Upper airway resistance syndrome (UARS)
Unrefreshing sleep and daytime exhaustion from a narrowed airway during sleep, often with a sleep study that looks nearly normal.
UARS sits between simple snoring and obstructive sleep apnoea. The airway narrows during sleep, each breath takes more effort, and that effort repeatedly nudges the brain out of deep sleep. Because the airway does not close fully and oxygen levels do not dip, a standard sleep study can look nearly normal while sleep is being fragmented many times an hour, which is why many people are told nothing is wrong despite years of exhaustion.
Common symptoms
- Waking unrefreshed however long you sleep
- Daytime fatigue, often more like exhaustion than outright sleepiness
- Light, broken sleep with frequent brief awakenings, often labelled insomnia
- Snoring that may be mild, intermittent or absent
Why the nose matters
The nose is the front half of the airway and is frequently where the resistance lives: a deviated septum, swollen turbinates or allergic rhinitis all force harder breathing in sleep. Treating the nose, medically or surgically, can transform sleep quality in the right patient, which is where a rhinology-led approach helps.
Assessment and treatment
Assessment includes a detailed sleep history, examination of the nose and upper airway with a small endoscope, and a sleep study interpreted with UARS in mind, looking at arousals and breathing effort rather than oxygen dips alone. Treatment ranges from nasal treatment and sleep habits through CPAP or a mandibular advancement device. Untreated, UARS can progress to sleep apnoea over time.
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This page is general information and not a substitute for individual medical advice.