# Beyond Snoring: Unexpected Presentation of Obstructive Sleep Apnea

**Authors:** Pedro M Vieira, Ana Carolina Aranda, Filipe António C Martins, Inês A Ferreira, Margarida Barroso, Mariana Khomynets

PMC · DOI: 10.7759/cureus.99866 · Cureus · 2025-12-22

## TL;DR

A young, non-obese man with severe obstructive sleep apnea showed unusual symptoms like fatigue and clubbed fingers, emphasizing the need for early diagnosis in primary care.

## Contribution

The paper presents an atypical case of obstructive sleep apnea with non-traditional symptoms, expanding diagnostic awareness in primary care settings.

## Key findings

- A 24-year-old non-obese male with severe OSAS showed atypical symptoms like fatigue and digital clubbing.
- CPAP therapy significantly improved the patient's symptoms and daytime functioning.
- Ancillary tests ruled out other causes of clubbing, confirming OSAS as the primary diagnosis.

## Abstract

Obstructive sleep apnea syndrome (OSAS) is a common yet often underdiagnosed sleep-related breathing disorder characterized by recurrent upper airway obstruction during sleep. We present a case of a 24-year-old, non-obese male patient with severe OSAS who exhibited an atypical clinical picture dominated by long-standing fatigue, poor concentration, and digital clubbing. Diagnostic evaluation included polysomnography, which confirmed severe OSAS, and ancillary testing to exclude pulmonary, cardiac, and gastrointestinal causes of clubbing. Continuous positive airway pressure (CPAP) therapy led to marked improvement in symptoms and daytime functioning. This case highlights the importance of early recognition of atypical OSAS presentations in primary care and reinforces the role of the family physician in coordinating diagnostic evaluation and treatment.

## Linked entities

- **Diseases:** Obstructive sleep apnea syndrome (MONDO:0007147), Obstructive sleep apnea (MONDO:0007147)

## Full-text entities

- **Diseases:** upper airway obstruction (MESH:D000402), clubbing (MESH:D003025), digital clubbing (MESH:D010004), obese (MESH:D009765), OSAS (MESH:D020181), fatigue (MESH:D005221), sleep-related breathing disorder (MESH:D012891)
- **Species:** Homo sapiens (human, species) [taxon 9606]

## Full text

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## Figures

2 figures with captions in the complete paper: https://tomesphere.com/paper/PMC12823139/full.md

## References

27 references — full list in the complete paper: https://tomesphere.com/paper/PMC12823139/full.md

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Source: https://tomesphere.com/paper/PMC12823139