The upper airway resistance syndrome

Area of Science:

• Sleep Medicine
• Respiratory Physiology

Background:

• Obstructive sleep apnea syndrome (OSA) is a significant public health concern with cardiovascular and metabolic implications.
• Intermittent hypoxia is the primary driver of OSA's adverse effects.
• Upper Airway Resistance Syndrome (UARS) is hypothesized to cause disease through snoring and respiratory effort-related arousals (RERAs) without significant oxygen desaturation.

Purpose of the Study:

• To delineate the specific characteristics of UARS relevant to clinical practice and research.
• To differentiate UARS from OSA, particularly in cases lacking oxygen desaturation.
• To highlight the diagnostic challenges and potential misinterpretations of UARS symptoms.

Main Methods:

• Review of existing literature on UARS and OSA.
• Analysis of diagnostic criteria and scoring of respiratory events.
• Comparison of clinical presentations and comorbidities.

Main Results:

• UARS is characterized by RERAs, leading to symptoms like diurnal sleepiness, insomnia, and altered quality of life.
• Diurnal sleepiness in UARS can be mistaken for simple tiredness, especially in women.
• Current classifications often group UARS patients under OSA, despite distinct pathophysiological features.

Conclusions:

• UARS represents a distinct clinical entity with significant health consequences, warranting specific recognition.
• Further research and refined diagnostic criteria are needed to individualize UARS.
• Clinicians should be aware of UARS to ensure accurate diagnosis and management.