Skip to main content

Auswirkungen atopischer Erkrankungen auf Schlafqualität und kognitive Kompetenz

Impact of atopic diseases on quality of sleep and cognitive competence

Zusammenfassung

Allergische Erkrankungen zeigen eine ausgeprägte zirkadiane Variabilität mit nächtlichem Beschwerdemaximum. Die damit einhergehende Schlaffragmentierung führt dazu, dass Betroffene häufig unter Tagesschläfrigkeit und relevanten Beeinträchtigungen der Lebensqualität leiden. Aufgrund der diagnostischen Lücke zur objektiven Erfassung werden nächtliche Asthmasymptome und allergieinduzierte Schlafstörungen in ihrer Häufigkeit unterschätzt. Daher sollten bei der Langzeitbetreuung von Asthma, atopischer Dermatitis oder allergischer Rhinitis die strukturierte Erfassung schlafbezogener Beschwerden sowie die Ermittlung von Schlafqualität und Tagesschläfrigkeit zur Routine gehören.

Umgekehrt müssen die sehr häufigen atopischen Erkrankungen bei der (primär somnologischen) Abklärung von Tagesschläfrigkeit berücksichtigt werden. Da Asthma und das obstruktive Schlafapnoe-Syndrom oft gemeinsam auftreten, sollte bei Diagnosestellung der einen Erkrankung auch gezielt nach der jeweils anderen gesucht werden.

Abstract

Allergic diseases display a marked circadian variability with the maximum of disease activity at night. Due to the subsequent disruption of sleep architecture, affected patients often suffer from daytime drowsiness and relevant impairment of their quality of life. Due to the diagnostic gaps in the objective detection, the frequency of nocturnal asthma symptoms and allergy-induced sleep disorders are underestimated. Therefore, the long-term care of patients with asthma, atopic dermatitis and allergic rhinitis should routinely include the structured detection of sleep-related complaints and a regular assessment of sleep quality and daytime drowsiness. Vice versa, the very frequent atopic diseases should be routinely considered in the differential diagnostics (primarily somnological) of daytime drowsiness. As asthma and obstructive sleep apnea syndrome often occur together, the finding of one of these entities should prompt the systematic search for the other.

This is a preview of subscription content, access via your institution.

Abb. 1
Abb. 2

Literatur

  1. 1.

    Beattie PE, Lewis-Jones MS (2006) An audit of the impact of a consultation with a paediatric dermatology team on quality of life in infants with atopic eczema and their families: further validation of the infants’ dermatitis quality of life index and dermatitis family impact score. Br J Dermatol 155:1249–1255

    CAS  PubMed  PubMed Central  Google Scholar 

  2. 2.

    Ben-Gashir MA, Seed PT, Hay RJ (2002) Are quality of family life and disease severity related in childhood atopic dermatitis? J Eur Acad Dermatol Venereol 16:455–462

    CAS  PubMed  PubMed Central  Google Scholar 

  3. 3.

    Bender BG, Leung SB, Leung DY (2003) Actigraphy assessment of sleep disturbance in patients with atopic dermatitis: an objective life quality measure. J Allergy Clin Immunol 111:598–602

    PubMed  PubMed Central  Google Scholar 

  4. 4.

    Bieber T (2008) Atopic dermatitis. N Engl J Med 358:1483–1494

    CAS  PubMed  PubMed Central  Google Scholar 

  5. 5.

    Bixler EO, Vgontzas AN, Lin HM et al (2009) Sleep disordered breathing in children in a general population sample: prevalence and risk factors. Sleep 32:731–736

    PubMed  PubMed Central  Google Scholar 

  6. 6.

    Bousquet J, Khaltaev N, Cruz AA et al (2008) Allergic rhinitis and its impact on asthma (ARIA) 2008 update (in collaboration with the world health organization, GA(2)LEN and allergen). Allergy 63(86):8–160

    PubMed  PubMed Central  Google Scholar 

  7. 7.

    Boyle J, Eriksson M, Stanley N et al (2006) Allergy medication in Japanese volunteers: treatment effect of single doses on nocturnal sleep architecture and next day residual effects. Curr Med Res Opin 22:1343–1351

    PubMed  PubMed Central  Google Scholar 

  8. 8.

    Brand PL (2013) The clinician’s guide on monitoring children with asthma. Paediatr Respir Rev 14:119–125

    PubMed  PubMed Central  Google Scholar 

  9. 9.

    Bringhurst C, Waterston K, Schofield O et al (2004) Measurement of itch using actigraphy in pediatric and adult populations. J Am Acad Dermatol 51:893–898

    PubMed  PubMed Central  Google Scholar 

  10. 10.

    Camfferman D, Kennedy JD, Gold M et al (2013) Sleep and neurocognitive functioning in children with eczema. Int J Psychophysiol 89:265–272

    PubMed  PubMed Central  Google Scholar 

  11. 11.

    Chamlin SL, Mattson CL, Frieden IJ et al (2005) The price of pruritus: sleep disturbance and cosleeping in atopic dermatitis. Arch Pediatr Adolesc Med 159:745–750

    PubMed  PubMed Central  Google Scholar 

  12. 12.

    Chang SY, Goh DY, Wang XS et al (2004) Snoring and atopic disease: a strong association. Pediatr Pulmonol 38:210–216

    Google Scholar 

  13. 13.

    Chang YS, Chou YT, Lee JH et al (2014) Atopic dermatitis, melatonin, and sleep disturbance. Pediatrics 134:e397–e405

    PubMed  PubMed Central  Google Scholar 

  14. 14.

    Chang YS, Lin MH, Lee JH et al (2016) Melatonin supplementation for children with atopic dermatitis and sleep disturbance: a randomized clinical trial. JAMA Pediatr 170:35–42

    PubMed  PubMed Central  Google Scholar 

  15. 15.

    Chervinsky P, Philip G, Malice MP et al (2004) Montelukast for treating fall allergic rhinitis: effect of pollen exposure in 3 studies. Ann Allergy Asthma Immunol 92:367–373

    CAS  PubMed  PubMed Central  Google Scholar 

  16. 16.

    Church MK, Maurer M, Simons FE et al (2010) Risk of first-generation H(1)-antihistamines: a GA(2)LEN position paper. Allergy 65:459–466

    CAS  PubMed  PubMed Central  Google Scholar 

  17. 17.

    Colas C, Galera H, Anibarro B et al (2012) Disease severity impairs sleep quality in allergic rhinitis (the SOMNIAAR study). Clin Exp Allergy 42:1080–1087

    CAS  PubMed  PubMed Central  Google Scholar 

  18. 18.

    Craig TJ, Mccann JL, Gurevich F et al (2004) The correlation between allergic rhinitis and sleep disturbance. J Allergy Clin Immunol 114:S139–S145

    PubMed  PubMed Central  Google Scholar 

  19. 19.

    Craig TJ, Teets S, Lehman EB et al (1998) Nasal congestion secondary allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol 101(5):633–637

    CAS  PubMed  PubMed Central  Google Scholar 

  20. 20.

    Desager KN, Nelen V, Weyler JJ et al (2005) Sleep disturbance and daytime symptoms in wheezing school-aged children. J Sleep Res 14:77–82

    PubMed  PubMed Central  Google Scholar 

  21. 21.

    Diepgen TL, Early Treatment of the Atopic Child Study Group (2002) Long-term treatment with cetirizine of infants with atopic dermatitis: a multi-country, double-blind, randomized, placebo-controlled trial (the ETAC trial) over 18 months. Pediatr Allergy Immunol 13:278–286

    PubMed  PubMed Central  Google Scholar 

  22. 22.

    Djukanovic R, Wilson SJ, Kraft M et al (2004) Effects of treatment with anti-immunoglobulin E antibody omalizumab on airway inflammation in allergic asthma. Am J Respir Crit Care Med 170:583–593

    PubMed  PubMed Central  Google Scholar 

  23. 23.

    Durrington HJ, Farrow SN, Loudon AS et al (2014) The circadian clock and asthma. Thorax 69:90–92

    PubMed  PubMed Central  Google Scholar 

  24. 24.

    Eising JB, Uiterwaal CS, van der Ent CK (2014) Nocturnal wheeze measurement in preschool children. Pediatr Pulmonol 49:257–262

    PubMed  PubMed Central  Google Scholar 

  25. 25.

    Emanuel MB (1999) Histamine and the antiallergic antihistamines: a history of their discoveries. Clin Exp Allergy 29(3):1–12

    CAS  PubMed  PubMed Central  Google Scholar 

  26. 26.

    Fagnano M, Bayer AL, Isensee CA et al (2011) Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma. Acad Pediatr 11:493–499

    PubMed  PubMed Central  Google Scholar 

  27. 27.

    Fernández-Pires P, Valera-Gran D, Hurtado-Pomares M et al (2021) Sleep duration and quality and sensory reactivity in school-aged children: the Spanish cross-sectional inProS study. Front Pediatr 9:646011

    PubMed  PubMed Central  Google Scholar 

  28. 28.

    Fishbein AB, Vitaterna O, Haugh IM et al (2015) Nocturnal eczema: review of sleep and circadian rhythms in children with atopic dermatitis and future research directions. J Allergy Clin Immunol 136:1170–1177

    PubMed  PubMed Central  Google Scholar 

  29. 29.

    Gina (2021) Global initiative for asthma: global strategy for asthma management and prevention. http://www.ginasthma.com. Zugegriffen: 26. Apr. 2021

  30. 30.

    Holgate ST, Canonica GW, Simons FE et al (2003) Consensus group on new-generation antihistamines (CONGA): present status and recommendations. Clin Exp Allergy 33:1305–1324

    CAS  PubMed  PubMed Central  Google Scholar 

  31. 31.

    Kheirandish-Gozal L, Dayyat EA, Eid NS et al (2011) Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy. Pediatr Pulmonol 46:913–918

    PubMed  PubMed Central  Google Scholar 

  32. 32.

    Koehler U, Brandenburg U, Weissflog A et al (2014) LEOSound, an innovative procedure for acoustic long-term monitoring of asthma symptoms (wheezing and coughing) in children and adults. Pneumologie 68:277–281

    CAS  PubMed  PubMed Central  Google Scholar 

  33. 33.

    Koinis-Mitchell D, Craig T, Esteban CA et al (2012) Sleep and allergic disease: a summary of the literature and future directions for research. J Allergy Clin Immunol 130:1275–1281

    PubMed  PubMed Central  Google Scholar 

  34. 34.

    Kunz B, Oranje AP, Labreze L et al (1997) Clinical validation and guidelines for the SCORAD index: consensus report of the European task force on atopic dermatitis. Dermatology 195:10–19

    CAS  PubMed  PubMed Central  Google Scholar 

  35. 35.

    Lawson V, Lewis-Jones MS, Finlay AY et al (1998) The family impact of childhood atopic dermatitis: the dermatitis family impact questionnaire. Br J Dermatol 138:107–113

    CAS  PubMed  PubMed Central  Google Scholar 

  36. 36.

    Le Fur I, Reinberg A, Lopez S et al (2001) Analysis of circadian and ultradian rhythms of skin surface properties of face and forearm of healthy women. J Invest Dermatol 117:718–724

    CAS  PubMed  PubMed Central  Google Scholar 

  37. 37.

    Lewis-Jones MS, Finlay AY, Dykes PJ (2001) The infants’ dermatitis quality of life index. Br J Dermatol 144:104–110

    CAS  PubMed  PubMed Central  Google Scholar 

  38. 38.

    Litinski M, Scheer FA, Shea SA (2009) Influence of the circadian system on disease severity. Sleep Med Clin 4:143–163

    PubMed  PubMed Central  Google Scholar 

  39. 39.

    Lokhandwala S, Holmes JF, Mason GM et al (2021) Sleep and coping in early childhood during the COVID-19 pandemic. Front Pediatr 9:716608

    PubMed  PubMed Central  Google Scholar 

  40. 40.

    Lunn M, Craig T (2011) Rhinitis and sleep. Sleep Med Rev 15:293–299

    PubMed  PubMed Central  Google Scholar 

  41. 41.

    Malakasioti G, Gourgoulianis K, Chrousos G et al (2011) Interactions of obstructive sleep-disordered breathing with recurrent wheezing or asthma and their effects on sleep quality. Pediatr Pulmonol 46:1047–1054

    PubMed  PubMed Central  Google Scholar 

  42. 42.

    Mccolley SA, Carroll JL, Curtis S et al (1997) High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest 111:170–173

    CAS  PubMed  PubMed Central  Google Scholar 

  43. 43.

    Meltzer EO, Blaiss MS, Derebery MJ et al (2009) Burden of allergic rhinitis: results from the pediatric allergies in America survey. J Allergy Clin Immunol 124:S43–S70

    PubMed  PubMed Central  Google Scholar 

  44. 44.

    Mochizuki H, Tashiro M, Tagawa M et al (2002) The effects of a sedative antihistamine, d‑chlorpheniramine, on visuomotor spatial discrimination and regional brain activity as measured by positron emission tomography (PET). Hum Psychopharmacol 17:413–418

    CAS  PubMed  PubMed Central  Google Scholar 

  45. 45.

    Monti JM (1993) Involvement of histamine in the control of the waking state. Life Sci 53:1331–1338

    CAS  PubMed  PubMed Central  Google Scholar 

  46. 46.

    Nayak A, Langdon RB (2007) Montelukast in the treatment of allergic rhinitis: an evidence-based review. Drugs 67:887–901

    CAS  PubMed  PubMed Central  Google Scholar 

  47. 47.

    AWMF online (2020) Nationale Versorgungsleitlinie Asthma, 4. Aufl. (Version 1, AWMF-Register-Nr.: nvl-002)

    Google Scholar 

  48. 48.

    Owens JA, Spirito A, Mcguinn M (2000) The children’s sleep habits questionnaire (CSHQ): psychometric properties of a survey instrument for school-aged children. Sleep 23:1043–1051

    CAS  PubMed  PubMed Central  Google Scholar 

  49. 49.

    Paller AS, McAlister RO, Doyle JJ et al (2002) Perceptions of physicians and pediatric patients about atopic dermatitis, its impact, and its treatment. Clin Pediatr (Phila) 41:323–332

    Google Scholar 

  50. 50.

    Petrovsky N, Harrison LC (1998) The chronobiology of human cytokine production. Int Rev Immunol 16:635–649

    CAS  PubMed  PubMed Central  Google Scholar 

  51. 51.

    Raap U, Weissmantel S, Gehring M et al (2012) IL-31 significantly correlates with disease activity and Th2 cytokine levels in children with atopic dermatitis. Pediatr Allergy Immunol 23:285–288

    PubMed  PubMed Central  Google Scholar 

  52. 52.

    Redline S, Tishler PV, Schluchter M et al (1999) Risk factors for sleep-disordered breathing in children. Associations with obesity, race, and respiratory problems. Am J Respir Crit Care Med 159:1527–1532

    CAS  PubMed  PubMed Central  Google Scholar 

  53. 53.

    Ricci G, Bendandi B, Bellini F et al (2007) Atopic dermatitis: quality of life of young Italian children and their families and correlation with severity score. Pediatr Allergy Immunol 18:245–249

    PubMed  PubMed Central  Google Scholar 

  54. 54.

    Romanos M, Gerlach M, Warnke A et al (2010) Association of attention-deficit/hyperactivity disorder and atopic eczema modified by sleep disturbance in a large population-based sample. J Epidemiol Community Health 64:269–273

    PubMed  PubMed Central  Google Scholar 

  55. 55.

    Ross KR, Storfer-Isser A, Hart MA et al (2012) Sleep-disordered breathing is associated with asthma severity in children. J Pediatr 160:736–742

    PubMed  PubMed Central  Google Scholar 

  56. 56.

    Sandoval LF, Huang K, O’neill JL et al (2014) Measure of atopic dermatitis disease severity using actigraphy. J Cutan Med Surg 18:49–55

    PubMed  PubMed Central  Google Scholar 

  57. 57.

    Schmitz R, Thamm M, Ellert U et al (2014) Prevalence of common allergies in children and adolescents in Germany: results of the KiGGS study: first follow-up (KiGGS Wave 1). Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz 57:771–778

    CAS  PubMed  PubMed Central  Google Scholar 

  58. 58.

    Shaw TE, Currie GP, Koudelka CW et al (2011) Eczema prevalence in the United States: data from the 2003 national survey of children’s health. J Invest Dermatol 131:67–73

    CAS  PubMed  PubMed Central  Google Scholar 

  59. 59.

    Sogut A, Altin R, Uzun L et al (2005) Prevalence of obstructive sleep apnea syndrome and associated symptoms in 3–11-year-old Turkish children. Pediatr Pulmonol 39:251–256

    PubMed  PubMed Central  Google Scholar 

  60. 60.

    Strachan D, Sibbald B, Weiland S et al (1997) Worldwide variations in prevalence of symptoms of allergic rhinoconjunctivitis in children: the international study of asthma and allergies in childhood (ISAAC). Pediatr Allergy Immunol 8:161–176

    CAS  PubMed  PubMed Central  Google Scholar 

  61. 61.

    Sukumaran S, Jusko WJ, Dubois DC et al (2011) Light-dark oscillations in the lung transcriptome: implications for lung homeostasis, repair, metabolism, disease, and drug action. J Appl Physiol 110(6):1732–1747

    PubMed  PubMed Central  Google Scholar 

  62. 62.

    Sutherland ER (2005) Nocturnal asthma. J Allergy Clin Immunol 116:1179–1187

    PubMed  PubMed Central  Google Scholar 

  63. 63.

    Tagawa M, Kano M, Okamura N et al (2002) Differential cognitive effects of ebastine and (+)-chlorpheniramine in healthy subjects: correlation between cognitive impairment and plasma drug concentration. Br J Clin Pharmacol 53:296–304

    CAS  PubMed  PubMed Central  Google Scholar 

  64. 64.

    Tamm S, Lensmar C, Andreasson A et al (2021) Objective and subjective sleep in rheumatoid arthritis and severe seasonal allergy: preliminary assessments of the role of sickness, central and peripheral inflammation. NSS 13:775–778

    Google Scholar 

  65. 65.

    Tashiro M, Duan X, Kato M et al (2008) Brain histamine H1 receptor occupancy of orally administered antihistamines, bepotastine and diphenhydramine, measured by PET with 11C-doxepin. Br J Clin Pharmacol 65:811–821

    CAS  PubMed  PubMed Central  Google Scholar 

  66. 66.

    Visness CM, London SJ, Daniels JL et al (2010) Association of childhood obesity with atopic and nonatopic asthma: results from the national health and nutrition examination survey 1999–2006. J Asthma 47:822–829

    PubMed  PubMed Central  Google Scholar 

  67. 67.

    Vuurman EF, van Veggel LM, Uiterwijk MM et al (1993) Seasonal allergic rhinitis and antihistamine effects on children’s learning. Ann Allergy 71:121–126

    CAS  PubMed  PubMed Central  Google Scholar 

  68. 68.

    Wilken JA, Kane RL, Ellis AK et al (2003) A comparison of the effect of diphenhydramine and desloratadine on vigilance and cognitive function during treatment of ragweed-induced allergic rhinitis. Ann Allergy Asthma Immunol 91:375–385

    CAS  PubMed  PubMed Central  Google Scholar 

  69. 69.

    Williams H, Flohr C (2006) How epidemiology has challenged 3 prevailing concepts about atopic dermatitis. J Allergy Clin Immunol 118:209–213

    PubMed  PubMed Central  Google Scholar 

  70. 70.

    Wilson AM, O’byrne PM, Parameswaran K (2004) Leukotriene receptor antagonists for allergic rhinitis: a systematic review and meta-analysis. Am J Med 116:338–344

    CAS  PubMed  PubMed Central  Google Scholar 

  71. 71.

    Yamada T, Yamamoto H, Kubo S et al (2012) Efficacy of mometasone furoate nasal spray for nasal symptoms, quality of life, rhinitis-disturbed sleep, and nasal nitric oxide in patients with perennial allergic rhinitis. Allergy Asthma Proc 33:e9–e16

    CAS  PubMed  PubMed Central  Google Scholar 

  72. 72.

    Yosipovitch G, Bernhard JD (2013) Clinical practice. Chronic pruritus. N Engl J Med 368:1625–1634

    CAS  PubMed  PubMed Central  Google Scholar 

  73. 73.

    Kerzel S (2016) Was hustet und juckt da im Dunkeln? Nächtliches Asthma und allergieinduzierte Schlafstörungen bei Kindern und Jugendlichen. Somnologie 20:288–296. https://doi.org/10.1007/s11818-016-0082-4

    Article  Google Scholar 

Download references

Author information

Affiliations

Authors

Corresponding author

Correspondence to Markus A. Rose M.P.H..

Ethics declarations

Interessenkonflikt

S. Kerzel hat Vortragshonorare der Firmen Heinen & Löwenstein GmbH und Nutricia GmbH erhalten. M.A. Rose hat Unterstützung für Forschungsprojekte, Kongressbesuche und Vortragshonorare u. a. der Firmen Bencard Allergie, Allergopharm, Leti, Pari erhalten.

Für diesen Beitrag wurden von den Autoren keine Studien an Menschen oder Tieren durchgeführt. Für die aufgeführten Studien gelten die jeweils dort angegebenen ethischen Richtlinien.

Additional information

Der Artikel basiert auf Kerzel S (2016) Was hustet und juckt da im Dunkeln? Nächtliches Asthma und allergieinduzierte Schlafstörungen bei Kindern und Jugendlichen. Somnologie 20:288–296. https://doi.org/10.1007/s11818-016-0082-4.

figureqr

QR-Code scannen & Beitrag online lesen

Redaktion

M. Rosewich, Oberursel

M. Rose, Stuttgart

Rights and permissions

Reprints and Permissions

About this article

Verify currency and authenticity via CrossMark

Cite this article

Kerzel, S., Rose, M.A. Auswirkungen atopischer Erkrankungen auf Schlafqualität und kognitive Kompetenz. Pneumologe 18, 378–390 (2021). https://doi.org/10.1007/s10405-021-00418-w

Download citation

Schlüsselwörter

  • Obstruktive Schlafapnoe
  • Allergische Rhinitis
  • Atopische Dermatitis
  • Asthma
  • Lebensqualität

Keywords

  • Obstructive sleep apnea
  • Allergic rhinitis
  • Atopic dermatitis
  • Asthma
  • Quality of life