{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T22:12:57Z","timestamp":1766441577178,"version":"3.48.0"},"reference-count":27,"publisher":"Springer Science and Business Media LLC","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,12,22]]},"DOI":"10.7759\/cureus.99866","type":"journal-article","created":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T22:06:35Z","timestamp":1766441195000},"source":"Crossref","is-referenced-by-count":0,"title":["Beyond Snoring: Unexpected Presentation of Obstructive Sleep Apnea"],"prefix":"10.7759","author":[{"given":"Pedro M","family":"Vieira","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ana Carolina","family":"Aranda","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Filipe Ant\u00f3nio C","family":"Martins","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"In\u00eas A","family":"Ferreira","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Margarida","family":"Barroso","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mariana","family":"Khomynets","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","reference":[{"key":"ref1","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.10890","article-title":"The lived experience of positive airway pressure therapy in patients with obstructive sleep apnea across the lifespan: a qualitative study","volume":"20","author":"Simon SL","year":"2024","unstructured":"Simon SL, Stephenson JJ, Haynes K, Kennedy ER, Frydman G, Amdur A, Parthasarathy S. The lived experience of positive airway pressure therapy in patients with obstructive sleep apnea across the lifespan: a qualitative study. J Clin Sleep Med. 2024, 20:407-16. 10.5664\/jcsm.10890","journal-title":"J Clin Sleep Med"},{"key":"ref2","unstructured":"The AASM International Classification of Sleep Disorders - Third Edition, Text Revision (ICSD-3-TR). https.\/\/aasm.org\/clinical-resources\/international-classification-sleep-disorders\/."},{"key":"ref3","doi-asserted-by":"publisher","DOI":"10.3390\/ijerph181910277","article-title":"Prevalence of obstructive sleep apnea syndrome: a single-center retrospective study","volume":"18","author":"Santilli M","year":"2021","unstructured":"Santilli M, Manciocchi E, D'Addazio G, Di Maria E, D'Attilio M, Femminella B, Sinjari B. Prevalence of obstructive sleep apnea syndrome: a single-center retrospective study. Int J Environ Res Public Health. 2021, 18:10.3390\/ijerph181910277","journal-title":"Int J Environ Res Public Health"},{"key":"ref4","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.1115","article-title":"Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women","volume":"306","author":"Yaffe K","year":"2011","unstructured":"Yaffe K, Laffan AM, Harrison SL, et al.. Sleep-disordered breathing, hypoxia, and risk of mild cognitive impairment and dementia in older women. JAMA. 2011, 306:613-9. 10.1001\/jama.2011.1115","journal-title":"JAMA"},{"key":"ref5","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(13)60734-5","article-title":"Adult obstructive sleep apnoea","volume":"383","author":"Jordan AS","year":"2014","unstructured":"Jordan AS, McSharry DG, Malhotra A. Adult obstructive sleep apnoea. Lancet. 2014, 383:736-47. 10.1016\/S0140-6736(13)60734-5","journal-title":"Lancet"},{"key":"ref6","doi-asserted-by":"publisher","DOI":"10.1183\/13993003.01104-2019","article-title":"EAN\/ERS\/ESO\/ESRS statement on the impact of sleep disorders on risk and outcome of stroke","volume":"55","author":"Bassetti CL","year":"2020","unstructured":"Bassetti CL, Randerath W, Vignatelli L, et al.. EAN\/ERS\/ESO\/ESRS statement on the impact of sleep disorders on risk and outcome of stroke. Eur Respir J. 2020, 55:10.1183\/13993003.01104-2019","journal-title":"Eur Respir J"},{"key":"ref7","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.6506","article-title":"Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline","volume":"13","author":"Kapur VK","year":"2017","unstructured":"Kapur VK, Auckley DH, Chowdhuri S, Kuhlmann DC, Mehra R, Ramar K, Harrod CG. Clinical practice guideline for diagnostic testing for adult obstructive sleep apnea: an American Academy of Sleep Medicine clinical practice guideline. J Clin Sleep Med. 2017, 13:479-504. 10.5664\/jcsm.6506","journal-title":"J Clin Sleep Med"},{"key":"ref8","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2024.06.014","article-title":"Weight reduction and the impact on apnea-hypopnea index: a systematic meta-analysis","volume":"121","author":"Malhotra A","year":"2024","unstructured":"Malhotra A, Heilmann CR, Banerjee KK, Dunn JP, Bunck MC, Bednarik J. Weight reduction and the impact on apnea-hypopnea index: a systematic meta-analysis. Sleep Med. 2024, 121:26-31. 10.1016\/j.sleep.2024.06.014","journal-title":"Sleep Med"},{"key":"ref9","doi-asserted-by":"publisher","DOI":"10.3390\/nu14132731","article-title":"Effect of a weight loss and lifestyle intervention on dietary behavior in men with obstructive sleep apnea: the INTERAPNEA trial","volume":"14","author":"Carneiro-Barrera A","year":"2022","unstructured":"Carneiro-Barrera A, Amaro-Gahete FJ, Jurado-Fasoli L, S\u00e1ez-Roca G, Mart\u00edn-Carrasco C, Tinahones FJ, Ruiz JR. Effect of a weight loss and lifestyle intervention on dietary behavior in men with obstructive sleep apnea: the INTERAPNEA trial. Nutrients. 2022, 14:10.3390\/nu14132731","journal-title":"Nutrients"},{"key":"ref10","doi-asserted-by":"publisher","DOI":"10.5664\/jcsm.9834","article-title":"Dose-response relationship between weight loss and improvements in obstructive sleep apnea severity after a diet\/lifestyle interventions: secondary analyses of the \"MIMOSA\" randomized clinical trial","volume":"18","author":"Georgoulis M","year":"2022","unstructured":"Georgoulis M, Yiannakouris N, Kechribari I, Lamprou K, Perraki E, Vagiakis E, Kontogianni MD. Dose-response relationship between weight loss and improvements in obstructive sleep apnea severity after a diet\/lifestyle interventions: secondary analyses of the \"MIMOSA\" randomized clinical trial. J Clin Sleep Med. 2022, 18:1251-61. 10.5664\/jcsm.9834","journal-title":"J Clin Sleep Med"},{"key":"ref11","doi-asserted-by":"publisher","DOI":"10.1016\/j.sleep.2017.12.005","article-title":"Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis","volume":"42","author":"Simou E","year":"2018","unstructured":"Simou E, Britton J, Leonardi-Bee J. Alcohol and the risk of sleep apnoea: a systematic review and meta-analysis. Sleep Med. 2018, 42:38-46. 10.1016\/j.sleep.2017.12.005","journal-title":"Sleep Med"},{"key":"ref12","doi-asserted-by":"publisher","DOI":"10.1111\/jsr.12495","article-title":"Gabapentin acutely increases the apnea-hypopnea index in older men: data from a randomized, double-blind, placebo-controlled study","volume":"26","author":"Piovezan RD","year":"2017","unstructured":"Piovezan RD, Kase C, Moizinho R, Tufik S, Poyares D. Gabapentin acutely increases the apnea-hypopnea index in older men: data from a randomized, double-blind, placebo-controlled study. J Sleep Res. 2017, 26:166-70. 10.1111\/jsr.12495","journal-title":"J Sleep Res"},{"key":"ref13","doi-asserted-by":"publisher","DOI":"10.1378\/chest.13-0938","article-title":"Nonalcoholic fatty liver disease, nocturnal hypoxia, and endothelial function in patients with sleep apnea","volume":"145","author":"Minville C","year":"2014","unstructured":"Minville C, Hilleret MN, Tamisier R, et al.. Nonalcoholic fatty liver disease, nocturnal hypoxia, and endothelial function in patients with sleep apnea. Chest. 2014, 145:525-33. 10.1378\/chest.13-0938","journal-title":"Chest"},{"key":"ref14","doi-asserted-by":"publisher","DOI":"10.1080\/15402002.2014.946597","article-title":"Patient and partner experiences with obstructive sleep apnea and CPAP treatment: a qualitative analysis","volume":"14","author":"Luyster FS","year":"2016","unstructured":"Luyster FS, Dunbar-Jacob J, Aloia MS, Martire LM, Buysse DJ, Strollo PJ. Patient and partner experiences with obstructive sleep apnea and CPAP treatment: a qualitative analysis. Behav Sleep Med. 2016, 14:67-84. 10.1080\/15402002.2014.946597","journal-title":"Behav Sleep Med"},{"key":"ref15","doi-asserted-by":"publisher","DOI":"10.1212\/01.CON.0000522245.13784.f6","article-title":"Sleep-disordered breathing","volume":"23","author":"Foldvary-Schaefer NR","year":"2017","unstructured":"Foldvary-Schaefer NR, Waters TE. Sleep-disordered breathing. Continuum (Minneap Minn). 2017, 23:1093-116. 10.1212\/01.CON.0000522245.13784.f6","journal-title":"Continuum (Minneap Minn)"},{"key":"ref16","article-title":"Hypertrophic osteoarthropathy","author":"Krugh M","year":"2019","unstructured":"Krugh M, Vaidya PN. Hypertrophic osteoarthropathy. StatPearls [Internet]. StatPearls Publishing, Treasure Island, FL; 2019."},{"key":"ref17","doi-asserted-by":"publisher","DOI":"10.1080\/17843286.2016.1152672","article-title":"Clubbing and hypertrophic osteoarthropathy: insights in diagnosis, pathophysiology, and clinical significance","volume":"71","author":"Callemeyn J","year":"2016","unstructured":"Callemeyn J, Van Haecke P, Peetermans WE, Blockmans D. Clubbing and hypertrophic osteoarthropathy: insights in diagnosis, pathophysiology, and clinical significance. Acta Clin Belg. 2016, 71:123-30. 10.1080\/17843286.2016.1152672","journal-title":"Acta Clin Belg"},{"key":"ref18","article-title":"Nails: Diagnosis, Therapy, Surgery. Third Edition","author":"Scher RK","year":"2005","unstructured":"Scher RK, Daniel III CR. Nails: Diagnosis, Therapy, Surgery. Third Edition. Elsevier Saunders, Philadelphia, PA; 2005."},{"key":"ref19","doi-asserted-by":"publisher","DOI":"10.3109\/9780203490693","article-title":"Nail signs of systemic disease","author":"Rich P","year":"2003","unstructured":"Rich P, Scher RK. Nail signs of systemic disease. An Atlas of Diseases of the Nail. First Edition. The Parthenon Publishing Group, Boca Raton, FL; 2003. 10.3109\/9780203490693"},{"key":"ref20","article-title":"Evaluation of digital clubbing","volume":"44","author":"Chan CW","year":"2015","unstructured":"Chan CW. Evaluation of digital clubbing. Aust Fam Physician. 2015, 44:113-6.","journal-title":"Aust Fam Physician"},{"key":"ref21","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.276185","article-title":"Does this patient have obstructive sleep apnea?: The rational clinical examination systematic review","volume":"310","author":"Myers KA","year":"2013","unstructured":"Myers KA, Mrkobrada M, Simel DL. Does this patient have obstructive sleep apnea?: The rational clinical examination systematic review. JAMA. 2013, 310:731-41. 10.1001\/jama.2013.276185","journal-title":"JAMA"},{"key":"ref22","doi-asserted-by":"publisher","DOI":"10.1016\/j.jsmc.2019.10.001","article-title":"Effect of obstructive sleep apnea on neurocognitive performance","volume":"15","author":"Seda G","year":"2020","unstructured":"Seda G, Han TS. Effect of obstructive sleep apnea on neurocognitive performance. Sleep Med Clin. 2020, 15:77-85. 10.1016\/j.jsmc.2019.10.001","journal-title":"Sleep Med Clin"},{"key":"ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-020-02084-3","article-title":"Cognitive impairment in obstructive sleep apnea syndrome: a descriptive review","volume":"25","author":"Caporale M","year":"2021","unstructured":"Caporale M, Palmeri R, Corallo F, et al.. Cognitive impairment in obstructive sleep apnea syndrome: a descriptive review. Sleep Breath. 2021, 25:29-40. 10.1007\/s11325-020-02084-3","journal-title":"Sleep Breath"},{"key":"ref24","doi-asserted-by":"publisher","DOI":"10.3109\/09537104.2013.821605","article-title":"Validation of the megakaryocyte fragmentation theory of finger clubbing in patients with cardiopulmonary diseases","volume":"25","author":"Arivazhagan S","year":"2014","unstructured":"Arivazhagan S, Kadhiravan T, Basu D, Dutta TK. Validation of the megakaryocyte fragmentation theory of finger clubbing in patients with cardiopulmonary diseases. Platelets. 2014, 25:317-21. 10.3109\/09537104.2013.821605","journal-title":"Platelets"},{"key":"ref25","doi-asserted-by":"publisher","DOI":"10.1007\/s11325-020-02021-4","article-title":"Increased platelet activation in sleep apnea subjects with intermittent hypoxemia","volume":"24","author":"Krieger AC","year":"2020","unstructured":"Krieger AC, Anand R, Hernandez-Rosa E, et al.. Increased platelet activation in sleep apnea subjects with intermittent hypoxemia. Sleep Breath. 2020, 24:1537-47. 10.1007\/s11325-020-02021-4","journal-title":"Sleep Breath"},{"key":"ref26","doi-asserted-by":"publisher","DOI":"10.3390\/ijms25031852","article-title":"Obstructive sleep apnea-associated intermittent hypoxia-induced immune responses in males, pregnancies, and offspring","volume":"25","author":"Song R","year":"2024","unstructured":"Song R, Baker TL, Watters JJ, Kumar S. Obstructive sleep apnea-associated intermittent hypoxia-induced immune responses in males, pregnancies, and offspring. Int J Mol Sci. 2024, 25:10.3390\/ijms25031852","journal-title":"Int J Mol Sci"},{"key":"ref27","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2018.00635","article-title":"Obstructive sleep apnea: from intermittent hypoxia to cardiovascular complications via blood platelets","volume":"9","author":"Gabryelska A","year":"2018","unstructured":"Gabryelska A, \u0141ukasik ZM, Makowska JS, Bia\u0142asiewicz P. Obstructive sleep apnea: from intermittent hypoxia to cardiovascular complications via blood platelets. Front Neurol. 2018, 9:10.3389\/fneur.2018.00635","journal-title":"Front Neurol"}],"container-title":["Cureus"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cureus.com\/articles\/441766-beyond-snoring-unexpected-presentation-of-obstructive-sleep-apnea","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,12,22]],"date-time":"2025-12-22T22:06:36Z","timestamp":1766441196000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cureus.com\/articles\/441766-beyond-snoring-unexpected-presentation-of-obstructive-sleep-apnea"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,12,22]]},"references-count":27,"URL":"https:\/\/doi.org\/10.7759\/cureus.99866","relation":{},"ISSN":["2168-8184"],"issn-type":[{"value":"2168-8184","type":"print"}],"subject":[],"published":{"date-parts":[[2025,12,22]]}}}