Öz

 

Objective: Seasonal allergic rhinitis (SAR) is one of the most common allergic diseases in childhood and is characterized by nasal congestion, rhinorrhea, sneezing, and itching. Beyond these classical nasal symptoms, SAR may also be associated with sleep disturbances. The present study aimed to determine the prevalence of sleep disturbances in children with SAR and to evaluate potential clinical predictors, including symptom severity, symptom timing, and comorbid allergic diseases.

Material and Methods: Children aged 6–16 years with seasonal allergic rhinitis (SAR) who were followed at the Pediatric Allergy and Immunology Department of Ankara City Hospital  were enrolled in the study. An age- and demographically matched control group was also recruited. Sleep disturbances were assessed using the Sleep Disturbance Scale for Children (SDSC). SAR severity was classified according to the Allergic Rhinitis and Its Impact on Asthma (ARIA) guidelines, and symptom intensity was further evaluated using a visual analog scale (VAS). Logistic regression analysis was performed to identify independent predictors of SDSC-defined sleep disturbances.

Results: A total of 115 children with SAR (mean age: 11.6±3.2 years; 61.7% male) and 115 healthy controls were included. According to SDSC, 43.3% of children with SAR had clinically significant sleep disturbances. Compared with controls, children with SAR had significantly higher SDSC total scores (63.4±15.5 vs. 53.9±12.2; p < 0.001) and higher scores across all subscales. In multivariate logistic regression, an elevated nasal VAS score remained an independent predictor of sleep disturbances (OR: 1.86; 95% CI: 1.06-2.41; p=0.020).

Conclusion: Sleep disturbances were more prevalent in children with SAR than in healthy controls, and greater nasal symptom severity was independently associated with impaired sleep quality. Incorporating routine sleep quality assessment into the clinical evaluation of children with SAR may improve disease management and contribute to better overall quality of life.

Anahtar Kelimeler: Seasonal allergic rhinitis, sleep disturbances, visual analogue scale

Kaynakça

  1. Seidman MD, Gurgel RK, Lin SY. Clinical practice guideline: allergic rhinitis executive summary. Otolaryngol Head Neck Surg. 2015;152:197-206. https://doi.org/10.1177/0194599814562166
  2. Schuler CF 4th, Montejo JM. Allergic rhinitis in children and adolescents. Pediatr Clin North Am. 2019;66:981-93. https://doi.org/10.1016/j.pcl.2019.06.004
  3. Settipane RA. Demographics and epidemiology of allergic and nonallergic rhinitis. Allergy Asthma Proc. 2001;22:185-9.
  4. Singh K, Axelrod S, Bielory L. The epidemiology of ocular and nasal allergy in the United States, 1988-1994. J Allergy Clin Immunol. 2010;126:778-83. https://doi.org/10.1016/j.jaci.2010.06.050
  5. Meltzer EO, Blaiss MS, Derebery MJ, Mahr TA, Gordon BR, Sheth KK, et al. Burden of allergic rhinitis: results from the Pediatric Allergies in America survey. J Allergy Clin Immunol. 2009;124:S43-S70. https://doi.org/10.1016/j.jaci.2009.05.013
  6. Craig TJ, Sherkat A, Safaee S. Congestion and sleep impairment in allergic rhinitis. Curr Allergy Asthma Rep. 2010;10:113-21.https://doi.org/10.1007/s11882-010-0091-5
  7. Bousquet J, Schünemann HJ, Samolinski B, Demoly P, Baena-Cagnani CE, Bachert C, et al. Allergic Rhinitis and its Impact on Asthma (ARIA): achievements in 10 years and future needs. J Allergy Clin Immunol. 2012;130:1049-62. https://doi.org/10.1016/j.jaci.2012.07.053
  8. Pagel JML, Mattos JL. Allergic rhinitis and its effect on sleep. Otolaryngol Clin North Am. 2024;57:319-28. https://doi.org/10.1016/j.otc.2023.09.003
  9. Craig TJ, Teets S, Lehman EB, Chinchilli VM, Zwillich CW. Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids. J Allergy Clin Immunol. 1998;101:633-7. https://doi.org/10.1016/S0091-6749(98)70171-X
  10. Blaiss MS, Hammerby E, Robinson S, Kennedy-Martin T, Buchs S. The burden of allergic rhinitis and allergic rhinoconjunctivitis on adolescents: a literature review. Ann Allergy Asthma Immunol. 2018;121:43-52. https://doi.org/10.1016/j.anai.2018.03.028
  11. Dąbrowska-Zimakowska A, Wojas O, Majak P, Jerzyńska J. Quality of life in children with allergic rhinitis and their parents. Health Qual Life Outcomes. 2020;18:133.
  12. Canova C, Harris JM, Mills PR, Whitehouse R, Moffat S, Cullinan P. Epidemiological association between allergic rhinitis and asthma in schoolchildren. Thorax. 2005;60:502-5.
  13. Craig TJ, McCann JL, Gurevich F, Davies MJ. The correlation between allergic rhinitis and sleep disturbance. J Allergy Clin Immunol. 2004;114:S139-45. https://doi.org/10.1016/j.jaci.2004.08.044
  14. Bruni O, Ottaviano S, Guidetti V, Romoli M, Innocenzi M, Cortesi F, et al. The Sleep Disturbance Scale for Children (SDSC). J Sleep Res. 1996;5:251-61. https://doi.org/10.1111/j.1365-2869.1996.00251.x
  15. Bousquet J, Schünemann HJ, Fonseca J, Samolinski B, Bachert C, Canonica GW, et al. MACVIA-ARIA Sentinel NetworK for allergic rhinitis (MASK-rhinitis): the new generation guideline implementation. Allergy. 2015;70:1372-92. https://doi.org/10.1111/all.12686
  16. Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation ARIA guidelines for allergic rhinitis based on GRADE and real-world evidence. J Allergy Clin Immunol. 2020;145:70-80. https://doi.org/10.1016/j.jaci.2019.06.049
  17. Heinzerling L, Frew AJ, Bindslev-Jensen C, Bonini S, Bousquet J, Bresciani M, et al. Standard skin prick testing and sensitization to inhalant allergens across Europe. Allergy. 2005;60:1287-300. https://doi.org/10.1111/j.1398-9995.2005.00895.x
  18. Ağadayı E, Çelik N, Başer DA. Validity and reliability of the Turkish version of the Sleep Disturbance Scale for Children. Turk J Sleep Med. 2020;7(2):65-72. https://doi.org/10.4274/jtsm.galenos.2020.98598
  19. Roxbury CR, Qiu M, Shargorodsky J, Lin SY. Association between allergic rhinitis and poor sleep parameters in U.S. adults. Int Forum Allergy Rhinol. 2018;8:1098-106. https://doi.org/10.1002/alr.22174
  20. Urrutia-Pereira M, Solé D, Chong Neto HJ, Acosta V, Cepeda AM, Álvarez-Castelló M, et al. Sleep disorders in Latin-American children with asthma and/or allergic rhinitis and normal controls. Allergol Immunopathol (Madr). 2017;45:145-51. https://doi.org/10.1016/j.aller.2016.05.005
  21. Liu J, Zhang X, Zhao Y, Wang Y. The association between allergic rhinitis and sleep: a systematic review and meta-analysis. PLoS One. 2020;15:e0228533. https://doi.org/10.1371/journal.pone.0228533
  22. Xu Z, Wu Y, Tai J, Feng G, Ge W, Zheng L, et al. Risk factors of obstructive sleep apnea syndrome in children. J Otolaryngol Head Neck Surg. 2020;49:11. https://doi.org/10.1186/s40463-020-0404-1
  23. Lai PH, Yang PS, Lai WY, Lin CL, Hsu CY, Wei CC. Allergic rhinitis and the associated risk of nocturnal enuresis in children: a population-based cohort study. Int Forum Allergy Rhinol. 2018;8:1260-6. https://doi.org/10.1002/alr.22219
  24. Sherrey J, Biggs S, Dorrian J, Martin J, Gold M, Kennedym D, et al. Allergic disease, sleep problems, and psychological distress in children. Ann Allergy Asthma Immunol. 2022;129:366-72. https://doi.org/10.1016/j.anai.2022.05.008
  25. Gudnadottir G, Ellegård E, Hellgren J. Intranasal budesonide and quality of life in pediatric sleep-disordered breathing: a randomized controlled trial. Otolaryngol Head Neck Surg. 2018;158:752-9. https://doi.org/10.1177/0194599817742597
  26. Marcuccio G, Di Bari MM, Precenzano F, Operto FF, Bitetti I, Motta G, et al. Relationship between sleep quality and rhinitis in children: role of medical treatment with isotonic and hypertonic saline. Minerva Pediatr. 2021;73:301-6. https://doi.org/10.23736/S2724-5276.19.05563-4
  27. Mansfield LE, Diaz G, Posey CR, Flores-Neder J. Sleep disordered breathing and daytime quality of life in children with allergic rhinitis during treatment with intranasal budesonide. Ann Allergy Asthma Immunol. 2004;92:240-4. https://doi.org/10.1016/S1081-1206(10)61554-2
  28. Li J, Zhang SY, Fan Z, Liu R, Jin L, Liang L. Impaired sleep quality in children with allergic conjunctivitis and their parents. Eye (Lond). 2023;37:1558-65. https://doi.org/10.1038/s41433-022-02182-4
  29. Lee KS, Lim DH, Sheen YH, Choi SH, Oh IH, Cho SW, et al. The relationship between sleep disturbances and allergic rhinitis in Korean children and adolescents. J Allergy Clin Immunol. 2022;149:AB127. https://doi.org/10.1016/j.jaci.2021.12.433
  30. Medalhas Rebelo da Silva CI, Martins R, Ferreira R. Impact of asthma and allergic rhinitis control on sleep disordered breathing in pediatrics. Sleep Med X. 2024;8:100129. https://doi.org/10.1016/j.sleepx.2024.100129

Nasıl atıf yapılır

1.
Aytekin Güvenir F, Kaan Kılıç E, Kuzu Kuşaklı A, Kutsal Gültekin TT, Şengül Emeksiz Z, Dibek Mısırlıoğlu E. Prevalence and clinical predictors of sleep disturbances in children with seasonal allergic rhinitis. Turk J Pediatr Dis. 2026;Early View:1-6. https://doi.org/10.12956/TJPD.2025.1268