TABLE X.K.
Evidence for an association between allergic rhinitis and sleep disturbance
| Study | Year | LOE | Study design | Study groups | Clinical endpoint | Conclusion |
|---|---|---|---|---|---|---|
| Yamada et al.673 | 2012 | 1b | RCT | PAR, adults (n = 57) | ESS and RQLQ | INCS mometasone significantly improves nasal symptoms, QOL, sleep quality, and upper airway condition. |
| Meltzer et al.1276 | 2010 | 1b | RCT | PAR, adults (n = 30) | PSG, ESS, RQLQ-S, and WPAI-AS | INCS mometasone improves nasal symptoms and sleepiness. |
| Craig et al.1275 | 2003 | 1b | RCT | AR, adults (n = 32) | PSG, ESS, RQLQ, direct sleep questions in daily diary | Improvement in NC and sleep with treatment with topical nasal fluticasone. |
| Hughes et al.706 | 2003 | 1b | RCT | PAR, adults (n = 22) | ESS, SSS, FOSQ, RQLQ | INCS budesonide improved daytime fatigue, somnolence and quality of sleep. |
| Craig et al.707 | 1998 | 1b | RCT | PAR, adults (n = 20) | Direct sleep questions in daily diary | Improvement in congestion and sleep with treatment with INCS flunisolide. |
| Sherkat et al.2030 | 2011 | 2b | RCT | AR, adults (n = 14) | ESS, PSQI, FOSQ, RQLQ, NRQLQ, Pennsylvania Quality of Life, direct sleep questions in daily diary | Sleep quality is not significantly affected by pseudoephedrine. |
| Colas et al.726 | 2012 | 2c | Population-based | AR, adults (n = 2275) | PSQI RQLQ, direct sleep questions based on Epworth scale | Moderate-severe AR and NC are associated with worse sleep quality. |
| Meltzer et al.2027 | 2009 | 2c | Population-based | AR, children (n = 1004) | Direct sleep questions by telephone interviews | AR disrupts the pattern and quality of sleep. |
| Bousquet et al.2028 | 2006 | 2c | Population-based | AR, adults (n = 3052) | Jenkins Questionnaire, RQLQ, WPAI-AS | The severity of the AR has more effect on QOL and sleep, than the duration (intermittent/persistent). |
| Leger et al.727 | 2006 | 2c | Population-based | AR, adults (n = 591) | ESS, Sleep Disorders Questionnaire, Score for Allergic Rhinitis | All dimensions of sleep were impaired by AR, and more impaired in severe AR than in mild AR. |
| Young et al.714 | 1997 | 2c | Population-based | Adults (n = 4927) | PSG, direct sleep questions | Moderate-to-severe SDB was 1.8 times more frequent in participants with NC due to allergy. |
| Ishman et al.2034 | 2012 | 3b | Case-control | AR, children (n = 21) | PSQ, PDSS, Obstructive Sleep Apnea-18 | AR children have higher SDB and sleepiness scores. |
| Meng et al.720 | 2011 | 3b | Case-control | PAR, adults (n = 98) | PSG | Differences in most PSG parameters including sleep efficiency, arousal index, and snoring time, statistically significant (though clinically modest). |
| Benninger & Benninger2036 | 2009 | 3b | Case-control | AR, adults (n = 701) | RSDI and sleep question by RSDI | AR has a significant negative impact on sexual function, sleep, and fatigue. |
| Meltzer et al.2037 | 2009 | 3b | Case-control | AR, adults (n = 7024) | MOS-Sleep and mini-RQLQ | AR adversely affects QOL and sleep parameters. |
| Yuksel et al.2035 | 2009 | 3b | Case-control | SAR, children (n = 14) | PSQI and actigraphy | Sleep dysfunction scores, sleep latency and fragmentation index are significantly higher in the AR group. |
| Shedden2026 | 2005 | 3b | Case-control | AR, adults and children (n = 2355) | Direct sleep questions | >80% with NC affected in some way at night, primarily causing them to wake up or made it difficult to fall asleep. |
| Stuck et al.731 | 2004 | 3b | Controlled trial | SAR, adults (n = 50) | ESS, SF-36, PSG | SAR increases daytime sleepiness, and worsens QOL. |
| Stull et al.682 | 2009 | 4 | Case series | AR, adults (n = 404) | MOS-Sleep, NRQLQ, WPAI-AS, PANAS-X | Those with more severe NC or ocular symptoms report poorer scores on sleep domains. |
| McNicholas et al.718 | 1982 | 4 | Case- series | SAR, adults (n = 7) | PSG | In patients with SAR, obstructive sleep apneas are more frequent during a period of symptomatic nasal obstruction. |
AR = allergic rhinitis; ESS = Epworth Sleepiness Scale; FOSQ = Functional Outcomes of Sleep; INCS = intranasal corticosteroid; LOE = level of evidence; mini-RQLQ = mini-Rhinoconjunctivitis Quality of Life Questionnaire; MOS-Sleep = Sleep Scale from the Medical Outcomes Study; NC = nasal congestion; NRQLQ = Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire; PANAS-X = Positive and Negative Affect Schedule-Expanded Form; PAR = perennial allergic rhinitis; PDSS = Pediatric Daytime Sleepiness Scale; PSG = polysomnogram; PSQ = Pediatric Sleep Questionnaire; PSQI = Pittsburgh Sleep Quality Index; QOL = quality of life; RCT = randomized controlled trial; RQLQ = Rhinoconjunctivitis Quality of Life Questionnaire; RQLQ-S = Standardized Rhinoconjunctivitis Quality of Life Questionnaire; RSDI = Rhinosinusitis Disability Index; SAR = seasonal allergic rhinitis; SDB = sleep disordered breathing; SF-36 = Medical Outcomes Study 36-item Short Form health survey; SSS = Stanford Sleepiness Score; WPAI-AS = Work Productivity and Activity Impairment Questionnaire-Allergy-Specific.