Obstructive sleep apnea (OSA) is the most common variant of sleep-disordered breathing that often goes undiagnosed. OSA is characterized mainly by anatomical obstruction or partial collapse of upper airways during sleep. The obstruction is multifactorial, and a lesser-known fact is that damage to the pharyngeal plexus during head and neck procedures or placement of hardware in the cervical area can lead to narrowing or collapse of the upper airway. We present such a case of a 59-year-old female who developed new-onset OSA after undergoing anterior cervical discectomy and fusion (ACDF). The severity of OSA worsened with the progression of her rheumatoid arthritis (RA) in the cervical region. This case report aims to raise awareness of such an association among clinicians to enable them to screen appropriate patients for sleepdisordered breathing and treat them accordingly.Categories: Family/General Practice Keywords: anterior cervical discectomy and fusion, rheumatoid arthritis, radiculopathy, myelopathy, neck pain, snoring, risk factors for obstructive sleep apnea (osa), obstructive sleep apnea, worsening obstructive sleep apnea (osa)