Snoring and Upper Airway Resistance Syndrome
Pp. 58-70 (13)
Kannan Ramar and Eric J. Olson
Snoring is a common phenomenon and results from vibration of the soft tissue structures in the upper airway. Snoring may occur alone or as a sign of upper airway resistance syndrome (UARS) or obstructive sleep apnea syndrome (OSA). Snoring carries social consequences and has been linked to increased risk for cardiovascular disease, although this relationship may be confounded by undiagnosed OSA. UARS is characterized by daytime dysfunction and repetitive respiratory effort-related arousals, episodes of increasingly intense breathing efforts that terminate with an arousal from sleep before a hypopnea (episode of partial airflow reduction) or apnea (episode of complete airflow reduction) occur. There is controversy whether UARS is a distinct clinical entity or part of the OSA spectrum. Long-term cardiovascular consequences of UARS are unclear. Risk factors for snoring and UARS are similar and include obesity, nasal congestion, ingestion of pharyngeal relaxing substances before bed such as alcohol, hypnotics, and skeletal muscle relaxants, and abnormalities of the bony and soft tissue structures of the head and neck. Treatment options for snoring and UARS overlap and include risk factor modifications, oral appliances to advance the mandible during sleep, continuous positive airway pressure, and upper airway surgeries.
Assistant Professor of Medicine, Mayo College of Medicine, Consultant Division of Pulmonary and Critical Care Medicine, Mayo Clinic, Rochester, MN, USA.