Usefulness of Checking Sensitization Status in Adult Patients with Suspected Sleep Apnea

Abstract

Aim: An association between obstructive sleep apnea (OSA) and allergic rhinitis (AR), both common with increasing prevalence worldwide, has frequently been reported. The objective of this study was to assess acceptability, feasibility, and usefulness of routinely checking sensitization status in suspected sleep apnea. Materials and methods: All consecutive adult patients referred to an adult sleep clinic in Malta over a 10-week period were included. A medical history, physical examination, and skin testing for common aeroallergens were performed for all and rhinoconjunctivitis quality of life questionnaire (RQLQ), Total-4-nasal symptom score (T4NSS), and visual analogue scale (VAS) for AR patients. Uncontrolled AR was treated. The polysomnography report was reviewed. Results: Our cohort included 95 patients—34.7% were sensitized and diagnosed with AR. The most common perennial aeroallergens were Dermatophagoides pteronyssinus (86.1%), farina (75%), seasonal aeroallergens, tree (19%), and grass pollen (19%). When comparing allergic and nonallergic groups, the former were younger (p = 0.002), more likely female (p = 0.06) and asthmatic (p = 0.014), suffered rhinorrhea (p = 0.02), or other rhinoconjunctivitis symptoms (p <0.001). Patients with AR were less likely diagnosed with sleep apnea (60.6%) compared to those without (81.3%) (p = 0.014). A total of 54.2% of patients with normal polysomnography were diagnosed with AR compared to 30% of sleep apnea patients (p = 0.26). Conclusion: Skin prick testing (SPT) in this context is acceptable, safe, and feasible, mainly useful in younger females, asthmatics, and those with AR symptoms. Diagnosing AR in patients whose symptoms have been mistaken for sleep apnea and in patients with coexisting sleep apnea will improve morbidity and quality of life. Clinical significance: Checking sensitization status in patients with suspected sleep apnea will improve clinical outcomes.