What Is Upper Airway Resistance Syndrome?
Understanding Upper Airway Resistance Syndrome (UARS)
Upper Airway Resistance Syndrome (UARS) is a sleep-related breathing disorder characterized by increased resistance in the upper airway during sleep, without the presence of apnea or significant hypopnea. Unlike obstructive sleep apnea, individuals with UARS experience repeated disruptions in their breathing patterns due to narrowed airways—leading to frequent arousals from sleep and poor sleep quality—even though full respiratory events like apneas may not meet diagnostic thresholds.
How UARS Differs From Sleep Apnea
While both UARS and obstructive sleep apnea (OSA) involve airway obstruction, the key distinction lies in the severity of breathing interruptions. In UARS, airflow is reduced but does not drop below the 50% threshold required to classify as hypopnea. However, the increased effort to breathe against a restricted airway activates the sympathetic nervous system, causing micro-awakenings throughout the night. These disruptions prevent deep, restorative sleep, often resulting in chronic fatigue, daytime sleepiness, and cognitive difficulties.
Symptoms and Common Indicators
People with UARS typically present with persistent snoring, unrefreshing sleep, and excessive daytime tiredness. Other common signs include frequent nighttime awakenings, difficulty concentrating, mood disturbances such as anxiety or depression, and elevated heart rate during sleep. Because symptoms can be subtle and overlap with other conditions like insomnia or chronic fatigue syndrome, UARS is frequently underdiagnosed or misdiagnosed.
Anatomical and Physiological Factors Behind Increased Airway Resistance
The condition arises when the muscles in the throat, nose, and pharynx relax excessively during sleep, narrowing the air passage. Structural factors such as a deviated septum, enlarged tonsils, nasal congestion, or a naturally narrow airway can contribute significantly. Additionally, lifestyle elements like obesity, alcohol consumption before bedtime, and sleeping on the back may exacerbate airway resistance, making it harder to maintain consistent airflow.
Diagnosis and Medical Evaluation
If UARS is suspected, patients should consult a specialist at a reputable medical center. Evaluations are typically conducted through departments specializing in pulmonology, neurology, or otolaryngology (ear, nose, and throat). Diagnosis usually requires an overnight sleep study—polysomnography—that measures respiratory effort, airflow, oxygen levels, and brain activity. A key diagnostic marker for UARS is the presence of increasing respiratory effort leading to arousal from sleep, even in the absence of apnea events.
Why Early Detection Matters
Early identification of UARS is crucial because untreated cases can progress into more severe sleep-disordered breathing, including full-blown obstructive sleep apnea. Moreover, chronic sleep fragmentation increases the risk of cardiovascular issues, insulin resistance, and mental health challenges. Recognizing the signs early allows for timely intervention and better long-term outcomes.
Treatment Options and Lifestyle Management
Effective management of UARS often involves a combination of medical treatments and lifestyle modifications. Continuous Positive Airway Pressure (CPAP) therapy is commonly prescribed to keep the airway open during sleep. For milder cases, oral appliances that reposition the jaw and tongue may provide relief. Addressing underlying causes—such as treating nasal obstructions, losing weight, avoiding sedatives, and changing sleep positions—can also dramatically improve symptoms and overall sleep architecture.
Seeking Professional Help for Better Sleep Health
If you regularly snore, wake up feeling unrested, or struggle with focus and energy during the day, don't dismiss these as normal habits. Consulting a healthcare provider for a comprehensive evaluation could uncover an underlying condition like UARS. With proper diagnosis and treatment, many patients experience significant improvements in sleep quality, daytime alertness, and general well-being.