Upper airway resistance syndrome (UARS) is a type of sleep-related breathing disorder similar to obstructive sleep apnea syndrome (OSAS), but it’s less severe.

People who experience UARS have narrow airways and other anatomical differences that make breathing during sleep more challenging. As a result, they experience more disrupted sleep, along with daytime fatigue and decreased quality of life.

UARS was first defined in 1993 and used to describe people who had symptoms that were not severe enough to be diagnosed with OSAS. Although breathing issues and daytime fatigue are observed in people who have UARS, they do not experience recognizable apnea, where breathing is fully interrupted.

If sleep-related breathing disorders are looked at on a spectrum, UARS would be placed somewhere between snoring and OSAS.

Let’s take a look at how UARS presents, what may cause it, how to get diagnosed and treated, and what the outlook is like for someone who has UARS.

Although many people with UARS experience nighttime wake-ups, some people who have UARS may not notice the other symptoms that occur while they’re sleeping. Usually, people with UARS notice symptoms that they experience during the day, after having slept poorly because of sleep disturbances.

Common symptoms of UARS include:

  • snoring
  • complaints of overall daytime exhaustion
  • not feeling refreshed even after enough hours of sleep
  • experiencing a headache in the morning
  • signs of depression
  • unexplained nighttime wake-ups
  • nighttime disruptions may involve moments where breathing feels difficult
  • no signs of apnea (moments where breathing stops completely)
  • overall diminished quality of life as a result of fragmented or poor sleep

As UARS progresses, especially if it isn’t treated, it can lead to cardiovascular issues, increased blood pressure, and metabolic conditions.

People who have UARS have anatomical differences in their upper airways that make breathing more difficult while sleeping. This may include narrowing and resistance in two areas:

  • the area between the uvula (the piece of flesh that hangs in the back of your throat) and soft palate
  • the area between the uvula and epiglottis (the small flap that guards your windpipe)

In addition to those anatomical traits, certain underlying conditions and demographic traits may make it more likely for you to develop UARS. For example:

If you have any signs or symptoms of UARS, such as interrupted sleep and daytime fatigue, you should visit a healthcare professional or sleep specialist.

You will likely be asked to describe your symptoms and discuss your overall medical history. If your healthcare professional believes that you may have UARS, they may order a sleep study or polysomnography (PSG), which is when you stay overnight in a lab to have your behavior and vitals monitored.

Currently, UARS is not a formal diagnosis recognized by the American Academy of Sleep Medicine (AASM) but may be suggested as a sub-diagnosis of OSAS. Either way, if your healthcare professional recognizes that you are experiencing UARS, they will help you move forward with a treatment plan that works for you.

Because UARS is not a separate diagnosis from OSAS, it does not have specific recommended treatments. For example, there are no FDA-approved pharmacological treatments for UARS. However, many of the treatments that work for OSAS work for UARS.

Here are some possible options:

CPAP therapy

Continuous Positive Airway Pressure Therapy (CPAP) is the most widely used and studied treatment for UARS. CPAP therapy involves using a CPAP machine that emits pressurized air into your body during sleep.


Surgery in the upper airway may be suggested for people who don’t have success with CPAP therapy or who don’t wish to use it.

Orthodontic treatments

Orthodontic procedures such as the use of mandibular advancement devices or rapid maxillary distraction can alter the positioning of your lower jaw, thereby lessening symptoms of UARS.

Oral Appliances

Oral appliances are devices that can be worn overnight to change the position of your tongue and jaw in an effort to open up the airway and reduce UARS.

In addition to daytime fatigue and fragmented sleep, UARS can cause psychological issues and related somatic issues. People with UARS may develop insomnia, depression, and anxiety. Additionally, they may develop irritable bowel syndrome, headaches, and acid reflux, which are often somatic manifestations of depression, anxiety, and broken sleep.

Combining talk therapy, such as cognitive behavioral therapy (CBT), with CPAP therapy and other treatments for UARS can be helpful, especially if you are dealing with insomnia, psychosomatic issues, anxiety, or depression as a result of your condition.

Living with a condition that disrupts your sleep can be stressful and have far-reaching effects in your mental health and social life. Thankfully, there are plenty of resources for those with sleep conditions. You can talk with your doctor about local support groups or consider trying any of these online ones:

Untreated UARS can result in increased cardiovascular issues, fatigue, depression, and insomnia. Over time, quality of life will gradually decrease because living on poor quality sleep is not sustainable or healthy. If untreated, UARS can progress into obstructive sleep apnea syndrome (OSAS).

People who are treated for UARS usually have positive outcomes and are able to resume a higher quality of life and avoid the health complications that are possible if UARS progresses.

If you are a snorer who never seems to get a good night’s sleep, or if you have unexplained sleep disturbances that leave you feeling fatigued most days, you might be dealing with upper airway resistance syndrome (UARS).

If you’re concerned about how you’re breathing while asleep, please contact a healthcare professional or a sleep specialist for an evaluation.

Sleep issues are no fun, but medical support and other resources are available. You deserve restful and restorative sleep.