Upper Airway Resistance Syndrome (UARS):
A sleep-breathing disorder characterized by partial airway resistance to breathing during sleep. UARS can be described as a "lighter" sleep-breathing disorder than Obstructive Sleep Apnea. People with UARS have some difficulty breathing during sleep, which makes them tired during the day.

Features  

    UARS, like obstructive sleep apnea, involves airway resistance to breathing during sleep. The airway partially collapses, which affects breathing, but not enough to reduce blood oxygen levels. Although not as severe or obvious as OSA, this sleep disorder not only interferes with sleep, but may negatively impact health.         
       There is some controversy in the medical community as to the existence and relevance of UARS. Among those who do recognize this condition, some prefer to label it as a mild form of sleep-disordered breathing.
     Many people with UARS have no idea that they have a sleep-breathing disorder. They may not snore dramatically enough to awaken their bed partners, or at all. They may not experience as much daytime sleepiness as those with OSA. Instead, they feel fatigued or may be diagnosed with other conditions such as Depression or Sleep-Onset Insomnia.


Diagnosis  

        A special type of sleep study is required to positively identify upper airway resistance. This type of polysomnography not only records several bodily functions, including respiratory rate, heart rate, and blood-oxygen levels, but also Pes or esophogeal pressure. Pes measures fluctuations in pressure around the esophagus that are associated with UARS. Because apneas and hypopneas detected through the use of standard polysomnography are either absent or minimal, Pes is the gold standard diagnostic test for UARS.

Treatment  

      Treatment for UARS is similar to that of sleep apnea. The first and most effective treatment involves mechanical therapy through the nightly use of a continuous positive airway pressure (CPAP) machine to aid with breathing during sleep. The CPAP machine or a variation of it blows air through  a mask worn over the nose, forcing the airway open. Reimbursement for the CPAP device may be a problem if the insurance provider does not recognize UARS. As with sleep apnea, surgical options such as Uvulo Palato Pharyngo Plasty (UPPP) and linguloplasty may be able to increase airway size.
      Behavioral Therapy such as weight loss and Good Sleep Habits  accompanies CPAP therapy, or may be all that is needed to treat mild UARS. Finally, dental devices and other small appliances (including a mandibular advancement appliance) may be enough to open the airway, in some cases.


UARS Mechanics

      A structural or mechanical problem reduces the flow of air in those with Upper Airway Resistance Syndrome. The airway tends to be smaller in size or otherwise restricted. Airway tissues relax during sleep, reducing the diameter of the airway even more.
    Although the airway does not become as narrowed or completely blocked as with obstructive sleep apnea, the constriction is still enough to reduce air flow. Breathing then becomes labored. UARS can be likened to breathing through a straw. Enough air is passing through to maintain healthy blood-oxygen levels, but not enough to prevent a brief arousal from sleep due to the work of breathing.


Suggested Downlaods

SleepIssues:
Sleep Breathing Disorders
Home Sleep Test
SleepCaptions:
Upper Airway Resistance Syndrome