Sleep Apnea and Allergies

allergic rhinitis allergies histamine holidays immune system inflammation leukotriene modifiers nasal congestion nasal corticosteroids obstructive sleep apnea side effects snoring Nov 02, 2024

In the U.S., over 100 million people experience allergies yearly. That means for every three adults, one winds up sneezing, sniffling, or having a more adverse reaction when exposed to a certain substance in the environment.¹

Although allergies are extremely common, they’re not the only widespread health condition affecting Americans. Nearly 39 million adults — about 12 percent of the U.S. population — are believed to suffer from obstructive sleep apnea (OSA).²

Interestingly, research shows that up to 35 percent of adults with OSA also have allergic rhinitis.³ How are these conditions linked? Can managing allergic rhinitis help you manage OSA too? We’ll answer these questions and more in this article:

Allergies and allergic rhinitis
Nasal inflammation and congestion
How does nasal congestion affect sleep?
The link between allergic rhinitis and OSA
Can allergic rhinitis treatments help with OSA?

But first, a quick primer on allergies and allergic rhinitis.

Allergies and allergic rhinitis

An allergy is a chronic condition in which your immune system overreacts to a normally harmless substance. This substance — a foreign protein — is called an allergen. Often, allergies result from eating foods. The top dietary triggers are milk, eggs, fish, shellfish, wheat, peanuts, and soy. Other common allergens are medications, pollen, latex, and insect venom.^4,5

Allergic rhinitis is an allergic reaction to tiny airborne particles. There are two types of allergic rhinitis: seasonal and perennial.^6,7

Seasonal allergic rhinitis (SAR) is triggered by pollen from trees, grasses, and weeds. These allergens exist in the air mainly in the spring and fall. SAR is also known as hay fever. But it’s worth noting that SAR isn’t caused by hay. You don’t typically get a fever from SAR either.⁷

In contrast, perennial allergic rhinitis is caused by allergens present throughout the year. They include mold, dust mites, animal dander, and cockroach debris.⁷

Symptoms of allergic rhinitis affect mainly your nose. After breathing in the allergen, you may sneeze a lot. Your nose may also be runny, stuffy, or itchy. The itching and irritation may affect your eyes, mouth, and throat too.^4,6

Nasal inflammation and congestion

When you breathe in pollen, dust mites, and other allergens in the air, they enter your nasal passages. Your immune system mistakenly views these allergens as a threat, activating a cascade of reactions.^8,9

First, your white blood cells secrete proteins called IgE antibodies. These proteins then bind to special cells called mast cells in your nasal lining. When the allergen binds to the IgE, your mast cells release inflammatory substances including histamine. Histamine, in turn, widens the blood vessels in your nasal lining, promoting the flow of blood to this region. The result is swelling of tissues and congestion in your nose.^8,9

What’s more, your inflamed nasal membranes try to trap and get rid of the allergen by producing mucus. But having too much mucus worsens your nasal congestion.^8,9

How does nasal congestion affect sleep?

Nasal congestion contributes to snoring and disrupts sleep patterns.¹⁰

Congested nasal passages obstruct the flow of air into your nose. So, you’re forced to breathe through your mouth, and you become more likely to snore. Plus, the unstable airflow due to nasal congestion can make the soft tissues in your throat vibrate, leading to the distinctive sound of snoring.¹⁰

What’s more, nasal congestion can lead to repeated awakenings at night, as you struggle to inhale enough air. These short but frequent disruptions prompt shifts from deep to light stages of sleep. Your impaired sleep cycle and fragmented sleep hinder you from resting well, making you feel tired and sleepy the next day.¹⁰

The link between allergic rhinitis and OSA

OSA is a disorder marked by frequent pauses in your breathing during sleep. It stems from the physical obstruction of your upper airway. The breathing interruptions in OSA lead to repeated awakenings and fragmented sleep. In the long term, these sleep issues drive a host of cardiovascular, metabolic, and mental problems. Allergic rhinitis seems to make you more prone to developing OSA in two main ways.^11,12

First, the hampered flow of air to your nose increases negative pressure in your upper airway. This suction-like effect makes the soft tissues in your throat more likely to collapse — and your throat more prone to blockage, contributing to OSA. The tendency for airway obstruction is even stronger when you’re lying down asleep.^10,12

Second, mouth breathing due to allergic rhinitis makes your lower jaw drop and your tongue move backward. These changes narrow your airway and impair the muscles that control it. Breathing through your mouth disrupts your natural breathing reflexes as well. All these events put you at a greater risk of OSA.¹²

Can allergic rhinitis treatments help with OSA?

Research shows that certain medications for allergic rhinitis can also help improve OSA symptoms in people with both conditions.¹²

Nasal corticosteroids have been found to reduce pauses in breathing and episodes of airway collapse per hour in OSA patients. These drugs, which are sprayed into your nose, block inflammatory chemicals. By targeting inflammation, the nasal sprays shrink swollen nasal tissues and decrease mucus. In effect, they allow air to flow through nasal passages more easily.^13,14

Other studies show that leukotriene modifiers can reduce OSA symptoms too. Leukotrienes are signaling molecules. They’re released by your mast cells upon coming in contact with allergens. These proinflammatory substances tighten your airway muscles and make you produce excess mucus. Leukotriene modifiers help manage allergic rhinitis by blocking the effect of leukotrienes, or by stopping your body from making them.^12,15,16

Although medications for allergic rhinitis may be beneficial for OSA, it’s important to note that they have side effects. Nasal corticosteroids may cause dryness, stinging, burning, or infection in your nasal passages. These drugs can also worsen sneezing and promote nosebleeds. Throat irritation and headaches are possible too.¹³

As for leukotriene modifiers, they may bring about cold and flu symptoms, along with ear infections. Intake of these drugs has also been linked to nausea, heartburn, diarrhea, and stomach pain. Skin rashes or hives may be observed as well. More severe side effects include liver damage and mental problems, such as depression, anxiety, insomnia, nightmares, and suicidal thoughts.¹⁶

Conclusion

Allergies, especially to airborne particles, may increase your risk of developing OSA.

Allergic rhinitis causes nasal congestion and mouth breathing. These events can narrow your upper airway and make it more likely to collapse, contributing to OSA.

Some nasal sprays and oral medications for allergic rhinitis have been shown to improve OSA symptoms. But these anti-inflammatory drugs have various side effects.

Fortunately, there are natural, practical ways to fight inflammation. These strategies can benefit your health, whether you struggle with allergies or not. And they’re particularly valuable during the holidays, when festive indulgences and disrupted routines make it tricky to maintain healthy habits. Ready to thrive this holiday season while prioritizing your well-being? Click here to sign up for our Healthy Happy Holidays workshop and navigate the upcoming holiday season with ease and grace!

References

Sleep Apnea and Allergies

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