Assessment of Sleep Impairment in Persistent Allergic Rhinitis Patients Using Polysomnography

Abstract

Background: Although questionnaires have demonstrated an association between impairment of quality of sleep and symptoms in allergic rhinitis (AR) patients, to date there is no report of an objective assessment of sleep in patients with persistent allergic rhinitis (PER) as defined by ARIA guidelines. The aim of the present study was therefore to assess sleep disturbance in PER patients by polysomnography (PSG). Methods: Ninety-eight PER patients with moderate-to-severe nasal obstruction and 30 healthy volunteers were included in the study. All patients underwent PSG during nocturnal sleep to assess the presence and severity of sleep disorders. Peak nasal inspiratory flow (PNIF) was also measured to assess nasal resistance. Results: There were statistically significant, though clinically modest, differences between PER patients and healthy controls in most PSG parameters including sleep efficiency, arousal index, average SaO₂, lowest SaO₂, time spent with a saturation below 90%, and snoring time. Although the apnea-hypopnea index (AHI) was not significantly different between the 2 groups, 17 subjects (17.3%) in the PER group but none of the control subjects had an AHI >5. Patients with higher T5SS scores (12 ≤ T5SS ≤ 15) had a greater tendency to snore than did patients with lower scores (8 ≤ T5SS ≤ 11). Finally, PNIF in the PER group was significantly lower than in the control group. Weak correlations between the arousal index and PNIF, average SaO₂, and PNIF were found. Conclusion: PSG showed modest changes in PER patients versus control subjects.

Allergic and Non-Allergic Rhinitis Are Common in Obstructive Sleep Apnea but Not Associated With Disease Severity

“…46 Recently, a study investigating sleep impairment using PSG in patients with persistent AR showed that there were statistically significant, though clinically modest, differences between patients with persistent AR and healthy controls in most PSG parameters, including sleep efficiency, arousal index, average SaO 2 , lowest SaO 2 , time spent with a saturation below 90%, and snoring time. 47 However, AHI was similar for the two groups. Interestingly, the current study has demonstrated that compared to patients with OSA and without rhinitis, patients with NAR, rather than with AR, had significantly lower average SaO 2 saturation (91.9 ± 0.6 versus 94.0 ± 0.6) and minimal SaO 2 saturation (70.6 ± 1.7 versus 77.3 ± 1.8).…”

The Effects of Mometasone Furoate and Desloratadine in Obstructive Sleep Apnea Syndrome Patients with Allergic Rhinitis

“…PSG is the gold standard for the objective evaluation of sleep disorders. 11 We did not observe any negative or positive effects of Ah on daily somnolence. There was a slight difference in REM percentage of the Ah group, but the difference was not found to be significant.…”

“…10 Daytime somnolence also causes a significant decrease in patients’ QOL. 11 It has been previously shown that AR is a risk factor for OSAS, especially in children. 12 AR symptoms per se may also cause cortical arousal and sleep fragmentation.…”

Role of nasal problems on positional and nonpositional obstructive sleep apnea

“…[19][20][21][22] McNicholas et al [19] clearly demonstrated that an increase in nasal resistance was directly associated with an increased AHI rate in parallel to corresponding changes in O 2 desaturation. Meng et al [23] reported that subjects with AR presented moderately more severe data in PSG compared to healthy controls. Although they did not find a significant difference in AHI between groups, rates of the subjects with AHI >5 was significantly higher in AR subjects than healthy control groups by chisquare test.…”