At least one of the following applies:

1. The patient complains of unintentional sleep episodes during wakefulness, daytime sleepiness, unrefreshing sleep, fatigue, or insomnia.

2. The patient wakes holding his/her breath, gasping, or choking.

3. The bed partner reports loud snoring or breathing interruptions during the patient's sleep.

Polysomnographic recording shows the following:

1. Five or more scoreable respiratory events occur per hour. These events can include any combination of obstructive apneas, hypopneas, or respiratory-associated arousals.

2. There is evidence of respiratory effort during all or a portion of each respiratory event.

This disorder is not better explained by another sleep, medical, or psychiatric disorder, substance abuse, or medication.

Associated features

• snoring

• obesity

• systemic hypertension

• pulmonary hypertension

• congestive heart failure

• sleep fragmentation

• recurrent awakening from sleep

• sleep-related cardiac dysrhythmias

• nocturnal angina

• gastroesophageal reflux

• impaired quality of life

• impaired concentration

• diabetes

• metabolic syndrome