower-your-risk-obstructive-sleep-apnea-329582">"How The Saxophone Could Solve Your Sleep Apnea"</a>. Medical Daily.</cite>

</li>

<li id="cite_note-136"><a href="#cite_ref-136">^</a> <cite id="CITEREFPuhanSuarezLo_CascioZahn2006" class="citation journal cs1">Puhan, Milo A.; Suarez, Alex; Lo Cascio, Christian; Zahn, Alfred; Heitz, Markus; Braendli, Otto (2006-02-04). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393">"Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial"</a>. BMJ (Clinical Research Ed.). 332 (7536): 266–270. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.38705.470590.55">10.1136/bmj.38705.470590.55</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1756-1833">1756-1833</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393">1360393</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16377643">16377643</a>.</cite>

</li>

<li id="cite_note-137"><a href="#cite_ref-137">^</a> <cite id="CITEREFWardYorkMcCoy2012" class="citation journal cs1">Ward, Christopher P.; York, Kaki M.; McCoy, John G. (15 June 2012). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365082">"Risk of Obstructive Sleep Apnea Lower in Double Reed Wind Musicians"</a>. Journal of Clinical Sleep Medicine. 08 (3): 251–255. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.1906">10.5664/jcsm.1906</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365082">3365082</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22701381">22701381</a>.</cite>

</li>

<li id="cite_note-138"><a href="#cite_ref-138">^</a> <cite id="CITEREFGaislHaileThielOsswald2019" class="citation journal cs1">Gaisl, Thomas; Haile, Sarah R.; Thiel, Sira; Osswald, Martin; Kohler, Malcolm (August 2019). "Efficacy of pharmacotherapy for OSA in adults: A systematic review and network meta-analysis". Sleep Medicine Reviews. 46: 74–86. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.smrv.2019.04.009">10.1016/j.smrv.2019.04.009</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/31075665">31075665</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:149455430">149455430</a>.</cite>

</li>

<li id="cite_note-Gottlieb-139"><a href="#cite_ref-Gottlieb_139-0">^</a> <cite id="CITEREFGottliebPunjabi2020" class="citation journal cs1">Gottlieb, Daniel J.; Punjabi, Naresh M. (14 April 2020). "Diagnosis and Management of Obstructive Sleep Apnea: A Review". JAMA. 323 (14): 1389–1400. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.2020.3514">10.1001/jama.2020.3514</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32286648">32286648</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:215759986">215759986</a>.</cite>

</li>

<li id="cite_note-Vea2003-140"><a href="#cite_ref-Vea2003_140-0">^</a> <cite id="CITEREFVeasey2003" class="citation journal cs1">Veasey, Sigrid C. (1 February 2003). "Serotonin Agonists and Antagonists in Obstructive Sleep Apnea". American Journal of Respiratory Medicine. 2 (1): 21–29. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2FBF03256636">10.1007/BF03256636</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14720019">14720019</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:8288291">8288291</a>.</cite>

</li>

<li id="cite_note-Babson2017-141"><a href="#cite_ref-Babson2017_141-0">^</a> <cite id="CITEREFBabsonSottileMorabito2017" class="citation journal cs1">Babson, Kimberly A.; Sottile, James; Morabito, Danielle (27 March 2017). "Cannabis, Cannabinoids, and Sleep: a Review of the Literature". Current Psychiatry Reports. 19 (4): 23. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1007%2Fs11920-017-0775-9">10.1007/s11920-017-0775-9</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28349316">28349316</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:7429763">7429763</a>.</cite>

</li>

<li id="cite_note-Carley2018-142"><a href="#cite_ref-Carley2018_142-0">^</a> <cite id="CITEREFCarleyPrasadReidMalkani2018" class="citation journal cs1">Carley, David W.; Prasad, Bharati; Reid, Kathryn J.; Malkani, Roneil; Attarian, Hryar; Abbott, Sabra M.; Vern, Boris; Xie, Hui; Yuan, Chengbo; Zee, Phyllis C. (1 January 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806568">"Pharmacotherapy of Apnea by Cannabimimetic Enhancement, the PACE Clinical Trial: Effects of Dronabinol in Obstructive Sleep Apnea"</a>. Sleep. 41 (1). <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1093%2Fsleep%2Fzsx184">10.1093/sleep/zsx184</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5806568">5806568</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29121334">29121334</a>.</cite>

</li>

<li id="cite_note-Ramar2018-143">^ <a href="#cite_ref-Ramar2018_143-0">a</a> <a href="#cite_ref-Ramar2018_143-1">b</a> <cite id="CITEREFRamarRosenKirschChervin2018" class="citation journal cs1">Ramar, Kannan; Rosen, Ilene M.; Kirsch, Douglas B.; Chervin, Ronald D.; Carden, Kelly A.; Aurora, R. Nisha; Kristo, David A.; Malhotra, Raman K.; Martin, Jennifer L.; Olson, Eric J.; Rosen, Carol L.; Rowley, James A. (15 April 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886446">"Medical Cannabis and the Treatment of Obstructive Sleep Apnea: An American Academy of Sleep Medicine Position Statement"</a>. Journal of Clinical Sleep Medicine. 14 (4): 679–681. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.7070">10.5664/jcsm.7070</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5886446">5886446</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29609727">29609727</a>.</cite>

</li>

<li id="cite_note-Kolla2018-144"><a href="#cite_ref-Kolla2018_144-0">^</a> <cite id="CITEREFKollaMansukhaniOlsonSt._Louis2018" class="citation journal cs1">Kolla, Bhanu Prakash; Mansukhani, Meghna P.; Olson, Eric J.; St. Louis, Erik K.; Silber, Michael H.; Morgenthaler, Timothy I. (June 2018). "Medical Cannabis for Obstructive Sleep Apnea: Premature and Potentially Harmful". Mayo Clinic Proceedings. 93 (6): 689–692. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.mayocp.2018.04.011">10.1016/j.mayocp.2018.04.011</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/29866280">29866280</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:46936292">46936292</a>.</cite>

</li>

<li id="cite_note-145"><a href="#cite_ref-145">^</a> <cite id="CITEREFRamarKirschCardenRosen2018" class="citation journal cs1">Ramar, Kannan; Kirsch, Douglas B.; Carden, Kelly A.; Rosen, Ilene M.; Malhotra, Raman K. (15 October 2018). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175803">"Medical Cannabis, Synthetic Marijuana Extracts, and Obstructive Sleep Apnea"</a>. Journal of Clinical Sleep Medicine. 14 (10): 1815–1816. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.7412">10.5664/jcsm.7412</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6175803">6175803</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30353829">30353829</a>.</cite>

</li>

<li id="cite_note-146"><a href="#cite_ref-146">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://emedicine.medscape.com/article/295807-medication">"Obstructive Sleep Apnea (OSA) Medication: CNS stimulants, Dopamine/Norepinephrine Reuptake Inhibitors"</a>. emedicine.medscape.com. Retrieved 2024-08-15.</cite>

</li>

<li id="cite_note-147"><a href="#cite_ref-147">^</a> <cite id="CITEREFGreenblattAdams2024" class="citation cs2">Greenblatt, Karl; Adams, Ninos (2024), <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/books/NBK531476/">"Modafinil"</a>, StatPearls, Treasure Island (FL): StatPearls Publishing, <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30285371">30285371</a>, retrieved 2024-08-15</cite>

</li>

<li id="cite_note-148"><a href="#cite_ref-148">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.medicalnewstoday.com/articles/sunosi">"Sunosi: Side effects, alternatives, uses, dosage, and more"</a>. www.medicalnewstoday.com. 2020-09-23. Retrieved 2024-08-15.</cite>

</li>

<li id="cite_note-149"><a href="#cite_ref-149">^</a> <cite id="CITEREFMalhotraGrunsteinFietzeWeaver2024" class="citation journal cs1">Malhotra, Atul; Grunstein, Ronald R.; Fietze, Ingo; Weaver, Terri E.; Redline, Susan; Azarbarzin, Ali; Sands, Scott A.; Schwab, Richard J.; Dunn, Julia P.; Chakladar, Sujatro; Bunck, Mathijs C.; Bednarik, Josef (2024-06-21). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598664">"Tirzepatide for the Treatment of Obstructive Sleep Apnea and Obesity"</a>. New England Journal of Medicine. 391 (13): 1193–1205. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMoa2404881">10.1056/NEJMoa2404881</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/0028-4793">0028-4793</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11598664">11598664</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/38912654">38912654</a>.</cite>

</li>

<li id="cite_note-150"><a href="#cite_ref-150">^</a> <cite id="CITEREFCommissioner2024" class="citation web cs1">Commissioner, Office of the (2024-12-27). <a rel="nofollow" class="external text" href="https://www.fda.gov/news-events/press-announcements/fda-approves-first-medication-obstructive-sleep-apnea">"FDA Approves First Medication for Obstructive Sleep Apnea"</a>. FDA. Retrieved 2025-07-31.</cite>

</li>

<li id="cite_note-151"><a href="#cite_ref-151">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://www.thedaybreak.com/resources/is-sleep-apnea-covered-by-insurance-a-comprehensive-guide">"Is Sleep Apnea Covered by Insurance? A Comprehensive Guide | Daybreak"</a>. www.thedaybreak.com. Retrieved 2025-07-31.</cite>

</li>

<li id="cite_note-Deenadayal2022-152">^ <a href="#cite_ref-Deenadayal2022_152-0">a</a> <a href="#cite_ref-Deenadayal2022_152-1">b</a> <a href="#cite_ref-Deenadayal2022_152-2">c</a> <cite id="CITEREFDeenadayalBommakanti2022" class="citation book cs1">Deenadayal, DS; Bommakanti, V (4 January 2022). Management of Snoring and Obstructive Sleep Apnea: A Practical Guide. Springer Nature. pp. 1, 4, 14, 29, 34, 44, 50, 51, 55, 56, 64, 98. <a href="ISBN_(identifier)" class="mw-redirect" title="ISBN (identifier)">ISBN</a> <bdi>978-981-16-6620-9</bdi>.</cite>

</li>

<li id="cite_note-153"><a href="#cite_ref-153">^</a> <cite id="CITEREFRose2004" class="citation journal cs1">Rose, E (2004). "Identifying the Ideal Oral Appliance Candidate". Journal of Orofacial Orthopedics. 65: 6.</cite>

</li>

<li id="cite_note-154"><a href="#cite_ref-154">^</a> <cite id="CITEREFChanLeeCistulli2007" class="citation journal cs1">Chan, A; Lee, R; Cistulli, PA (Aug 2007). "Oral Appliances for Obstructive Sleep Apnea". Chest. 132 (2): 693–9. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.06-2038">10.1378/chest.06-2038</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/17699143">17699143</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:14252887">14252887</a>.</cite>

</li>

<li id="cite_note-155"><a href="#cite_ref-155">^</a> Lazard DS, Blumen M, Levy P, Chauvin P, Fragny D, Buchet I, Chabolle F. The tongue-retaining device: efficacy and side effects in obstructive sleep apnea syndrome. Journal of Clinical Sleep Medicine. 2009 Oct 15;5(5):431-8.

</li>

<li id="cite_note-156"><a href="#cite_ref-156">^</a> <cite id="CITEREFCartwrightStefoskiCaldarelliKravitz1988" class="citation journal cs1">Cartwright, Rosalind; Stefoski, Dusan; Caldarelli, David; Kravitz, Howard; Knight, Sara; Lloyd, Stephen; Samelson, Charles (1988). "Toward a treatment logic for sleep apnea: The place of the tongue retaining device". Behaviour Research and Therapy. 26 (2): 121–126. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2F0005-7967%2888%2990111-8">10.1016/0005-7967(88)90111-8</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/3365202">3365202</a>.</cite>

</li>

<li id="cite_note-157"><a href="#cite_ref-157">^</a> <cite id="CITEREFLazardBlumenLevyChauvin2009" class="citation journal cs1">Lazard, Diane S.; Blumen, Marc; Levy, Pierre; Chauvin, Pierre; Fragny, Dorothee; Buchet, Isabelle; Chabolle, Frederic (15 October 2009). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762714">"The Tongue-Retaining Device: Efficacy and Side Effects in Obstructive Sleep Apnea Syndrome"</a>. Journal of Clinical Sleep Medicine. 5 (5): 431–438. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.5664%2Fjcsm.27598">10.5664/jcsm.27598</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2762714">2762714</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19961027">19961027</a>.</cite>

</li>

<li id="cite_note-158"><a href="#cite_ref-158">^</a> <cite id="CITEREFCarvalhoLentini-OliveiraPradoPrado2016" class="citation journal cs1">Carvalho, Fernando R; Lentini-Oliveira, Débora A; Prado, Lucila BF; Prado, Gilmar F; Carvalho, Luciane BC (4 October 2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458031">"Oral appliances and functional orthopaedic appliances for obstructive sleep apnoea in children"</a>. Cochrane Database of Systematic Reviews. 10 (11): CD005520. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2F14651858.CD005520.pub3">10.1002/14651858.CD005520.pub3</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6458031">6458031</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27701747">27701747</a>.</cite>

</li>

<li id="cite_note-159"><a href="#cite_ref-159">^</a> <cite id="CITEREFLiTangLiuLuo2020" class="citation journal cs1">Li, Qiming; Tang, Hongyi; Liu, Xueye; Luo, Qing; Jiang, Zhe; Martin, Domingo; Guo, Jing (1 May 2020). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032299">"Comparison of dimensions and volume of upper airway before and after mini-implant assisted rapid maxillary expansion"</a>. The Angle Orthodontist. 90 (3): 432–441. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.2319%2F080919-522.1">10.2319/080919-522.1</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8032299">8032299</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/32045299">32045299</a>.</cite>

</li>

<li id="cite_note-160"><a href="#cite_ref-160">^</a> <cite id="CITEREFAbdullatifCertalZaghiSong2016" class="citation journal cs1">Abdullatif, Jose; Certal, Victor; Zaghi, Soroush; Song, Sungjin A.; Chang, Edward T.; Gillespie, M. Boyd; Camacho, Macario (1 May 2016). "Maxillary expansion and maxillomandibular expansion for adult OSA: A systematic review and meta-analysis". Journal of Cranio-Maxillofacial Surgery. 44 (5): 574–578. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.jcms.2016.02.001">10.1016/j.jcms.2016.02.001</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26948172">26948172</a>.</cite>

</li>

<li id="cite_note-161"><a href="#cite_ref-161">^</a> <cite id="CITEREFBrowaldhNerfeldtLysdahlBring2013" class="citation journal cs1">Browaldh, Nanna; Nerfeldt, Pia; Lysdahl, Michael; Bring, Johan; Friberg, Danielle (1 September 2013). <a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2012-202610">"SKUP3 randomised controlled trial: polysomnographic results after uvulopalatopharyngoplasty in selected patients with obstructive sleep apnoea"</a>. Thorax. 68 (9): 846–853. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fthoraxjnl-2012-202610">10.1136/thoraxjnl-2012-202610</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/23644225">23644225</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:27682387">27682387</a>.</cite>

</li>

<li id="cite_note-onlinelibrary.wiley.com-162">^ <a href="#cite_ref-onlinelibrary.wiley.com_162-0">a</a> <a href="#cite_ref-onlinelibrary.wiley.com_162-1">b</a> <cite id="CITEREFTschoppTschopp2019" class="citation journal cs1">Tschopp, Samuel; Tschopp, Kurt (2019). <a rel="nofollow" class="external text" href="https://onlinelibrary.wiley.com/doi/abs/10.1002/lary.27899">"Tonsil size and outcome of uvulopalatopharyngoplasty with tonsillectomy in obstructive sleep apnea"</a>. The Laryngoscope. 129 (12): E449 – E454. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1002%2Flary.27899">10.1002/lary.27899</a>. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/1531-4995">1531-4995</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/30848478">30848478</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:73503702">73503702</a>.</cite>

</li>

<li id="cite_note-163"><a href="#cite_ref-163">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20080430151746/http://www.umm.edu/patiented/articles/what_surgical_procedures_sleep_apnea_000065_10.htm">"Sleep apnea"</a>. University of Maryland Medical Center. Archived from <a rel="nofollow" class="external text" href="http://www.umm.edu/patiented/articles/what_surgical_procedures_sleep_apnea_000065_10.htm">the original</a> on 2008-04-30.</cite>

</li>

<li id="cite_note-164"><a href="#cite_ref-164">^</a> <cite id="CITEREFShahBotrosYaggiMohsenin2007" class="citation pressrelease cs1">Shah NA, Botros NA, Yaggi HK, Mohsenin V (May 20, 2007). <a rel="nofollow" class="external text" href="https://web.archive.org/web/20090524193435/http://www.thoracic.org/sections/publications/press-releases/conference/articles/2007/press-releases/sleep-apnea-increases-risk-of-heart-attack-or-death-by-30.html">"Sleep Apnea Increases Risk of Heart Attack or Death by 30%"</a> (Press release). New Haven, Connecticut: American Thoracic Society. Archived from <a rel="nofollow" class="external text" href="http://www.thoracic.org/sections/publications/press-releases/conference/articles/2007/press-releases/sleep-apnea-increases-risk-of-heart-attack-or-death-by-30.html">the original</a> on May 24, 2009.</cite>

</li>

<li id="cite_note-pmid24445697-165"><a href="#cite_ref-pmid24445697_165-0">^</a> <cite id="CITEREFSunYuanZhaoWang2014" class="citation journal cs1">Sun, Yi; Yuan, Hai; Zhao, Miao-Qing; Wang, Yan; Xia, Ming; Li, Yan-Zhong (April 2014). <a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F0300060513502890">"Cardiac structural and functional changes in old elderly patients with obstructive sleep apnoea–hypopnoea syndrome"</a>. Journal of International Medical Research. 42 (2): 395–404. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1177%2F0300060513502890">10.1177/0300060513502890</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/24445697">24445697</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:23011075">23011075</a>.</cite>

</li>

<li id="cite_note-Sleep_Apnea-166"><a href="#cite_ref-Sleep_Apnea_166-0">^</a> <cite id="CITEREFSilverbergIainaOksenberg2002" class="citation journal cs1">Silverberg DS, Iaina A, Oksenberg A (January 2002). "Treating obstructive sleep apnea improves essential hypertension and quality of life". American Family Physician. 65 (2): 229–236. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/11820487">11820487</a>.</cite>

</li>

<li id="cite_note-167"><a href="#cite_ref-167">^</a> <cite id="CITEREFGrigg-Damberger2006" class="citation journal cs1">Grigg-Damberger, Madeleine (February 2006). "Why a Polysomnogram Should Become Part of the Diagnostic Evaluation of Stroke and Transient Ischemic Attack". Journal of Clinical Neurophysiology. 23 (1): 21–38. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1097%2F01.wnp.0000201077.44102.80">10.1097/01.wnp.0000201077.44102.80</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16514349">16514349</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:19626174">19626174</a>.</cite>

</li>

<li id="cite_note-168"><a href="#cite_ref-168">^</a> <cite id="CITEREFGaislBrattonKohler2015" class="citation journal cs1">Gaisl T, Bratton DJ, Kohler M (August 2015). <a rel="nofollow" class="external text" href="https://doi.org/10.1183%2F09031936.00029315">"The impact of obstructive sleep apnoea on the aorta"</a>. The European Respiratory Journal. 46 (2): 532–544. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1183%2F09031936.00029315">10.1183/09031936.00029315</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/26113685">26113685</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:14458813">14458813</a>.</cite>

</li>

<li id="cite_note-169"><a href="#cite_ref-169">^</a> <cite id="CITEREFPeppardYoungPaltaSkatrud2000" class="citation journal cs1">Peppard, Paul E.; Young, Terry; Palta, Mari; Skatrud, James (11 May 2000). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJM200005113421901">"Prospective Study of the Association between Sleep-Disordered Breathing and Hypertension"</a>. New England Journal of Medicine. 342 (19): 1378–1384. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJM200005113421901">10.1056/NEJM200005113421901</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10805822">10805822</a>.</cite>

</li>

<li id="cite_note-170"><a href="#cite_ref-170">^</a> <cite id="CITEREFLavieHererHoffstein2000" class="citation journal cs1">Lavie, P.; Herer, P; Hoffstein, V (19 February 2000). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27290">"Obstructive sleep apnoea syndrome as a risk factor for hypertension: population study"</a>. BMJ. 320 (7233): 479–482. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.320.7233.479">10.1136/bmj.320.7233.479</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC27290">27290</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/10678860">10678860</a>.</cite>

</li>

<li id="cite_note-171"><a href="#cite_ref-171">^</a> <cite id="CITEREFYaggiConcatoKernanLichtman2005" class="citation journal cs1">Yaggi, H. Klar; Concato, John; Kernan, Walter N.; Lichtman, Judith H.; Brass, Lawrence M.; Mohsenin, Vahid (10 November 2005). <a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMoa043104">"Obstructive Sleep Apnea as a Risk Factor for Stroke and Death"</a>. New England Journal of Medicine. 353 (19): 2034–2041. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1056%2FNEJMoa043104">10.1056/NEJMoa043104</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16282178">16282178</a>. <a href="S2CID_(identifier)" class="mw-redirect" title="S2CID (identifier)">S2CID</a> <a rel="nofollow" class="external text" href="https://api.semanticscholar.org/CorpusID:23360654">23360654</a>.</cite>

</li>

<li id="cite_note-pmid15982424-172"><a href="#cite_ref-pmid15982424_172-0">^</a> <cite id="CITEREFSchröderO'Hara2005" class="citation journal cs1">Schröder, Carmen M; O'Hara, Ruth (2005). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1181621">"Depression and Obstructive Sleep Apnea (OSA)"</a>. Annals of General Psychiatry. 4 (1): 13. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1186%2F1744-859X-4-13">10.1186/1744-859X-4-13</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1181621">1181621</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/15982424">15982424</a>.</cite>

</li>

<li id="cite_note-173"><a href="#cite_ref-173">^</a> <cite id="CITEREFGagnonBarilGagnonFortin2014" class="citation journal cs1">Gagnon K, Baril AA, Gagnon JF, Fortin M, Décary A, Lafond C, et al. (October 2014). "Cognitive impairment in obstructive sleep apnea". Pathologie-Biologie. 62 (5): 233–240. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.patbio.2014.05.015">10.1016/j.patbio.2014.05.015</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/25070768">25070768</a>.</cite>

</li>

<li id="cite_note-174"><a href="#cite_ref-174">^</a> <cite id="CITEREFLalStrangeBachman2012" class="citation journal cs1">Lal C, Strange C, Bachman D (June 2012). "Neurocognitive impairment in obstructive sleep apnea". Chest. 141 (6): 1601–1610. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1378%2Fchest.11-2214">10.1378/chest.11-2214</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/22670023">22670023</a>.</cite>

</li>

<li id="cite_note-punjabi2008-175">^ <a href="#cite_ref-punjabi2008_175-0">a</a> <a href="#cite_ref-punjabi2008_175-1">b</a> <cite id="CITEREFPunjabi2008" class="citation journal cs1">Punjabi NM (February 2008). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645248">"The epidemiology of adult obstructive sleep apnea"</a>. Proceedings of the American Thoracic Society. 5 (2): 136–43. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1513%2Fpats.200709-155MG">10.1513/pats.200709-155MG</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2645248">2645248</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/18250205">18250205</a>.</cite>

</li>

<li id="cite_note-:0-176">^ <a href="#cite_ref-:0_176-0">a</a> <a href="#cite_ref-:0_176-1">b</a> <a href="#cite_ref-:0_176-2">c</a> <a href="#cite_ref-:0_176-3">d</a> <cite id="CITEREFSenaratnaPerretLodgeLowe2017" class="citation journal cs1">Senaratna CV, Perret JL, Lodge CJ, Lowe AJ, Campbell BE, Matheson MC, et al. (August 2017). "Prevalence of obstructive sleep apnea in the general population: A systematic review". Sleep Medicine Reviews. 34: 70–81. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.smrv.2016.07.002">10.1016/j.smrv.2016.07.002</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/27568340">27568340</a>.</cite>

</li>

<li id="cite_note-177"><a href="#cite_ref-177">^</a> <cite id="CITEREFJehanAugusteZiziPandi-Perumal2016" class="citation journal cs1">Jehan, Shazia; Auguste, Evan; Zizi, Ferdinand; Pandi-Perumal, Seithikurippu R.; Gupta, Ravi; Attarian, Hrayr; Jean-Louis, Giradin; McFarlane, Samy I. (2016). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323064">"Obstructive Sleep Apnea: Women's Perspective"</a>. Journal of Sleep Medicine and Disorders. 3 (6): 1064. <a href="ISSN_(identifier)" class="mw-redirect" title="ISSN (identifier)">ISSN</a> <a rel="nofollow" class="external text" href="https://search.worldcat.org/issn/2379-0822">2379-0822</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5323064">5323064</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/28239685">28239685</a>.</cite>

</li>

<li id="cite_note-facial_phenotype-178"><a href="#cite_ref-facial_phenotype_178-0">^</a> <cite id="CITEREFShamsuzzamanGershSomers2003" class="citation journal cs1">Shamsuzzaman AS, Gersh BJ, Somers VK (October 2003). <a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.290.14.1906">"Obstructive sleep apnea: implications for cardiac and vascular disease"</a>. JAMA. 290 (14): 1906–14. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1001%2Fjama.290.14.1906">10.1001/jama.290.14.1906</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/14532320">14532320</a>.</cite>

</li>

<li id="cite_note-AAO2013-179"><a href="#cite_ref-AAO2013_179-0">^</a> <cite class="citation web cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20210415085147/https://www.entnet.org/content/submucosal-ablation-tongue-base-osas">"Position Statement: Submucosal Ablation of the Tongue Base for OSAS"</a>. American Academy of Otolaryngology-Head and Neck Surgery. 20 March 2014. Archived from <a rel="nofollow" class="external text" href="https://www.entnet.org/content/submucosal-ablation-tongue-base-osas">the original</a> on 15 April 2021. Retrieved 5 September 2020.</cite>

</li>

<li id="cite_note-180"><a href="#cite_ref-180">^</a> <cite id="CITEREFKezirianBoudewynsEiseleSchwartz2010" class="citation journal cs1">Kezirian EJ, Boudewyns A, Eisele DW, Schwartz AR, Smith PL, Van de Heyning PH, De Backer WA (October 2010). "Electrical stimulation of the hypoglossal nerve in the treatment of obstructive sleep apnea". Sleep Medicine Reviews. 14 (5): 299–305. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1016%2Fj.smrv.2009.10.009">10.1016/j.smrv.2009.10.009</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/20116305">20116305</a>.</cite>

</li>

<li id="cite_note-181"><a href="#cite_ref-181">^</a> <cite class="citation news cs1"><a rel="nofollow" class="external text" href="https://web.archive.org/web/20220120173530/https://www.medgadget.com/2012/03/imthera-aura6000-system-for-sleep-apnea-gets-a-go-in-europe.html">"ImThera aura6000 System for Sleep Apnea Gets a Go in Europe"</a>. Medgadget. 15 March 2012. Archived from <a rel="nofollow" class="external text" href="https://www.medgadget.com/2012/03/imthera-aura6000-system-for-sleep-apnea-gets-a-go-in-europe.html">the original</a> on 20 January 2022. Retrieved 5 September 2020.</cite>

</li>

<li id="cite_note-182"><a href="#cite_ref-182">^</a> <cite id="CITEREFPuhanSuarezCascioZahn2006" class="citation journal cs1">Puhan, Milo A.; Suarez, Alex; Cascio, Christian Lo; Zahn, Alfred; Heitz, Markus; Braendli, Otto (2 February 2006). <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393">"Didgeridoo playing as alternative treatment for obstructive sleep apnoea syndrome: randomised controlled trial"</a>. BMJ. 332 (7536): 266–270. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1136%2Fbmj.38705.470590.55">10.1136/bmj.38705.470590.55</a>. <a href="PMC_(identifier)" class="mw-redirect" title="PMC (identifier)">PMC</a> <a rel="nofollow" class="external text" href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360393">1360393</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/16377643">16377643</a>.</cite>

</li>

<li id="cite_note-Guimaraes_KC,_Drager_LF,_Genta_PR,_Marcondes_BF,_Lorensi-Filhol_G_2009_962–966-183"><a href="#cite_ref-Guimaraes_KC,_Drager_LF,_Genta_PR,_Marcondes_BF,_Lorensi-Filhol_G_2009_962–966_183-0">^</a> <cite id="CITEREFGuimarãesDragerGentaMarcondes2009" class="citation journal cs1">Guimarães, Kátia C.; Drager, Luciano F.; Genta, Pedro R.; Marcondes, Bianca F.; Lorenzi-Filho, Geraldo (15 May 2009). "Effects of Oropharyngeal Exercises on Patients with Moderate Obstructive Sleep Apnea Syndrome". American Journal of Respiratory and Critical Care Medicine. 179 (10): 962–966. <a href="Doi_(identifier)" class="mw-redirect" title="Doi (identifier)">doi</a>:<a rel="nofollow" class="external text" href="https://doi.org/10.1164%2Frccm.200806-981OC">10.1164/rccm.200806-981OC</a>. <a href="PMID_(identifier)" class="mw-redirect" title="PMID (identifier)">PMID</a> <a rel="nofollow" class="external text" href="https://pubmed.ncbi.nlm.nih.gov/19234106">19234106</a>.</cite>

</li>

</ol></div>

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbox{box-sizing:border-box;border:1px solid #a2a9b1;width:100%;clear:both;font-size:88%;text-align:center;padding:1px;margin:1em auto 0}.mw-parser-output .navbox .navbox{margin-top:0}.mw-parser-output .navbox+.navbox,.mw-parser-output .navbox+.navbox-styles+.navbox{margin-top:-1px}.mw-parser-output .navbox-inner,.mw-parser-output .navbox-subgroup{width:100%}.mw-parser-output .navbox-group,.mw-parser-output .navbox-title,.mw-parser-output .navbox-abovebelow{padding:0.25em 1em;line-height:1.5em;text-align:center}.mw-parser-output .navbox-group{white-space:nowrap;text-align:right}.mw-parser-output .navbox,.mw-parser-output .navbox-subgroup{background-color:#fdfdfd}.mw-parser-output .navbox-list{line-height:1.5em;border-color:#fdfdfd}.mw-parser-output .navbox-list-with-group{text-align:left;border-left-width:2px;border-left-style:solid}.mw-parser-output tr+tr>.navbox-abovebelow,.mw-parser-output tr+tr>.navbox-group,.mw-parser-output tr+tr>.navbox-image,.mw-parser-output tr+tr>.navbox-list{border-top:2px solid #fdfdfd}.mw-parser-output .navbox-title{background-color:#ccf}.mw-parser-output .navbox-abovebelow,.mw-parser-output .navbox-group,.mw-parser-output .navbox-subgroup .navbox-title{background-color:#ddf}.mw-parser-output .navbox-subgroup .navbox-group,.mw-parser-output .navbox-subgroup .navbox-abovebelow{background-color:#e6e6ff}.mw-parser-output .navbox-even{background-color:#f7f7f7}.mw-parser-output .navbox-odd{background-color:transparent}.mw-parser-output .navbox .hlist td dl,.mw-parser-output .navbox .hlist td ol,.mw-parser-output .navbox .hlist td ul,.mw-parser-output .navbox td.hlist dl,.mw-parser-output .navbox td.hlist ol,.mw-parser-output .navbox td.hlist ul{padding:0.125em 0}.mw-parser-output .navbox .navbar{display:block;font-size:100%}.mw-parser-output .navbox-title .navbar{float:left;text-align:left;margin-right:0.5em}body.skin--responsive .mw-parser-output .navbox-image img{max-width:none!important}@media print{body.ns-0 .mw-parser-output .navbox{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><style data-mw-deduplicate="TemplateStyles:r1129693374">

/* start https://en.wikipedia.org/ */

.mw-parser-output .hlist dl,.mw-parser-output .hlist ol,.mw-parser-output .hlist ul{margin:0;padding:0}.mw-parser-output .hlist dd,.mw-parser-output .hlist dt,.mw-parser-output .hlist li{margin:0;display:inline}.mw-parser-output .hlist.inline,.mw-parser-output .hlist.inline dl,.mw-parser-output .hlist.inline ol,.mw-parser-output .hlist.inline ul,.mw-parser-output .hlist dl dl,.mw-parser-output .hlist dl ol,.mw-parser-output .hlist dl ul,.mw-parser-output .hlist ol dl,.mw-parser-output .hlist ol ol,.mw-parser-output .hlist ol ul,.mw-parser-output .hlist ul dl,.mw-parser-output .hlist ul ol,.mw-parser-output .hlist ul ul{display:inline}.mw-parser-output .hlist .mw-empty-li{display:none}.mw-parser-output .hlist dt::after{content:": "}.mw-parser-output .hlist dd::after,.mw-parser-output .hlist li::after{content:" · ";font-weight:bold}.mw-parser-output .hlist dd:last-child::after,.mw-parser-output .hlist dt:last-child::after,.mw-parser-output .hlist li:last-child::after{content:none}.mw-parser-output .hlist dd dd:first-child::before,.mw-parser-output .hlist dd dt:first-child::before,.mw-parser-output .hlist dd li:first-child::before,.mw-parser-output .hlist dt dd:first-child::before,.mw-parser-output .hlist dt dt:first-child::before,.mw-parser-output .hlist dt li:first-child::before,.mw-parser-output .hlist li dd:first-child::before,.mw-parser-output .hlist li dt:first-child::before,.mw-parser-output .hlist li li:first-child::before{content:" (";font-weight:normal}.mw-parser-output .hlist dd dd:last-child::after,.mw-parser-output .hlist dd dt:last-child::after,.mw-parser-output .hlist dd li:last-child::after,.mw-parser-output .hlist dt dd:last-child::after,.mw-parser-output .hlist dt dt:last-child::after,.mw-parser-output .hlist dt li:last-child::after,.mw-parser-output .hlist li dd:last-child::after,.mw-parser-output .hlist li dt:last-child::after,.mw-parser-output .hlist li li:last-child::after{content:")";font-weight:normal}.mw-parser-output .hlist ol{counter-reset:listitem}.mw-parser-output .hlist ol>li{counter-increment:listitem}.mw-parser-output .hlist ol>li::before{content:" "counter(listitem)"\a0 "}.mw-parser-output .hlist dd ol>li:first-child::before,.mw-parser-output .hlist dt ol>li:first-child::before,.mw-parser-output .hlist li ol>li:first-child::before{content:" ("counter(listitem)"\a0 "}

/* end https://en.wikipedia.org/ */

</style></div><div role="navigation" class="navbox" aria-label="Navbox32" style="width:100%; margin:0.5em 0 0.5em 0;;padding:3px"><table class="nowraplinks navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">Classification</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em"><div style="position:relative; float:right; font-size:0.8em;"><a href="https://www.wikidata.org/wiki/Q16606552" class="extiw external" title="d:Q16606552">D</a></div><div class="hlist" style="text-align:left;"><ul><li><a href="International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="ICD-11" title="ICD-11">11</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse/latest-release/mms/en#1919233290">7A41</a></li><li><a href="International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="ICD-10" title="ICD-10">10</a>: <a rel="nofollow" class="external text" href="https://icd.who.int/browse10/2019/en#/G47.3">G47.3</a></li><li><a href="International_Statistical_Classification_of_Diseases_and_Related_Health_Problems" class="mw-redirect" title="International Statistical Classification of Diseases and Related Health Problems">ICD</a>-<a href="ICD-10-CM" title="ICD-10-CM">10-CM</a>: <a rel="nofollow" class="external text" href="https://icd10cmtool.cdc.gov/?fy=FY2024&query=G47.33">G47.33</a></li><li><a href="Medical_Subject_Headings" title="Medical Subject Headings">MeSH</a>: <a rel="nofollow" class="external text" href="https://meshb.nlm.nih.gov/record/ui?ui=D020181">D020181</a></li></ul></div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%;background: #EAECF0;color:black;">External resources</th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em"><div class="hlist" style="text-align:left;"><ul><li><a href="MedlinePlus" title="MedlinePlus">MedlinePlus</a>: <a rel="nofollow" class="external text" href="https://www.nlm.nih.gov/medlineplus/ency/article/000811.htm">000811</a></li><li><a href="Patient_UK" title="Patient UK">Patient UK</a>: <a rel="nofollow" class="external text" href="https://patient.info/doctor/obstructive-sleep-apnoea-pro">Obstructive sleep apnea</a></li></ul></div></div></td></tr></tbody></table></div><div class="navbox-styles"></div><div role="navigation" class="navbox" aria-labelledby="Sleep_and_sleep_disorders127" style="padding:3px"><table class="nowraplinks mw-collapsible autocollapse navbox-inner" style="border-spacing:0;background:transparent;color:inherit"><tbody><tr><th scope="col" class="navbox-title" colspan="2"><style data-mw-deduplicate="TemplateStyles:r1239400231">

/* start https://en.wikipedia.org/ */

.mw-parser-output .navbar{display:inline;font-size:88%;font-weight:normal}.mw-parser-output .navbar-collapse{float:left;text-align:left}.mw-parser-output .navbar-boxtext{word-spacing:0}.mw-parser-output .navbar ul{display:inline-block;white-space:nowrap;line-height:inherit}.mw-parser-output .navbar-brackets::before{margin-right:-0.125em;content:"[ "}.mw-parser-output .navbar-brackets::after{margin-left:-0.125em;content:" ]"}.mw-parser-output .navbar li{word-spacing:-0.125em}.mw-parser-output .navbar a>span,.mw-parser-output .navbar a>abbr{text-decoration:inherit}.mw-parser-output .navbar-mini abbr{font-variant:small-caps;border-bottom:none;text-decoration:none;cursor:inherit}.mw-parser-output .navbar-ct-full{font-size:114%;margin:0 7em}.mw-parser-output .navbar-ct-mini{font-size:114%;margin:0 4em}html.skin-theme-clientpref-night .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}@media(prefers-color-scheme:dark){html.skin-theme-clientpref-os .mw-parser-output .navbar li a abbr{color:var(--color-base)!important}}@media print{.mw-parser-output .navbar{display:none!important}}

/* end https://en.wikipedia.org/ */

</style><div id="Sleep_and_sleep_disorders127" class="nowrap" style="font-size:114%;margin:0 4em"><a href="Sleep" title="Sleep">Sleep</a> and <a href="Sleep_disorder" title="Sleep disorder">sleep disorders</a></div></th></tr><tr><th scope="row" class="navbox-group" style="width:1%">Stages of <a href="Sleep_cycle" title="Sleep cycle">sleep cycles</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist nowrapitems" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Rapid_eye_movement_sleep" title="Rapid eye movement sleep">Rapid eye movement (REM)</a></li>

<li><a href="Non-rapid_eye_movement_sleep" title="Non-rapid eye movement sleep">Quiescent sleep</a></li>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Electroencephalography" title="Electroencephalography">Brain waves</a></th><td class="navbox-list-with-group navbox-list navbox-even hlist nowrapitems" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Alpha_wave" title="Alpha wave">Alpha wave</a></li>

<li><a href="Delta_wave" title="Delta wave">Delta wave</a></li>

<li><a href="Gamma_wave" title="Gamma wave">Gamma wave</a></li>

<li><a href="K-complex" title="K-complex">K-complex</a></li>

<li><a href="Mu_wave" title="Mu wave">Mu rhythm</a></li>

<li><a href="PGO_waves" title="PGO waves">PGO waves</a></li>

<li><a href="Sensorimotor_rhythm" title="Sensorimotor rhythm">Sensorimotor rhythm</a></li>

<li><a href="Sleep_spindle" title="Sleep spindle">Sleep spindle</a></li>

<li><a href="Theta_wave" title="Theta wave">Theta wave</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Sleep_disorder" title="Sleep disorder">Sleep disorders</a></th><td class="navbox-list-with-group navbox-list navbox-odd hlist nowrapitems" style="width:100%;padding:0"><div style="padding:0 0.25em"></div><table class="nowraplinks navbox-subgroup" style="border-spacing:0"><tbody><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Oral_and_maxillofacial_pathology" title="Oral and maxillofacial pathology">Anatomical</a></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Mouth_breathing" title="Mouth breathing">Mouth breathing</a></li>

<li><a href="Sleep_apnea" title="Sleep apnea">Sleep apnea</a>

<ul><li><a href="Catathrenia" title="Catathrenia">Catathrenia</a></li>

<li><a href="Central_hypoventilation_syndrome" title="Central hypoventilation syndrome">Central hypoventilation syndrome</a></li>

<li><a href="Obesity_hypoventilation_syndrome" title="Obesity hypoventilation syndrome">Obesity hypoventilation syndrome</a></li>

<li><a href="Periodic_breathing" title="Periodic breathing">Periodic breathing</a></li></ul></li>

<li><a href="Snoring" title="Snoring">Snoring</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Dyssomnia" title="Dyssomnia">Dyssomnia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Excessive_daytime_sleepiness" title="Excessive daytime sleepiness">Excessive daytime sleepiness</a></li>

<li><a href="Hypersomnia" title="Hypersomnia">Hypersomnia</a></li>

<li><a href="Insomnia" title="Insomnia">Insomnia</a></li>

<li><a href="Kleine%E2%80%93Levin_syndrome" title="Kleine–Levin syndrome">Kleine–Levin syndrome</a></li>

<li><a href="Narcolepsy" title="Narcolepsy">Narcolepsy</a></li>

<li><a href="Idiopathic_hypersomnia" title="Idiopathic hypersomnia">Idiopathic hypersomnia</a></li>

<li><a href="Night_eating_syndrome" title="Night eating syndrome">Night eating syndrome</a></li>

<li><a href="Nocturia" title="Nocturia">Nocturia</a></li>

<li><a href="Sleep_state_misperception" title="Sleep state misperception">Sleep state misperception</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><div style="display: inline-block; line-height: 1.2em; padding: .1em 0; line-height: 1.15em;"><a href="Circadian_rhythm_sleep_disorder" title="Circadian rhythm sleep disorder">Circadian rhythm disorders</a></div></th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Advanced_sleep_phase_disorder" title="Advanced sleep phase disorder">Advanced sleep phase disorder</a></li>

<li><a href="Cyclic_alternating_pattern" title="Cyclic alternating pattern">Cyclic alternating pattern</a></li>

<li><a href="Delayed_sleep_phase_disorder" title="Delayed sleep phase disorder">Delayed sleep phase disorder</a></li>

<li><a href="Irregular_sleep%E2%80%93wake_rhythm" class="mw-redirect" title="Irregular sleep–wake rhythm">Irregular sleep–wake rhythm</a></li>

<li><a href="Non-24-hour_sleep%E2%80%93wake_disorder" title="Non-24-hour sleep–wake disorder">Non-24-hour sleep–wake disorder</a></li>

<li><a href="Shift_work_sleep_disorder" title="Shift work sleep disorder">Shift work sleep disorder</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Parasomnia" title="Parasomnia">Parasomnia</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Bruxism" title="Bruxism">Bruxism</a></li>

<li><a href="Nightmare_disorder" title="Nightmare disorder">Nightmare disorder</a></li>

<li><a href="Night_terror" title="Night terror">Night terror</a></li>

<li><a href="Periodic_limb_movement_disorder" title="Periodic limb movement disorder">Periodic limb movement disorder</a></li>

<li><a href="Rapid_eye_movement_sleep_behavior_disorder" title="Rapid eye movement sleep behavior disorder">Rapid eye movement sleep behavior disorder</a></li>

<li><a href="Sleepwalking" title="Sleepwalking">Sleepwalking</a></li>

<li><a href="Sleep_driving" class="mw-redirect" title="Sleep driving">Sleep driving</a></li>

<li><a href="Sleep-talking" title="Sleep-talking">Sleep-talking</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Benign phenomena</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Dream" title="Dream">Dreams</a>

<ul><li><a href="Lucid_dream" title="Lucid dream">Lucid dreams</a></li></ul></li>

<li><a href="Exploding_head_syndrome" title="Exploding head syndrome">Exploding head syndrome</a></li>

<li><a href="Hypnic_jerk" title="Hypnic jerk">Hypnic jerk</a></li>

<li><a href="Hypnagogia" title="Hypnagogia">Hypnagogia</a> / <a href="Sleep_onset" title="Sleep onset">Sleep onset</a></li>

<li><a href="Hypnopompia" title="Hypnopompia">Hypnopompia</a></li>

<li><a href="Sleep_paralysis" title="Sleep paralysis">Sleep paralysis</a></li>

<li><a href="Sleep_inertia" title="Sleep inertia">Sleep inertia</a></li>

<li><a href="Somnolence" title="Somnolence">Somnolence</a></li>

<li><a href="Nocturnal_clitoral_tumescence" title="Nocturnal clitoral tumescence">Nocturnal clitoral tumescence</a></li>

<li><a href="Nocturnal_penile_tumescence" title="Nocturnal penile tumescence">Nocturnal penile tumescence</a></li>

<li><a href="Nocturnal_emission" title="Nocturnal emission">Nocturnal emission</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%"><a href="Sleep_medicine" title="Sleep medicine">Treatment</a></th><td class="navbox-list-with-group navbox-list navbox-even" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Sleep_diary" title="Sleep diary">Sleep diary</a></li>

<li><a href="Sleep_hygiene" title="Sleep hygiene">Sleep hygiene</a></li>

<li><a href="Sleep_induction" title="Sleep induction">Sleep induction</a>

<ul><li><a href="Hypnosis" title="Hypnosis">Hypnosis</a></li>

<li><a href="Lullaby" title="Lullaby">Lullaby</a></li></ul></li>

<li><a href="Somnology" title="Somnology">Somnology</a>

<ul><li><a href="Polysomnography" title="Polysomnography">Polysomnography</a></li></ul></li>

<li><a href="Sleep_surgery" title="Sleep surgery">Sleep surgery</a></li></ul>

</div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Other</th><td class="navbox-list-with-group navbox-list navbox-odd" style="width:100%;padding:0"><div style="padding:0 0.25em">

<ul><li><a href="Sleep_medicine" title="Sleep medicine">Sleep medicine</a></li>

<li><a href="Behavioral_sleep_medicine" title="Behavioral sleep medicine">Behavioral sleep medicine</a></li>

<li><a href="Sleep_study" title="Sleep study">Sleep study</a></li>

<li><a href="Melatonin" title="Melatonin">Melatonin</a></li>

<li><a href="Neuroscience_of_sleep" title="Neuroscience of sleep">Neuroscience of sleep</a></li></ul>

</div></td></tr></tbody></table><div></div></td></tr><tr><th scope="row" class="navbox-group" style="width:1%">Daily life</th><td class="navbox-list-with-group navbox-list navbox-even hlist nowrapitems" style="width:100%;padding:0"><div style="padding:0 0.25em">

<li><a href="Daybed" title="Daybed">Daybed</a></li>

<li><a href="Four-poster_bed" title="Four-poster bed">Four-poster bed</a></li>

<li><a href="Futon" title="Futon">Futon</a></li>

<li><a href="Hammock" title="Hammock">Hammock</a></li>

<li><a href="Mattress" title="Mattress">Mattress</a></li>

<li><a href="Sleeping_bag" title="Sleeping bag">Sleeping bag</a></li></ul></li>

<li><a href="Bedding" title="Bedding">Bedding</a></li>

<li><a href="Bedroom" title="Bedroom">Bedroom</a></li>

<li><a href="Bedtime" title="Bedtime">Bedtime</a>

<ul><li><a href="Bedtime_procrastination" title="Bedtime procrastination">Procrastination</a></li>

<li><a href="Bedtime_story" title="Bedtime story">Story</a></li></ul></li>

<li><a href="Biphasic_and_polyphasic_sleep" class="mw-redirect" title="Biphasic and polyphasic sleep">Biphasic and polyphasic sleep</a></li>

<li><a href="Chronotype" title="Chronotype">Chronotype</a></li>

<li><a href="Circadian_rhythm" title="Circadian rhythm">Circadian rhythm</a></li>

<li><a href="Comfort_object" title="Comfort object">Comfort object</a></li>

<li><a href="Dream_diary" title="Dream diary">Dream diary</a></li>

<li><a href="Microsleep" title="Microsleep">Microsleep</a></li>

<li><a href="Nightwear" title="Nightwear">Nightwear</a></li>

<li><a href="Power_nap" title="Power nap">Power nap</a></li>

<li><a href="Second_wind_(sleep)" title="Second wind (sleep)">Second wind</a></li>

<li><a href="Siesta" title="Siesta">Siesta</a></li>

<li><a href="Sleep_and_breathing" title="Sleep and breathing">Sleep and breathing</a></li>

<li><a href="Sleep_and_creativity" title="Sleep and creativity">Sleep and creativity</a></li>

<li><a href="Sleep_and_learning" title="Sleep and learning">Sleep and learning</a></li>

<li><a href="Sleep_and_memory" title="Sleep and memory">Sleep and memory</a></li>

<li><a href="Sleep_deprivation" title="Sleep deprivation">Sleep deprivation</a> / <a href="Sleep_debt" title="Sleep debt">Sleep debt</a></li>

<li><a href="Sleeping_while_on_duty" title="Sleeping while on duty">Sleeping while on duty</a></li>

<li><a href="Sleepover" title="Sleepover">Sleepover</a></li></ul>

</div></td></tr></tbody></table></div></div><div><div class="zim-footer">

This article is issued from <a class="external text" title="Last edited on 2025-08-03" href="https://en.wikipedia.org/wiki/?title=Obstructive_sleep_apnea&oldid=1303984900">Wikipedia</a>. The text is available under <a class="external text" href="https://creativecommons.org/licenses/by-sa/4.0/deed.en">Creative Commons Attribution-Share Alike 4.0</a> unless otherwise noted. Additional terms may apply for the media files.

</div>

</div></div>

</div>

</main>

</div>

</body></html>