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Review
. 2012 Dec;130(6):1275-81.
doi: 10.1016/j.jaci.2012.06.026. Epub 2012 Aug 3.

Sleep and allergic disease: a summary of the literature and future directions for research

Affiliations
Review

Sleep and allergic disease: a summary of the literature and future directions for research

Daphne Koinis-Mitchell et al. J Allergy Clin Immunol. 2012 Dec.

Abstract

Atopic diseases, such as asthma and allergic rhinitis, are common conditions that can influence sleep and subsequent daytime functioning. Children and patients with allergic conditions from ethnic minority groups might be particularly vulnerable to poor sleep and compromised daytime functioning because of the prevalence of these illnesses in these groups and the high level of morbidity. Research over the past 10 years has shed light on the pathophysiologic mechanisms (eg, inflammatory mediators) involved in many atopic diseases that can underlie sleep disruptions as a consequence of the presence of nocturnal symptoms. Associations between nocturnal symptoms and sleep and poorer quality of life as a result of missed sleep have been demonstrated across studies. Patients with severe illness and poor control appear to bear the most burden in terms of sleep impairment. Sleep-disordered breathing is also more common in patients with allergic diseases. Upper and lower airway resistance can increase the risk for sleep-disordered breathing events. In patients with allergic rhinitis, nasal congestion is a risk factor for apnea and snoring. Finally, consistent and appropriate use of medications can minimize nocturnal asthma or allergic symptoms that might disrupt sleep. Despite these advances, there is much room for improvement in this area. A summary of the sleep and allergic disease literature is reviewed, with methodological, conceptual, and clinical suggestions presented for future research.

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Conflict of interest statement

Disclosure of potential conflict of interest: T. Craig is an Interest Section Leader for the American Academy of Allergy, Asthma & Immunology; is a board member for the American College of Allergy, Asthma & Immunology and the Joint Council of Allergy, Asthma & Immunology; has consultant arrangements with CSL Behring, Dyax, and Viropharma; has provided expert testimony in a case related to anaphylaxis; has received grants from Viropharma, CSL Behring, Shire, Dyax, Pharming, Forrest, Genentech, Merck, and GlaxoSmithKline; has received payment for lectures from Viropharma, CSL Behring, Dyax, Merck, Novartis, Shire, and Teva; and has received payment for development of educational presentations from the Vietnam Education Foundation. C. A. Esteban has received a grant from the National Institute of Child Health and Human Development. The rest of the authors declare that they have no relevant conflicts of interest.

Figures

FIG 1
FIG 1
Conceptual model of the association between allergic disease and sleep. SES, Socioeconomic status.

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