Sleep disruption is extremely common in patients with allergic diseases such as asthma, allergic rhinitis and atopic dermatitis with 48% of patients suffering from allergic rhinitis and 68% suffering from perennial rhinitis reporting the condition interferes with their sleep.
Labored breathing due to upper airways resistance, sleep apnea, insomnia, anxiety/depression and effects of allergy medications can lead to sleep disruption in patients with allergic rhinitis. However, nasal obstruction is the most important factor because the nasal receptor reflexes are critical to the control of breathing. Loss of this reflex results in disordered breathing during sleep. Polysomnography in patients with nasal obstruction has revealed decreased sleep efficiency, decreased deep sleep (slow wave sleep), and decreased dream sleep (REM sleep).
Patients with chronic nasal congestion have a threefold increased risk of habitual snoring. Compared with healthy control subjects, patients with allergic rhinitis had 10 times more microarousals from sleep associated with periodic breathing and hypopneic and hyperpneic episodes.
Topical nasal steroid therapy can improve subjective sleep quality and daytime function. However, some medications used to treat allergic conditions are also known to affect sleep. Oral antihistamines may cause sedation and drowsiness while oral decongestants can cause insomnia.
Children with allergies also suffer sleep disruption, which can impact learning, neurocognitive development and behavior. Some studies show 88% of children with allergic rhinitis suffer from sleep disorders, but more research is necessary to better define the underlying mechanisms responsible for the association between allergic diseases and sleep disordered breathing.
BayCare’s St. Joseph’s Hospital Sleep Disorders Center recently received accreditation from the American Academy of Sleep Medicine (AASM). St. Joseph’s Hospital Sleep Disorders Center laboratories have the most advanced diagnostic sleep testing available. Overnight studies take place in comfortable, private patient rooms that are closely monitored by polysomnographic technologists. After being assessed, the patient’s doctor receives a detailed sleep evaluation with a treatment recommendation plan. Call (813) 356-7106 to learn more or schedule an appointment.
Natarajan Subramanian, MD and John Prpich, MD
Natarajan Subramanian, MD is Director of St. Joseph’s Hospitals Sleep Disorders Center. John Prpich, MD is a Pediatric Pulmonologist, St. Joseph’s Children’s Hospital.