Year-Round and Seasonal Allergies

Allergic rhinitis occurs when allergens in the air are breathed by a patient that is allergic to them, irritating and inflaming the nasal passages. Allergens may include dust mites, pollen, molds, or pet dander. In people who are allergic to them, these particles trigger the release of a chemical in the body that causes nasal congestion, sneezing, watery eyes, and runny nose. These symptoms can lead to poor sleep, which can result in significant daytime sleepiness and fatigue.

Allergic rhinitis (allergies) may occur year-round or seasonally. When it occurs seasonally it is usually caused by airborne particles from trees, grass, ragweed, or outdoor mold. Causes of year-round allergic rhinitis include indoor substances such as pet dander, indoor mold, cockroach and dust mites in bedding, mattresses, and carpeting.

Sleep problems are common in people with allergic rhinitis. One study found that sleep is dramatically impaired by allergic symptoms and that the degree of impairment is related to the severity of those symptoms. In addition, sleep problems are linked with fatigue and daytime sleepiness as well as decreased productivity at work or school, impaired learning and memory, depressed mood, and a reduced quality of life.

Obstructive sleep apnea (OSA), a sleep disorder in which breathing is briefly and repeatedly interrupted during sleep, is linked with allergic rhinitis. OSA occurs when the muscles of the throat relax and fail to hold the airway open during sleep. People with OSA may suffer from severe daytime sleepiness and a range of chronic health problems such as heart disease, stroke, and sexual dysfunction. Nasal congestion, which causes the upper airway to narrow, increases the risk of both snoring and OSA among allergic rhinitis patients. The good news is that reducing nasal inflammation may reduce symptoms of snoring and OSA as well as daytime fatigue and sleepiness, according to at least one study. This is particularly important for those OSA patients who have trouble with continuous positive airway pressure(CPAP) devices because of nasal congestion.

In addition, research suggests that allergic rhinitis is a risk factor for snoring and OSA among children. Snoring and other sleep problems are linked with poor performance in school, lower IQ, and even brain damage, according to recent research. Parents are urged to pay close attention to sleep symptoms in children with allergic rhinitis and discuss their children's sleep with their pediatricians.

With such a high rate of sleep disorders and other health problems among allergic rhinitis patients, getting adequate sleep on a regular basis is essential to maintaining physical and mental health as well as performance, safety, and overall well-being.

SYMPTOMS:

Symptoms of allergic rhinitis (allergies) include:

• nasal congestion
• sore throat
• coughing
• sneezing
• runny nose
• headache

Allergic rhinitis is sometimes associated with itchy, watery eyes (allergic conjunctivitis) and wheezing and coughing (asthma). These symptoms - especially nasal congestion - can lead to impaired sleep, which can result in significant daytime sleepiness and fatigue.

TREATMENT:

Treatment of allergic rhinitis (allergies) begins with a diagnosis of allergies. A history and physical examination is the first step. Your physician will ask about the severity and duration of your symptoms as well as what triggers them (e.g., pollen, pet dander). You may also be given an allergy test to identify the specific allergens causing your symptoms. Due to the prevalence of sleep problems among allergic rhinitis patients, questions about sleep and daytime sleepiness should also be a part of a medical examination for allergic rhinitis.

There are several over-the-counter medications that may relieve symptoms of allergic rhinitis, including antihistamines, and decongestants. These medications may cause drowsiness and daytime sleepiness. Talk to your physician about finding the best medication to treat your symptoms and discuss any concerns you may have that use of a medication might interfere with your alertness when driving, at work, or completing your responsibilities or activities.

Research shows that intranasal corticosteroids reduce congestion, improve sleep, and reduce daytime fatigue in allergic rhinitis patients. Montelukast is also approved for the treatment of allergic rhinitis and may significantly improve both daytime and nighttime symptoms, according to at least one study. Montelukast and corticosteroids are available by prescription. Allergy shots may be prescribed for severe symptoms or those that do not respond to other treatments.

Treatment for allergic rhinitis should also focus on improving sleep, which may improve health, quality of life, and general well-being.

COPING:

The best way to cope with allergic rhinitis (allergies) is to avoid the allergens and irritants that trigger symptoms. Those triggers may include:

• pollen
• dust
• pet dander
• mold
• dust mites
• feathers
• tobacco smoke

Symptoms caused by dust mites in bedding and mattresses may be reduced by washing sheets and blankets once a week in hot water. Most pillows are also washable, even some made of feathers and down. To minimize exposure to dust mites and pet dander, pillows, mattresses, and box springs can be sealed with special coverings. Some are made of plastic, but others are made from micro-weave fibers that allow air to pass through making the fabric have a more natural, softer, and fluffier feel than plastic.

In addition, try these tips for coping with allergic rhinitis symptoms:

• Stay indoors on days with high pollen or ragweed counts
• Keep windows closed and air-conditioning on to prevent pollens and pollutants from entering and lower humidity
• Use a dehumidifier to help prevent to accumulation of mold spores
• Wash pets regularly and do not sleep in the same room with them
• Use vacuums and air cleaners rated for their ability to remove allergens from the air
• Vacuum often
• Change air filters monthly

Finally, it is important to allow time for sleep. Being sleep deprived may affect your overall health and prevent your body from defending itself against the allergens that cause your symptoms. Also, try this tip before bedtime: take a hot shower which may be relaxing but may also help open nasal passages and also wash away allergens in the hair or on the skin.

POLL DATA:

According to NSF's 2006 Sleep in America poll, 15% of American adolescents take medications for allergies.

Reviewed by Terry B. Young, PhD, and Beth A. Miller, MD.