Morbidly obese, lethargy, drowsiness, headache,
and muscle twitching; may develop mental retardation; exertional dyspnea,
cyanosis, and periodic breathing, particularly marked during sleep,
enuresis; hypertension and later signs of chronic cor pulmonale (distended
neck veins, enlarged heart and liver, peripheral edema). Major improvement
is usual following nasal continuous positive airway pressure at night:
daytime sleepiness and behavioral problems regress, and a better quality of
sleep allows enhanced physical activity and favors weight loss.