Upper airway resistance sndrome (UARS)

UARS is when there is resistance to your breathing at night that cause arousals that disrupt your sleep.  This increases your fight or fight response and causes a low arousal threshhold.

Often seen in young, thinner people and kids.

Since most sleep studies don't count 9 seconds or less of holding breath, these apneas are included in the diagnosis of UARS.

Since UARS decreases your arousal threshold, patients will describe themselves as a light or restless sleeper.  Patients tend to fall asleep easily, but wake in middle of the night and have trouble falling back to sleep.

Many will describe themselves as having Chronic Fatigue Syndrome. A family member of mine was diagnosed with this when I was a child. She has now advanced to Obstructive Sleep Apnea. Her "Chronic Fatigue Syndrome" I think was really UARS. 

Many insomniacs report waking up after 1-2 hours and are unable to fall back asleep. Some report waking every repeatedly every 1-2 hours or particularly around 4-6am. 

These wake times mirror the cycles that normal sleep follows. Each sleep cycle from onset to REM is 90-120 min. Also, towards the end of sleep is when we are in REM the longest and our muscles relax which would coincide with 4-6am.

Some people battling with insomnia, may have the onset of UARS. Strengthening the tongue to stay out of the airway and strengthen surrounding tissue is imperiaive.   

Certain sleep studies screen for UARS. It is measured by Respiratory Effort Related Arousals (RERAs) and Respiratory Disturbance Index (RDI). These are disruptions in sleep that are not classified as a apnea (stop in breathing) or hypopneas (shallow breathing)

Most sleep studies do not look for RERAs and UARS is often missed. 

Most sleep studies are looking for Obstructive Sleep Apnea. This is an stop of breathing for 10 seconds or more. If you stop breathing for 9 seconds or less, this is not counted as an apnea. You could be stopping breathing 40 times an hour for 9 seconds each and be told there is nothing wrong with you!

I have screened patients for sleep apnea for years as a Dental Hygienist. I have had so many people tell me they had a sleep study with low apneas, but they show classic clinical signs of significant sleep issues and report being tired and not sleeping well. It makes so much sense now!