# Obstructive sleep apnea syndrome (OSAS) often results in all of the following except:
A. Excessive daytime sleepiness
B. Aggressive behavior
C. Personality changes
D. Depression
The correct answer is B. Aggressive behavior.
Signs and symptoms
Generally, symptoms of OSA begin insidiously and are often present for years before the patient is referred for evaluation.
Nocturnal symptoms may include the following:
- Snoring, usually loud, habitual, and bothersome to others
- Witnessed apneas, which often interrupt the snoring and end with a snort
- Gasping and choking sensations that arouse the patient from sleep, though in a very low proportion relative to the number of apneas they experience
- Nocturia
- Insomnia; restless sleep, with patients often experiencing frequent arousals and tossing or turning during the night
Daytime symptoms may include the following:
- Nonrestorative sleep (ie, “waking up as tired as when they went to bed”)
- Morning headache, dry or sore throat
- 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)
- Daytime fatigue/tiredness
- Cognitive deficits; memory and intellectual impairment (short-term memory, concentration)
- Decreased vigilance
- Morning confusion
- Personality and mood changes, including depression and anxiety
- Sexual dysfunction, including impotence and decreased libido
- Gastroesophageal reflux
- Hypertension
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