the absence of these symptoms if there is evidence by polysomnography of 15 or more ob-
structive apneas and/or hypopneas pe r hour of sleep (Criterion A2). 
Specific attention to disturbe d sleep occurring in association with snoring or breathing
pauses and physical findings that increase ri sk of obstructive sleep apnea hypopnea (e.g.,
central obesity, crowded pharyngeal airway, el evated blood pressure) is needed to reduce
the chance of misdiagnosing this treatable condition.
Associated Features Supporting Diagnosis
Because of the frequency of nocturnal awakenin gs that occur with obstructive sleep apnea
hypopnea, individuals may report symptoms  of insomnia. Other common, though non-
specific, symptoms of obstructive sleep apne a hypopnea are heartbur n, nocturia, morning
headaches, dry mouth, erectile  dysfunction, and reduced li bido. Rarely, individuals may
complain of difficulty breathing while lying supine or sleeping. Hypertension may occur
in more than 60% of individuals with obstructive sleep apnea hypopnea.
Prevalence
Obstructive sleep apnea hypopnea is a very common disorder, affecting at least 1%–2% of
children, 2%–15% of middle-age adults, and mo re than 20% of older individuals. In the
general community, prevalence  rates of undiagnosed obst ructive sleep apnea hypopnea
may be very high in elderly individuals. Sinc e the disorder is strongly associated with obe-
sity, increases in obesity rates are likely to be accompanied by an increased prevalence of
this disorder. Prevalen ce may be particularly high amon g males, older adults, and certain