We can only speculate as to why greater recognition of sleep apnea has occurred. The authors suggest that the growth in sleep-disorders centers and publication of scientific articles are at least partly responsible based on the correlation of these factors with the increase in sleep apnea listed as a diagnosis. However, we propose that there are other possible contributions. A visual inspection of Figures 1, 2 indicates that the majority of the increase in patient visits came in two steps, namely from 1992 to 1993 and 1994 to 1996. These dates coincide with the release of the NCSDR reports (volumes one and two) and information at the National Institutes of Health of the National Center on Sleep Disorders Research in the National Heart, Lung, and Blood Institute in 1993.3Since 1990, there has been an increase in organizations, both professional and lay, that have addressed the interests of patients with sleep apnea. For example, the National Sleep Foundation4and the American Sleep Apnea Association5 have publicized the extent of the health-care issue, and have directly helped patients with sleep apnea, as well as other sleep disorders. In addition, the American Academy of Sleep Medicine (formerly known as the American Sleep Disorders Association) grew in membership from approximately 2,250 in 1993 to approximately 3,200 in 1998, and approximately 4,100 by 2000. In 1993, there were 648 diplomates of the American Board of Sleep Medicine, by 1998 there were 1,186 diplomates, and by 2001 there were 1,721 diplomates (personal communication). This activity and growth including the increase in sleep-disorders centers is likely to have raised awareness and increased access to care for patients with sleep apnea and sleep disorders in general.