Sleep deprivation as a risk factor for anaphylaxis in children with food allergy

Severity of food allergic reactions is unpredictable, and cofactors influence the development of food-induced anaphylaxis. A lot of cofactors might increase allergic reaction severity, and little is known about sleep deprivation as a possible cofactor in food allergy, especially in children. With the description of a case of a middle child, we want to emphasise the role that sleep deprivation might play as a cofactor, especially during oral immunotherapy (OIT). She was undergoing OIT for milk and experienced anaphylaxis after ingestion of milk and sleep deprivation (sleeping time 3 hours less than the minimum optimal hours per age). No other cofactors were identified. In conclusion, sleep loss could influence the severity of adverse reactions in children with food allergies. Moreover, we propose a questionnaire to be submitted to the patient or the patient's parent prior to dose administration during OIT in order to reduce the risk of severe reactions at home.