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[Correlation between allergic rhinitis and childhood obstructive sleep apnea-hypopnea syndrome]
Feng Wang1, Chengyong Zhou, Jinghong Zhang
1Department of Otorhinolaryngology, the First Affiliated Hospital of Chinese PLA General Hospital, Beijing,100048, China. wangfeng304@sohu.com
Insights
Allergic rhinitis is common in children with obstructive sleep apnea-hypopnea syndrome (OSAHS), with fungal allergens being the most frequent trigger. Anti-allergic drugs can effectively manage mild to moderate OSAHS, potentially avoiding surgery.
Area of Science:
- Pediatric Sleep Medicine
- Allergy and Immunology
- Otolaryngology
Context:
- Childhood obstructive sleep apnea-hypopnea syndrome (OSAHS) is a significant health concern.
- Allergic rhinitis is a prevalent condition in children.
- The co-occurrence of these conditions requires further investigation.
Purpose:
- To determine the correlation between allergic rhinitis and OSAHS in pediatric patients.
- To identify common allergens associated with this comorbidity.
- To evaluate the efficacy of anti-allergic treatments for children with OSAHS and allergic rhinitis.
Summary:
- A study of 574 children with OSAHS found a 44.9% incidence of allergic rhinitis, predominantly perennial.
- Fungal allergens were the most common trigger (72.5%), followed by dust mites.
- Anti-allergic drug treatment for 3 weeks showed significant improvement in mild to moderate OSAHS cases, with limited effect on severe cases.
Impact:
- Highlights the strong association between allergic rhinitis and childhood OSAHS.
- Suggests anti-allergic therapy as a primary treatment for mild/moderate cases, potentially reducing the need for surgery.
- Recommends routine anti-allergic therapy post-tonsillectomy/adenoidectomy for OSAHS patients with allergic rhinitis.
Objective:
To investigate the correlation between allergic rhinitis and obstructive sleep apnea-hypopnea (OSAHS) syndrome in children.
Method:
(1) According to medical history, physical signs, skin-prick test, serum sIgE, endoscopic examination and polysomnography, the incidence of allergic rhinitis was confirmed in 574 cases of childhood obstructive sleeping apnea-hypopnea syndrome in our hospital between July in 2008 to June in 2010. (2) Effects of anti-allergic drugs were observed on 78 children with OSAHS and allergic rhinitis meanwhile.
Result:
(1) 258 cases of allergic rhinitis were confirmed in 574 cases of OSAHS, accounting for 44.9% of the OSAHS cases and 50.4% of all cases of allergic rhinitis during the same period. Most of them were perennial allergic rhinitis (223 cases, 86.4%), and 72.5% of them were aroused by fungal allergen. Compared with other allergen, statistically significant difference was found (P < 0.05). (2) After receiving anti-allergic drugs regularly for 3 weeks, 40 cases suffering from mild and moderate OSAHS and allergic rhinitis, 3 cases out of 38 cases suffering from serious OSAHS and allergic rhinitis showed satisfactory results, while other cases had little improvement.
Conclusion:
Allergic rhinitis is closely related to childhood OSAHS, and perennial allergic rhinitis dominates. The most common allergen is fungal allergen, the second is house and flour dust mites. So for patients of mild and moderate OSAHS with allergic rhinitis, regular anti-allergic drugs can lighten OSAHS effectively and may make patients avoid surgery. Severe OSAHS cases can receive surgical intervention if prior anti allergic therapy fails. Anti allergic therapy should be adopted routinely after tonsillectomy and adenoidectomy in case of hypopnea due to hypertrophy of inferior turbinate or tubal torus in allergic rhinitis.
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