title: Allergic rhinitis affects the duration of rapid eye movement sleep in children with sleep-disordered breathing without sleep apnea.
abstract: Our goals were to assess whether allergic rhinitis (AR) is an aggravating factor that affects the severity of sleep apnea in children with tonsils/adenoid hypertrophy (T&A) and to compare polysomnographic data from children with and without AR.
  
  
  
  This prospective study included 135 children (age range, 3 to 14 years) with sleep-disordered breathing (SDB) resulting from T&A. Children with lung, neurological, or craniofacial problems; septal deviations; previous pharyngeal surgeries; or orthodontic treatments were excluded. All children underwent a clinical evaluation, nasopharyngoscopy or lateral X-ray imaging, sleep study, and hypersensitivity skin-prick test.
  
  
  
  The mean patient age was 6.44 ± 2.55 years (83 males). AR was present in 42.2% of the children; 40% presented with sleep apnea; and 17.04% had sleep apnea and AR. The percentage of time spent in the rapid eye movement (REM) sleep stage was lower among children with AR without sleep apnea (p = 0.028); however, the percentage of REM sleep was not significantly different among children with apnea (p = 0.2922). No difference in the apnea-hypopnea index (AHI) was observed between the children with (AHI = 2.79 events/hour) and without AR (3.75 events/hour, p = 0.4427). A multivariate analysis showed that nasal congestion was an important factor that can affect the duration of the REM sleep stage.
  
  
  
  AR affects REM sleep in children with SDB without sleep apnea, and AR is not an aggravating factor regarding the severity of AHI.
authors.affiliation: Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São, Paulo, Brazil.
authors.forename: Renata C
authors.initials: RC
authors.lastname: Di Francesco
authors.affiliation: Department of Otolaryngology, Hospital das Clínicas da Faculdade de Medicina da Universidade de São Paulo, São, Paulo, Brazil.
authors.forename: Jessica
authors.initials: J
authors.lastname: Alvarez
mesh_terms: D000293:Adolescent; D000485:Allergens / Q000276:immunology; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D012119:Respiration; D065631:Rhinitis, Allergic / Q000175:diagnosis / Q000276:immunology / Q000503:physiopathology*; D012882:Skin Tests; D012891:Sleep Apnea Syndromes / Q000503:physiopathology*; D012895:Sleep, REM
chemical_list: D000485:Allergens
keywords: REM sleep; adenoid and tonsil; allergic rhinitis; children; sleep apnea; sleep-disordered breathing