Clinical control in the dual diagnosis of obstructive sleep apnea syndrome and rhinitis: a prospective analysis.
BACKGROUND
Obstructive sleep apnea syndrome (OSAS) and allergic rhinitis (AR) are common coexisting disorders. Upper airway, specifically nasal resistance, is thought to increase during exacerbations of AR and nonallergic rhinitis (NAR), as well as in OSAS. The study objective was to determine if a correlation exists between clinical control of rhinitis and OSAS.


METHODS
This prospective study followed 43 patients with concurrent OSAS and AR or NAR. OSAS was diagnosed by polysomnography, and AR or NAR was diagnosed by history, skin testing, serum-specific IgE, and total IgE levels. Measurements of control of OSAS included the Epworth Sleepiness Scale (ESS) survey and compliance with continuous positive airway pressure (CPAP) device. Measurements of rhinitis control included Assessment of Nasal Symptom Severity and Assessment of Nonnasal Symptom Severity (NSS refers to both) and Global Assessment of Nasal and Nonnasal Symptom Severity surveys (GSS). Higher NSS scores correlate with more rhinitis symptoms, whereas higher GSS scores correlate with less symptoms.


RESULTS
All patients completed the study. There was a positive correlation between ESS and NSS scores (p < 0.001), inverse correlation between ESS and GSS scores (p < 0.001), inverse correlation between CPAP compliance and NSS scores (p < 0.001), and positive correlation between CPAP compliance and GSS scores (p < 0.001). There was no statistically significant difference between the AR, NAR, and AR/NAR groups.


CONCLUSIONS
Our study showed a statistically significant positive correlation between clinical control of rhinitis symptoms and clinical control of OSAS. This study emphasizes the importance of achieving concurrent optimal control of both OSAS and AR/NAR.
Division of Allergy and Immunology, Veterans Affairs Greater Los Angeles Healthcare Systems/The David Geffen School of Medicine at University of California-Los Angeles, Los Angeles, California, USA.
Neil G
NG
Parikh
Imran
I
Junaid
Lee
L
Sheinkopf
Inderpal
I
Randhawa
Silverio M
SM
Santiago
William B
WB
Klaustermeyer
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D045422:Continuous Positive Airway Pressure; D018450:Disease Progression; D005260:Female; D006801:Humans; D007073:Immunoglobulin E / Q000097:blood; D008297:Male; D008875:Middle Aged; D010349:Patient Compliance / Q000706:statistics & numerical data; D017286:Polysomnography; D011446:Prospective Studies; D012221:Rhinitis, Allergic, Perennial / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000175:diagnosis / Q000628:therapy*; D012720:Severity of Illness Index; D012882:Skin Tests; D020181:Sleep Apnea, Obstructive / Q000150:complications / Q000175:diagnosis / Q000628:therapy*
D007073:Immunoglobulin E