Background: Allergic rhinitis (AR) causes increased upper airway resistance and may lead to undiagnosed sleep-disordered breathing (SDB). This problem may be further complicated in the pediatric inner-city population where indoor allergens such as rat, cockroach, and mouse may contribute to morbidity. Objective: To determine the pattern of aeroallergen sensitization in inner-city pediatric patients with SDB and to determine if intranasal corticosteroid treatment improves SDB, using a validated Pediatric Sleep Questionnaire (PSQ). Methods: Patients (ages 2-18) were evaluated for AR and completed the PSQ prior to treatment. Skin prick testing (SPT) to aeroallergens, including inner-city culprits (rat, cockroach, and mouse), was performed. Patients with a history of AR, a positive SPT evaluation, and at least one positive response on the PSQ were treated with intranasal mometasone furoate monohydrate, environmental control, (±) antihistamines. After 6 weeks of treatment, PSQ responses were reassessed. Results: Of the 23 patients recruited in this study, 100% had SDB as per screening PSQ responses; 100% had 1 positive SPT, 78% of which were SPT-positive to cockroach, mouse, or rat. Prior to treatment, patients' average PSQ score = 6.00 questions; following treatment, an average PSQ score = 2.35, indicating clinical improvement (P < 0.0001 paired t test). Conclusion: Children suffering from AR have increased nasal obstruction leading to sleep-disordered events. This study demonstrated that adequate treatment, that is, intranasal steroids, may significantly improve SDB. In inner-city children, elimination of indoor allergens such as cockroach, mouse, or rat may further improve SDB. Larger prospective studies are needed to further validate these preliminary results.
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health
- Immunology and Allergy
- Pulmonary and Respiratory Medicine