Study Objective: The aim of this article was to identify the most common sites of obstruction in patients with obstructive sleep apnea (OSA) by a systematic review of published studies.

Design: The review was conducted by a MEDLINE search of the English literature published during the years 1980 to 2002. The inclusion criteria were experiments involving five or more adult subjects, total rather than partial obstruction or narrowing of the upper airway, and techniques that were performed on the subjects while they were asleep.

Conclusion: Although there was considerable variability in the techniques and the results, the most common site of obstruction detected by these studies was at the level of the oropharynx, with extension to the laryngopharynx commonly observed.

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