Upper Airway Resistance Syndrome disturbs sleep patterns, but can be remedied

It may not be your mattress that’s keeping you from having a good night’s sleep. It could be Upper Airway Resistance Syndrome (UARS), according to Jeffrey Raval, MD FACS, located at 250 Steele St., Denver, CO. While sleep apnea has gotten a lot of press in the last few years, UARS is a more recent diagnosis. It’s so new, in fact, that the equipment used in some sleep clinics is not geared up to diagnose the problem the way that an ear-nose-throat surgeon can.

Sleep apnea affects men far more frequently than women. However, older women suffer from UARS than do any other demographic group, says Dr. Raval, an American Board Certified Facial Plastic Surgeon and Ear/Nose/Throat/Head Neck Surgeon. Curiously, UARS is often diagnosed after nasal surgery to correct crookedness or surgery for a deviated septum.

“We have women patients who report back to us that they had spent years of restless, sleepless nights chalking that up to stress, menopause or insomnia. They’ll tell us they never made the connection between breathing well and sleeping well…until after their surgery to correct the nasal obstruction,” Dr. Raval says. Frequently women who suffer UARS have severe nasal airway obstruction. Simple nasal airway reconstructive surgery such as straightening the septum, called a septoplasty, can vastly improve their life by allowing them to sleep throughout the night.

UARS differs from sleep apnea in that many people suffering from sleep apnea are overweight, while those diagnosed with UARS share the opposite condition of a thin face, a small or narrow jaw and a thin neck. When taking his patient’s health histories, Dr. Raval has found that it’s not uncommon among this group of UARS patients to have had orthodontia as a child to correct overcrowded teeth-one of the defining characteristics of the thin face and small or narrow jaw.

Otolaryngologist Steven Park, M.D. released a book in 2008 called “Sleep Interrupted: A Physician Reveals the #1 Reason Why So Many of Us Are Sick and Tired (Jodev Press), on the topic of UARS. His findings in the book are consistent with those Dr. Raval has witnessed among patients who complain of cold hands and feet, low blood pressure, and the inability to sleep on their backs comfortably.
European studies (one study of French women) show that almost half of the women with chronic insomnia and resulting daytime fatigue have UARS-a sleep disorder caused by resistance to air flow through the nasal passages.

Breathing strips (Breathe Right is one such product) do help some patients with UARS. Others see improvement using nasal dilators such as Nozovent or a saline nasal spray. Over-the-counter Claritin can remedy congestion from allergies. When either of those remedies doesn’t solve the problem, an ENT can prescribe a nasal spray containing itraconazole (Sporanox), xylitol, mupirocin (Bactroban) and dexamethasone. In other cases, Dr. Raval has had success prescribing dental devices that push the jaw forward preventing it from blocking the throat opening. And a special nasal mask called a Continuous Positive Airway Pressure (CPAP) can be recommended to deliver air to the airway while preventing the nasal passages from collapsing during sleep.

“A good night’s sleep is one of the best things a person can do to maintain their health,” adds Dr. Raval. “Now that we understand UARS, we have solutions that can help.”