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Association between allergic rhinitis and poor sleep parameters in U.S. adults
Authors:Christopher R Roxbury MD  Mary Qiu MD  Josef Shargorodsky MD  MPH  Sandra Y Lin MD
Institution:1. Section of Rhinology, Sinus and Skull Base Surgery, Head & Neck Institute,, Cleveland Clinic Foundation, Cleveland, OH;2. Wilmer Eye Institute, Johns Hopkins University, Baltimore, MD;3. Coastal Ear, Nose and Throat, Neptune, NJ;4. Department of Otolaryngology–Head and Neck Surgery, Johns Hopkins University, Baltimore, MD
Abstract:

Background

Evidence suggests relationships between allergic rhinitis (AR) and poor sleep parameters, but population‐based studies in the United States are lacking. This study investigates the relationship between AR and sleep parameters in a representative sample of U.S. adults.

Methods

Cross‐sectional study of 5563 participants ≥18 years old from the 2005–2006 National Health and Nutrition Examination Survey who participated in the allergy and sleep questionnaires. The predictor variable was AR (self‐reported hay fever and/or nasal symptoms in the past 12 months). The outcome variables were individual sleep parameters (sleep latency, sleep duration, sleep disorders, sleep habits, sleep medication use, daytime dysfunction). Covariates included age, gender, race, and obesity.

Results

The population‐weighted prevalence of AR was 36.5%. Adjusting for covariates, subjects with AR had higher odds of sleep latency ≥30 minutes (OR 1.24; 95% CI, 1.01 to 1.51; p = 0.04), sleep apnea (OR 1.86; 95% CI, 1.22 to 2.82; p < 0.01), insomnia (OR 1.85; 95% CI, 1.04 to 3.32; p = 0.04), trouble falling asleep (OR 1.43; 95% CI, 1.17 to 1.75; p < 0.01), waking up during the night (OR 1.49; 95% CI, 1.11 to 1.99; p = 0.01), waking up too early in the morning (OR 1.46; 95% CI, 1.20 to 1.79; p < 0.01), feeling unrested during the day (OR 1.76, 95% CI, 1.43 to 2.16; p < 0.01), feeling overly sleeping during the day (OR 1.54; 95% CI, 1.25 to 1.90; p < 0.01), not getting enough sleep (OR 1.68; 95% CI, 1.41 to 1.99; p < 0.01), using sleep medication (OR 1.69; 95% CI, 1.23 to 2.33; p < 0.01), difficulty concentrating (OR 1.93; 95% CI, 1.30 to 2.88; p < 0.01), remembering (OR 1.91; 95% CI, 1.22 to 2.97; p < 0.01), managing finances (OR 1.68; 95% CI, 1.09 to 2.56; p = 0.02), working (OR 2.16; 95% CI, 1.45 to 3.22; p < 0.01), and getting things done (OR 2.35; 95% CI, 1.36 to 4.06; p < 0.01) due to daytime sleepiness.

Conclusion

This analysis of a representative sample of U.S. adults revealed associations between AR and poor sleep parameters including prolonged sleep latency, insomnia, sleep apnea, sleep disturbances, sleep medication use, and daytime dysfunction. These findings reinforce the need to assess sleep quality in patients undergoing evaluation for AR.
Keywords:allergic rhinitis  patient reported outcome measure  quality of life  aeroallergen  sleep
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