Treatment of allergic rhinitis: does it make a difference in sleep and quality of life?
Main Article Content
Keywords
allergic rhinitis, allergic conjunctivitis, children, CSHQ, PRQLQ, quality of life, sleep quality
Abstract
Objective: Allergic rhinitis (AR) and allergic conjunctivitis (AC) are common atopic conditions of childhood that significantly impair sleep quality and health-related quality of life (HRQoL). Although effective treatment strategies exist, their broader impact on sleep and daily functioning has remained underexplored. This study aimed to evaluate the effect of AR and/ or AC treatment on sleep quality and HRQoL in children using validated, parent-reported instruments.
Methods: In this prospective observational cohort study, 98 children aged 6–13 years with AR and/or AC were treated according to standard guidelines. Sleep quality and HRQoL were assessed pre- and post-treatment using the Children’s Sleep Habits Questionnaire (CSHQ) and the Pediatric Rhinoconjunctivitis Quality of Life Questionnaire (PRQLQ), respectively. Changes in scores were analyzed using the Wilcoxon Signed-Rank test.
Results: Post-treatment evaluations demonstrated a significant reduction in total CSHQ scores (median: 56–43, P < 0.001), indicating improved sleep quality. Similarly, total PRQLQ scores decreased significantly (median: 3.47–2.28, P < 0.001), reflecting enhanced QoL. Improvements were observed in most subdomains, including nose and eye symptoms, activity limitations, and other symptoms.
Conclusions: A 4-week standard treatment regimen for AR and/or AC led to significant improvements in sleep quality and HRQoL in children. These findings highlight the importance of early and appropriate management of allergic conditions to enhance both physical and functional well-being in pediatric patients.
References
2. Chrysouli K, Theodorakopoulos C, Saratsiotis A, Kakosimou C, Tsami C, Vrettakos P, et al. Allergic rhinitis in children: An underestimated disease. Indian J Otolaryngol Head Neck Surg. 2024;76(2):1759–64. https://doi.org/10.1007/s12070-023-04402-z
3. Ciprandi G, Leonardi S, Zicari AM, Tosca MA, Marseglia G. Allergic rhinoconjunctivitis: Pathophysiological mechanism and new therapeutic approach. Acta Biomed. 2020;91(1):93–6.
4. Kakli HA, Riley TD. Allergic rhinitis. Prim Care. 2016;43(3):465–75. https://doi.org/10.1016/j.pop.2016.04.009
5. Bousquet J, Toumi M, Sousa-Pinto B, Anto JM, Bedbrook A, Czarlewski W, et al. The allergic rhinitis and its impact on asthma (ARIA) approach of value-added medicines: As-needed treatment in allergic rhinitis. J Allergy Clin Immunol Pract. 2022;10(11):2878–88. https://doi.org/10.1016/j.jaip.2022.07.020
6. Li J, Zhang SY, Fan Z, Liu R, Jin L, Liang L. Impaired sleep quality in children with allergic conjunctivitis and their parents. Eye (Lond). 2023;37(8):1558–65. https://doi.org/10.1038/s41433-022-02182-4
7. D'Elia C, Gozal D, Bruni O, Goudouris E, Meira ECM. Allergic rhinitis and sleep disorders in children—Coexistence and reciprocal interactions. J Pediatr (Rio J). 2022;98(5):444–54. https://doi.org/10.1016/j.jped.2021.11.010
8. Bosnic-Anticevich S, Smith P, Abramson M, Hespe CM, Johnson M, Stosic R, et al. Impact of allergic rhinitis on the day-to-day lives of children: Insights from an Australian cross-sectional study. BMJ Open. 2020;10(11):e038870. https://doi.org/10.1136/bmjopen-2020-038870
9. Sikorska-Szaflik H, Sozańska B. Quality of life in allergic rhinitis—Children's and their parents' perspective in Polish urban and rural population. Health Qual Life Outcomes. 2020;18(1):64. https://doi.org/10.1186/s12955-020-01315-1
10. Owens JA, Spirito A, McGuinn M. The Children's Sleep Habits Questionnaire (CSHQ): Psychometric properties of a survey instrument for school-aged children. Sleep. 2000;23(8):1043–51. https://doi.org/10.1093/sleep/23.8.1d
11. Fis NP, Arman A, Ay P, Topuzoglu A, Güler AS, Imren SG, et al. Çocuk uyku aliskanliklari anketinin Türkçe geçerliligi ve güvenilirligi. [The validity and the reliability of Turkish version of children's sleep habits questionnaire]. Anadolu Psikiyatri Dergisi. 2010;11(2):151.
12. Juniper EF, Thompson AK, Ferrie PJ, Roberts JN. Validation of the standardized version of the rhinoconjunctivitis quality of life questionnaire. J Allergy Clin Immunol. 1999;104(2 Pt 1):364–9. https://doi.org/10.1016/S0091-6749(99)70380-5
13. Yüksel H, Yilmaz O, Söğüt A, Eser E. Validation and reliability study of the Turkish version of the Pediatric Rhinitis Quality of Life Questionnaire. Turkish J Pediat. 2009;51(4):361–6.
14. Meltzer EO, Nathan R, Derebery J, Stang PE, Campbell UB, Yeh WS, et al. Sleep, quality of life, and productivity impact of nasal symptoms in the United States: Findings from the Burden of Rhinitis in America survey. Allergy Asthma Proc. 2009;30(3):244–54. https://doi.org/10.2500/aap.2009.30.3230
15. Aycan ÖK, Özcanlı Çay Ö. Evaluation of sleep quality in children with allergic rhinitis. Ankyra Med J. 2024;4(4):84–7. https://doi.org/10.51271/ANKMJ-0020
16. Liu J, Zhang X, Zhao Y, Wang Y. The association between allergic rhinitis and sleep: A systematic review and meta-analysis of observational studies. PLoS One. 2020;15(2):e0228533. https://doi.org/10.1371/journal.pone.0228533
17. Juniper EF, Guyatt GH, Dolovich J. Assessment of quality of life in adolescents with allergic rhinoconjunctivitis: Development and testing of a questionnaire for clinical trials. J Allergy Clin Immunol. 1994;93(2):413–23. https://doi.org/10.1016/0091-6749(94)90349-2
18. Bousquet J, Schünemann HJ, Togias A, Bachert C, Erhola M, Hellings PW, et al. Next-generation allergic rhinitis and its impact on asthma (ARIA) guidelines for allergic rhinitis based on grading of recommendations assessment, development and evaluation (GRADE) and real-world evidence. J Allergy Clin Immunol. 2020;145(1):70–80.e3.