Quality of life impairment. A reason for rethink the importance of upper airway resistance syndrome

Abstract

Introduction The Upper Airway Resistance Syndrome (UARS) was described by Guilleminault in 1993 to report patients that didn’t meet criteria for Obstructive Sleep Apnea Hypopnea Syndrome (OSAHS) but presented with similar symptoms, specially Excessive Daytime Sleepiness (ESS) and an abnormal breathing pattern during sleep. The diagnosis of UARS is controversial and in many cases patients are left untreated or misdiagnosed. The impact of UARS in the quality of life (QoL) haven’t been studied before in contrast with OSAHS patients in whom QoL have been reported to be decreased. Our objectives were to assess the difference in QoL measured by SF36 questionnaire between UARS and OSAS patients and to evaluate the clinical differences between both groups. Materials and methods A total of 711 consecutive patients from 2007–2012 were retrospectively evaluated using their medical records and Polysomnography (PSG). Diagnosis of UARS was made following Guilleminault definition (AHI 10), diagnosis of OSAHS was made according to ICSD-2 criteria (AHI > 5 + symptoms or AHI > 15) and the recommended definitions for respiratory events of the Manual for Scoring of Sleep and Associated Events of the AASM v2007. Quality of Life was evaluated by the SF36 questionnaire, previously validated in our country. Results Of the 711 consecutive records, 632 were classified as UARS (23.5%) or OSAHS (65.4%) patients, 79 (11.1%) didn’t meet any of the syndrome’s diagnosis criteria. No differences were found in SF 36 QoL domains, but in the Physical Factor component with worse score in the OSAHS group. Regarding clinical features, the OSAHS group presented with older patients (52.81 ± 13.56yo vs 44.11 ± 13.17yo p Conclusion The impact in QoL, secondary to UARS or OSAHS in our patients, is pretty similar, giving a strong reason for an exhausting diagnosis protocol and an early treatment in symptomatic patients, especially since UARS represents a significant proportion of our sleep clinic consultations. Special attention should be paid to clinical features such as younger age, female gender and lower BMI, where PSG must be consider as gold standard for a correct diagnosis. Acknowledgements Hypnos Instituto del Sueno, Lima, Peru.