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Upper airway resistance syndrome

N Hasan¹, E C Fletcher

¹Department of Medicine, Louisville Veterans Affairs Medical Center, KY, USA.

The Journal of the Kentucky Medical Association

|July 24, 1998

Summary

Upper Airway Resistance Syndrome (UARS) presents symptoms similar to obstructive sleep apnea (OSA) but with incomplete airway obstruction. Diagnosis involves identifying EEG arousals, airflow changes, and increased respiratory effort, often confirmed by nasal positive airway pressure treatment.

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Area of Science:

Sleep Medicine
Respiratory Physiology

Background:

Obstructive Sleep Apnea (OSA) is a well-recognized sleep disorder characterized by complete airway obstruction, leading to breathing pauses, oxygen desaturation, and daytime somnolence.
Cardiovascular complications like hypertension, myocardial infarction, and stroke are associated with OSA.
Upper Airway Resistance Syndrome (UARS) is a newly recognized condition presenting similar symptoms to OSA, but with incomplete airway obstruction.

Observation:

UARS is characterized by increased pharyngeal resistance during sleep.
Key findings on sleep studies include repetitive EEG arousals, fluctuating respiratory airflow, and increased respiratory effort (measured by esophageal pressure).
Snoring is often prominent in UARS, while apneas and hypopneas with oxygen desaturation may be minimal or absent.

Findings:

UARS diagnosis relies on identifying specific polysomnographic findings: EEG arousals, waxing and waning airflow, and increased respiratory effort.
The absence of significant apneas or hypopneas differentiates UARS from classic OSA.
Nasal Positive Airway Pressure (NCPAP) treatment effectively alleviates UARS symptoms, serving as a diagnostic confirmation.

Implications:

Recognizing UARS expands the understanding of sleep-disordered breathing and its clinical manifestations.
Prompt diagnosis and treatment of UARS can mitigate associated daytime symptoms and potential cardiovascular risks.
Further research into the pathophysiology and long-term outcomes of UARS is warranted.

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