Wellness at the Speed of Light Life Saving Sleep Secrets with Dr Barry Krakow
Jan 27, 2025
Dr. Barry Krakow, sleep medicine expert and author who studies UARS and insomnia, explains the hidden impact of subtle airway resistance on fatigue, cognition, mood, and metabolic health. He discusses why standard tests miss UARS, how esophageal pressure monitoring and RERA detection reveal it, and why bi‑level ventilation often works better than CPAP. Practical testing and conservative treatments are also covered.
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UARS Explains Lifelong Daytime Sleepiness
- Upper Airway Resistance Syndrome (UARS) is a subtle variant of sleep apnea that fragments sleep and causes chronic fatigue.
- Treating UARS transformed Krakow's lifelong sleepiness; he now has more energy in his 70s than as a teenager.
Small Resistance Events Have Big Health Effects
- UARS events sit between hypopnea and normal breathing and are missed by many standard sleep tests and AHI-focused analysis.
- Small resistance events alone can cause high blood pressure, insomnia, fibromyalgia, headaches, and nocturia.
Switch To Bi-Level When CPAP Feels Unbearable
- If CPAP causes discomfort or feelings of drowning, ask about switching to Bi-Level (bilevel) or ASV which lowers exhalation pressure.
- Document expiratory flow problems in-lab to justify insurance-covered bilevel therapy.
