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Updated: May 12, 2026

Drug-Induced Sleep Endoscopy (DISE) with Target Controlled Infusion (TCI) and Bispectral Analysis in Obstructive Sleep Apnea
Published on: December 6, 2016
Severe onychophagia and finger mutilation associated with obstructive sleep apnea
Gustavo Nino1, Ravi Singareddy
1Penn State Hershey Children’s Hospital, Division of Pediatric Pulmonary and Sleep Medicine, Pennsylvania State University College of Medicine, Hershey, PA 17033-0850, USA. gninobarrera@hmc.psu.edu
Abstract:
Untreated obstructive sleep apnea (OSA) can lead to important neurobehavioral consequences including cognitive deficits, hyperactivity/inattention, daytime sleepiness, and mood disturbances. Interestingly, the potential role of OSA in the pathogenesis of impulse-control disorders such as nail biting (onychophagia) is currently unknown. We present a case of a man with severe onychophagia and biting-induced finger mutilation that was completely resolved after diagnosis and treatment of severe OSA. Accordingly, this report represents an important clinical observation that suggests a connection between sleep physiology and the neurobiological circuits implicated in the regulation of impulse-control behaviors. Further research in this area may improve our current understanding of the neurobehavioral consequences of untreated OSA.
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