The role of montelukast on perennial allergic rhinitis and associated sleep disturbances and daytime somnolence

Santos, Carah B.; Hanks, Christopher; McCann, Jeffrey L.; Lehman, Erik; Pratt, Ellen L.; Craig, Timothy J.

doi:10.2500/aap.2008.29.3097

Cited by 34 publications

(23 citation statements)

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“…The cause of the improved sleep and daytime somnolence may be a reduction in congestion, a reduction in inflammatory mediators, or a combination of the two. Even in young children with large adenoids, especially those with high levels of inflammatory mediators, montelukast has been shown to be an effective intervention [64].…”

Section: Effects Of Therapymentioning

confidence: 99%

Congestion and Sleep Impairment in Allergic Rhinitis

Craig

Sherkat

Safaee

2010

Curr Allergy Asthma Rep

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Allergic rhinitis is a prevalent disease in developed nations, and its prevalence has been increasing throughout the world. Nasal congestion is the most common and bothersome symptoms of rhinitis. Congestion is associated with sleep-disordered breathing and is thought to be a key cause of sleep impairment in individuals with rhinitis. The end result is a decrease in quality of life and productivity and an increase in daytime sleepiness. Treatment with intranasal corticosteroids has been shown to reduce nasal congestion. Data on sleep-related end points from clinical trials of intranasal corticosteroids indicate that this reduction is associated with improved sleep, reduced daytime fatigue, and improved quality of life. Other therapies, such as montelukast, also have a positive influence on congestion and sleep. This review examines nasal congestion and the associated sleep impairment of allergic rhinitis patients. It explores the adverse effects of disturbed sleep on quality of life and how these conditions can be reduced by therapies that decrease congestion.

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Section: Effects Of Therapymentioning

confidence: 99%

Congestion and Sleep Impairment in Allergic Rhinitis

Craig

Sherkat

Safaee

2010

Curr Allergy Asthma Rep

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“…Recent data have shown the ability of therapies targeting nasal inflammation (e.g. nasal corticosteroids and montelukast) to improve OSA . Upper airway patency can worsen at night due to redistribution of dependent oedema in the supine position; this narrowing is worse in states of fluid overload such as cor‐pulmonale …”

Section: Pathophysiology: What Factors Might Contribute To the Overlap?mentioning

confidence: 99%

The overlaps of asthma or COPD with OSA: A focused review

Owens

Macrea²,

Teodorescu

2017

Respirology

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Asthma, chronic obstructive pulmonary disease (COPD) and obstructive sleep apnoea (OSA) are the most common respiratory disorders worldwide. Given demographic and environmental changes, prevalence for each is likely to increase. Although exact numbers are not known, based on chance alone, many people will be affected by both lower airways obstruction and concomitant upper airway obstruction during sleep. Some recent studies suggest that there is a reciprocal interaction, with chronic lung disease predisposing to OSA, and OSA worsening control and outcomes from chronic lung disease. Thus, the combination of wake and sleep respiratory disorders can create an overlap syndrome with unique pathophysiological, diagnostic and therapeutic concerns. Although much work needs to be done, given the above, Respirologists, Sleep Medicine and Primary Care providers must be vigilant for overlap syndromes. Accurate diagnosis of, for example, OSA as a cause of nocturnal symptoms in a patient with asthma is likely to limit further ineffective titration of medications for asthma. Moreover, prompt treatment of OSA in the overlap syndromes will not only offer symptomatic benefit of OSA, but also improve symptoms and healthcare resource utilization attributable to obstructive lung disease, and in COPD, it may reduce mortality.

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“…A randomised double-blind crossover trial [53] assessing at the effects of montelukast on 31 patients with persistent allergic rhinitis and sleep disturbances found a significant effect of this leukotriene antagonist in reducing daytime somnolence as measured by Epworth sleepiness scale. However, none of the patients underwent polysomnography and this result has not been replicated in any other studies.…”

Section: Medical Treatmentmentioning

confidence: 99%

The role of the nose in snoring and obstructive sleep apnoea: an update

Georgalas

2011

Eur Arch Otorhinolaryngol

199

149

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Multilevel anatomic obstruction is often present in snoring and obstructive sleep apnoea (OSA). As the nose is the first anatomical boundary of the upper airway, nasal obstruction may contribute to sleep-disordered breathing (SDB). A number of pathophysiological mechanisms can potentially explain the role of nasal pathology in SDB. These include the Starling resistor model, the unstable oral airway, the nasal ventilatory reflex and the role of nitric oxide (NO). Clinically, a number of case–control studies have shown that nasal obstruction is associated with snoring and mild SDB. However, there is not a linear correlation between the degree of nasal obstruction and the severity of SDB, while nasal obstruction is not the main contributing factor in the majority of patients with moderate to severe OSA. Randomised controlled studies have shown that in patients with allergic rhinitis or non-allergic rhinitis and sleep disturbance, nasal steroids could improve the subjective quality of sleep, and may be useful for patients with mild OSA, however, they are not by themselves an adequate treatment for most OSA patients. Similarly, nasal surgery may improve quality of life and snoring in a subgroup of patients with mild SDB and septal deviation, but it is not an effective treatment for OSA as such. On the other hand, in patients who do not tolerate continuous positive airway pressure (CPAP) well, if upper airway evaluation demonstrates an obstructive nasal passage, nasal airway surgery can improve CPAP compliance and adherence.

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The role of montelukast on perennial allergic rhinitis and associated sleep disturbances and daytime somnolence

Cited by 34 publications

References 0 publications

Congestion and Sleep Impairment in Allergic Rhinitis

Congestion and Sleep Impairment in Allergic Rhinitis

The overlaps of asthma or COPD with OSA: A focused review

The role of the nose in snoring and obstructive sleep apnoea: an update

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