Obesity-related obstructive sleep apnea (OROSA) causes recurrent airway obstruction, impairing sleep quality, cardiometabolic health, and daily functioning. Globally, OSA affects about 1 billion adults aged 30–69 years, including 29 million in India. Obesity is the major risk factor, with increasing body mass index (BMI) associated with greater OSA severity. In Unani medicine, obesity (Samān-e-Mufraṭ) caused by excess Balgham, and treatment focuses on correcting Asbāb-e-Sitta Ḍarūriyya. Aim: To evaluate Unani interventions in OROSA patient by measuring quality of life, obesity indices, daytime sleepiness, psychosocial function, and behavior through Asbāb-e-Sitta Ḍarūriyya-based lifestyle guidance. Methods: A 41-year-old female with OROSA presented with exertional dyspnea, daytime somnolence, and CPAP dependence. Over 60 days she received a polyherbal decoction (150 ml OD), Jawārish-e-Jālīnūs (2.5g OD), and Ḥamām-e-Bukhārī (steam bath twice weekly), plus guidance on diet, physical and psychic activity/rest, and sleep–wake regulation. BMI, Epworth Sleepiness Scale (ESS), and IWQOL-Lite-CT assessed on 0, 15, 30, 45, and 60 days. Results: BMI decreased from 46.8 to 40.3 kg/m² (13.9%); waist circumference 103 to 86 cm (16.5%); mid-thigh 68 to 58 cm (14.7%); mid-arm 39 to 35 cm (10.3%); hip 133 to 130 cm (2.3%); WHR 0.774 to 0.662 (14.5%). IWQOL-Lite-CT improved from 84 to 27 (67.9%). ESS fell from 17 to 8 (52.9%). Exertional and speech-induced breathlessness and vocal hoarseness improved. CPAP use reduced from nightly to twice weekly.Conclusion: Unani therapeutics combined with lifestyle regulation show substantial improvements in clinical and quality-of-life measures in this case