Upper airway resistance syndrome (UARS) is a sleep disorder where the upper airway narrows during sleep, causing labored breathing and frequent nighttime awakenings. It is often confused with sleep apnea, but is different. UARS is treatable with over-the-counter remedies, CPAP devices, or oral appliances. Diagnosis should be made by a sleep specialist or doctor.
Upper airway resistance syndrome (UARS) is a sleep disorder characterized by an obstruction or narrowing of the upper airway, the passageway that extends from the nose to the esophagus, during sleep. This resistance requires the diaphragm and chest muscles to work harder to breathe. The strain that comes with such labored breathing can cause frequent bouts of nighttime wakefulness and difficulty reaching deeper stages of sleep, such as REM (Rapid Eye Movement) sleep.
UARS is often considered a member of the spectrum of disorders known as sleep-disordered breathing (SDB); the most commonly recognized disorder in this spectrum is obstructive sleep apnea. Although upper airway resistance syndrome is sometimes confused with sleep apnea, it is a very different disorder. In sleep apnea, individuals may stop breathing completely many times during the night and will exhibit reduced oxygen levels as a result. Upper airway resistance syndrome, on the other hand, does not cause complete cessation of breathing and does not necessarily cause a decrease in oxygen levels, but is generally characterized by increased difficulty breathing due to airway narrowing.
The most common symptoms of upper airway resistance syndrome include chronic fatigue, chronic night-time awakenings with difficulty getting back to sleep, loud snoring, and cold hands and feet. Both low blood pressure and hypertension can also be observed. In some cases, fatigue caused by frequent night-time awakenings in UARS patients is severe enough to interfere with daily function, resulting in reduced productivity at work and in daily life.
Patients with upper airway resistance syndrome are often of average build, and obesity is not as important a cause as in those with other sleep disorders such as sleep apnea. More than half of those with the disorder are reportedly women, and many are between the ages of 30 and 60. The reduced breathing capabilities experienced due to UARS may be caused by another underlying condition, such as chronic nasal obstruction due to allergic rhinitis, deviated septum, or even nasal tumors. Often, patients with UARS may already have smaller than average airways; such patients often have delicate features that include a narrow face, small or narrow jaw, thin neck, or other similar features that can cause narrowed air passages. These smaller features mean that the normal relaxation that occurs in the airways during sleep causes more narrowing of the airways that may not necessarily occur in a person whose airways are of average size.
This condition can be difficult to diagnose without the correct tools. On the surface, its symptoms may mirror those of other non-sleep disorders such as chronic fatigue syndrome, hypothyroidism, or depression. The best way for a patient to get an accurate diagnosis of upper airway resistance syndrome is to see a polysomnologist or sleep clinic. Such professionals will have the appropriate tools to test for pressure changes in the nose, changes in breathing, or pulse wave signals during sleep that would indicate probable upper airway resistance syndrome.
UARS is treatable through a number of techniques, including over-the-counter remedies such as breathing strips, nasal dilators, or nasal sprays. Using a continuous positive airway pressure (CPAP) device or oral appliances may also help. Patients should consult a sleep specialist or doctor to make an accurate diagnosis and develop an appropriate treatment plan.
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