Upper Airway Resistance Syndrome

Classification according to ICD-10
G47.3	Sleep apnea
ICD-10 online (WHO version 2019)

The upper airway resistance syndrome (UARS) is a sub-form of sleep-disordered breathing (SDB). In those affected, snoring , daytime sleepiness , affective disorders, difficulty falling asleep and respiratory flow limitations associated with waking reactions during sleep are found, but in contrast to obstructive sleep apnea syndrome (OSAS) no desaturation or apnea.

The three forms "snoring", "upper airway resistance syndrome" and "obstructive sleep apnea syndrome" are considered to be different degrees of severity of the same disorder. The UARS is defined by the fact that the muscle tone in the area of the upper airways is still high enough to keep part of the lumen of the airways open. This leads to increased respiratory wake-up reactions without real respiratory arrests.

examination

After a detailed anamnesis, polysomnography is used in the sleep laboratory for diagnosis . The typical changes in breathing during sleep and the resulting wake-up reactions are recognized and distinguished from OSAS.

treatment

The " Nasal continuous positive airway pressure " (CPAP) is considered the treatment of choice in patients with UARS. However, it was found that the patient's compliance with therapy is worse than that of patients with obstructive sleep apnea syndrome.

In some cases, mandibular protrusion splints are used for therapy . These are adjustable and intra-orally wearable splint systems that are individually manufactured after taking an impression of the teeth. Wearing it reduces the constriction of the pharynx, the airways are kept open mechanically during sleep and the airway resistance decreases.

In certain cases, different surgical alternatives can be considered, in which excess soft tissue in the extrathoracic airways or bony anatomical constrictions are removed.

Individual evidence

↑ ^a ^b Riccardo A. Stoohs: resistance syndrome of the upper airways . In: Deutsches Ärzteblatt . Vol. 104, No. 12 , 2007, p. A784–789 ( online [PDF; 336 kB ; accessed on February 4, 2013]).
↑ Susanne Schwarting, Ulrich Huebers, Markus Heise, Joerg Schlieper, Andreas Hauschild: Position paper on the use of mandibular advancement devices in adults with sleep-related breathing disorders . In: Sleep and Breathing . Vol. 11, No. 2 , 2007, p. 125–126 , doi : 10.1007 / s11325-007-0116-z , PMID 17464519 , PMC 2211364 (free full text) - (English).
^ Karl Hörmann, Thomas Verse: Surgery for Sleep Disordered Breathing . Springer, Berlin 2005, ISBN 978-3-540-21951-4 .

[stoohs2007-1] Riccardo A. Stoohs: resistance syndrome of the upper airways . In: Deutsches Ärzteblatt . Vol. 104, No. 12 , 2007, p. A784–789 ( online [PDF; 336 kB ; accessed on February 4, 2013]).

[dgzs2007-2] Susanne Schwarting, Ulrich Huebers, Markus Heise, Joerg Schlieper, Andreas Hauschild: Position paper on the use of mandibular advancement devices in adults with sleep-related breathing disorders . In: Sleep and Breathing . Vol. 11, No. 2 , 2007, p. 125–126 , doi : 10.1007 / s11325-007-0116-z , PMID 17464519 , PMC 2211364 (free full text) - (English).

[SurgerySleep2005-3] Karl Hörmann, Thomas Verse: Surgery for Sleep Disordered Breathing . Springer, Berlin 2005, ISBN 978-3-540-21951-4 .