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 evolves into obstructive sleep apnea.

Sample of UARS sufferer

Consequences of UARS

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. Imagine trying to breathe through an opening the size of the following circle:

Very loud snoring results — its sound reaching through walls. At some point, the effort of this labored breathing becomes so intense that the sleeper arouses from deeper levels of sleep; takes a few fuller, easier breaths, and goes back into deeper levels of sleep, only to start the process all over again as seen in the nasal airflow test below. Surprisingly, UARS sufferers are not aware of the difficulty that they have breathing in their sleep and often experience daytime sleepiness and high blood pressure.

This process of UARS breathing can be seen in the nasal air flow tracing shown below. This record of air flow 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.

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. UARS commonly masquerades as:

• Chronic fatigue syndrome

• Fibromyalgia

• Migraine

• Hypothyroidism

• Depression

In addition, UARS is implicated in conditions as diverse as fibromyalgia and pre-eclampsia in pregnancy.

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. Physicians, often unaware of the underlying UARS condition, label their patient as a "migraine patient" or diagnosing depression or hypothyroid conditions.

Easy home diagnosis

The presence of UARS can be diagnosed by a medical sleep lab if their instruments are sensitive enough to pick it up. UARS can easily be diagnosed by the home sleep monitoring device used at The Center for Sound Sleep, called the Watch PAT.

You can learn more in our Home Diagnosis section