The association between allergic rhinitis and sleep-disordered breathing in children: A systematic review

Sandra Y. Lin, Thuy Anh N. Melvin, Emily F. Boss, Stacey L. Ishman

Research output: Contribution to journalArticlepeer-review


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.

Original languageEnglish (US)
Pages (from-to)504-509
Number of pages6
JournalInternational Forum of Allergy and Rhinology
Issue number6
StatePublished - Jun 1 2013


  • Allergic rhinitis
  • Obstructive sleep apnea
  • Pediatric
  • Sleep-disordered breathing
  • Snoring
  • Systematic review

ASJC Scopus subject areas

  • Immunology and Allergy
  • Otorhinolaryngology


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