Upper Airway Resistance Syndrome

The term ‘upper airway resistance syndrome’ denotes an entity characterized by the presence of daytime fatigue or sleepiness in the presence of a normal respiratory disturbance index and oxygen saturation. Despite some similarities, certain specific clinical and diagnostic features distinguish it from the obstructive sleep apnea syndrome. The essence of diagnosis lies in the documentation of increasing esophageal pressures during sleep with associated transient EEG arousals. Furthermore, the evidence suggests an abnormal blood pressure response to the changes in esophageal pressures and arousals. The exact pathophysiology is currently unclear. Continuous positive airway pressure is an effective mode of therapy, although the low compliance rate limits its use. The role of radiofrequency ablation of the palatal tissues, other surgical procedures, and oral appliances in the treatment of upper airway resistance syndrome need to be investigated more rigorously.