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Among 48 patients included in the study, 16 (33%) presented an AHI15 upon polysomnography and 14 (29%) had ORSH. The test revealed no difference in ORSH prevalence between patients with AHI 15 or ≥15 (31% vs. 25%). No SAT variables were independently associated with increased PtCO . This study shows that SAT overestimates OSA severity and ORSH affects one third of patients with grade III obesity without awake hypercapnia and with moderate-to-severe OSA at SAT, suggesting how polysomnography combined with PtCO monitoring is the mo