Nonrestorative sleep (ie, “waking up as tired as when they went to bed”)
Large degree of overjet
Narrowing of the lateral airway walls: Independent predictor of the presence of obstructive sleep apnea in men but not women
Daytime fatigue/tiredness
Morning headache, dry or sore throat
Witnessed apneas, which often interrupt the snoring and end with a snort
Excessive daytime sleepiness that usually begins during quiet activities (eg, reading, watching television); as the severity worsens, patients begin to feel sleepy during activities that generally require alertness (eg, school, work, driving)
Gastroesophageal reflux
Morning confusion
Gasping and choking sensations that arouse the patient from sleep, though in a very low proportion relative to the number of apneas they experience
Hypertension
Cognitive deficits; memory and intellectual impairment (short-term memory, concentration)
Congestive heart failure
Nocturia
Systemic arterial hypertension: Present in about 50% of obstructive sleep apnea cases
Decreased vigilance
Abnormal (increased) Mallampati score: Identifies risk for difficult tracheal intubation
Retrognathia or micrognathia
Enlarged (ie, "kissing") tonsils (3+ to 4+)
Sexual dysfunction, including impotence and decreased libido
Insomnia; restless sleep, with patients often experiencing frequent arousals and tossing or turning during the night
High-arched hard palate
Snoring, usually loud, habitual, and bothersome to others
