Upper airway resistance syndrome 2018: non-hypoxic sleep disordered breathing. Expert review of respiratory medicine Arnold, W. C., Guilleminault, C. 2019


INTRODUCTION: Upper airway resistance syndrome (UARS) as obstructive sleep apnea syndrome (OSAS) has been described as abnormal breathing during sleep, based on the recording technologies and knowledge of the time. These terms have advanced the field, but the question raised is are they still useful? Area Covered: Historically, the definition of UARS syndrome was aimed at recognizing pathology not covered by 'OSAS' and to prompt specialists to go further than the obvious. It was aimed also at pushing specialists to recognize pathologies earlier and to elicit research in the developmental features of sleep-disordered-breathing (SDB). The technology used to monitor SDB changed over-time, allowing recognition of SDB differently but not necessarily better. Authors have had different views of what they felt that "UARS" was overtime. Expert Commentary: Currently, we have a better understanding of the development of SDB, and its evolution with aging, leading to co-morbid-OSA. However, the real issue is to recognize the problems leading to the co-morbid obstructive sleep apnea (OSA) much earlier, and to understand what can be done to prevent the development of co-morbid OSA. The notion of OSA, UARS, apnea hypopnea index (AHI) are only historical. There is enough knowledge to date to go beyond these definitions, to recognize problems differently and to lead to the prevention of the factors leading to SDB. The recognition of non-hypoxic sleep disordered breathing (NHSDB) is a step in this direction.

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