Schlaf und Schläfrigkeit bei allergischer Rhinitis

Abstract

Apart from the classic complaints related to allergic rhinitis, associated symptoms have received increased attention over the last few years. Above all, daytime fatigue and daytime sleepiness are of particular importance in this context. Although daytime fatigue and daytime sleepiness in patients with allergic rhinitis are frequently attributed to an impairment of nocturnal sleep, convincing data supporting this relationship are hard to obtain and the alleged link has not been proven conclusively. While increasing evidence is available with regard to subjective complaints, objective measurements are still an exception, especially when it comes to the objective assessment of nocturnal sleep. An analysis of the current literature demonstrates that allergic rhinitis - at least according to epidemiological trials - constitutes a risk factor for sleep-disordered breathing in adults and, even more so, in children. Corresponding clinical trials, using standardized questionnaires, have revealed a statistically significant increase in daytime sleepiness with the start of the pollen season in patients with seasonal allergic rhinitis. Antiallergic medication, and especially the use of topical nasal steroids, also leads to an improvement in the subjective assessment of nocturnal sleep and daytime performance in patients with perennial allergic rhinitis. Nevertheless, a clinically relevant deterioration in objective sleep measures could not be demonstrated in recent, methodically more rigorous investigations. Allergic rhinitis alone does not seem to be capable of inducing clinically relevant sleep-disordered breathing, at least in otherwise healthy patients with allergic rhinitis.