Severity of allergic rhinitis impacts sleep and anxiety: results from a large Spanish cohort

Abstract

BackgroundAllergic rhinitis (AR) is a highly prevalent disease that generates high social and health care costs and also has a significant effect on quality of life and quality of sleep. It has also been related to some psychological disorders like anxiety or depression. ObjectiveTo evaluate anxiety, depression, and quality of sleep and life alteration in a group of patients with perennial AR compared to a group of seasonal AR patients.MethodsSix-hundred seventy adults (> 18 years) with perennial and seasonal AR were recruited consecutively in 47 centers in Spain. Individuals were grouped in “Perennial” and “Seasonal” according to the seasonality of their symptoms. Anxiety, depression, sleep quality and health related quality of life were evaluated using the Hospital Anxiety and Depression Scale, Medical Outcomes Study Sleep Scale (MOS Sleep Scale) and the Health-related quality of life questionnaire ESPRINT-15, respectively. Both groups of patients were evaluated in and out of the pollen season. ResultsAR symptoms are related to worse quality of life and more anxiety and depression symptoms. Indeed, symptom severity also correlates with worse outcomes (quality of life, sleep and depression/anxiety) regardless allergen seasonality. Symptoms severity, compared with seasonality and persistence, is the most important factor related with more anxiety and depression and poor sleep. However, symptoms severity, persistence and seasonality are independently affecting the quality of life in patients with AR.ConclusionsAlthough AR symptoms have a great impact on depression and anxiety symptoms, quality of life and quality of sleep in all AR patients, as expected, individuals with more severe AR seem to suffer more intensely their effects.Electronic supplementary materialThe online version of this article (10.1186/s13601-018-0212-0) contains supplementary material, which is available to authorized users.

Montelukast use over the past 20 years: monitoring of its effects and safety issues

“…46,47) A study assessing a cohort of 670 adults with allergic rhinitis in Spain reported that the severity of allergic rhinitis was related to a worse quality of life, sleep disturbances, depression, and anxiety. 48) One study investigated the association between montelukast and antidepressant use and reported that montelukast initiation was weakly associated with antidepressant prescription. However, the study concluded that antidepressant use, not montelukast use, may be correlated with asthma severity.…”

ARIA guideline 2019: treatment of allergic rhinitis in the German health system

“…ICPs are structured, multidisciplinary care plans that describe key steps in patient care [23]. They promote the implementation of guideline recommendations into local protocols and their application in clinical practice [24,25]. Typically, ICPs improve recommendations by iteratively combining interventions, integrating quality assurance, and promoting the coordination of treatment.…”

ARIA guideline 2019: treatment of allergic rhinitis in the German health system

“…Pharmacotherapy for AR patients is considered to control the disease. It depends on (i) patient empowerment and preferences, (ii) prominent symptoms, symptom severity and multimorbidity, (iii) efficacy and safety of the treatment [30], (iv) speed of onset of action of treatment, (v) current treatment, (vi) historic response to treatment, (vii) impact on sleep and work productivity [31,32], (viii) self-management strategies and (ix) resource use.…”