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Sleep and Quality of Life in Allergic Rhinitis

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Sleep and Quality of Life in Clinical Medicine
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Summary

Allergic rhinitis (AR) is a common inflammatory illness that affects over 10% of the world’s population. Among patients with AR, difficulties with falling asleep and maintaining sleep often result in decreased daytime energy, easy fatigability, decreased cognitive and psychomotor function, and reduced quality of life. Two models have been proposed to explain sleep-related symptoms associated with AR. One model focuses on the role of nasal congestion and ventilation during sleep, resulting in obstructive arousals and awakening. An alternate model involves the direct role of systemic inflammatory mediators on the regulation of sleep and nocturnal events, resulting in daytime symptoms and decreased quality of life. The present chapter explores the interaction of nasal obstruction and systemic inflammatory mediators using these two models to evaluate their role on sleep quality and resultant symptomatic and functional effects. It also examines pharmacologic and nonpharmacologic therapies that are commonly used to treat AR, and how these agents can have both beneficial and adverse effects.

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References

  1. Juniper EF, Rohrbaugh T, Meltzer EO. A questionnaire to measure quality of life in adults with nocturnal allergic rhinoconjunctivitis. J Allergy Clin Immunol 2003 111:484–90.

    Article  PubMed  Google Scholar 

  2. Bousquet J, Van Cauwenberge P, Khaltaev N; ARIA Workshop Group; World Health Organization. Allergic rhinitis and its impact on asthma. J Allergy Clin Immunol 2001;108:S147–334.

    Google Scholar 

  3. Reed SD, Lee TA, McCrory DC. The economic burden of allergic rhinitis: a critical evaluation of the literature. Pharmacoeconomics 2004;22:345–61.

    Article  PubMed  Google Scholar 

  4. Baroody FM. Allergic rhinitis: broader disease effects and implications for management. Otolaryngol Head Neck Surg 2003;128:616–31.

    Article  PubMed  Google Scholar 

  5. Lierl MB. Allergy of the upper respiratory tract. In: Lawlor GM Jr, Fischer TJ, Adelman DC, eds. Manual of Allergy and Immunology. 3rd ed. Boston: Little, Brown and Company, 1995.

    Google Scholar 

  6. Ferguson BJ. Influences of allergic rhinitis on sleep. Otolaryngol Head Neck Surg 2004;130:617–29.

    Article  PubMed  Google Scholar 

  7. McNicholas WT, Tarlo S, Cole P, et al. Obstructive apneas during sleep in patients with seasonal allergic rhinitis. Am Rev Respir Dis 1982;126:625–8.

    PubMed  CAS  Google Scholar 

  8. Lavie P, Gertner R, Zomer J, et al. Breathing disorders in sleep associated with “microarousals” in patients with allergic rhinitis. Acta Otolaryngol 1981;92:529–33.

    Article  PubMed  CAS  Google Scholar 

  9. McColley SA, Carroll JL, Curtis S, et al. High prevalence of allergic sensitization in children with habitual snoring and obstructive sleep apnea. Chest 1997;111:170–3.

    Article  PubMed  CAS  Google Scholar 

  10. Gomez E, Corrado OH, Baldwin DL, et al. Direct in vivo evidence for mast cell degranulation during allergen-induced reactions in man. J Allergy Clin Immunol 1986;78:637–45.

    Article  PubMed  CAS  Google Scholar 

  11. Naclerio RM. Allergic rhinitis. N Engl J Med 1991;325:860–9.

    Article  PubMed  CAS  Google Scholar 

  12. Craig TJ, Hanks CD, Fisher LH. How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis? J Allergy Clin Immunol 2005;116:1265.

    Article  CAS  Google Scholar 

  13. Krouse HJ, Davis JE, Krouse JH. Immune mediators in allergic rhinitis and sleep. Otolaryngol Head Neck Surg 2002;126:607–13.

    Article  PubMed  Google Scholar 

  14. Krouse JH, Krouse HJ. Modulation of immune mediators with MQT-based immunotherapy. Otolaryngol Head Neck Surg 2006;134:746–50.

    Article  PubMed  Google Scholar 

  15. Alexander C, Tarzi M, Larche M, et al. The effect of Fel d1-derived T-cell peptides on upper and lower airway outcome measurements in cat-allergic subjects. Allergy 2005;60:1269–74.

    Article  PubMed  CAS  Google Scholar 

  16. Zwillich C, Pickett C, Hanson F, et al. Disturbed sleep and prolonged apneas during nasal obstruction in normal men. Am Rev Respir Dis 1981;81:159–60.

    Google Scholar 

  17. Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disorder breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997;99:S757–62.

    Article  PubMed  CAS  Google Scholar 

  18. Stuck BA, Czajkowski J, Hagher AE, et al. Changes in daytime sleepiness, quality of life, and objective sleep patterns in seasonal allergic rhinitis: a controlled clinical trial. J Allergy Clin Immunol 2004;113:663–8.

    Article  PubMed  Google Scholar 

  19. Craig TJ, Teets S, Lehman EB, et al. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol 1998;101:633–7.

    Article  PubMed  CAS  Google Scholar 

  20. Craig TJ, Mende C, Hughes K, et al. The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis. Allergy Asthma Proc 2003;24:53–8.

    Google Scholar 

  21. Hughes K, Glass C, Ripchinski M, et al. Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in perennial allergic rhinitis. Allergy 2003;58:380–5.

    Article  PubMed  CAS  Google Scholar 

  22. Lung MA. The role of the autonomic nerves in the control of nasal circulation. Biol Signals 1995;4:179–85

    Article  PubMed  CAS  Google Scholar 

  23. Loehrl TA, Smith TL, Darling RJ, et al. Autonomic dysfunction, vasomotor rhinitis, and extraesophageal manifestations of gastroesophageal reflux. Otolaryngol Head Neck Surg 2002;126:382–7.

    Article  PubMed  Google Scholar 

  24. Tashiro M, Mochizuki H, Iwabuchi K, et al. Roles of histamine in regulations of arousal and cognition: functional neuroimaging of histamine H1 receptors in human brain. Life Sci 2002;72:409–14.

    Article  PubMed  CAS  Google Scholar 

  25. Naclerio R. Clinical manifestations of the release of histamine and other inflammatory mediators. J Allergy Clin Immunol 1999;103:S382–5.

    Article  PubMed  CAS  Google Scholar 

  26. Woods L, Craig TJ. The importance of rhinitis on sleep, daytime somnolence, productivity and fatigue. Curr Opin Pulm Med 2006;12:390–6.

    Article  PubMed  Google Scholar 

  27. Sri Kantha S, Matsumura H, Kubo E, et al. Effects of prostaglandin D2, lipoxins and leukotrienes on sleep and brain temperature of rats. Prostaglandins Leukot Essent Fatty Acids 1994;51:87–93.

    Article  PubMed  CAS  Google Scholar 

  28. Obal FJ, Krueger JM. Biochemical regulation of non-rapid-eye-movement sleep. Front Biosci 2003;8:D520–550.

    Article  PubMed  CAS  Google Scholar 

  29. Arimura A, Yasui K, Kishino J, et al. Prevention of allergic inflammation by a novel prostaglandin receptor antagonist, s-5751. J Pharmacol Exp Ther 2001;298:411–9.

    PubMed  CAS  Google Scholar 

  30. Woodfolk JA. Cytokines as a therapeutic target for allergic diseases: a complex picture. Curr Pharm Des 2006;12:2349–63.

    Article  PubMed  CAS  Google Scholar 

  31. Wagenmann M, Schumacher L, Bachert C. The time course of the bilateral release of cytokines and mediators after unilateral nasal allergen challenge. Allergy 2005;60:1132–8.

    Article  PubMed  CAS  Google Scholar 

  32. Krueger JM, Obal FJ, Fang J, et al. The role of cytokines in physiologic sleep regulation. Ann N Y Acad Sci 2001;933:211–21.

    Article  PubMed  CAS  Google Scholar 

  33. Calhoun WJ. Nocturnal asthma. Chest 2003;123:399S–405S.

    Article  PubMed  Google Scholar 

  34. Aoyagi M, Watanabe H, Sekine K, et al. Circadian variation in nasal reactivity in children with allergic rhinitis: correlation with the activity of eosinophils and basophilic cells. Int Arch Allergy Immunol 1999;120 (suppl 1):95–9.

    Article  PubMed  Google Scholar 

  35. Kraft M, Vianna E, Martin RJ, et al. Nocturnal asthma is associated with reduced glucocorticoid receptor binding affinity and decreased steroid responsiveness at night. J Allergy Clin Immunol 1999;103:66–71.

    Article  PubMed  CAS  Google Scholar 

  36. Bellia V, Bonanno A, Cibella F, et al. Urinary leukotriene E4 in the assessment of nocturnal asthma. J Allergy Clin Immunol 1996;97:735–41.

    Article  PubMed  CAS  Google Scholar 

  37. Krause HF. Pharmacotherapy of otolaryngic allergy. In: Krouse JH, Chadwick SJ, Gordon BR, et al., eds. Allergy and Immunology: An Otolaryngic Approach. Philadelphia: Lippincott, Williams and Wilkins, 2002, pp. 142–50.

    Google Scholar 

  38. Gross GN, May BC, Fromer LM, et al. Allergic rhinitis: on the road to better management. Cortlandt Forum 2005:1–16.

    Google Scholar 

  39. Knapp HR. Reduced allergen-induced nasal congestion and leukotriene synthesis with an orally active 5-lipoxygenase inhibitor. N Engl J Med 1990;323:1745–8.

    Article  PubMed  CAS  Google Scholar 

  40. Philip G, Malmstrom K, Hampel FC, et al. Montelukast for treating seasonal allergic rhinitis: a randomized, double-blind, placebo-controlled trial performed in the spring. Clin Exp Allergy 2002;32:1020–8.

    Article  PubMed  CAS  Google Scholar 

  41. Nayak AS, Philip G, Lu S, et al. Efficacy and tolerability of montelukast alone or in combination with loratadine in seasonal allergic rhinitis: a multicenter, randomized, double-blind, placebo-controlled trial performed in the fall. Ann Allergy Asthma Immunol 2002;88:592–600.

    PubMed  CAS  Google Scholar 

  42. van Adelsberg J, Philip G, LaForce CF, et al. Randomized controlled trial evaluating the clinical benefit of montelukast for treating spring seasonal allergic rhinitis. Ann Allergy Asthma Immunol 2003;90:214–22.

    Article  PubMed  Google Scholar 

  43. Ohashi Y, Nakai Y, Tanaka, et al. Allergen-specific immunotherapy for allergic rhinitis: a new insight into its clinical efficacy and mechanism. Acta Otolaryngol Suppl 1998;538:178–90.

    Google Scholar 

  44. Pastorello EA, Incorvaia C, Zanussi C. Specific immunotherapy: clinical efficacy and mechanisms of action. Pharmacol Res 1992;26:46–7.

    Article  PubMed  Google Scholar 

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© 2008 Humana Press, Totowa, NJ

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Krouse, H.J., Krouse, J.H. (2008). Sleep and Quality of Life in Allergic Rhinitis. In: Verster, J.C., Pandi-Perumal, S.R., Streiner, D.L. (eds) Sleep and Quality of Life in Clinical Medicine. Humana Press. https://doi.org/10.1007/978-1-60327-343-5_40

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  • DOI: https://doi.org/10.1007/978-1-60327-343-5_40

  • Publisher Name: Humana Press

  • Print ISBN: 978-1-60327-340-4

  • Online ISBN: 978-1-60327-343-5

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