Understanding UARS: Symptoms, Causes, and Treatment Options

Introduction

Do you have daytime fatigue, disturbed sleep, or frequent night waking? You could have Upper Airway Resistance Syndrome (UARS), a sleep disorder that is frequently undiagnosed but can ruin your lifestyle. Unlike Obstructive Sleep Apnea (OSA), UARS is not always accompanied by complete airway collapse, so it is more difficult to diagnose. In this guide, we’ll outline UARS symptoms, causes, and treatments so you can take the next steps toward healthier sleep and a better life.

Table of contents

1. What is UARS?
2. Symptoms of UARS
3. Causes of UARS
4. How is UARS Diagnosed?
5. Treatment Options for UARS
6. Conclusion
7. FAQ

What is UARS?

UARS is a sleep breathing disorder that happens when the airway is partially obstructed during sleep, resulting in harder breathing. In contrast to OSA, UARS does not usually result in complete airway obstruction or a dramatic decrease in blood oxygen levels. But the increased resistance makes breathing more difficult, interfering with sleep and keeping the body from entering deep, restorative stages of sleep.

Symptoms of UARS

People with UARS often experience symptoms similar to those of sleep apnea and other sleep disorders. Some common signs include:

1. Daytime Fatigue and Sleepiness: Individuals might feel tired during the day even after a full night’s sleep.
2. Unrefreshing Sleep: A person may sleep for the recommended duration but still wake up feeling unrested.
3. Frequent Nighttime Awakenings: It’s common for someone to wake up several times throughout the night.
4. Difficulty Falling Asleep or Staying Asleep: Those with UARS often find it hard to either fall asleep or stay asleep.
5. Snoring: Light snoring can be a symptom for people with UARS.
6. Morning Headaches: Waking up with headaches is frequent, likely due to inadequate sleep quality.
7. Dry Mouth or Sore Throat in the Morning: This can result from breathing through the mouth while sleeping.
8. Cognitive Impairments: Issues with concentration, memory lapses, and brain fog are prevalent due to poor sleep.
9. Mood Disturbances: Chronic sleep deprivation can lead to anxiety, depression, irritability, and mood swings.
10. Frequent Urination at Night: Some individuals may find themselves waking up multiple times to use the bathroom during the night.
11. Breathing Difficulty During Sleep: Symptoms may include gasping, choking, or a feeling of resistance when trying to breathe in.

Causes of UARS

The main reason for UARS is constricted upper airways, which can be caused by different anatomical and physiological factors, such as:

1. Crowded or small airway – The palate can be narrow, jaw small, or tongue large and thus contribute to airway resistance.
2. Nasal obstruction or congestion – Chronic nasal congestion, a deviated septum, or enlarged turbinates can narrow the airways.
3. Weak airway muscles – Poor muscle tone in the throat, usually exacerbated by age, can raise airway resistance.
4. Obesity – Neck fat can lead to airway narrowing.
5. Autonomic nervous system dysfunction – Excessive sympathetic nervous system activity can contribute to UARS.

How is UARS Diagnosed?

The clinical evaluation of Upper Airway Resistance Syndrome (UARS) involves a comprehensive assessment of symptoms, medical history, physical examination, and sleep studies.A thorough history is crucial in UARS diagnosis Airway orthodontist will inquire about the symptoms, will do a physical examination to identify anatomical factors that could contribute to upper airway resistance, and will suggest a CBCT scan and a Sleep study.

Clinical evaluation steps include

1. History and Symptom Evaluation: Daytime fatigue, insomnia, non-restorative sleep, snoring.
2. Physical Examination: Check for anatomical airway abnormalities (e.g., small jaw, crowded oral cavity).
3. CBCT scan: This scan shows details of bones and soft tissues which provide accurate measurements including the jaw size and shape, airway obstruction, nasal septum deviation, turbinates hypertrophy, enlarged adenoids, and airway volume.
4. Sleep Study: Focus on detecting respiratory effort-related arousals (RERAs) and flow limitations.

Treatment Options for UARS

UARS treatment focuses on improving airflow and reducing nighttime disruptions. Treatment options include:

MSE (Maxillary skeletal expander) And RME (Rapid maxillary Expander)

An airway-focused orthodontist can reduce the air flow resistance by expanding the upper jaw with MSE in adults and RME Children which increases nasal volume and makes sleep better. MSE widens the nasal cavity and nasal floor. It decreases the resistance to airflow through the nose and improves nasal breathing. MSE expands the upper arch & creates more space for the tongue to occupy & helps the tongue to move forward & opens up the lower pharyngeal airway space. Since the bone density of children (below 11 years) is less we can expand the maxilla very easily with a simple RME appliance that increases nasal volume.

Advantages:

1. Significant improvement in nasal airflow, often reducing snoring and symptoms of UARS or OSA.
2. More effective and stable expansion compared to traditional dental-only expansion methods.

Mandibular Advancement Devices (MAD)

A Mandibular Advancement Device (MAD) is an oral appliance designed to reposition the lower jaw slightly forward during sleep, preventing airway collapse and improving airflow. While MADs are widely used for obstructive sleep apnea (OSA), they can also be effective for treating Upper Airway Resistance Syndrome (UARS)—especially when jaw position contributes to airway resistance.

Conclusion

UARS is a severe sleep disorder that frequently goes unnoticed but has the potential to greatly affect one’s daily life. It is important to learn about its symptoms, causes, and treatments to enhance sleep quality and overall health. If you think you might have UARS, it would be best to seek the services of an airway focussed orthodontist who specializes in sleep disorders for proper diagnosis and UARS therapy. With proper intervention, UARS can be treated effectively, which results in better sleep and general health.