Clinical characteristics of upper airway resistance syndrome

Abstract

Polysomnographic findings and clinical symptoms were investigated in 14 cases of upper airway resistance syndrome. The mean scores of the Epworth sleepiness scale and self-rating depression scale in eight cases were 13.5 and 38.6, respectively. The mean sleep latency of the multiple sleep latency test in four cases was 10.2 min. Seven cases were treated with continuous positive airway pressure (CPAP), and one with hormone replacement therapy. The most common symptom was daytime sleepiness. Five cases had hypertension. CPAP reduced increasing negative esophageal pressure (Pes) and frequency of EEG arousals, and improved hypertension in one case. Hormone replacement therapy ameliorated increasing negative Pes and clinical symptoms.

Treatment of upper airway resistance syndrome in adults: Where do we stand?

“… [1,23,24] CPAP treatment was associated to decrease in transient arousals, increase in percentage of NREM stages 3 and 4 and the sleep latency at MSLT. [1] Subjective daytime sleepiness, fatigue [1,23] and snoring [24] also can improve after CPAP treatment. Nevertheless, in some studies there were patients that did not have their excessive daytime sleepiness and fatigue decreased after CPAP treatment [24] .…”

“…From the 17 articles analyzed, 4 were about CPAP treatment [1,23,24,25] , 1 about drug treatment [26] , 1 about CPAP and surgery [27] , 1 was about rapid palatal expansion [28] , 4 about surgery [22–32] , 5 about oral device treatment [33–37] and 1 about external nasal device [38] . The definition of UARS also varied.…”

“…Other studies only considered objective parameters from sleep study. The polysomnographic parameters considered were AHI less than 5–15 events/hour (10 studies) [24,25,27,28,31,32,34,35,37,38] , RDI<5–10 events/hour (3 studies) [29,30,33] , RDI>5 events/hour (2 studies) [31,35] , Pes more negative than 10 or 20 mmH 2 O (8 studies) [1,23,24,27,29,30,33,35] , total arousal index (TAI)>5–15 events/hour (7 studies) [1,24,25,33,34,35,38] , the presence of excessive daytime sleepiness or fatigue or snoring (9 studies) [22,25,26,29,30,32,33,36,38] and presence of RERA or flow limitation (3 studies). [25,27,28] …”

“…CPAP is the UARS treatment modality better investigated. [1,23,24] One month of therapeutic trial with nasal CPAP can significantly change objective polysomnographic parameters [1] and subjective complaints. [1,23,24] CPAP treatment was associated to decrease in transient arousals, increase in percentage of NREM stages 3 and 4 and the sleep latency at MSLT.…”

“… [1,23,24] One month of therapeutic trial with nasal CPAP can significantly change objective polysomnographic parameters [1] and subjective complaints. [1,23,24] CPAP treatment was associated to decrease in transient arousals, increase in percentage of NREM stages 3 and 4 and the sleep latency at MSLT. [1] Subjective daytime sleepiness, fatigue [1,23] and snoring [24] also can improve after CPAP treatment.…”