UARS Treatment
The treatment for UARS is very similar to that for obstructive sleep apnea.
If you have nasal congestion for any reason, this is the first thing that is addressed. Nasal allergies are treated with medications or allergy shots. Structural problems such as a deviated nasal septum or nasal valve collapse are treated with surgery. Chronic sinusitis is also treated appropriately. By allowing you to breathe more freely through your nose, less vacuum forces are created further downstream around the palatal or tongue area that can potentially collapse.
Because the mechanism of obstruction for UARS is very similar to OSA, the same treatment options are possible. CPAP is the first line therapy. The original UARS paper out of stanford reported that most of the patients did well on CPAP. If this is not logistically or physically possible, then a mandibular advancement device is also a good option, assuming that tongue collapse is the main culprit. Lastly, and only as a last resort, The same surgical options reserved for OSA will work, with similar degrees of efficacy and potential complications. However, since UARS is typically mostly a tongue problem, treating the tongue tends to be the main problem for most people.
There are many ways of dealing with tongue collapse. A number of dental appliances have been created to address this issue. A tongue retaining device is essentially a small cup-shaped mouthpiece that you place your tongue into and using a vacuum seal, it holds your tongue forward. In theory, it sounds great, but in practice, it’s questionable whether or not it works at all. There are no strict clinical studies that I know if that shows any usefulness from this device.
Mandibular advancement devices (MAD) are used for snoring and OSA. This is a good option for most people with mainly tongue collapse as a source of their UARS.
Although there are no surgical procedures specifically designated for UARS, surgery for OSA should work just as well. For most people a simple procedure to advance the tongue base should suffice (such as the Repose suture, which is similar in function to the MAD).
If you are interested in enrolling in a clinical study regarding the usefulness of tongue exercises for UARS, click here to find out more information.
Steven Y. Park, M.D.
Otolaryngology – Head & Neck Surgery
(212) 315-9058
