Editing Sleep apnea (section)

==Signs and symptoms==
The typical screening process for sleep apnea involves asking patients about common symptoms such as snoring, witnessed pauses in breathing during sleep and [[excessive daytime sleepiness]].<ref name="Lim4"/> There is a wide range in presenting symptoms in patients with sleep apnea, from being asymptomatic to falling asleep while driving.<ref name="Lim4" /> Due to this wide range in clinical presentation, some people are not aware that they have sleep apnea and are either misdiagnosed or ignore the symptoms altogether.<ref name="elad2">{{cite journal |vauthors=El-Ad B, Lavie P |date=August 2005 |title=Effect of sleep apnea on cognition and mood |journal=International Review of Psychiatry |volume=17 |issue=4 |pages=277–82 |doi=10.1080/09540260500104508 |pmid=16194800 |s2cid=7527654}}</ref> A current area requiring further study involves identifying different subtypes of sleep apnea based on patients who tend to present with different clusters or groupings of particular symptoms.<ref name="Lim4" />

OSA may increase risk for driving accidents and work-related accidents due to sleep fragmentation from repeated arousals during sleep.<ref name="Lim4" /> If OSA is not treated it results in excessive daytime sleepiness and oxidative stress from the repeated drops in oxygen saturation, people are at increased risk of other systemic health problems, such as diabetes, hypertension or cardiovascular disease.<ref name="Lim4" /> Subtle manifestations of sleep apnea may include treatment refractory hypertension and cardiac arrhythmias and over time as the disease progresses, more obvious symptoms may become apparent.<ref name="Stansbury-2015"/> Due to the disruption in daytime cognitive state, behavioral effects may be present. These can include moodiness, belligerence, as well as a decrease in attentiveness and energy.<ref name="aloiaetal2">{{cite journal |vauthors=Aloia MS, Sweet LH, Jerskey BA, Zimmerman M, Arnedt JT, Millman RP |date=December 2009 |title=Treatment effects on brain activity during a working memory task in obstructive sleep apnea |journal=Journal of Sleep Research |volume=18 |issue=4 |pages=404–10 |doi=10.1111/j.1365-2869.2009.00755.x |pmid=19765205 |s2cid=15806274 |hdl-access=free |hdl=2027.42/73986}}</ref> These effects may become intractable, leading to depression.<ref>{{cite journal |vauthors=Sculthorpe LD, Douglass AB |date=July 2010 |title=Sleep pathologies in depression and the clinical utility of polysomnography |url=https://nrc-publications.canada.ca/eng/view/accepted/?id=31e80401-0de8-408d-90c5-1a593b660ea8 |url-status=live |journal=Canadian Journal of Psychiatry |volume=55 |issue=7 |pages=413–21 |doi=10.1177/070674371005500704 |pmid=20704768 |archive-url=https://web.archive.org/web/20240210170911/https://nrc-publications.canada.ca/eng/view/accepted/?id=31e80401-0de8-408d-90c5-1a593b660ea8 |archive-date=10 February 2024 |access-date=6 December 2023 |doi-access=free}}</ref>