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RATIONALE: Prior work suggests that Black patients have more severe obstructive sleep apnea (OSA) upon clinical presentation. However, the extent to which this may reflect differences in symptoms or other standard measures of OSA risk is unclear. OBJECTIVES: We assessed for racial disparities in OSA characteristics at time of initial clinical diagnosis. METHODS: Data from 890 newly diagnosed patients with OSA at an urban academic sleep center were included in this analysis. All patients completed a standardized questionnaire on demographics and sleep-related symptoms and underwent laboratory polysomnography. Symptom severity at the time of evaluation was compared across race and sex. RESULTS: Black men were underrepresented in the sleep lab, making up only 15.8% of the cohort and 31.3% of Black participants (P