• Anna M May, Kamal Gandotra, and Dennis H Auckley.
• Division of Pulmonary, Critical Care, and Sleep Medicine, University Hospitals Cleveland Medical Center, Case Western Reserve University, Cleveland, OH. Electronic address: anna.may@uhhospitals.org.
• Chest. 2018 Jan 1; 153 (1): e9-e12.

Case PresentationA 15-year-old boy presented as a direct referral for polysomnography for evaluation of snoring, unrefreshing sleep, and daytime sleepiness despite a self-reported average of 8 hours of sleep a night. The mother reported he snored intermittently, although there were no witnessed apneic episodes or fragmented sleep. He denied morning headaches. He reported that his sleep was generally unrefreshing and he would experience significant daytime sleepiness, especially after school or when doing his homework. However, his Epworth Sleepiness Scale score was only 3 of 24. He denied any symptoms consistent with a movement disorder, parasomnia, cataplexy, hypnogogic/hypnopompic hallucinations, sleep paralysis, circadian rhythm disorders, or insomnia. He reported a family history of sleep apnea in his grandfather.Copyright © 2016 American College of Chest Physicians. All rights reserved.

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