Personality patterns, signs of mental impairment, mental health correlates, and psychosocial consequences were assessed in 50 patients who had obstructive sleep apnea of sufficient severity to warrant recommendation for tracheostomy. The personality patterns of sleep apnea patients were consistently those of a somatic-neurotic type, similar to typical patterns for medical outpatients. The high level of psychologic distress demonstrated was clearly a consequence rather than a cause of the disorder. Most patients showed cognitive impairment; 76% had suspected or mild to severe deficits in terms of thinking, perception, memory, communication, or the ability to learn new information, resulting in a greater potential for being distractible, confused, and irritable. Finally, another striking finding was the high incidence of patients' reports of frequent, severe psychosocial disruption in their lives--involving the family, social interactions and work situations.