Upper Airway Resistance Syndrome (UARS) Evaluation in Riverview, NB

Your Sleep Study Came Back Normal. You're Still Exhausted. Here's Why.

Most people who end up at East Coast Sleep Clinic- Riverview have already been through the New Brunswick public system once. They did the home test, waited out the referral cycle, got a call telling them nothing was found, and still couldn't make it past 2 p.m. without three cups of coffee.

Then the call came back: normal. AHI within acceptable range. No apnea detected worth noting.

So why are you still waking up feeling like you didn't sleep at all?

This is one of the most common frustrations we hear at East Coast Sleep Clinic- Riverview. Patients come through our door at 631 Pinewood Road after exactly this sequence. A normal result on paper, and a body that refuses to cooperate. Dragging through afternoons. Struggling to concentrate. Reaching for coffee at 2 p.m. and still barely making it to dinner.

Here is what that test did not rule out: a breathing disorder called Upper Airway Resistance Syndrome, or UARS.

Standard home sleep tests score your results using something called the Apnea-Hypopnea Index, or AHI. That number counts full apneas and oxygen drops big enough to register. UARS causes neither. Instead, it works through subtler disruptions the AHI misses entirely, which means a completely normal result is still compatible with a real, diagnosable, treatable condition.

If you are still tired after a full night of sleep and the problem has never been properly investigated, East Coast Sleep Clinic- Riverview is the right place to start. Call (506) 405-0700 and we'll talk through what the evaluation involves before you commit to anything.

What Is Upper Airway Resistance Syndrome (UARS)?

Think of it as the middle ground your sleep test was never designed to find.

UARS is a breathing-related sleep disorder where the upper airway narrows repeatedly during sleep, enough to disrupt your rest but not enough to trigger the oxygen drops that show up as apneas or hypopneas on a standard report. The airway resists. Your body works harder to breathe through the restriction. That effort wakes the brain, briefly, before you'd ever register a full arousal. Then it happens again. And again.

These events are called respiratory effort-related arousals, or RERAs. They are the core of what UARS actually is. A home sleep test scored only for AHI can miss them entirely. That's why patients across Greater Moncton come into East Coast Sleep Clinic- Riverview with a "normal" result and a fatigue level that is anything but.

UARS is not a fringe label or a contested theory. It is a recognized clinical entity, distinct from primary snoring on one end and obstructive sleep apnea on the other. The diagnosis requires looking at the right data, and that starts with understanding exactly how UARS differs from the condition most people have already been tested for.

UARS vs. Obstructive Sleep Apnea: Why Standard AHI Misses It

The number that comes back on your sleep report is called the AHI, or Apnea-Hypopnea Index. It counts the events where your airway fully closes (apneas) or partially closes with a measurable oxygen drop (hypopneas). If your AHI is under five, the report says normal.

For someone with obstructive sleep apnea, this system works reasonably well. For someone with UARS, it misses the problem entirely.

UARS produces a different kind of event: a respiratory effort-related arousal, or RERA. Your airway narrows, your breathing becomes labored, your brain pulls you out of deep sleep to restore airflow. But the airway never closes completely and your oxygen level barely moves. The AHI doesn't count it. The machine doesn't flag it. The report says nothing is wrong.

The right metric is the RDI, or Respiratory Disturbance Index, which includes RERAs alongside apneas and hypopneas. Many home sleep tests, including the type commonly used through the public system in New Brunswick, are not built to score RERAs at all. A useful breakdown of home sleep study vs. in-lab polysomnography explains why that gap exists and what each test is actually measuring. So patients arrive at East Coast Sleep Clinic- Riverview with a normal result and an unchanged level of exhaustion.

The patient profile matters here too. Classic OSA tends to show up in older, heavier patients with loud snoring and witnessed pauses. UARS more often affects younger adults, people with lower body weight, and women. It also shows up in older Riverview patients who don't match the typical OSA picture and have been passed over because of it.

If those details sound familiar, the symptoms themselves are worth a closer look. East Coast Sleep Clinic- Riverview works with patients who fit this exact profile regularly. People who don't check the classic OSA boxes and have spent too long being told everything looks fine.

Symptoms of UARS — What It Actually Feels Like

Patients often describe it the same way: "I slept eight hours and I feel like I didn't sleep at all."

That non-refreshing quality is one of the most consistent complaints, and it's what separates UARS from the snoring-and-gasping picture most people associate with sleep disorders. The symptoms tend to land in a few buckets. On the cognitive side, brain fog in the morning, trouble concentrating, memory that feels unreliable. Physically, waking with headaches, cold hands and feet even in a warm room, blood pressure that runs on the low side, a body that never quite feels rested. On the mood and nervous system side, anxiety that hums in the background without a clear cause, heightened sensitivity to stress, insomnia that won't respond to sleep hygiene alone.

Here in Greater Moncton, this symptom cluster gets misread constantly. CN Rail workers and hospital staff at the Moncton Hospital chalk the fatigue up to rotating shifts. Call centre employees blame screen time and odd hours. Come November, half the region starts pointing at the dark. Six weeks of grey skies and everyone's vitamin D is suspect.

These explanations aren't wrong exactly. But they delay the real question: is something happening in the airway at night?

If any of this describes your pattern, the next step is understanding what proper evaluation for UARS actually involves. East Coast Sleep Clinic- Riverview can walk you through that before you book. Call (506) 405-0700 and we'll tell you whether your history fits what the evaluation is designed to find.

How We Evaluate UARS in Riverview

The first appointment is a conversation, not a test.

We want to hear your full history. How long you've been tired, what your sleep looks like on a good night versus a bad one, and what you've already been told. If you have a prior home sleep study showing a normal AHI, we want to see that report. A low apnea score doesn't close the file here. It opens a different set of questions.

From there, the path depends on what the history suggests. At-home sleep testing can rule out moderate-to-severe OSA, and we do offer that testing at no cost. But UARS is a different target. Picking up RERAs reliably requires in-lab polysomnography with full RDI scoring, where we can measure respiratory effort, cortical arousals, and airflow limitation in a way that a portable home device simply isn't built to capture. If your symptom picture points toward UARS, we'll tell you that upfront so you're not repeating a test that won't answer the question.

Our in-lab studies run through the clinic at 631 Pinewood Road, and the wait is considerably shorter than going back into the public system for another referral. For patients coming from Moncton, Dieppe, or further out through Salisbury or Hillsborough, that matters.

Once the study is complete, we go over the findings with you directly, walk through what the RDI score means, and talk through what comes next. Which, if UARS is confirmed, brings us to the part most patients are really waiting to hear.

Treatment Options Once UARS Is Diagnosed

Good news: UARS tends to respond well to treatment, and you have more options than you might expect.

CPAP therapy is often the first conversation, but the pressures required for UARS are typically lower than those used for moderate or severe obstructive sleep apnea. Many patients who tried CPAP before and gave up on it find it far more tolerable once the settings are dialed in to what UARS actually requires. East Coast Sleep Clinic- Riverview handles CPAP fitting and ongoing follow-up in-house, so adjustments don't mean booking somewhere new and starting over.

Oral appliance therapy through a dental sleep medicine referral is another solid option, particularly for patients who simply cannot tolerate CPAP or whose obstruction is mild enough that repositioning the jaw does the job. Appliances work by holding the lower jaw slightly forward, keeping the airway open without any pressure at all.

Positional therapy helps a real subset of UARS patients whose symptoms get noticeably worse when sleeping on their back. Worth addressing separately: nasal congestion. Whether it stems from allergies, a deviated septum, or the dry air that comes with heating a Maritime home through a long winter, even minor upper airway narrowing compounds RERA frequency overnight.

The right approach depends on your anatomy, your tolerance, and what the evaluation actually shows.

Booking a UARS Evaluation at East Coast Sleep Clinic- Riverview

If you've been dismissed after a normal home sleep test and you're still running on empty, this is the right next call. East Coast Sleep Clinic- Riverview is at (506) 405-0700.

The clinic is located at 631 Pinewood Road, Unit 102A in Riverview, a straightforward drive from Coverdale Road or across the Gunningsville Bridge for patients coming from Moncton and Dieppe. East Coast Sleep Clinic- Riverview serves the full Greater Moncton catchment, including Salisbury and Hillsborough, and offers intake and patient education in both English and French.

When you book, bring whatever you have: any prior sleep study reports, a rough timeline of your symptoms, and your current medication list. That paperwork helps skip the back-and-forth and get directly to what the evaluation needs to look at.

The team at East Coast Sleep Clinic- Riverview can walk you through what the process looks like for your situation before you commit to anything. If calling doesn't work right now, you can also reach us through the contact form on this page and someone will follow up within one business day. People coming from Riverview, Moncton, Dieppe, and Salisbury tend to arrive at the same handful of questions before they're ready to book. The most common ones are below.

Frequently Asked Questions

Can I have UARS if my home sleep test came back normal?

Yes. Standard home sleep tests score results using the Apnea-Hypopnea Index, which counts full apneas and significant oxygen drops. UARS is driven by respiratory effort-related arousals, or RERAs — subtler disruptions the AHI is not designed to capture. A normal AHI result does not rule out UARS. The right follow-up is an evaluation that includes RDI scoring, which accounts for RERAs alongside apneas and hypopneas.

What is the difference between AHI and RDI?

AHI, or Apnea-Hypopnea Index, counts full airway closures and partial closures with measurable oxygen drops. RDI, or Respiratory Disturbance Index, adds respiratory effort-related arousals to that count. UARS shows up on RDI but hides on AHI — which is why patients with a normal sleep report can still have a real, diagnosable breathing disorder.

Does UARS only affect young, thin people?

No. While the classic UARS profile does tend to skew younger and leaner than the typical obstructive sleep apnea profile, East Coast Sleep Clinic- Riverview evaluates UARS across all ages and body types. Older patients in Riverview who don't fit the standard OSA picture are regularly diagnosed with UARS after years of being told their results looked fine.

Is UARS treated with CPAP?

Often yes, though UARS patients typically require lower pressures than those used for obstructive sleep apnea. Oral appliance therapy and positional therapy are also effective options for many patients. The right treatment depends on what the evaluation finds, and East Coast Sleep Clinic- Riverview will walk through the options that fit your specific results.

How long is the wait to be evaluated in Riverview?

Wait times at East Coast Sleep Clinic- Riverview are typically much shorter than the public system referral route in New Brunswick. Current availability changes, so the best way to get an accurate answer is to call the clinic directly and ask about next available appointments.