Disease severity impairs sleep quality in allergic rhinitis (The SOMNIAAR study)
Article first published online: 18 JAN 2012
© 2012 Blackwell Publishing Ltd
Clinical & Experimental Allergy
Volume 42, Issue 7, pages 1080–1087, July 2012
How to Cite
C. Colás, H. Galera, B. Añ ibarro, R. Soler, A. Navarro, I. Jáuregui and A. Peláez, Clinical & Experimental Allergy, 2012 (42) 1080–1087.
- Issue published online: 15 JUN 2012
- Article first published online: 18 JAN 2012
- Manuscript Accepted: 11 NOV 2011
- Manuscript Revised: 6 NOV 2011
- Manuscript Received: 27 JUN 2011
- Fundación Aragonesa para la Investigación en Alergología (FADIA)
- Laboratorios Recordati, Spain
- allergic rhinitis;
- ARIA ;
- Pittsburgh Sleep Quality Index;
- quality of life;
- sleep disturbance;
- sleep initiation and maintenance disorders
Sleep is impaired in allergic rhinitis (AR) patients, with subsequent effects on daytime performance and health-related quality of life (QOL). Sleep quality in AR has rarely been considered through validated tools and consensus classifications.
To evaluate sleep quality and daytime somnolence in AR patients, and to estimate its relationship to disease severity according to Allergic Rhinitis and Its Impact on Asthma (ARIA) conventional and modified classifications, as well as in terms of QOL and comorbidities.
Allergic rhinitis adult patients were evaluated through a prospective, observational, multicentre survey in Spain. Symptoms were assessed using the Total Symptoms Score (TSS), specific QOL by the Rhinitis Quality of Life Questionnaire (RQLQ), sleep quality by Pittsburgh scale, and diurnal somnolence by a scale based on Epworth's, all recorded in a unique visit.
A total of 2275 patients were included. According to ARIA criteria, 50.2% had persistent and 49.8% intermittent rhinitis, whereas 87.6% were classified as moderate-severe and 12.4% as mild; 52.8% had poor sleep quality, with a global median score for Pittsburgh scale of 6 (normal < 5) and 21.1% suffered from excessive diurnal somnolence. Correlation between Pittsburgh scale and RQLQ was moderate (r = 0.54). Among symptoms, nasal obstruction and concomitant asthma mainly, contributed to bad sleep quality. In a logistic regression model, moderate-severe rhinitis and nasal obstruction were all associated with a worse sleep quality.
Conclusions and clinical relevance
Sleep quality is altered in AR patients. Sleep quality was worse in moderate-severe, and particularly in severe AR. Nasal obstruction and RQLQ deterioration are associated with a poorer sleep quality. Sleep impairment is common in allergic rhinitis, particularly in more severe forms. Nasal obstruction and concomitant asthma should be considered as contributing factors.
This is a large epidemiological survey of patients with allergic rhinitis showing a strong relationship between disease severity, as assessed by a consensus classification, and sleep impairment, as measured by a validated sleep quality tool.