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Patients with severe allergic rhinitis are more often affected by sleep disorders.
  1. Anilkumar Pillai
  1. Registrar in Medicine, Ninewells Hospital, Dundee; anilkumarpillai{at}doctors.org.uk

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Allergic rhinitis is common in the general population and impairs sleep and social life. This French study seems to be the first attempt to assess the impact of duration and severity of allergic rhinitis on the quality of sleep and consequently on everyday living.

From a nationwide controlled cross sectional epidemiological study, 591 patients with allergic rhinitis (>1 year) were selected. Those with nasal polyps and/or major nasal septum deviation were excluded. Sleepiness was assessed by self administered questionnaires: sleep disorders questionnaire and Epworth sleepiness scale score.

Sleep impairment was significantly worse (p <0.001) with increased severity of allergic rhinitis. Patients with allergic rhinitis reported significantly more use of sedative drugs (p = 0.003) and alcohol (p <0.001). Snoring and sleep apnoea were also reported significantly more often in patients with allergic rhinitis (p <0.001). Poor quality of sleep induced by allergic rhinitis had an adverse impact on everyday living.

There may have been an unavoidable element of bias in the study as patients with allergic rhinitis would expectedly have better recall about their sleep quality than the control group interviewed in the general population. The effect of cofactors such as anxiety and depression or comorbidities such as asthma on sleep quality was not evaluated.

The authors conclude that early detection and treatment of sleep disorders in patients with allergic rhinitis would have a positive impact on their social and general well being. Further studies focusing on the mechanisms that link allergic rhinitis with altered sleep are needed.

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