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Pollen levels on the day of polysomnography influence sleep disordered breathing severity in children with allergic rhinitis

  • Pediatrics • Original Article
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Abstract

Purpose

Allergic rhinitis (AR) is a common risk factor for sleep disordered breathing (SDB) in children. Allergy to pollen is a trigger for allergic rhinitis, causing nasal inflammation, upper airway congestion and obstruction. We aimed to determine if the pollen count on the day of diagnostic polysomnography for SDB affected the result.

Methods

Children (3–18 years; n = 90) who participated in research studies between 1 October and 31 December, when daily regional pollen counts were available, in the years 2005–2016 were eligible for inclusion. All children underwent overnight polysomnography for assessment of SDB severity. Pollen was categorised as grass or other pollen. Multiple stepwise linear regression was performed to determine whether the pollen count for that day, a diagnosis of asthma, age, and BMI-z-score were determinants of respiratory parameters measured on polysomnography, including the obstructive apnoea hypopnoea index (OAHI), SpO2 nadir, average SpO2 drop, SpO2 < 90%, oxygen desaturation index > 4% (ODI4), and average transcutaneous CO2 (TCM).

Results

Sixteen/90 children had AR. In children with AR, an increase in grass pollen of 1 grain/m3 predicted an increase in OAHI of 0.2 events/h, ODI4 of 0.18 times/h, SpO2 < 90% of 0.03 times/h, and TCM of 0.07 mmHg. None of the factors were determinants of SDB severity in children without AR.

Conclusion

Our findings highlight that daily pollen counts may be an important factor influencing the severity of SDB on a single night of polysomnography in children with clinical allergic rhinitis and should be taken into account when determining treatment options.

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Acknowledgements

We would like to thank Associate Professor Ed Newbigin from Melbourne University who provided the pollen count data and the parents and children who participated in this study.

Funding

Funding for this project was provided by The Heart Foundation of Australia (G12M 6564), The National Health and Medical Research Council of Australia (APP1008919, APP1063500, APP491001) and the Victorian Government’s Operational Infrastructure Support Program.

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Authors and Affiliations

  1. The Ritchie Centre, Hudson Institute of Medical Research and Department of Paediatrics, Monash University, Melbourne, Australia

    Lisa M. Walter, Knarik Tamanyan, Lauren Nisbet, Aidan J. Weichard, Margot J. Davey, Gillian M. Nixon & Rosemary S. C. Horne

  2. Melbourne Children’s Sleep Centre, Monash Children’s Hospital, Melbourne, Australia

    Knarik Tamanyan, Lauren Nisbet, Aidan J. Weichard, Margot J. Davey, Gillian M. Nixon & Rosemary S. C. Horne

Authors
  1. Lisa M. Walter
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  2. Knarik Tamanyan
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  5. Margot J. Davey
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Correspondence to Lisa M. Walter.

Ethics declarations

Ethical approval for this project was granted by the Monash Health and Monash University Human Research Ethics Committees. Written informed consent was obtained from parents and verbal assent from the children after a full explanation of the procedure. There was no monetary incentive for participation.

Conflict of interest

The authors declare that they have no conflict of interest.

Ethical approval

All procedures performed in studies involving human participants were in accordance with the ethical standards of Monash Health and Monash University Human Research Ethics Committees and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.

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Informed consent was obtained from all individual participants included in the study.

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Walter, L.M., Tamanyan, K., Nisbet, L. et al. Pollen levels on the day of polysomnography influence sleep disordered breathing severity in children with allergic rhinitis. Sleep Breath 23, 651–657 (2019). https://doi.org/10.1007/s11325-019-01819-1

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  • DOI: https://doi.org/10.1007/s11325-019-01819-1

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