Obstructive sleep apnea is not something that just appears one morning. Instead, obstructive sleep apnea (OSA) is thought to represent the most severe form of a spectrum of sleep-related breathing difficulties.
On the opposite extreme is benign snoring, which has no effect on sleep health but may interrupt the sleep of a bedmate. Upper airway resistance syndrome (UARS) is generally the first stage in the progression from snoring’s initial, less serious cause—mouth breathing while sleeping—to the more serious sleep problem known as sleep apnea.
Snoring may or may not be the first sign of sleep apnea, which is usually considered to begin with a gradual airway collapse. However, a person’s health and the quality of their sleep might suffer as a result of the constant disruption. As obstructive sleep apnea is a condition that can arise from upper airway resistance syndrome, it is crucial to diagnose and treat people who have UARS before they progress to OSA.
Therefore, if you snore and have fatigue but have been told that you do not have sleep apnea, discuss upper airway resistance syndrome with your primary care physician.
However, what precisely is UARS? How does it vary from OSA in this regard? And what kinds of treatments are there to stop it from progressing into OSA in the first place? In this article, we want to address these questions and some more.
Upper Airway Resistance Syndrome
When the muscles in your throat relax during sleep, preventing adequate airflow, you may have upper airway resistance syndrome (UARS).
It’s a condition comparable to OSA but less in intensity. Some medical professionals place UARS between snoring and sleep apnea on the spectrum of sleep disorders.
It is still difficult to fall asleep, and you may feel sleepy during the day if you have UARS. However, even if you’re having trouble breathing while you sleep, your doctor doesn’t think it meets the criteria for a diagnosis of classic sleep apnea.
Managing your UARS symptoms with therapy and lifestyle modifications will help you avoid further issues.
The term “UARS” was first coined in 1993 and was initially applied to individuals whose symptoms did not meet the criteria for a diagnosis of OSAS. People who have UARS do not suffer from recognized apnea, which is when there is a complete cessation of breathing.
How Are OSA And UARS Different From One Another?
UARS and OSA undoubtedly have certain commonalities and linkages, but they also have unique characteristics. For example, in individuals with UARS, breathing pauses and reductions are uncommon, in contrast to the prevalence of these phenomena in OSA patients. In addition, people with OSA often struggle with their weight. However, those with UARS tend to be of a normal build.
Although UARS can affect people of any race or gender, obstructive sleep apnea is disproportionately more frequent among white males.
Since blood pressure drops during apnea and hypopnea episodes, obstructive sleep apnea is also linked to other chronic health problems such as hypertension, cardiovascular problems, arrhythmias, strokes, and cardiac arrest.
Patients who are not treated for UARS run the risk of acquiring OSA and other related health issues.
Symptoms of UARS
The following symptoms may characterize UARS:
- Snoring
- Excessive drowsiness during the day
- Insomnia/sleep disturbances
- Problems falling or staying asleep
- Exhaustion
- Difficulty remembering things or thinking clearly
Causes of UARS
The causes of UARS can be identified since they are comparable to the causes of obstructive sleep apnea. UARS is caused by the neck’s loosened or relaxed fatty tissues collapsing, which, when paired with restricted airways, results in decreased airflow. In addition, as you sleep, your tongue may slide to the back of your throat, which can restrict your airway and make it harder for you to breathe.
People with UARS may experience heavy, hard breathing rather than loud snoring noises commonly associated with the disorder. This is because UARS causes the increased breathing effort required to overcome the blockages.
The brain has been trained to wake itself up from a deep sleep state to make up for the greater work required to breathe. However, when this occurs, it is hard for the brain to perform the required restorative functions that normally occur during the various stages of a typical night’s sleep.
RERAs, or Respiratory Effort Related Arousals, are used for these types of stimulation. In addition, an obstructive event that does not match the objective standards for obstructive sleep apnea but yet results in awakening from sleep is considered a RERA.
Diagnosis of UARS
It is possible that individuals affected by this ailment are unaware they have it. For example, a person who suffers from narcolepsy will not recall waking up in the middle of the night since the arousal episodes are shallow and only last for a short period.
Because Upper Airway Resistance Syndrome doesn’t always go hand in hand with audible and evident snoring, partners might not realize that anything is wrong if the snoring isn’t particularly loud or obvious.
Therefore, the only option to achieve a diagnosis is to collaborate with a medical professional who specializes in sleep medicine and who is able to recommend the appropriate sleep study. The condition known as obstructive sleep apnea can be identified with the use of a sleep study (also known as polysomnography).
The findings of the study offer some insight into the regularity of the pauses in breathing that occur while a person is asleep. These pauses in breathing are referred to as apneas, and the apnea-hypopnea index is used to quantify how frequently they occur (AHI).
In most cases, people with Upper Airway Resistance Syndrome do not pause in their breathing for a period that is sufficient for their arousals to appear on the apnea-hypopnea index when a standard sleep study is performed.
But the correct kind of sleep study will still indicate frequent arousals even if there is no indication of obstructive sleep apnea (apnea or hypopnea episodes) or lowered oxygen levels. Therefore, an Upper Airway Resistance Syndrome diagnosis may be made if several arousals occur during sleep, but there are no apneic episodes.
Even while we are not dealing with real pauses in breathing, the respiratory resistance and arousals represented in the presence of RERAs may absolutely impair sleep quality and produce bad health effects.
Upper Airway Resistance Syndrome is a disorder that can be difficult to discern, and as a result, people who have this illness can be diagnosed as having a number of other health concerns. Depressive illness, mental illnesses, Lyme disease, chronic fatigue syndrome, and fibromyalgia are just a few examples.
Treatment Options For UARS
Because this ailment can be brought on by a variety of events or even a confluence of factors, the therapy for it will often be tailored to the individual patient. Among the potential treatments, modalities are altering one’s lifestyle and behavior patterns, such as dropping excess weight, switching to a healthier diet, cutting back on alcohol intake, and other similar adjustments.
The Continuous Positive Airway Pressure (CPAP) therapy is a typical treatment technique for Upper Airway Resistance Syndrome. Depending on the severity of the problem and the underlying cause of it, this treatment may also be used to treat obstructive sleep apnea (OSA).
A mandibular advancement device, often known as a MAD, is a dental appliance that works by pulling the lower jaw forwards in order to keep the airway open while the patient sleeps.
A sleep dentist may recommend that a patient have one of these devices. Additionally, there are circumstances in which a surgical procedure may be recommended; however, this, along with the remainder of the treatment plan, will very much rely on the person being treated.
When combined with conventional medical care, myofunctional therapy can be an excellent means of resolving Upper Airway Resistance Syndrome. A myofunctional therapist who specializes in treating individuals with sleep-disordered breathing may help relieve symptoms by addressing underlying causes such as allergy, nasal congestion, and inflammation. They also facilitate better sleeping habits.
In addition, the exercises that are a component of a myofunctional therapy program are a huge help. For example, mouth myofunctional exercises are a non-invasive method of strengthening and retraining malfunctioning oral and facial muscles, which can help alleviate symptoms of sleep apnea. This reduces the likelihood that the upper airway will become relaxed and closed off as you sleep. This, in turn, minimizes the incidence of breathing disruptions during sleep.
First, if UARS is a problem, lifestyle and behavior adjustments are the first to be evaluated for therapy. Practicing excellent sleep hygiene, having a decent diet, and getting a fair amount of physical activity will go a long way to decreasing the symptoms. Furthermore, oral and dental appliances may be utilized to keep the airways open. These are typically prescribed together with the previously mentioned lifestyle and behavioral adjustments.
Closing Thoughts
Upper airway resistance syndrome is possible if you are a chronic snorer or suffer from sleep difficulties that leave you feeling tired most days.
If you are concerned about how you breathe when you are asleep, you should seek the advice of a healthcare expert or a sleep specialist to have an assessment performed.
Sleep problems are never pleasant, but medical treatment and other assistance are available. You should get a good night’s sleep that helps you recharge your batteries.
Upper Airway Resistance Syndrome (UARS) is similar to other forms of sleep-disordered breathing in that effective therapy requires an accurate diagnosis and an all-encompassing treatment strategy centered on identifying and resolving the underlying problems.
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