Leger D, et al. – Experts distinguished the sleep disorders associated with respiratory allergy to house dust mites (HDM) at the time of initiation of sublingual allergen immunotherapy (SLIT) in routine clinical practice. In particular, when allergic rhinitis (AR) was persistent and severe, the high frequency of sleep disorders and their significant impact on patients with AR induced by HDM were outlined. Moreover, it seemed to be crucial to ask allergic patients about the quality of their sleep, especially when the patient had persistent and severe AR.

Methods

• Incorporating 1750 participants suffering from HDM allergy who were initiating SLIT, this prospective, cross-sectional, observational study was conducted between November 2014 and March 2015 at 189 French trial sites.
• This study did not enroll participants aged less than 5 years old and those who had previously started an allergen immunotherapy (AIT) for HDM allergy.
• They appraised sleep disorders by self-administered questionnaires: the Epworth Sleepiness Scale (ESS), the Insomnia Severity Index (ISI) and a modified version of the Hotel Dieu-42 (HD-42) sleep disorder questionnaire.
• They used logistic regression models adjusted for obesity, smoking status, asthma control and nasal obstruction to study the relationship between allergic rhinitis (AR) classification and sleep disorders/complaints.

Results

• 1750 (907 adults and 843 children) composed the analysis population, among the 1786 participants enrolled.
• Sleep disorders were the reason for the majority of participants (73.5% of adults and 65.8% of children) to consult their physician.
• Poor-quality sleep (50.3% of adults and 37.3% of children), snoring (48.1 and 41.4%, respectively) and nocturnal awakening (37.6 and 28.2%, respectively) were the most commonly observed sleep complaints.
• Furthermore, difficulties falling asleep were reported by 27.0% of adults and 24.7% of children.
• As compared to participants with intermittent or mild persistent AR, adults and children suffering from severe persistent AR experienced sleep complaints significantly more often.