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UARS is a common but rarely diagnosed problem that causes significant sleep disruption.

It is easiest to think of Upper Airway Resistance Syndrome (UARS) as severe snoring.

Although there are times when UARS can occur with little noise, particularly in children. UARS is a condition when the air passageway narrows so much that chest muscles and diaphragm have to work very hard to pull air into the lungs. UARS is at the midpoint of severity in breathing disorders between snoring and obstructive sleep apnea. As snoring gets worse, it becomes UARS. Untreated UARS can evolve into obstructive sleep apnea.

There are some major differences between those with sleep apnea and people suffering from UARS.

1. While sleep apnea is more common in men, women are as likely to suffer from UARS as men.
2. While people with sleep apnea are more likely to be overweight, it is extremely common for UARS suffers to be normal weight.
3. Chronic insomnia with frequent awakenings and difficulty resuming sleep are more common in those with UARS than with sleep apnea.

Notice this person struggling to breathe during sleep. Pay little attention to the sound, since the sound emitted while struggling to breathe differs from person to person. Instead, pay attention to the effort being generated attempting to pull air into the lungs.

Video of a Woman Suffering from Upper Airway Resistance Syndrome

Consequences of Upper Airway Resistance Syndrome

To understand the difficulty that someone with UARS has with breathing, try to imagine breathing for an extended period of time through an opening no larger than a small soda straw.

This process of UARS breathing can be seen in the nasal air flow tracing shown below which was obtained with a device fastened underneath the nose that measures airflow during sleep. This airflow tracing shows a record of the inhalations and exhalations over a five minute period of time. Notice how the air flow gets progressively more and more restricted (red arrows). This increasing restriction takes place as this UARS sufferer progressively goes deeper and deeper into sleep and the airway slowly collapses with increased muscle relaxation. When the effort of inhalation gets too extreme, this UARS sufferer arouses from a deeper level of sleep, takes a few easy, deep breaths (green arrows), and starts the process all over again. In this period of five minutes, this repetitive arousal process occurs about once a minute.

This graph demonstrates the effect of Upper Airway Resistance Syndrome (UARS) on your breathing.

Diagnosing UARS

UARS is often mistaken for other conditions and is frequently overlooked by those suffering from it

UARS is the orphan child of sleep medicine since far more emphasis is placed on its more attention-getting sibling, obstructive sleep apnea. However, all of the symptoms attributable to obstructive sleep apnea can also be attributed to UARS.

Upper Airway Resistance Syndrome commonly masquerades as

  • Chronic fatigue syndrome – severe, continued tiredness that is not relieved by rest and is not directly caused by other medical conditions.
  • Fibromyalgia – a common syndrome in which a person has long-term, body-wide pain and tenderness in the joints, muscles, tendons, and other soft tissues. Studies show that the vast majority of fibromyalgia suffers have undiagnosed UARS. When UARS is properly managed, fibromyalgia pain can dramatically decrease.
  • Migraine – a common type of headache that may occur with symptoms such as nausea, vomiting, or sensitivity to light.
  • Depression – described as feeling sad, blue, unhappy, miserable, or down in the dumps. When children don’t get enough sleep they get hyper and cranky. When adults don’t get enough sleep over a prolonged period of time, depression can easily set in. Sadly, mental health professionals rarely evaluate their patients for difficulty breathing during sleep.

Women in the third trimester of pregnancy will often develop UARS as they experience weight gain.

Studies have estimated that 14 percent of women snore while 28 percent of pregnant women snore. Studies have shown that managing UARS during pregnancy relieves the symptoms of pre-eclampsia.

People with UARS get reports from their physician that their blood pressure is rising, requiring blood pressure medication to get it under control. However, sleep studies are rarely done to find the underlying problem taking place during sleep.

Those who snore and experience daytime fatigue and sleepiness often are sent to the sleep lab to check for the presence of sleep apnea. Many times these patients don’t stop breathing often enough to get a diagnosis of sleep apnea. The conclusion is usually made that sleep isn’t the reason why they feel so bad. Since UARS is much more difficult to diagnose and since insurance companies rarely reimburse for the management of UARS, sleep physicians rarely pay much attention to this common condition.

Treatment of UARS

UARS can be predictably managed in most patients with an Oral Systemic Balance (OSB) orthotic worn over the lower teeth during sleep. This orthotic is easy to insert and remove and is extremely comfortable to wear as seen in the following video.

What’s OSB?

UARS is often caused by a narrow upper airway which can be the cause of other problems including headaches, neck pain, chest tightness, problems swallowing, and TMJ pain. If you suffer from any of these symptoms, call Dr. Lawler’s office today at 812-339-4499 to set up your initial consultation. We can help you feel better.