Which physical findings are characteristic of obstructive sleep apnea (OSA)?

Updated: Sep 15, 2020
  • Author: Himanshu Wickramasinghe, MD, MBBS; Chief Editor: Zab Mosenifar, MD, FACP, FCCP  more...
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Physical examination findings may include the following:

  • Obesity – Body mass index (BMI) greater than 30 kg/m2

  • Large neck circumference – Greater than 43 cm (17 in) in men and 37 cm (15 in) in women

  • Abnormal (increased) Mallampati score

  • Narrowing of the lateral airway walls, which is an independent predictor of the presence of OSA in men but not women

  • Enlarged (ie, "kissing") tonsils (3+ to 4+) (see the image below)

  • Retrognathia or micrognathia

  • Large degree of overjet

  • High-arched hard palate

  • Systemic arterial hypertension, present in approximately 50% of patients with OSA

  • Congestive heart failure (CHF)

  • Pulmonary hypertension

  • Stroke

  • Metabolic syndrome

  • Type 2 diabetes mellitus

    Tonsil grades. Tonsil grades.

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