A study conducted by New York Medical College finds that allergies are associated with abnormalities during rapid eye movement (REM) sleep, the restorative stage of sleep. The study is published in International Forum of Allergy & Rhinology.
The study by Shelley Rose Berson, MD, FACS, FAASM, FAAOA, the lead author and a clinical assistant professor of otolaryngology at New York Medical College, the 67% of her patients with allergies in the study were found to take longer to enter REM sleep, to have fewer dreams, and they often experience disrupted breathing upon entering the dream state.
The REM–respiratory disturbance index (REM-RDI), used in the study, was shown to be a more accurate indicator of REM-specific sleep disturbances associated with allergies than other measures like all-night apnea-hypopnea index (AHI), respiratory-disturbance (RDI), or REM-specific apnea-hypopnea indices (REM-AHI). The study also concluded that the REM-RDI is an underutilized, clinically relevant, and knowable sleep parameter that is significantly related to allergic status.
According to Berson, the index provides patients with sleep issues with more options beyond surgery, and provides new data which can be used in making better informed decisions about treatment.
This retrospective analysis of ear-nose-throat (ENT) patients with primary complaints of upper airway obstruction, suspected allergic inflammation, and/or sleep-disordered breathing (SDB). Patients who tested positive for allergies were compared with allergy test–negative subjects. In addition to the upper airway exam, standardized questionnaires, allergy testing, and sleep tests were administered to the patients. Sleeping data was obtained using in-laboratory or home sleep test medical devices with certified sleep technicians or proprietary algorithms scoring the respiratory disturbance index values.
“When I started focusing on the new REM-RDI numbers, I was able to connect patient’s symptoms such as fatigue, allergies, nasal blockage, or congestion” with REM abnormalities, Berson says in a release. “This led to the correlation of tired allergic patients having a problem during REM and some patients who were tired and had REM-RDI elevations testing positive for allergies.”
While the new approach can provide patients with sleep issues better diagnoses and new symptoms to look for, Berson cautions that there is no one-size-fits-all diagnosis. “Every patient is different and the study aims to provide more clarity on the relationship between allergies and a person’s overall quality of sleep,” Berson says. “The airway begins in the nose and its anatomic form needs to be properly balanced with its function. This shows that ear, nose, and throat (ENT) doctors as well as allergists and sleep physicians should be collaborating more closely to help pinpoint sleeping problems patients may be facing.”