Upper Airway Resistance Syndrome (UARS)

upper airway resistance syndrome

Elle magazine writer Rachael Combe describes her experience with relentless sleep problems and how she finally found help in her article, “The Mysterious Answer to My Unrelenting Insomnia”.

Averaging only four hours of sleep a night, by day her mind wandered and her body started to break down. Her doctors and gynecologist couldn’t pinpoint any one issue. After following all the sleep hygiene tips available with no relief, her dentist was the one to note the size of her tongue which was a key to diagnosing this sleep problem. He called it the “young, thin, beautiful women’s sleep disorder.”

The description may sound a bit silly, but Upper Airway Resistance Syndrome (UARS) is categorized by the American Academy of Sleep Medicine as a form of the more commonly diagnosed obstructive sleep apnea (OSA). And this version of the disorder does tends to be found more often in women with a smaller build, just as the common OSA patient is often thought of as overweight and male. (Though that group is definitely not the only one to suffer from the disorder).

Some experts describe UARS as being at a midpoint in severity somewhere between basic snoring and OSA, though snoring may or may not be a symptom for all patients suffering with these disorders. Some people describe it more “like trying to breathe through a straw.”

What are the Symptoms for Upper Airway Resistance Syndrome?

As with most sleep problems, people usually first notice symptoms like increased snoring, daytime sleepiness, cognitive impairment, not feeling refreshed after sleeping, and waking up frequently (referred to as “arousals”).

UARS is specifically characterized by the narrowing or blockage of the airway that can cause those disruptions to sleep. It can manifest in different ways, such as…

  • a naturally narrowed air passage,
  • loose fatty tissues of the throat collapsing back into the airway,
  • or the tongue’s position in the month (falling back) during sleep.

The syndrome is similar to obstructive sleep apnea (OSA) in the way that the soft tissue of the throat relaxes which reduces the size of the airway which in turn results in disturbed sleep and the daytime impairments, including excessive daytime sleepiness or fatigue.

Treatment for Upper Airway Resistance Syndrome

A sleep study can monitor and record many aspects of how you sleep, such as brain wave activity, muscle activity, eye movements (particularly REM stage sleep), heart rate, airflow, etc. Based on those findings, the sleep doctor will be able to determine the cause — such as UARS — and recommend treatment options. The most common recommendation for UARS is a CPAP machine (for “continuous positive airway pressure), the same successful treatment used for other forms of OSA for more than two decades. Like the Elle writer, many patients require special fittings for their CPAP mask and equipment, as well as a trial period to adjust to the device and fine-tune the settings. Depending on the severity of symptoms, other oral appliances or even surgery may be options to consider.

If you experience daytime fatigue and other symptoms — even if they may not seem related — and you are not finding a solution, consider scheduling a sleep consultation and sleep study. You may finally find that all the pieces come together and you really can feel better.

Learn more about Sleep Apnea and our Sleep Apnea Specialists.

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