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Upper Airways Resistance Syndrome (UARS)

A less well-known, yet common Sleep Disorder, is Upper Airways Resistance Syndrome (UARS) and is often the case when people have a sleep study with too low an AHI (apnoea-hypopnoea index) score to be classed as a diagnosis for Sleep Apnoea.  It should be noted that very often UARS does eventually progress into Sleep Apnoea as people age and lose muscle tone, or if they gain weight.  Sadly UARS is often not recognised and people can suffer with just as severe daytime symptoms as someone untreated for Sleep Apnoea!  We have come across many people who were sure they had Sleep Apnoea, and were actually disappointed to be told they don't have it and discharged from the sleep clinic.

Dr Christian Guilleminault is the sleep researcher who discovered UARS and there is an interesting interview between him and Dr Steven Park on this link http://doctorstevenpark.com/expert-interview-dr-christian-guilleminault-on-uars


Symptoms of UARS

The symptoms are almost identical to Sleep Apnoea (see the symptoms in What Is Sleep Apnoea?) and the biggest cause is narrow airways.  Women and children are just as likely to have UARS and often people are of average size or very slim.  Insomnia is common with UARS - as are migraines, depression, chronic fatigue and Fibroymyalgia, but put simply it appears to be Sleep Apnoea without the diagnosis as UARS sufferers don't actually stop breathing for the minimum of 10 seconds which is classed as an apnoea, but they struggle to breathe during sleep and suffer from sleep arousals.  Snoring is common in UARS, but we hear from many people who don't actually snore, but breathe noisily or make other sounds and moans when sleeping.


Diagnosing UARS

It is difficult to get a true diagnosis of Sleep Apnoea here in the UK as there are few hospitals that offer the gold standard diagnosis, which is Esophageal Manometry (Pes).  However, it can be suspected by experienced scoring on a Polysomnography sleep study by studying the wave forms and other data.

More sleep clinics these days are willing to treat people for UARS at their discretion, but here in the UK the National Institute for Health and Care Excellence (NICE) does not offer guidance for the treatment of UARS.  In fact it was only in 2008 that they recommended CPAP for Obstructive Sleep Apnoea, so we have to hope things will improve for UARS sufferers soon.


Treating UARS

  • CPAP very often successfully treats people with UARS
  • Sufferers of UARS have also got good results with oral appliances.  However, it is not recommended to purchase off-the-shelf 'mouth guards' but to have a dentist trained in sleep make a device.  See the expert-written free guide on 'How To Choose A Mouthpiece'  at https://www.snorer.com/information-guides/
  • Self-help can improve UARS with products like Breathe Right Nasal Strips or Nasal Cones etc., which can be bought in local supermarkets and chemists.
  • A consultation with an ENT consultant can be beneficial to examine the airways and be professionally advised.

We totally empathise with those of you who are struggling with the symptoms of UARS, and would encourage you to research local services in your area.

We would also recommend Dr Park's book 'Sleep Interrupted' where there is a wealth of information on UARS.

Sleep Interrupted Book by Doctor Steven Park