UARS

The #1 Reason You're So Tired (It's Not What You Think)
nose

Does this sound familiar? You finally manage to get everything done and fall into bed, where it's easy to fall asleep because you're bone-tired. You sleep a reasonable number of hours -- at least it seems as if you do -- but when you wake up, you feel like you hardly slept. Then you drag around all day, feeling fuzzy-headed, grumpy, and longing for a nap.

If this sounds like you or someone close to you, you'll want to know about a little-known breathing problem called Upper Airway Resistance Syndrome (UARS). Unlike sleep apnea, which has been well known for a long time, UARS has only recently been getting attention. The term "resistance" refers to the fact that something is slowing or blocking air in the nasal passages. The most common causes are mild nasal congestion or tongue position during sleep that blocks breathing. Because resistance in the upper airways makes it harder work simply to breathe, your sleep is disrupted throughout the night. According to otolaryngologist Steven Park, UARS is extremely common in older women. One French study found that nearly half of all women with chronic insomnia and daytime fatigue turned out to have this type of sleep-disordered breathing.

Park says he sees many patients with UARS who think they're sleeping poorly due to stress or insomnia, but it's more complicated than that. He wrote a book about the phenomenon called Sleep Interrupted: A Physician Reveals the #1 Reason Why So Many of Us Are Sick and Tired. What's really happening, Park says, is that your body is half-waking up over and over again during the night. Since you're unable to fall into a deep restorative sleep, you don't feel refreshed in the morning.

How to Find out if You Have UARS

While sleep apnea is much more common in men (only 5 percent of those with apnea are women) UARS affects men and women about equally. Other characteristics common to many people with UARS: having a narrow face, having a small or narrow jaw, and having a thin neck. In fact, if you had to have orthodontia as a child for overcrowded teeth, Park says it's very likely you could develop UARS. Some people with UARS also have low blood pressure and cold hands and feet. And, says Park, if you have found over the years that you simply cannot sleep on your back (you invariably wake up) it's very likely the reason is UARS.

UARS is so new, not all doctors are familiar with it, and many sleep clinics don't use techniques capable of identifying these subtle changes in breathing patterns. (UARS may not show up in traditional tests for disordered breathing, which measure oxygen levels.) So if you suspect you have UARS, choose a sleep study lab that's familiar with the disorder and has the equipment to test for pressure changes in your nose or alternations in breathing or pulse wave signals.

Things You Can Do to Help With UARS

Over-the-counter products can be effective at treating UARS, says Park, so this is a great first step. Many people benefit from breathing strips, such as "Breathe Right."

To see if breathing strips might work for you, try this simple test: Looking in a mirror, press the side of one nostril firmly to close it off. Then close your mouth and try to breathe. If you feel resistance as you inhale through the open nostril, try holding it wider open with your pinky finger or the flat side of a toothpick. Try this on both sides. If you notice that you breathe more easily with your nostril propped open, you're a good candidate for breathing strips.

Some people also find great benefit from the nasal dilator Nozovent, available online. Other steps to try include irrigating the nasal passages with a saline nasal spray and taking a non-sedating allergy medication such as Claritin if you suspect congestion from allergies. You can also ask your doctor for a prescription nasal spray containing itraconazole (Sporanox), xylitol, mupirocin (Bactroban), and dexamethasone.

When to See an ENT for UARS

If these don't work, the next step is to ask your doctor for a referral to an ear, nose, and throat (ENT) specialist. With the help of an ENT, you'll have access to a number of treatments, including dental devices and Continuous Positive Airway Pressure (CPAP), a specially designed nasal mask that prevents your nasal passages from collapsing and delivers air directly into your airway.

If the otolaryngologist determines that tongue position during sleep is causing your UARS, she might recommend a dental device that pushes the jaw forward, which also pushes the tongue forward and prevents it from blocking the opening to the throat. If the obstruction is in the nasal passages, then CPAP is likely to work best. There are also minimally invasive surgical techniques available in cases where the obstruction is located in the area of the soft palate.

Getting a good night's sleep is absolutely essential in order to be at your best during the day, so if any of this sounds like it might apply to you, take action. Once you experience what if feels like to sleep deeply again, you'll look back and be thankful you got help.


over 1 year ago, said...

I have to take Adderall TO FUNCTION! I am certainly thankful for it. I work 16 hour days and am on call 24/7. But as I posted earlier, it is because I have Epstein-Barr and Chronic Fatigue. My Dr. thought I may have UARS, so I recorded several nights and all I did was cough a few times. THis was before the other testing and diagnosis.


over 1 year ago, said...

My EXHAUSTION was FINALLY diagnosed. I have Epstein Barr Virus and Chronic Fatigue Syndrome.


over 1 year ago, said...

I had no idea my insomnia etc, were due to UARS , so tried the strips and the Flonase, and what a difference! So much better. and not so tired all the time..


almost 2 years ago, said...

thanks


almost 2 years ago, said...

8 years ago I reported to my VA doc sleep problems, exactly like this. he sent me to a ENT VA doc who came into the room and angrily said to me, "HA!, You do not have sleep apnea. If you did, you be asleep in that chair right now."... (gotta love those VA docs..) I was sent for a sleep study and told that I do not have sleep apnea, but my O2 levels dropped when I fell asleep. so my doc ordered an oxygen concentrator I was to use when sleeping. it has never helped. I don't understand why my doctor does not know about this!! I will be getting some strips first thing tomorrow. thank you.


over 2 years ago, said...

Nurse Chris - which sleep study did you have - the take home kind or the hooked up to about 50 wires and filmed kind all night kind? I never would have thought I had sleep apnea, but I have very severe sleep apnea. My mouth is very small (per my dentist, not my former husband), and my throat opening is very small per my pulmonologist and ENT. Get it checked out (again) If you are always tired when you wake up, there's a problem!


over 2 years ago, said...

It confirmed that how I feel is indeed a condition that it needs to be attended to. Thank you.


over 2 years ago, said...

I wonder if having a deviated nasal septum could cause this condition. I also have been told by dentists that I have an extremely small mouth for all my teeth but never had braces.Can anyone comment? I may just try the breathing strips because for years now I have thought I had insomnia due to frequent wakening and difficulty falling asleep but Sleep studies showed nothing although sometimes I can use a low dose of Restoril and it helps with sleep although I am forever waking up utterly exhausted.. I guess I just think it would be fabulous to wake up feeling rested and refreshed ready for the day.


over 2 years ago, said...

this article is written so a person can understand exactly what is happening and sounds just like me hopefully i will get my doctor to look into this more to see if i can be helped. been a very long time since i have had a restorative sleep.


over 2 years ago, said...

Pretty sure I have this disorder.


over 2 years ago, said...

knowing that the interrupted sleep is th villian


over 2 years ago, said...

I was recently changed from a CPAP to a BiPAP. It has made quite a difference, but has yet to get me the rest I need. Still exhausted at least 3 days a week, especially if I do ANYTHING on the weekends. I use a full face mask, because sometimes I open my mouth during the night, which keeps the CPAP/BiPAP from working. They think that I had severe sleep apnea for more than 10 years before it was discovered. The take-home tests are junk - I agree with a previous poster about that. I've had 4 sleep studies in about 8 months trying to get this under control. It takes the body a long time to repair itself, once you are able to get good nights' sleep!


over 2 years ago, said...

I have found that leaving a ceiling fan running on low speed while I'm sleeping greatly enhances my sleep experience. My nose was often stuffy at bedtime. The fan seems to dry up or clear up all the stuffiness, and I sleep wonderfully and wake up thoroughly refreshed. I use the fan all year round. Robert C. Visconti


over 2 years ago, said...

I have UASR symptom for longtime. It seems that this article may help. I wiil try .


over 2 years ago, said...

I force myself to breathe thru my nose by taping my mouth shut with Scotch Tape.


over 2 years ago, said...

I have to add that my doctors all agree that 7-8 hours is NOT for everyone and since I am not fatigued and function extremely well there's no problem! Doctors: I go to the Head of Geriatrics at a NYC Hospital and a doctor he trained and is head of Geriatrics at a local Hospital near where I live. I see each once a year. I also see an Internist who specializes in alternative medicine I now see him only once a year. Also I take only 2 medications; one for blood pressure and one for low thyroid. I also get checked twice a year by my Cardiologist because there's a history of heart attacks on both sides of my family. I show no signs of heart problems other than slightly high BP which is controlled with a small dose of medication. I still see my OB-GYN once a year because, 31 years ago I had Breast Cancer. Lack of sleep is NOT my problem.


over 2 years ago, said...

My cpap actually began to be troublesome. One night while sleeping without it I awakened to find that air was not flowing through the palate. Then I began to breathe through the mouth. Now, if the throat was closing, why was air entering through the mouth, I wondered. This article has given me something to think about. All they have told me concerning the sleep study is my throat closes, and my breathing stops. Now, I am wondering what role UARS plays in this. I do not believe itis to be ignored. Thanks for such an informative article.


over 2 years ago, said...

I am 84 and need very little sleep (3-4 hours a night). I feel great when I get up and I keep going from 5 am (usually ) until I turn off the lights at 1-2 AM. Some nights my 3-4 hours is interrupted, by leg cramps, by something wrong with the oil burner and there's no heat when I need it! But I stay in bed and rest quietly and that's all I need. Who ever invented the "everyone needs 7-8 hours a night" didn't know what they were talking about. When I was a young Mother with 4 children I could have used 10 hours a night and an afternoon nap but it wasn't possible. Also all my children stopped napping around the age of 2 unless we were in the car. If I then carried them into the house they would wake up screaming. But I didn't like leaving them in the car once we were home. Luckily they grew up and now have children of their own who range in age from 31 to 8. My oldest son (61) tells me I should get more sleep because he needs more than I do. Nonsense!


over 2 years ago, said...

All of you need to see a sleep professional so you can be properly diagnosed and treated. Stop wondering, wasting time and money and finally get a better nights sleep. Go to a lab that has been practicing for more than 10 years and you should get good results. Don't have an In-home study done. Those studies are vague and inaccurate. Have a study attended by a registered sleep technologist and read by an experienced sleep doctor. THE GOLD STANDARD.