Effects of poor sleep in allergic rhinitis.
OBJECTIVE
Allergic rhinitis affects a large portion of the population. These patients often suffer from daytime fatigue, both as a result of the mechanics of the nasal airway in patients with allergic rhinitis as well as through central effects on sleep by immune mediators. By understanding these mechanisms and by becoming familiar with effective treatments for allergic rhinitis that are beneficial in alleviating rather than worsening daytime somnolence, physicians may improve patient quality of life.


RESULTS
Children with rhinitis and snoring have poorer school performance compared with controls. The role of rhinitis in chronic fatigue remains controversial despite an increase in literature on this subject. The role of immune mediators on rhinitis and sleep is evolving as well. Nasal steroids effectively treat rhinitis and improve daytime fatigue. Second-generation antihistamines are preferred to first-generation antihistamines based on efficacy and safety studies.


CONCLUSIONS
Understanding the relationship between rhinitis in sleep abnormalities and subsequent daytime fatigue is still developing. Nasal steroids are the mainstay of treatment, but the role of future agents is promising although undefined.
Fisher
Laura
L
Department of Medicine, Allergy, Asthma and Immunology H041, Penn State Milton S Hershey Medical Center, Hershey, Pennsylvania, USA. lfisher@psu.edu
Ghaffari
Gisoo
G
Davies
Michael
M
Craig
Timothy
T
D000281:Administration, Intranasal; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage / Q000627:therapeutic use; D002648:Child; D039563:Histamine H1 Antagonists, Non-Sedating / Q000627:therapeutic use; D006801:Humans; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000188:drug therapy / Q000276:immunology; D012893:Sleep Wake Disorders / Q000150:complications* / Q000276:immunology
D000305:Adrenal Cortex Hormones; D039563:Histamine H1 Antagonists, Non-Sedating