Snoring and daytime sleepiness are not associated with allergic rhinitis, but are associated with obstructed nasal passages, regardless of an individual’s allergic status, according to an article released on December 15, 2008 in Archives of Otolaryngology–Head & Neck Surgery, one of the JAMA/Archives journals.

One persistent symptom of allergic rhinitis, a runny nose due to allergies, is nasal obstruction. The authors point out that the resulting obstructed breathing can cause complications. “People with nasal obstruction often experience other symptoms, including headache, thirst, lack of concentration, daytime cognitive deficits, daytime sleepiness and disturbed sleep, which impair their daily and social activities,” they write. “There has been growing awareness that the morbidity [illness] of allergic rhinitis in the general population is increasing and is leading to a decline in school and work performance, resulting not only in a medical economic loss but also in a large social economic loss.”

In order to explore the relationship between nasal obstruction, snoring, and excessive daytime sleepiness with the presence or absence of allergies, Nobuaki Hiraki, M.D., and colleagues at the University of Occupational and Environmental Health, Kitakyushu, Japan, analyzed a survey distributed to 1,878 workers, 78% (1,459) of whom responded with sufficient information to perform the analysis.

The participants were, based on their responses, classified into one of the following groups of participants: allergies and nasal obstruction, nasal obstruction but no allergies, allergies but no nasal obstruction, and neither ailment. The odds of snoring and daytime sleepiness were greater in the nasal obstruction groups, regardless of allergy status, while no significant differences were found in these symptoms for the allergies only and control groups.

The authors infer that nasal obstruction is more directly related to the problem: “The present results strongly suggest that nasal obstruction causes sleep-disordered breathing and, thus, daytime sleepiness in individuals without allergic rhinitis as well as in those with allergic rhinitis,” they write. This is postulated to occur by several different means, such as pressure abnormalities causing parts of the throat to collapse, a shift from nasal to mouth breathing, or changes in the neurological signals sent from the respiratory system to the brain.

The authors conclude that pursuing rhinologic treatment is a worthy investment. “We speculate that, although nasal obstruction itself is not a life-threatening condition, prompt and appropriate rhinologic treatment would improve sleep quality and, thus, daily and social activities in patients with sinonasal diseases,” they write. “This remains to be further investigated in future studies.”

Snoring, Daytime Sleepiness, and Nasal Obstruction With or Without Allergic Rhinitis
Nobuaki Hiraki, MD; Hideaki Suzuki, MD, PhD; Tsuyoshi Udaka, MD; Teruo Shiomori, MD
Arch Otolaryngol Head Neck Surg. 2008;134(12):1254-1257.
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Written by Anna Sophia McKenney