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The association between allergic rhinitis and sleep‐disordered breathing in children: a systematic review
Author(s) -
Lin Sandra Y.,
Melvin ThuyAnh N.,
Boss Emily F.,
Ishman Stacey L.
Publication year - 2013
Publication title -
international forum of allergy and rhinology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.503
H-Index - 46
eISSN - 2042-6984
pISSN - 2042-6976
DOI - 10.1002/alr.21123
Subject(s) - medicine , polysomnogram , obstructive sleep apnea , medline , sleep disordered breathing , evidence based medicine , systematic review , breathing , cochrane library , polysomnography , pediatrics , meta analysis , physical therapy , apnea , alternative medicine , psychiatry , pathology , political science , law
Background The objective of this work was to systematically review existing literature on the association between allergic rhinitis (AR) and sleep‐disordered breathing (SDB) in children. Methods We performed a literature search encompassing the last 25 years in PubMed, EMBASE, and Cochrane CENTRAL. Inclusion criteria included English‐language papers containing original human data, number of subjects ≥7, and age <18 years old. Data was systematically collected on study design, patient demographics, clinical characteristics/outcomes, and level‐of‐evidence. Two investigators independently reviewed all articles. Results The initial search yielded 433 abstracts, of which 18 articles were included. Twelve (67%) of the 18 articles showed a statistically significant association between AR and SDB. All articles were either case‐series or case‐control studies. Based on the Newcastle‐Ottawa scale, the quality of the articles was determined to be fair to good. For characterizing AR, 7 (39%) studies included skin‐prick testing and/or in vitro testing. For determining presence of SDB, 7 (39%) of the studies used polysomnographic data, of which 1 study incorporated data from a home polysomnogram. Habitual snoring was the most common form of SDB studied, in 10 (56%) of the articles. Obstructive sleep apnea was studied in 6 (33%) articles. Conclusion Although the majority of the studies included in this review showed a significant association between AR and SDB, all of the studies were evidence level 3b and 4, for an overall grade of B− evidence (Oxford Evidence‐Based Medicine Center). Further higher‐quality studies should be performed in the future to better evaluate the relationship between AR and SDB in children.