Sleep disorders in children with moderate to severe persistent allergic rhinitis.
BACKGROUND
Allergic rhinitis is associated with several complications, including sleep disorders. The Children's Sleep Habits Questionnaire has been recently translated and validated in Portuguese for the evaluation of sleep disorders in children.


OBJECTIVE
To assess sleep disorders in children with moderate to severe persistent allergic rhinitis and to correlate the findings with disease severity markers.


METHODS
We evaluated 167 children (4-10 years), 112 with allergic rhinitis and 55 controls. Parents/guardians of the children answered the Children's Sleep Habits Questionnaire, consisting of 33 questions divided into eight subscales, which refers to the previous week. Patients with rhinitis were also evaluated regarding the score of nasal and extra-nasal symptoms related to the previous week and the peak nasal inspiratory flow.


RESULTS
There were no significant differences between groups of different age. All patients with rhinitis were being treated with nasal topical corticosteroids. The total Children's Sleep Habits Questionnaire score was significantly higher among children with rhinitis than in controls (median 48 vs. 43, p<0.001). Significantly higher values were also observed for the parasomnia (9 vs. 8), respiratory disorders (4 vs. 3) and daytime sleepiness (14 vs. 12) subscales. Among the patients with rhinitis, no significant correlation was observed between the total Children's Sleep Habits Questionnaire score and disease activity variables, but moderate correlations were observed for the respiratory distress subscale vs. nasal symptom score (r=0.32) and vs. extra-nasal symptom score (r=0.32).


CONCLUSIONS
Children with moderate to severe persistent allergic rhinitis, even when submitted to regular treatment, have a higher frequency of sleep disorders than controls, particularly concerning nocturnal breathing disorders, daytime sleepiness, and parasomnias. The intensity of sleep disorders found in some subscales was correlated with objective markers of allergic rhinitis severity.
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Jessica
J
Loekmanwidjaja
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Ana Cláudia F
ACF
Carneiro
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Maria Lúcia T
MLT
Nishinaka
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Daniela A
DA
Munhoes
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Gabriela
G
Benezoli
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil. Electronic address: gfwandalsen@uol.com.br.
Gustavo F
GF
Wandalsen
Universidade Federal de São Paulo (UNIFESP), Escola Paulista de Medicina (EPM), Departamento de Pediatria, São Paulo, SP, Brazil.
Dirceu
D
Solé
D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D005260:Female; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D008297:Male; D015508:Nasal Obstruction / Q000150:complications / Q000188:drug therapy; D065631:Rhinitis, Allergic / Q000150:complications* / Q000188:drug therapy / Q000503:physiopathology; D012720:Severity of Illness Index; D012893:Sleep Wake Disorders / Q000209:etiology* / Q000503:physiopathology; D011795:Surveys and Questionnaires
D005938:Glucocorticoids
Allergic rhinitis; Children; Crianças; Distúrbios de sono; Questionário escrito; Rinite alérgica; Sleep disorders; Written questionnaire