Table 8.

Clinical presentation of OSA

Signs and symptoms

Clinical examination

Snoring during sleep, frequent nycturia, poor quality of sleep, night-time sweating, waking up gasping or choking Decreased libido Excessive daytime sleepiness Morning dry mouth Daytime headache, impaired attention and memory during work activities Motor vehicle accidents High-risk patients include also those with current and/or past history of arrhythmias, pulmonary HT, diabetes type 2 mellitus, coronary disease, and ‘difficult-to-treat’ HT 24-h ABPM characterized by a non-dipping profile and elevated BP variability indices

Upper airway abnormalities (e.g. Mallampati score ≥ 3) Neck and waist circumference (e.g. neck circumference > 43 cm in males and > 40 cm in females) BMI (e.g. ≥ 30 kg/m2)

The criteria developed by the American Academy of Sleep Medicine (AASM) are a combination of at least 5 obstructive breathing episodes per hour during sleep and at least one of the following criteria: (a) excessive daytime sleepiness that is not better explained by other factors; (b) two or more of the following symptoms not explained by other factors: choking or gasping during sleep, recurrent awakenings from sleep, unrefreshing sleep, daytime fatigue, and impaired concentration [48]

OSA obstructive sleep apnea, HT hypertension, ABPM ambulatory blood pressure monitoring, BMI body mass index