Screening for Allergic Disease in a Child with Sleep Disorder and Screening for Sleep Disturbance in Allergic Disease

  • Tanvi H. Mukundan


Allergic disease and sleep disorders are common pediatric conditions. The interplay of these two disorders is described primarily in prevalence studies; however, there is a growing body of literature that shows how these two conditions can impact each other, both with amelioration and worsening of symptoms. Thus, it is crucial for sleep specialists, allergists, pulmonologists, otolaryngologists, and general primary care physicians to understand the connection of these two conditions, common history and physical features, and available screening tools to best serve their patients.


Screening for allergy Pediatric allergy screening Allergy screening in children Pediatric sleep disorder Allergy and sleep disorder in children Sleep disorder and allergy in children 


  1. 1.
    Akdis CAS, Scott H. Allergy and the immunologic basis of atopic disease. In: Robert M. Kliegman BS, Joseph St. Geme, Nina F. Schor ; editor emeritus, Richard E. Behrman, editors. Nelson textbook of pediatrics. 20 ed: Philadelphia: Elsevier; 2016. p. 1074–978.Google Scholar
  2. 2.
    Thompson A, Sardana N, Craig TJ. Sleep impairment and daytime sleepiness in patients with allergic rhinitis: the role of congestion and inflammation. Ann Allergy Asthma Immunol. 2013;111(6):446–51.CrossRefGoogle Scholar
  3. 3.
    Camfferman D, Kennedy JD, Gold M, Martin AJ, Winwood P, Lushington K. Eczema, sleep, and behavior in children. J Clin Med. 2010;6(6):581–8.Google Scholar
  4. 4.
    Desager KN, Nelen V, Weyler JJ, De Backer WA. Sleep disturbance and daytime symptoms in wheezing school-aged children. J Sleep Res. 2005;14(1):77–82.CrossRefGoogle Scholar
  5. 5.
    Camhi SL, Morgan WJ, Pernisco N, Quan SF. Factors affecting sleep disturbances in children and adolescents. Sleep Med. 2000;1(2):117–23.CrossRefGoogle Scholar
  6. 6.
    Calhoun SL, Vgontzas AN, Fernandez-Mendoza J, et al. Prevalence and risk factors of excessive daytime sleepiness in a community sample of young children: the role of obesity, asthma, anxiety/depression, and sleep. Sleep. 2011;34(4):503–7.CrossRefGoogle Scholar
  7. 7.
    Tal A. Obstructive Sleep apnea syndrome: pathophysiology and clinical characteristics. In: Sheldon S, ed. Principles and practice of pediatric sleep medicine: Elsevier; 2014. p. 215–220.Google Scholar
  8. 8.
    Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich C. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998;101(5):633–7.CrossRefGoogle Scholar
  9. 9.
    Ishman SL, Smith DF, Benke JR, Nguyen MT, Lin SY. The prevalence of sleepiness and the risk of sleep-disordered breathing in children with positive allergy test. Int Forum Allergy Rhinol. 2012;2(2):139–43.CrossRefGoogle Scholar
  10. 10.
    Fagnano M, Bayer AL, Isensee CA, Hernandez T, Halterman JS. Nocturnal asthma symptoms and poor sleep quality among urban school children with asthma. Acad Pediatr. 2011;11(6):493–9.CrossRefGoogle Scholar
  11. 11.
    Diette GB, Markson L, Skinner EA, Nguyen TT, Algatt-Bergstrom P, Wu AW. Nocturnal asthma in children affects school attendance, school performance, and parents’ work attendance. Arch Pediatr Adolesc Med. 2000;154(9):923–8.CrossRefGoogle Scholar
  12. 12.
    Jensen ME, Gibson PG, Collins CE, Hilton JM, Latham-Smith F, Wood LG. Increased sleep latency and reduced sleep duration in children with asthma. Sleep & breathing = Schlaf & Atmung. 2013;17(1):281–7.CrossRefGoogle Scholar
  13. 13.
    van Keimpema AR, Ariaansz M, Nauta JJ, Postmus PE. Subjective sleep quality and mental fitness in asthmatic patients. J Asthma. 1995;32(1):69–74.CrossRefGoogle Scholar
  14. 14.
    Janson C, De Backer W, Gislason T, et al. Increased prevalence of sleep disturbances and daytime sleepiness in subjects with bronchial asthma: a population study of young adults in three European countries. Eur Respir J. 1996;9(10):2132–8.CrossRefGoogle Scholar
  15. 15.
    Dahan P, de Bessa J, Jr de Oliveira DM, et al. Association between asthma and primary nocturnal enuresis in children. J Urol. 2016;195(4 Pt 2):1221–6.CrossRefGoogle Scholar
  16. 16.
    Sadeh A, Horowitz I, Wolach-Benodis L, Wolach B. Sleep and pulmonary function in children with well-controlled, stable asthma. Sleep. 1998;21(4):379–84.CrossRefGoogle Scholar
  17. 17.
    Kieckhefer GM, Ward TM, Tsai SY, Lentz MJ. Nighttime sleep and daytime nap patterns in school age children with and without asthma. J Dev Behav Pediatr. 2008;29(5):338–44.CrossRefGoogle Scholar
  18. 18.
    van Maanen A, Wijga AH, Gehring U, et al. Sleep in children with asthma: results of the PIAMA study. Eur Respir J. 2013;41(4):832–7.CrossRefGoogle Scholar
  19. 19.
    Stores G, Ellis AJ, Wiggs L, Crawford C, Thomson A. Sleep and psychological disturbance in nocturnal asthma. Arch Dis Child. 1998;78(5):413–9.CrossRefGoogle Scholar
  20. 20.
    Verhulst SL, Vekemans K, Ho E, et al. Is wheezing associated with decreased sleep quality in Sri Lankan children? A questionnaire study. Pediatr Pulmonol. 2007;42(7):579–83.CrossRefGoogle Scholar
  21. 21.
    Garrison MM, Lozano P, Christakis DA. Controller medication use and sleep problems in pediatric asthma: a longitudinal case-crossover analysis. Arch Pediatr Adolesc Med. 2011;165(9):826–30.CrossRefGoogle Scholar
  22. 22.
    Braido F, Baiardini I, Lacedonia D, et al. Sleep apnea risk in subjects with asthma with or without comorbid rhinitis. Respir Care. 2014;59(12):1851–6.CrossRefGoogle Scholar
  23. 23.
    Dixon AE, Clerisme-Beaty EM, Sugar EA, et al. Effects of obstructive sleep apnea and gastroesophageal reflux disease on asthma control in obesity. J Asthma. 2011;48(7):707–13.CrossRefGoogle Scholar
  24. 24.
    Goldstein NA, Aronin C, Kantrowitz B, et al. The prevalence of sleep-disordered breathing in children with asthma and its behavioral effects. Pediatr Pulmonol. 2015;50(11):1128–36.CrossRefGoogle Scholar
  25. 25.
    Julien JY, Martin JG, Ernst P, et al. Prevalence of obstructive sleep apnea-hypopnea in severe versus moderate asthma. J Allergy Clin Immunol. 2009;124(2):371–6.CrossRefGoogle Scholar
  26. 26.
    Guven SF, Dursun AB, Ciftci B, Erkekol FO, Kurt OK. The prevalence of obstructive sleep apnea in patients with difficult-to-treat asthma. Asian Pac J Allergy Immunol. 2014;32(2):153–9.PubMedGoogle Scholar
  27. 27.
    Alharbi M, Almutairi A, Alotaibi D, Alotaibi A, Shaikh S, Bahammam AS. The prevalence of asthma in patients with obstructive sleep apnoea. Prim Care Respir J. 2009;18(4):328–30.CrossRefGoogle Scholar
  28. 28.
    Kheirandish-Gozal L, Dayyat EA, Eid NS, Morton RL, Gozal D. Obstructive sleep apnea in poorly controlled asthmatic children: effect of adenotonsillectomy. Pediatr Pulmonol. 2011;46(9):913–8.CrossRefGoogle Scholar
  29. 29.
    Ross KR, Storfer-Isser A, Hart MA, et al. Sleep-disordered breathing is associated with asthma severity in children. J Pediatr. 2012;160(5):736–42.CrossRefGoogle Scholar
  30. 30.
    Gutierrez MJ, Zhu J, Rodriguez-Martinez CE, Nino CL, Nino G. Nocturnal phenotypical features of obstructive sleep apnea (OSA) in asthmatic children. Pediatr Pulmonol. 2013;48(6):592–600.CrossRefGoogle Scholar
  31. 31.
    Shanley LA, Lin H, Flores G. Factors associated with length of stay for pediatric asthma hospitalizations. J Asthma. 2015;52(5):471–7.CrossRefGoogle Scholar
  32. 32.
    ten Brinke A, Sterk PJ, Masclee AA, et al. Risk factors of frequent exacerbations in difficult-to-treat asthma. Eur Respir J. 2005;26(5):812–8.CrossRefGoogle Scholar
  33. 33.
    Kohli N, DeCarlo D, Goldstein NA, Silverman J. Asthma outcomes after adenotonsillectomy: a systematic review. Int J Pediatr Otorhinolaryngol. 2016;90:107–12.CrossRefGoogle Scholar
  34. 34.
    Ferguson BJ. Influences of allergic rhinitis on sleep. Otolaryngol Head Neck Surg. 2004;130(5):617–29.CrossRefGoogle Scholar
  35. 35.
    Colas C, Galera H, Anibarro B, et al. Disease severity impairs sleep quality in allergic rhinitis (the SOMNIAAR study). Clin Exp Allergy. 2012;42(7):1080–7.CrossRefGoogle Scholar
  36. 36.
    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(3):244–54.CrossRefGoogle Scholar
  37. 37.
    Lavie P, Gertner R, Zomer J, Podoshin L. Breathing disorders in sleep associated with “microarousals” in patients with allergic rhinitis. Acta Otolaryngol. 1981;92(5–6):529–33.CrossRefGoogle Scholar
  38. 38.
    Meltzer EO, Blaiss MS, Derebery MJ, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009;124(3 Suppl):S43–70.CrossRefGoogle Scholar
  39. 39.
    Fisher L, Ghaffari G, Davies M, Craig T. Effects of poor sleep in allergic rhinitis. Curr Opin Allergy Clin Immunol. 2005;5(1):11–6.CrossRefGoogle Scholar
  40. 40.
    Lunn M, Craig T. Rhinitis and sleep. Sleep Med Rev. 2011;15(5):293–9.CrossRefGoogle Scholar
  41. 41.
    Rappai M, Collop N, Kemp S, deShazo R. The nose and sleep-disordered breathing: what we know and what we do not know. Chest. 2003;124(6):2309–23.CrossRefGoogle Scholar
  42. 42.
    Young T, Finn L, Kim H, et al. Nasal obstruction as a risk factor for sleep-disordered breathing. J Allergy Clin Immunol. 1997;99(2):S757–62.CrossRefGoogle Scholar
  43. 43.
    Park CE, Shin SY, Lee KH, Cho JS, Kim SW. The effect of allergic rhinitis on the degree of stress, fatigue and quality of life in OSA patients. Eur Arch Otorhinolaryngol. 2012;269(9):2061–4.CrossRefGoogle Scholar
  44. 44.
    Kim DK, Han DH. Impact of allergic rhinitis on quality of life after adenotonsillectomy for pediatric sleep-disordered breathing. Int Forum Allergy Rhinol. 2015;5(8):741–6.CrossRefGoogle Scholar
  45. 45.
    Hughes K, Glass C, Ripchinski M, et al. Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis. Allergy. 2003;58(5):380–5.CrossRefGoogle Scholar
  46. 46.
    Camfferman D, Kennedy JD, Gold M, Martin AJ, Lushington K. Eczema and sleep and its relationship to daytime functioning in children. Sleep Med Rev. 2010;14(6):359–69.CrossRefGoogle Scholar
  47. 47.
    Wasilewska J, Kaczmarski M, Protas PT, Kowalczuk-Kryston M, Mazan B, Topczewska M. Sleep disorders in childhood and adolescence, with special reference to allergic diseases. Polski merkuriusz lekarski : organ Polskiego Towarzystwa Lekarskiego. 2009;26(153):188–93.Google Scholar
  48. 48.
    Bringhurst C, Waterston K, Schofield O, Benjamin K, Rees JL. Measurement of itch using actigraphy in pediatric and adult populations. J Am Acad Dermatol. 2004;51(6):893–8.CrossRefGoogle Scholar
  49. 49.
    Kobayashi S, Hayashi K, Koyama S, et al. Actigraphy for the assessment of sleep quality in pediatric atopic dermatitis patients. Arerugi. 2010;59(6):706–15.PubMedGoogle Scholar
  50. 50.
    Bender BG, Ballard R, Canono B, Murphy JR, Leung DY. Disease severity, scratching, and sleep quality in patients with atopic dermatitis. J Am Acad Dermatol. 2008;58(3):415–20.CrossRefGoogle Scholar
  51. 51.
    Chng SY, Goh DY, Wang XS, Tan TN, Ong NB. Snoring and atopic disease: a strong association. Pediatr Pulmonol. 2004;38(3):210–6.CrossRefGoogle Scholar
  52. 52.
    Owens JA, Dalzell V. Use of the ‘BEARS’ sleep screening tool in a pediatric residents’ continuity clinic: a pilot study. Sleep Med. 2005;6(1):63–9.CrossRefGoogle Scholar
  53. 53.
    Chervin RD, Hedger K, Dillon JE, Pituch KJ. Pediatric sleep questionnaire (PSQ): validity and reliability of scales for sleep-disordered breathing, snoring, sleepiness, and behavioral problems. Sleep Med. 2000;1(1):21–32.CrossRefGoogle Scholar
  54. 54.
    Franco RA Jr, Rosenfeld RM, Rao M. First place--resident clinical science award 1999. Quality of life for children with obstructive sleep apnea. Otolaryngology--Head Neck Surg. 2000;123(1 Pt 1):9–16.CrossRefGoogle Scholar
  55. 55.
    Mindell JA, Owens JA. A clinical guide to pediatric sleep: diagnosis and management of sleep problems. Philadelphia: Lippincott Williams & Wilkins; 2009.Google Scholar

Copyright information

© Springer Nature Switzerland AG 2019

Authors and Affiliations

  • Tanvi H. Mukundan
    • 1
  1. 1.Department of Sleep MedicineAnn & Robert H. Lurie Children’s Hospital of ChicagoChicagoUSA

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