How to detect sleep disorders in patients treated for asthma and allergic rhinitis

Introduction: Asthma is frequently associated to rhinitis. This association have a variable impact on the quality of sleep (QS). Evaluate this impact and treat an eventual OSA may help to ameliorate the control of the disease. Aim: Evaluate the QS in asthmatic patients treated for allergic rhinitis and detect an OSA. Methods: A cross sectional study was conducted in a pulmonology department for 6 months. Asthmatic patients who has allergic rhinitis answered three questionnaires: the Spiegel Sleep Questionnaire, the Pittsburgh Quality of Sleep Index and the Epworth score. Patients who had an Epworth score ≥ 10 undergo a respiratory polygraphy. Results: Fifty-nine patients were enrolled (mean age= 41 years, sex-ratio F/M= 0.22, mean body mass index (BMI)= 28.6 kg/m2). Asthma was uncontrolled in 12% of cases, partially controlled in 34% and controlled in 50%. Rhinitis was permanent in 24% of cases, moderate to severe in 54% and controlled in 56%. At respiratory function exploration, the mean FEV1 was 2.39 liters (84.6%) and the mean FVC was 3.18 liters (90.9%). Pneumallergens skin tests had shown a polysensitization in 12%. On Spiegel questionnaire, 20% of patients had a poor QS (score 10). Respiratory polygraphy exclude obstructive sleep apnea syndrome (OSA) in 4 cases and confirm a mild OSA in 9 cases. Conclusion: QS was poor in 1/5 of our patients. The Spiegel Questionnaire, the Pittsburgh Index and the Epworth Score concluded to the same results. OSA wasn’t frequent in our population but further studies are required to determine its prevalence among asthmatic patients suffering from allergic rhinitis.