Association of Allergic Rhinitis with Obstructive Sleep Apnea: A Meta-analysis

Overview

Journal Medicine (Baltimore)

Specialty General Medicine

Date 2018 Dec 22

PMID 30572534

Citations 26

Authors

Yuan Cao

Shuang Wu

Liyu Zhang

Ying Yang

Sancheng Cao

Qiao Li

Affiliations

Soon will be listed here.

Abstract

Background: The co-existence of allergic rhinitis (AR) and obstructive sleep apnea (OSA) is a common phenomenon in clinical practice. AR has long been considered a risk factor for OSA. However, the relationship is not completely clear. Therefore, we conducted a meta-analysis to evaluate the prevalence of AR in sleep-disordered breathing (SDB) /OSA and their relationship.

Methods: A comprehensive literature search was performed in PubMed/Medline, Google Scholar, Wiley Online Library, EMBASE, and Web of Science. Data were analyzed and pooled to estimate effect size (ES) /odds ratio (OR) with 95% confidence intervals (95%CI). Heterogeneity was quantified and evaluated by chi-squared-based Q-test and I2 test, with P < .05 and I > 50% indicating evidence of heterogeneity.

Results: 44 studies contained 6086 participants were included in this meta-analysis. For adults, the prevalence of AR was 22.8 (95% CI, 15.0-30.6) % in SDB and 35.2 (95% CI, 25.6-44.7) % in OSA. In children with SDB and OSA, the prevalence of AR was 40.8 (95% CI, 24.3-57.2) %, and 45.2 (95% CI, 25.4-65.0) % respectively. The odds ratios of prevalence of the SDB pediatric patients with AR was 2.12 (95%CI, 1.75, 2.57; P < .0001) times higher than that of non-SDB pediatric patients. There were no significant differences between OSA adults with or without AR in BMI (Body Mass Index), neck circumference, apnea hypopnea index (AHI) and epworth sleep scale score (ESS).

Conclusion: The prevalence of AR in OSA/SDB is considerably high and children with SDB suffering from a higher incidence of AR than non-SDB. OSA adults accompanied with AR do not have any influences on sleep parameters.

Citing Articles

Risk and Protective Factors for Obstructive Sleep Apnea Syndrome Throughout Lifespan: From Pregnancy to Adolescence.

Petrongari D, Ciarelli F, Di Filippo P, Di Ludovico A, Di Pillo S, Chiarelli F Children (Basel). 2025; 12(2).

PMID: 40003319 PMC: 11854123. DOI: 10.3390/children12020216.

Whole-Genome Deep Sequencing of the Healthy Adult Nasal Microbiome.

Cannon M, Ferrer G, Tesch M, Schipma M Microorganisms. 2024; 12(7).

PMID: 39065175 PMC: 11279209. DOI: 10.3390/microorganisms12071407.

The Role of Telemedicine in Children with Obstructive Sleep Apnea Syndrome (OSAS): A Review of the Literature.

Rizzo L, Barbetta E, Ruberti F, Petz M, Tornesello M, Deolmi M J Clin Med. 2024; 13(7).

PMID: 38610873 PMC: 11012248. DOI: 10.3390/jcm13072108.

Surgical Management of Pediatric Obstructive Sleep Apnea Beyond Adenotonsillectomy: The Nose, Nasopharynx, and Palate.

Lenze N, Bharadwaj S, Baldassari C, Kirkham E Otolaryngol Clin North Am. 2024; 57(3):421-430.

PMID: 38508883 PMC: 11060425. DOI: 10.1016/j.otc.2024.02.008.

Multilevel Risk Factors for Sleep-Disordered Breathing-Related Symptom Burden in an Urban Pediatric Community-Based Sample.

Gueye-Ndiaye S, Hauptman M, Yu X, Li L, Rueschman M, Castro-Diehl C CHEST Pulm. 2024; 1(3).

PMID: 38222082 PMC: 10786403. DOI: 10.1016/j.chpulm.2023.100019.

References

Brouillette R, Manoukian J, Ducharme F, Oudjhane K, Earle L, Ladan S . Efficacy of fluticasone nasal spray for pediatric obstructive sleep apnea. J Pediatr. 2001; 138(6):838-44. DOI: 10.1067/mpd.2001.114474. View

Larsson L, Lindberg A, Franklin K, Lundback B . Symptoms related to obstructive sleep apnoea are common in subjects with asthma, chronic bronchitis and rhinitis in a general population. Respir Med. 2001; 95(5):423-9. DOI: 10.1053/rmed.2001.1054. View

Young T, Finn L, Palta M . Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med. 2001; 161(12):1514-9. DOI: 10.1001/archinte.161.12.1514. View

Kramer M, de la Chaux R, Dreher A, Pfrogner E, Rasp G . Allergic rhinitis does not constitute a risk factor for obstructive sleep apnea syndrome. Acta Otolaryngol. 2001; 121(4):494-9. View

Anuntaseree W, Rookkapan K, Kuasirikul S, Thongsuksai P . Snoring and obstructive sleep apnea in Thai school-age children: prevalence and predisposing factors. Pediatr Pulmonol. 2001; 32(3):222-7. DOI: 10.1002/ppul.1112. View

Kapur V, Strohl K, Redline S, Iber C, OConnor G, Nieto J . Underdiagnosis of sleep apnea syndrome in U.S. communities. Sleep Breath. 2002; 6(2):49-54. DOI: 10.1007/s11325-002-0049-5. View

Virkkula P, Maasilta P, Hytonen M, Salmi T, Malmberg H . Nasal obstruction and sleep-disordered breathing: the effect of supine body position on nasal measurements in snorers. Acta Otolaryngol. 2003; 123(5):648-54. DOI: 10.1080/00016480310001493. View

Greenfeld M, Tauman R, DeRowe A, Sivan Y . Obstructive sleep apnea syndrome due to adenotonsillar hypertrophy in infants. Int J Pediatr Otorhinolaryngol. 2003; 67(10):1055-60. DOI: 10.1016/s0165-5876(03)00182-4. View

Chesson Jr A, Berry R, Pack A . Practice parameters for the use of portable monitoring devices in the investigation of suspected obstructive sleep apnea in adults. Sleep. 2003; 26(7):907-13. DOI: 10.1093/sleep/26.7.907. View

10.

Canova C, Downs S, Knoblauch A, Andersson M, Tamm M, Leuppi J . Increased prevalence of perennial allergic rhinitis in patients with obstructive sleep apnea. Respiration. 2004; 71(2):138-43. DOI: 10.1159/000076674. View

11.

Ersu R, Rodopman Arman A, Save D, Karadag B, Karakoc F, Berkem M . Prevalence of snoring and symptoms of sleep-disordered breathing in primary school children in istanbul. Chest. 2004; 126(1):19-24. DOI: 10.1378/chest.126.1.19. View

12.

Chng S, Goh D, Wang X, Tan T, Ong N . Snoring and atopic disease: a strong association. Pediatr Pulmonol. 2004; 38(3):210-6. DOI: 10.1002/ppul.20075. View

13.

Craig T, McCann J, Gurevich F, Davies M . The correlation between allergic rhinitis and sleep disturbance. J Allergy Clin Immunol. 2004; 114(5 Suppl):S139-45. DOI: 10.1016/j.jaci.2004.08.044. View

14.

Sogut A, Altin R, Uzun L, Ugur M, Tomac N, Acun C . Prevalence of obstructive sleep apnea syndrome and associated symptoms in 3--11-year-old Turkish children. Pediatr Pulmonol. 2005; 39(3):251-6. DOI: 10.1002/ppul.20179. View

15.

Li A, Hung E, Tsang T, Yin J, So H, Wong E . Induced sputum inflammatory measures correlate with disease severity in children with obstructive sleep apnoea. Thorax. 2006; 62(1):75-9. PMC: 2111280. DOI: 10.1136/thx.2006.060657. View

16.

Ramos R, Daltro C, Gregorio P, de Freitas Souza L, Andrade N, Andrade Filho A . OSAS in children: clinical and polysomnographic respiratory profile. Braz J Otorhinolaryngol. 2006; 72(3):355-61. PMC: 9443558. DOI: 10.1016/s1808-8694(15)30968-x. View

17.

Liukkonen K, Virkkula P, Aronen E, Kirjavainen T, Pitkaranta A . All snoring is not adenoids in young children. Int J Pediatr Otorhinolaryngol. 2008; 72(6):879-84. DOI: 10.1016/j.ijporl.2008.02.018. View

18.

Stewart M . Identification and management of undiagnosed and undertreated allergic rhinitis in adults and children. Clin Exp Allergy. 2008; 38(5):751-60. DOI: 10.1111/j.1365-2222.2008.02937.x. View

19.

Hellgren J, Yee B, Dungan G, Grunstein R . Altered positional regulation of nasal patency in patients with obstructive sleep apnoea syndrome. Eur Arch Otorhinolaryngol. 2008; 266(1):83-7. DOI: 10.1007/s00405-008-0701-1. View

20.

Li A, Lam H, Chan M, So H, Ng S, Chan I . Inflammatory cytokines and childhood obstructive sleep apnoea. Ann Acad Med Singap. 2008; 37(8):649-54. View