BACKGROUND: Patients with obstructive sleep apnea syndrome (OSAS) exhibits repititive, prolonged episode of apnea during sleep with serious nocturnal and diurnal physiologic derangements. With their physiologic derangements, they are often obese, very sensitive to central depressant drugs and difficult to intubate. The purpose of this paper is to evaluate the potential problems encountered in anesthetic management of adult OSAS. METHODS: Anesthetic records of 28 patients with OSAS who had undergone the uvulopalatopharyngoplasty (UPPP) under the general anesthesia during the period of 1981 and 1996 years were analysed retrospectively. RESULTS: Although past anesthetic records were not recorded completely, we discovered that the policy in selection of drugs with shorter duration of action time and not using central depressant drugs during the induction of anesthesia of adult OSAS patients were not kept. CONCLUSIONS: Sleep apnea syndrome presents the anesthetists with many implications. In addition to difficulties of tracheal intubation imposed by anatomical features, these patients are sensitive to central depressant drugs particularly opioids. Anesthetic care, postoperative analgesia, cardiorespiratory management need to be handled with care.