Allergic rhinitis (AR) is a common condition in many, occurring due to airborne allergens. Individuals often have difficulty in sleeping as there is inflammation in the nose and this leads to continuous sneezing along with blockages in the nose and other allergic symptoms. While allergic rhinitis is not considered a severe problem, the symptoms however overlap with a sleep disorder-sleep apnea.
The link between sleep apnea and allergic rhinitis
Both sleep apnea and allergic rhinitis cause sleep difficulties by making it difficult to breathe.
“In an individual with sleep apnea, the airway is compromised when he/she is sleeping. The upper airway, i.e., the area above the vocal cords, or the voice box collapses, interrupting the air flow to the lungs,” says Dr Mihir G, consultant pulmonologist, Fortis Hospital, Mumbai.
This leads to pauses in the breathing throughout the night and leading to sudden microarousals.
In allergic rhinitis, there is an obstruction in breathing due to the inflammation and blockage of the nose. This leads an individual to switch to mouth breathing. “When breathing through the mouth, individuals try to breathe more vigorously. This tends to produce a negative pressure inside because they are breathing against a blocked nose and that negative pressure can cause the airway to collapse a little bit, adds Dr Mihir.
This collapse compromises the flow of air and accentuates the problem of obstruction.
Does allergic rhinitis (AR) lead to sleep apnea?
A review paper published in 2018, emphasized the prevalence of allergic rhinitis in Obstructive Sleep Apnea (OSA). The paper also concluded that children with Sleep Disordered Breathing (SDB) had a higher incidence of AR than non-SDB. Sleep Disorder Breathing is irregular or disordered breathing while asleep.
“While AR alone may not directly cause sleep apnea, its symptoms and associated inflammation can contribute to the development or exacerbation of sleep apnea. The connection lies in the shared mechanisms of airway obstruction and inflammation that can influence sleep quality and respiratory function,” says Dr Pavan Yadav, lead consultant- interventional pulmonology and lung transplantation, Aster RV Hospital, Bengaluru.
What happens to the children?
“In the paediatric age group, kids who have allergic rhinitis and frequent upper respiratory infections tend to develop adenoid hypertrophy, a kind of local polyp in the upper airway. And due to the swelling, they tend to face a larger amount of sleep disorder breathing or obstructive sleep apnea,” says Dr Mihir.
Dr Mihir says that if one were to measure the frequency of finding obstructive sleep apnea in a non-allergic rhinitis population versus a population of purely allergic rhinitis, we find it more frequently about 1.5 – 2 times more in a population which has allergic rhinitis.
While few studies do show a positive correlation between the two conditions, it needs more research to further confirm the correlation.
Read more:
Sleep apnea in children: When breathing easy becomes difficult
Obstructive sleep apnea tests can determine your sleep condition
Running away from a runny nose: Managing allergic rhinitis
Sleep, don’t sneeze: Managing allergies for a good night’s sleep
How are they treated?
Allergic rhinitis is usually treated with anti-allergic medications, which can make people drowsy. If individuals have both conditions when treating for AR, sleep apnea-like symptoms also subside to a certain level say experts. Since both conditions disturb sleep through breathing difficulties, treating AR can help improve breathing through the nose.
However, it should be noted that treating allergic rhinitis is not the cure for sleep apnea, says Dr Hirenappa Udnur, consultant pulmonologist, Manipal Hospitals, Bengaluru.
Treatment for sleep apnea is different from that of allergic rhinitis. There are different types of sleep apnea and based on the type and severity, Continuous Positive Airway Pressure (CPAP) is prescribed.
Takeaways
- Allergic Rhinitis and sleep apnea are two different health conditions both affecting the upper respiratory tract causing sleep disturbances.
- Sleep apnea was found to be more prominent in individuals experiencing allergic rhinitis frequently.
- Experts recommend treating AR can subdue sleep apnea like symptoms in some individuals.
