Allergic rhinitis is inflammation of the lining of the nose caused by allergy. Both seasonal and chronic allergic rhinitis impair sleep in adults and children, leading to fatigue and other deficits in quality of life, according to the Burden of Rhinitis in America survey. Allergic rhinitis causes more than one sleep disorder in most sufferers, and the problems tend to recur. The most dominant allergy-related symptom causing sleep disorders is nasal congestion. Drug advances help remedy sleep disorders.
Sleep-related Problems in Allergy
Typical sleep-related problems in people with allergic rhinitis include disordered breathing, breathing pauses and snoring, all of which result from nasal congestion, reports the American Journal of Otolaryngology. Repeatedly waking up, known as microarousals, also occur. Nasal nocturnal syndrome is the term clinicians use to describe breathing difficulty when lying down, restless sleep, sudden awakening, gasping respiration and snoring.
Impact
According to the Burden of Rhinitis in America survey, sleep problems affect about 57 percent of adults and nearly 90 percent of children with allergic rhinitis. People with allergy-related disturbed sleep have a lower quality of life and reduced concentration. They are tired during the day, and their productivity is lower. Their sleep-related problems lead to absences from work and school. The burden from sleep problems is higher for people with severe nasal symptoms.
Nasal Congestion
Nasal congestion due to allergic rhinitis causes stuffiness and pressure. It makes it difficult to breathe through the nose when asleep. This leads to snoring and breathing abnormalities, such as temporary stops in breathing. This, in turn, causes a person to wake up briefly, reducing the depth and quality of sleep. In worst case scenarios, children breathing through their nose over the long term develop abnormalities in their facial structure. One cause of long-term nasal blockage causing facial changes is enlarged tonsils.
Management
Intranasal steroids reduce the inflammation associated with nasal congestion and are the most effective medicine to treat it, reports the Allergic Rhinitis and its Impact on Asthma workshop (ARIA), an expert international panel that issues treatment guidelines. Nasal steroids should be the first medicine taken by people suffering from sleep disorders due to stuffy nose. An analysis of three studies showed that people with rhinitis and blocked nose who were treated with these agents had less stuffiness and fewer sleep problems and were not as tired during the day, reports the Journal of Allergy and Clinical Immunology. Children with persistent nasal congestion and sleep problems should have their tonsils evaluated. If their tonsils are enlarged, tonsillectomy cures sleep disorders in more than 80 percent of children.
Expert Insight
Children who habitually snore are likely to have undiagnosed allergies. They should undergo allergen tests and be checked for nasal obstruction.
References
- Allergy and Asthma Proceedings (journal); "Sleep, Quality of Life and Productivity Impact of Nasal Symptoms in the United States (Findings from the Burden of Rhinitis in America Survey)"; 2005
- "The Nose and Sleep-Disordered Breathing"; Chest; Rappai M. 2003
- Journal of Allergy and Clinical Immunology; "How Do Topical Nasal Corticosteroids Improve Sleep and Daytime Somnolence in Allergic Rhinitis?"; 2005
- Allergy (journal); "Allergic Rhinitis and Its Impact on Asthma"; Bousquet J, et al.; 2008
