Congestion and Sleep Impairment in Allergic Rhinitis
Allergic rhinitis is a prevalent disease in developed nations, and its prevalence has been increasing throughout the world. Nasal congestion is the most common and bothersome symptoms of rhinitis. Congestion is associated with sleep-disordered breathing and is thought to be a key cause of sleep impairment in individuals with rhinitis. The end result is a decrease in quality of life and productivity and an increase in daytime sleepiness. Treatment with intranasal corticosteroids has been shown to reduce nasal congestion. Data on sleep-related end points from clinical trials of intranasal corticosteroids indicate that this reduction is associated with improved sleep, reduced daytime fatigue, and improved quality of life. Other therapies, such as montelukast, also have a positive influence on congestion and sleep. This review examines nasal congestion and the associated sleep impairment of allergic rhinitis patients. It explores the adverse effects of disturbed sleep on quality of life and how these conditions can be reduced by therapies that decrease congestion.
KeywordsSleep Rhinitis Allergic rhinitis Quality of life Somnolence
Dr. Craig has conducted research for GlaxoSmithKline, Schering, Novartis, Genentech, and Merck & Co. and served as a speaker for Teva Pharmaceuticals, Genentech, Schering, Novartis, and Merck & Co. No other potential conflicts of interest relevant to this article were reported.
Papers of particular interest, published recently, have been highlighted as: • Of Importance •• Of major importance
- 5.•• Meltzer EO, Nathan R, Derebery J, et al.: Sleep, quality of life, and productivity impact of nasal symptoms in the United States: findings from the Burden of Rhinitis in America survey. Allergy Asthma Proc 2009, 30:244–254. This is the most up-to-date article on the burden of rhinitis on patients.CrossRefPubMedGoogle Scholar
- 16.• Rimmer J, Downie S, Bartlett DJ, et al.: Sleep disturbance in persistent allergic rhinitis measured using actigraphy. Ann Allergy Asthma Immunol 2009, 103:190–194. This study showed that actigraphy may be an effective way to measure sleep disturbance in rhinitis and the response to therapy.CrossRefPubMedGoogle Scholar
- 28.Impact of Nasal Congestion Among Allergic Rhinitis Sufferers. An Internet Survey of 2002 People. New York: Roper Public Affairs Group of NOP World; 2004.Google Scholar
- 69.Berlin JM, Golden SJ, Teets S, et al.: Efficacy of a steroid nasal spray compared with an antihistamine nasal spray in the treatment of perennial allergic rhinitis. J Am Osteopath Assoc 2000, 100:8–13.Google Scholar
- 70.• Mansfield LE, Posey CR: Daytime sleepiness and cognitive performance improve in seasonal allergic rhinitis treated with intranasal fluticasone propionate. Allergy Asthma Proc 2007, 28:226–229. This article is important in that it shows the benefits of intranasal corticosteroids in patients with rhinitis and associated sleep disturbance.CrossRefPubMedGoogle Scholar
- 74.Mintz M, Garcia J, Diener P, et al.: Triamcinolone acetonide aqueous nasal spray improves nocturnal rhinitis-related quality of life in patients treated in a primary care setting: the Quality of Sleep in Allergic Rhinitis study. Ann Allergy Asthma Immunol 2004, 92:255–261.CrossRefPubMedGoogle Scholar