Allergic Rhinitis and Its Consequences on Quality of Sleep: An Unexplored Area

Abstract

Leger D, Annesi-Maesano I, Carat F, et al. Arch Intern Med. 2006;166:1744–1748 PURPOSE OF THE STUDY. Allergic rhinitis (AR) is common and has been shown to impair social life and sleep. Patients with severe symptoms may have more sleep disturbances than those with a mild form of the disease, but this has never been assessed with a validated tool. The objective of this study was to assess, in patients with AR, whether duration and severity of AR are associated with sleep impairment. METHODS. A nationwide controlled, cross-sectional epidemiologic study was conducted. A representative sample of 260 French ear, nose, and throat and allergy specialists enrolled 591 patients aged 18 to 50 years with AR of at least 1 year's duration. Sleep disorders, sleep quality, and AR were assessed by using validated tools (Sleep Disorders Questionnaire, Epworth sleepiness scale, and score for allergic rhinitis). The severity of AR was assessed by using the allergic rhinitis and its impact on asthma classification. RESULTS. All dimensions of sleep were impaired by AR, particularly by the severe type. Sleep was significantly more impaired in patients with severe AR than in those with the mild type. The duration of AR (intermittent or persistent) had no effect on sleep. CONCLUSIONS. These data underline the close relationship between AR and sleep and highlight the need for clinicians, particularly general practitioners, to be attentive in this respect. REVIEWER COMMENTS. This was the DREAMS study (Etude Descriptive des Rhinites Allergiques et des Modifications du Sommeneil), and although that is really cute, I am not sure it is truly fair to use the authors’ native French to make an English acronym. Anyway, the main weakness here is that they did not perform sleep studies on the patients. Nonetheless, they used validated instruments (questionnaires) to establish the severity of the AR and its impact on sleep quality. There is no reason to think that similar effects would not also occur in children with AR. The study also points out the importance of understanding the effects of AR on many quality-of-life indicators.