Obstructive sleep apnea (OSA) is a common syndrome occurring in 1% to 4% of the population. While obesity is the most common predisposition to OSA, metabolic disorders have been associated with this syndrome. We describe a patient who presented with severe OSA while in an advanced untreated uremic state, which resolved following intensive dialysis. We speculate that the sleep disturbances, which are common in uremia, may be accounted for in some patients by OSA and may resolve with specific therapy for advanced renal failure.