Allergies, Quality of Life & Sleep
National Kapodistrian University of Athens, Greece
Allergies have only appeared two centuries ago; they have however been increasing ever since and are currently a major public health concern. Atopic dermatitis, asthma and allergic rhinitis affect up to 25% of the population, having a major impact on the quality of life of sufferers. In atopic dermatitis, a defective skin barrier allows external stimuli to initiate inflammation, which is augmented by the allergic immune response, producing mediators that stimulate itch. A disturbed circadian rhythm contributes to inflammation, while key cytokines are upregulated during sleep, leading a large proportion of patients to sleep disturbances.
This is also the case for asthma, where QoL is affected by persistent symptoms and exacerbations. Asthma symptoms are aggravated during the night and early morning; both circadian and behavioral components contribute. Allergic rhinitis is associated with important impairments in vigilance and cognitive functioning. Sleep deprivation and morning drowsiness have an impact on education and work performance. In all conditions, symptoms of the underlying disease (e.g. congestion, itch), inflammatory immune mediators and neuroimmune interactions contribute to sleep disturbance. Disease severity and multimorbidity are major risk/multiplicative factors. Therapeutic interventions improve symptoms and QoL. Additional insight/interventions focusing on sleep are needed.