Review of upper airway resistance syndrome: nursing and clinical management

Aims.  This study aims to help nurses and nurse practitioners identify and manage paediatric patients with upper airway resistance syndrome. A review of upper airway resistance syndrome is provided, including the signs and symptoms of upper airway resistance syndrome, criteria for diagnosis, recommendations for treatment and implications for nursing in paediatric primary care. Background.  Nurses often encounter sleep‐related problems in the paediatric primary care setting. Commonly, these problems are well known and include snoring and obstructive sleep apnoea. Upper airway resistance syndrome is a relatively new diagnosis among sleep‐related breathing disorders with which nurses and nurse practitioners should be familiar. Upper airway resistance syndrome is characterised by incomplete obstruction of the airway during sleep, leading to increased respiratory efforts and frequent arousals despite normal oxygen saturations. Design.  Systematic review. Method.  A review of the sleep literature identified articles regarding sleep and/or sleep‐related breathing disorders and paediatrics, and upper airway resistance syndrome. Articles published since 2002 were prioritised; however, all articles describing upper airway resistance syndrome since 1993 were considered. Conclusion.  Timely recognition of sleep‐disordered breathing is crucial to ensuring that patients receive effective and appropriate treatment. Upper airway resistance syndrome should be a part of the differential diagnosis when assessing a child with a sleep‐related breathing disorder. Relevance to clinician practice.  Nurses and nurse practitioners should become comfortable and skilled in performing a thorough sleep history and physical examination to help identify when a child should receive a sleep study or referral to a specialist.