Association Between Allergic Rhinitis and Sleep Disorders in Pediatric and Adult Populations in Pakistan

Abstract

Background: Allergic rhinitis (AR) is a prevalent chronic inflammatory condition of the upper airways that heavily impacts the quality of sleep because of nasal obstruction, inflammation of the nasal mucosa, and alteration in the upper airway flow. As the burden of AR rises in the Pakistani population, there remains a scarcity of information regarding disturbed sleep in the pediatric and adult AR patient groups according to the patient's age. Objectives: To identify the intensity and factors of sleep disorders in pediatric and adult patients who suffer from physician-verified AR in Pakistan. Methods: This was a cross-sectional study involving 124 participants: 62 children and adults each with AR according to ARIA guidelines. Sleep problems were assessed using standardized scales: the Pittsburgh Sleep Quality Index (PSQI), the Epworth Sleepiness Scale (ESS), and the Insomnia Severity Index (ISI). Sleep breathing problems were screened by the Pediatric Sleep Questionnaire in the pediatric group and symptom reports in the adult group. Comparisons of groups were done using the χ² test, the t-test, and the odds ratio at the 95% confidence level. Results: Sleep problems existed in high proportions in both the pediatric and adult groups: 80.6% in the pediatric group and 85.5% in the adult group. Difficulty in initiating sleep existed predominantly in the adult group (59.7% vs. 45.2%), although OSA existed predominantly in the pediatric group (12.9% vs. 3.2%).In both groups, the average value of the PSQI score exceeded the cut-off value of 8.5. In addition, both groups experienced excessive daytime somnolence and disrupted sleep. Conclusion: The co-occurrence of disturbed sleep is evident across the spectrum of AR in Pakistan, especially within the pediatric population, who are at risk of OSA. The incorporation of the management of disturbed sleep in the treatment of AR could be beneficial.