Abstract
Purpose
Persistent allergic rhinitis (PAR) is characterized by a chronic, eosinophilic inflammation with nasal congestion and rhinorrhea. Nasal congestion can constitute to sleep-disordered breathing problems that range from simple snoring to obstructive sleep apnea syndrome (OSAS). The purpose of this study was to investigate the effect of PAR on sleep quality and severity of OSAS.
Methods
The study included 150 patients presenting with typical symptoms of sleep apnea. Fifty-five patients were diagnosed as PAR (group-1) and were compared with age and body mass index matched 95 individuals (group-2) without any nasal disease. Skin prick tests and polysomnography were performed in all patients.
Results
There were no differences between groups for polysomnographic findings including sleep architecture, arousal and respiratory index, and mean and minimal oxygen saturations. Simple snoring was determined in 41.8 % allergic and 32.6 % non-allergic patients. Mild OSAS was determined in 32.7 % allergic and 29.4 % non-allergic patients. Moderate OSAS was determined in 9 % allergic and 17.8 % non-allergic patients. Severe OSAS was determined in 16.3 % allergic and 20 % non-allergic patients. Their entire Epworth sleepiness scale index was also found similar.
Conclusions
Our data pointed out that in patients with sleep-related breathing disorders symptoms, presence of PAR does not affect polysomnographic parameters compared with other patients without any nasal inflammation. Besides, prevalence of OSAS was similar between groups.
Similar content being viewed by others
References
Berry RB, Brooks R, Gamaldo CE, Hardling S, Marcus C, Vaughn B (2012) The AASM manual for the scoring of sleep and associated events. Rules, terminology and technical specifications. American Academy of Sleep Medicine, Darien
Sullivan C, Issa F (1980) Pathophysiological mechanisms in obstructive sleep apnea. Sleep 3(3–4):235
Scharf MB, Cohen AP (1998) Diagnostic and treatment implications of nasal obstruction in snoring and obstructive sleep apnea. Annals of Allergy, Asthma & Immunology 81(4):279–290
Young T, Finn L, Kim H (1997) Nasal obstruction as a risk factor for sleep-disordered breathing. J Allergy Clin Immunol 99(2):S757–S762
Proctor DF (1977) The upper airways: I. nasal physiology and defense of the lungs 1, 2. Am Rev Respir Dis 115(1):97–129
de Aguiar VT, Haddad FLM, Gregório LC, Poyares D, Tufik S, Bittencourt LRA (2013) Subjective, anatomical, and functional nasal evaluation of patients with obstructive sleep apnea syndrome. Sleep and Breathing 17(1):427–433
Lofaso F, Coste A, Zerah-Lancner F, Delclaux C, Goldenberg F, Harf A (2000) Nasal obstruction as a risk factor for sleep apnoea syndrome. Eur Respir J 16(4):639–643
Sugiura T, Noda A, Nakata S, Yasuda Y, Soga T, Miyata S, Nakai S, Koike Y (2005) Influence of nasal resistance on initial acceptance of continuous positive airway pressure in treatment for obstructive sleep apnea syndrome. Respiration 74(1):56–60
Settipane RA, Charnock DR (2007) Epidemiology of rhinitis: allergic and nonallergic. Clinical allergy and immunology 19:23
Hadley J, Derebery M, Marple B (2012) Comorbidities and allergic rhinitis: not just a runny nose. The Journal of family practice 61(2 Suppl):S11–S15
Craig TJ, Ferguson BJ, Krouse JH (2008) Sleep impairment in allergic rhinitis, rhinosinusitis, and nasal polyposis. Am J Otolaryngol 29(3):209–217
Meltzer E, Gross GN, Katial R, Storms W (2012) Allergic rhinitis substantially impacts patient quality of life: findings from the nasal allergy survey assessing limitations. The Journal of family practice 61(2 Suppl):S5–10
Johns MW (1991) A new method for measuring daytime sleepiness: the Epworth sleepiness scale. Sleep 14(6):540–545
Berry RB, Budhiraja R, Gottlieb DJ, Gozal D, Iber C, Kapur VK, Marcus CL, Mehra R, Parthasarathy S, Quan SF (2012) Rules for scoring respiratory events in sleep: update of the 2007 AASM manual for the scoring of sleep and associated events. J Clin Sleep Med 8(5):597–619
Spengler CM, Shea SA (2000) Endogenous circadian rhythm of pulmonary function in healthy humans. Am J Respir Crit Care Med 162(3):1038–1046
Ballard RD, Saathoff MC, Patel DK, Kelly PL, Martin RJ (1989) Effect of sleep on nocturnal bronchoconstriction and ventilatory patterns in asthmatics. J Appl Physiol 67(1):243–249
Ko J-H, Kuo TB, Lee G-S (2008) Effect of postural change on nasal airway and autonomic nervous system established by rhinomanometry and heart rate variability analysis. Am J Rhinol 22(2):159–165
Krouse HJ, Davis JE, Krouse JH (2002) Immune mediators in allergic rhinitis and sleep. Otolaryngol Head Neck Surg 126(6):607–613
Léger D, Annesi-Maesano I, Carat F, Rugina M, Chanal I, Pribil C, El Hasnaoui A, Bousquet J (2006) Allergic rhinitis and its consequences on quality of sleep: an unexplored area. Arch Intern Med 166(16):1744–1748
Bousquet J, Neukirch F, Bousquet PJ, Gehano P, Klossek JM, Le Gal M, Allaf B (2006) Severity and impairment of allergic rhinitis in patients consulting in primary care. J Allergy Clin Immunol 117(1):158–162
Rodríguez PA, González J (1999) Data on the safety of antihistaminics obtained from published clinical trials. Allergol Immunopathol 28(5):272–277
Young T, Finn L, Palta M (2001) Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med 161(12):1514–1519
Acar M, Cingi C, Sakallioglu O, San TFYM, Bal C (2013) The effects of mometasone furoate and desloratadine in obstructive sleep apnea syndrome patients with allergic rhinitis. Am J Rhinol Allergy 27(4):e113–e116
Stuck BA, Czajkowski J, Hagner A-E, Klimek L, Verse T, Hörmann K, Maurer JT (2004) Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal allergic rhinitis: a controlled clinical trial. J Allergy Clin Immunol 113(4):663–668
Meng J, Xuan J, Qiao X, Li X, Liu S, Lukat K, Zhang N, Bachert C (2010) Assessment of sleep impairment in persistent allergic rhinitis patients using polysomnography. Int Arch Allergy Immunol 155(1):57–62
Kramer M, De La Chaux R, Dreher A, Pfrogner E, Rasp G (2001) Allergic rhinitis does not constitute a risk factor for obstructive sleep apnea syndrome. Acta Otolaryngol 121(4):494–499
Duchna H, Rasche K, Lambers N, Orth M, Merget R, Schultze-Werninghaus G (1997) [Incidence of cutaneous sensitization to environmental allergens in obstructive sleep apnea syndrome]. Pneumologie (Stuttgart, Germany) 51:763–766
Author information
Authors and Affiliations
Corresponding author
Ethics declarations
Declaration of conflicting interests
All authors certify that they have no affiliations with or involvement in any organization or entity with any financial interest (such as honoraria; educational grants; participation in speakers’ bureaus; membership, employment, consultancies, stock ownership, or other equity interest; and expert testimony or patent-licensing arrangements) or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.
Funding
No funding was received for this research.
Ethical approval
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent
Informed consent was obtained from all individual participants included in the study.
Rights and permissions
About this article
Cite this article
Bozkurt, B., Serife Ugur, K., Karamanli, H. et al. Polysomnographic findings in persistent allergic rhinitis. Sleep Breath 21, 255–261 (2017). https://doi.org/10.1007/s11325-016-1390-4
Received:
Revised:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s11325-016-1390-4