Upper airway resistance syndrome (UARS) is a part of spectrum of sleep disordered breathing characterized by a partial collapse of the airway resulting in increased resistance to airflow. The resistance to airflow is typically subtle and does not result in apneic or hypopneic events. However, it does cause an increased negative intrathoracic pressure during inspiration which results in multiple sleep fragmentation. The diagnosis rests on polysomnographic documentation of >10 electroencephalogram (EEG) arousals per hour of sleep correlated with episodes of reduced intrathoracic pressures measured by esophageal manometer in regular heavy snorers with daytime sleepiness. Oesophageal manometry being an invasive test, increasing number of non-invasive tests are developed to document the presence of UARS. In India these tests are not easily available hence high index of suspicion with polysomnographic correlation and use of available tests make the diagnosis possible.

A questionnaire based survey was performed to determine the prevalence of sleep related disorders in Indian school-going children residing in Delhi. The questionnaire used for the purposes of this study was based on the Pediatric Sleep Questionnaire, University of Michigan, USA. A total number of 4000 questionnaires were distributed of which 2774 were received back. A total number of 2475 questionnaires were finally selected for analysis as they satisfied all criteria for acceptance. A sub-group of patients who were suspected as having sleep disordered breathing on the basis of the questionnaire were subjected to polysomnography. The overall prevalence of snoring was found to be 12.7% (Males=12.8%, Females=12.6%). The overall prevalence of sleep disordered breathing (SDB) was 4.8%. Approximately 24.3% of the children (26.3% males and 22.9% females) were seen to suffer from excessive daytime sleepiness. Sleep deprivation(32.2%) was found to correlate positively with age (p<0.001). The overall prevalence of bedtime resistance was found to be 25.8%. About 41% (Males=41.1%, Female=40.9%) of the children experienced nightmare once in a while. Amongst all subjects, 5.8% suffered from night terrors. About 12% of the entire population (13.3% males and 10.4% females) were seen to suffer from bruxism. Approximately 7.7 % of the overall population was observed to suffer from bedwetting. Insomnia was found in 17.3% of our subjects. On the whole, approximately 47.5% of the children were observed to suffer from some form of sleep disorder. This study is an attempt to highlight the sleep problems in general and those related to sleep-disordered breathing in particular amongst school-going children in an urban setting in North India. An attempt has been made to compare and contrast the western and Asian scenario of sleep disorders in school children with that in India. It also highlights the fact that no effort was made on the part of parents to seek medical help in the significantly large number of children in whom sleep disorders were present, indicating a total lack of awareness amongst the general population about the larger implications of sleep disorders in children.

Objective: To study respiratory arousals with and without obstructive sleep apnoea (OSA) in the same patient. Design: Cross-sectional study, tertiary hospital based. Duration: One year (2007 to 2008) Observation and results: The study included 100 patients with suspected SDB who underwent split night sleep study. We came up with diagnosis in 97 cases. With calculation of arousal index with & without apnoea/hypopnoea, we were able to divide patients into OSA, combined (OSA+UARS) & Upper Airway Resistance Syndrome (UARS) groups. The outcome of study was as follows- 74 cases of OSA, 12 cases of combined(OSA+UARS), 5 cases of UARS, 3 cases of PLM, 3 cases of OSA+PLM and 3 normal studies. OSA was found to be most common SDB among men (83.1%) in age group 40-70 yrs with sedentary lifestyle and it is strongly associated with weight & BMI. UARS patients were non-obese with active lifestyle and had low threshold for arousals with prolonged nocturnal awakenings and SpO2 >91 % throughout study period. Conclusions: UARS is not a distinct syndrome. It is merely a part of the disease spectrum of OSAHS. There exists a group that has characteristics of both OSA & UARS. The spectrum of disease is Primary snorers(PS)à UARS à combined (OSA+UARS) à OSA à OSAHS. UARS patients were mostly non-obese with active life style as compared to OSA patients. Also they displayed poor sleep efficiency with more prolonged awakenings compared to OSA patients.

Sleep is an important indicator of physical and mental health. Little is known about the quality, pattern and correlates of sleep among Indian adults. This study was aimed to analyze the quality of sleep in medical students using the Pittsburgh Sleep Quality Index and to relate sleep with blood pressure, body mass index and academic performance. The sample consisted of 67 medical students in the age group of 18-22 years. 28(42%) medical students had ‘poor sleep’. 57% reported inadequate sleep and 54% had sleep disturbances. ‘Poor sleepers’ had higher blood pressure, body mass index and lowered academic performance compared with good sleepers. Global PSQI score showed significant positive correlation with blood pressure and body mass index but not with academic performance. This study shows the high prevalence of poor sleep quality and underline the close relationship of sleep with BP, BMI and academic performance among medical students.

Pierre Robin Syndrome is a rare genetic disorder characterized by micrognathia, cleft palate and glossoptosis. We present one child with PRS in whom sleep study performed showed presence of significant sleep disordered breathing. It also shows the effects of SDB's on physical and mental development.