Sleep and allergic disease: A summary of the literature and future directions for research

Abstract

Atopic diseases, such as asthma and allergic rhinitis, are common conditions that can influence sleep and subsequent daytime functioning. Children and patients with allergic conditions from ethnic minority groups might be particularly vulnerable to poor sleep and compromised daytime functioning because of the prevalence of these illnesses in these groups and the high level of morbidity. Research over the past 10 years has shed light on the pathophysiologic mechanisms (eg, inflammatory mediators) involved in many atopic diseases that can underlie sleep disruptions as a consequence of the presence of nocturnal symptoms. Associations between nocturnal symptoms and sleep and poorer quality of life as a result of missed sleep have been demonstrated across studies. Patients with severe illness and poor control appear to bear the most burden in terms of sleep impairment. Sleep-disordered breathing is also more common in patients with allergic diseases. Upper and lower airway resistance can increase the risk for sleep-disordered breathing events. In patients with allergic rhinitis, nasal congestion is a risk factor for apnea and snoring. Finally, consistent and appropriate use of medications can minimize nocturnal asthma or allergic symptoms that might disrupt sleep. Despite these advances, there is much room for improvement in this area. A summary of the sleep and allergic disease literature is reviewed, with methodological, conceptual, and clinical suggestions presented for future research.

The Disease Burden of Patients with Allergic Rhinitis from a Hospital Surveillance in Beijing

“…AR remains a significant health problem in Hungary, for the burden of symptoms, high rates of concomitant asthma, and the significant proportion of moderate or severe AR affecting general well-being [31]. Sleep-disordered breathing is also more common in patients with allergic diseases [32]. Results in our study indicated that all of the AR patients who consulted with specialists had moderate-to-severe severity AR.…”

“…Nasal congestion is the most prominent symptom of AR, and it is associated with sleep-disordered breathing, a condition that can have a profound effect on mental health, including increased psychiatric disorders, depression, anxiety, and alcohol abuse [12]. For patients with AR, nasal congestion is a risk factor for apnea and snoring [32]. Allergic conjunctivitis is characterized by ocular itching, swelling, and discharge.…”

El niño alérgico en la escuela. ¿Qué es lo que se necesita saber?

“…darios adicionales de los regímenes de tratamiento utilizados para su control. 23 Los niños alternan períodos de inquietud e irritabilidad con otros de somnolencia y desaliento para participar en las actividades escolares. Las lesiones pueden ser muy visibles y causar estigmas, acoso laboral discriminación, lo que determina cambios emocionales que pueden llevar al absentismo escolar.…”

Is parent–child bed-sharing a risk for wheezing and asthma in early childhood?

“…Later on, parents may adopt bed-sharing practices that allow for closer monitoring of their already asthmatic children [12], as asthma symptoms are frequently experienced during night-time hours. Asthma symptoms exacerbate during the night due to changes in serum cortisol and inflammatory mediators, sleep posture, and increased allergen exposure [12]. Indeed, in some studies asthma has been associated with increased sleep problems in children [13,14].…”

“…It is, therefore, important to capture both early and later bed-sharing practices. A recent review [12] suggested that research should focus on direction of the effects between sleep and asthma, with accurate diagnosis of asthma, large sample sizes, inclusion of ethnic minorities, and assessment of crowding and sleep routines such as bed-sharing. In a large-scale, multi-ethnic prospective study, we try to disentangle the reciprocal effects of bed-sharing and asthmatic symptoms in young children, by longitudinally testing the hypotheses that bed-sharing practices may increase the development and persistence of asthmatic symptoms or that asthmatic symptoms may stimulate bed-sharing practices.…”