Understanding Upper Airway Resistance Syndrome (UARS)

 

Do you wake up feeling tired, even after a full night's sleep? Perhaps you have seen your physician, but have been told you don’t have sleep apnea.

 

You might be dealing with something called Upper Airway Resistance Syndrome (UARS), a lesser-known but very real sleep disorder.

What Is UARS, and Why Is It So Often Missed?

UARS is a form of sleep-disordered breathing, but it’s much harder to detect than obstructive sleep apnea (OSA). While OSA involves a full or partial collapse of the airway, UARS is caused by increased resistance in the upper airway, making it harder to breathe during sleep.

That extra effort to breathe doesn’t usually cause loud snoring or obvious breathing pauses, which is why it often flies under the radar. But your brain still senses the increased effort to breathe and stays on high alert, triggering frequent micro-arousals (tiny wake-ups you likely don’t remember).

The result?

Light, fragmented sleep that leaves you feeling exhausted, even if you were in bed for 8+ hours.

"Fit Female Syndrome"

 

One of the biggest challenges with UARS is that it often affects people who don’t match the usual picture of someone with a sleep disorder. While OSA is often linked to older, overweight men, UARS is more common in women, especially those who are younger, slimmer, and appear healthy—hence the nickname "fit female syndrome."

 

Despite feeling completely exhausted, women may be overlooked or dismissed because they don’t “look” like someone with a sleep problem.

 

Some Signs You Might Have UARS[1] [2]

• You’re always tired, no matter how long you sleep
• You have trouble falling asleep, wake up frequently, or have restless sleep
• You snore or breathe heavily at night
• You clench or grind your teeth (bruxism)
• History of orthodontic work
• You have a small jaw and narrow airway
• You tend to breathe through your mouth
• You’ve been tested for sleep apnea and told it’s “mild” or “not present”

Why UARS Matters

Even though UARS does not stop your breathing entirely (like sleep apnea), it can still:

• Disrupt your sleep cycles and reduce sleep quality
• Trigger fatigue, brain fog, and mood swings
• Raise your risk of anxiety and depression
• Lower your quality of life

This is because the body remains in a state of heightened alertness due to repeated sleep disruptions. Over time, the cycle of poor sleep and increased stress can make it even harder to rest properly, creating a feedback loop that worsens symptoms.

The good news? There’s a solution—and it starts with your breath.

The Buteyko Method and UARS

If you're dealing with UARS, the Buteyko Breathing Method offers a powerful, natural way to reduce symptoms and support better sleep. By improving nasal breathing, calming your breath, and strengthening airway function, this approach helps you breathe easier, day and night.

1. Support Nasal Breathing and Keep the Airway Open

Nasal congestion is a big trigger for airway resistance. The Nose Unblocking Exercise can help clear blocked nasal passages and promote healthy, consistent nasal breathing. Practice before bed to help clear your nose naturally and make nasal breathing easier during sleep.

Nose Unblocking Exercise 

How to do it:

1. Sit up straight and breathe gently through your nose for a few breaths.
2. Take a small breath in, then a small breath out through your nose.
3. Pinch your nose shut and hold your breath.
4. Gently nod your head up and down until you feel a strong urge to breathe.
5. Release your nose and breathe in through your nose (not your mouth).
6. Breathe calmly for 30 seconds, then repeat 5–6 times.

Practice a few short breath holds followed by 6 longer breath holds until a strong air hunger is experienced. Use this exercise anytime your nose feels blocked during the day and before sleep.

🔗 Check out: Why the Nose Unblocking Exercise Works

MyoTape to support Nasal Breathing and CPAP, and MAD use

MyoTape is a specially designed, gentle adhesive tape that wraps around the lips to encourage nasal breathing during sleep, without sealing the mouth completely shut.

Unlike full mouth tape, MyoTape surrounds the lips without sealing them shut, allowing for emergency mouth breathing if needed. It supports nasal breathing safely while still allowing airflow, making it a better option for those using CPAP or a Mandibular Advancement Device (MAD).

🔗 [Click here to learn more about MyoTape or to order yours]

🔗Check Out Our Guide to Mouth Taping: Do’s, Don’ts, and Benefits for Sleep and Breathing

🔗Check Out Our Article on Mouth Puffing and Mouth Taping for Sleep

Proper Tongue Posture

Breathing through your nose, day and night, naturally encourages your tongue to rest on the roof of your mouth. This position helps hold the airway open during sleep, reducing breathing resistance and nighttime wake-ups. 

Engaging the Diaphragm

Nasal breathing and diaphragmatic breathing, like the Breathe Deep Exercise (see below), stabilize throat muscles and encourage smoother airflow. When you engage your diaphragm, you help keep your airway more stable and reduce nighttime disruptions. 

Consider Nasal Dilators or Snore Strips
If nasal resistance is high, simple tools like nasal dilators or snore strips can physically open up your nasal passages. This allows easier airflow and reduces the work of breathing during sleep.

2. Normalize Breathing Volume and Patterns

Breathing too much, especially too fast or too hard, can make your airway less stable during sleep. The Buteyko Method helps you retrain your breathing to be light, slow, and deep.

Breathe Light Exercise

Practice the Breathe Light Exercise to build calm, efficient breathing patterns that help:

• Reduce your breathing volume
• Reduce resistance in your airways
• Promote nasal breathing all night long
• Activate your body’s natural “rest, digest, and repair” response
• Help you fall asleep more easily
• Improve carbon dioxide tolerance—so you can breathe more lightly and calmly, even during sleep

Goal: Practice 5 minutes, 4–6 times a day, and a full 10 minutes before bed.

🎧 Click here to practice the Breathe Light Exercise guided audio session.

Breathe Nose, Slow, and Deep Exercise

This simple breathing exercise helps you train your diaphragm and build a light, slow, nasal breathing pattern, which supports better breathing throughout the day and night. Practicing regularly can help you feel more relaxed, breathe more efficiently, and sleep more soundly.

How to Do It:

1. Lie on Your Back
   Bend your knees to take pressure off your lower back and help your diaphragm work more easily.
2. Rest Your Hands on Your Lower Ribs
   Gently place your hands on either side of your lower ribcage. This helps you feel the movement as you breathe.
3. Inhale Gently Through Your Nose
   Feel your lower ribs expand outward with each gentle breath in.
4. Exhale Slowly Through Your Nose
   Feel your ribs move inward as you exhale.
5. Engage your Diaphragm
   About 80% of the movement should come from your diaphragm, with minimal movement in your upper chest.
6. Keep It Calm and Light
   Keep your breathing light, slow, nasal, and deep, focusing on a gentle rhythm.

When to Practice

Do this exercise for 5 minutes, once or twice a day. It’s especially helpful before bed to ease your body into a calm, restful state.

Tip: This isn’t about taking big, deep breaths. Instead, keep it soft and natural. Let the air gently fill your lower lungs without forcing it. The goal is to create a quiet, smooth breathing pattern that supports better sleep and overall health.

Aim for a Control Pause Score of 20+ seconds

Your Control Pause is a simple breath-hold test that reflects your breathing efficiency and progress with the Buteyko Method.

How to Do the Control Pause Test:

1. Sit down comfortably and breathe normally for a minute or so.
2. Take a normal breath in (not a big inhale), then a normal breath out.
3. Hold your breath after exhaling and start a timer.
4. Stop the timer as soon as you feel the first urge to breathe—this could be a slight movement in your throat or a twitch in your diaphragm.
5. Breathe in gently through your nose and return to normal breathing.

Your Control Pause score is the number of seconds you can comfortably hold your breath after a normal exhale. With regular practice of breathing exercises, this score will improve.

A Control Pause of 20 seconds or more indicates calmer, more stable breathing patterns, reducing airway resistance and improving sleep quality. Even small improvements in your CP score (5 seconds at a time) show real progress.

Tip: It’s normal to feel a little “air hunger” at first—this gets better as your breathing improves and your Control Pause score increases.

3. Balance the Nervous System for Better Sleep

People with UARS often describe feeling “tired but wired.” That’s because the body is stuck in “fight, flight, or freeze” mode, even when it’s time to rest. This overactive sympathetic nervous system keeps you on high alert, making it harder to fall asleep, stay asleep, or feel refreshed.

The Buteyko Method is a science-based way to calm your nervous system. By slowing your breath and reducing breathing volume, exercises like Breathe Light and Breathe Slow shift your body into the parasympathetic “rest, digest and repair” state. This helps:

• Lower your heart rate and blood pressure
• Reduce anxiety and hyperarousal (where your body and brain are stuck in "high alert" mode)
• Make it easier to fall asleep and stay asleep
• Improve sensitivity to subtle breathing changes during the night

🔗Click here to read our article about Breathing to Calm Your Nervous System Before Bed

Breathe Slow Exercise

Looking for a simple way to unwind before bed—or anytime stress hits during the day? Breathe Slow is a powerful breathing exercise that helps calm your nervous system, lower stress levels, and prepare your body for restful sleep.

When you slow your breathing to around 4.5 to 6.5 breaths per minute, your body naturally shifts into “rest, digest, and repair” mode. This gentle rhythm balances the autonomic nervous system and tells your brain: it’s safe to relax.

How to Do  It:

1. Bring your attention to your breathing. Feel the slightly colder air coming into your nose and the slightly warmer air leaving your nose. Hold your attention to your breathing for a few moments, observing the air as it flows into and leaves your nose.
2. Begin to slow the speed of the air as it enters and leaves your nose. The breath should be through the nose, soft and silent.
3. As you breathe out, bring a feeling of relaxation to the body and allow a slow and gentle breath out.
4. Continue to practice this exercise for 5 minutes, or longer.

Helpful Tips:

• Go at your own pace. Slow your breathing only to a level that feels comfortable. The goal is to find a rhythm that feels natural and sustainable. Avoid taking big breaths. The key is to take a soft breath in and allow a relaxed and slow breath out.
• Always breathe through your nose. Your breathing should stay light, silent, and fully nasal throughout the exercise.

When to Practice:

Use Breathe Slow during the day to reset your nervous system during moments of stress or include it in your evening wind-down routine to help you fall asleep faster and sleep more deeply.

Want to Sleep Better?

If you're struggling with UARS symptoms—or suspect you are—don’t wait. The tools in The Breathing Cure for Better Sleep target the root causes of UARS, like mouth breathing and nasal congestion, and can help you take control of your breathing and transform your sleep.

Want to get started? Try the [Breathe Light Exercise] or check out our other guided breathing audios.

Want to learn more? [Discover The Breathing Cure for Better Sleep by Patrick McKeown →]