When inhalant allergies (i.e., “hay fever”) affect the nasal passages it is known as allergic rhinitis. Swelling of the nasal lining associated with allergic rhinitis leads can lead to turbulent airflow with snoring as a consequence. Several studies have suggested a link between allergic rhinitis and OSA; with allergic rhinitis as a risk factor for OSA (obstructive sleep apnea). This link is likely based on the fact that nasal airway resistance accounts for two-thirds of total airway resistance. When the nasal airway becomes blocked as a result of allergic-swelling, total airway resistance increases. Some studies have shown improvement in OSA parameters after medical treatment of allergic rhinitis. For these reasons, allergy testing should be part of the evaluation of most patients with complaints of snoring and sleep apnea.
Allergy testing is now simple, quick, and easy. While some patients are best tested with standard “prick” testing, many patients can easily be tested with a simple blood test (RAST test). For those patients who do have allergies, there are many management options available. Oral antihistamines, nasal anti-histamines and nasal steroid sprays – along with several other medicines – are effective options for many patients. These treatments will often improve or control patient symptoms; however, they must be taken on a regular basis as long as the triggering allergen (ie-dust mites, cats, ragweed, etc.) is present. Unlike allergy pills and sprays, immunotherapy is designed to “cure” patients of their allergies. Immunotherapy comes in two forms: 1) allergy shots and SubCutaneous ImmunoTherapy – SCIT and 2) allergy drops. (SubLingual ImmunoTherapy – SLIT).
Each of these options has “pros” and “cons.” Allergy treatments are effective; however, there is an associated level of inconvenience since most allergists require patients to come in to their office on a weekly basis to have their shot administered, and sometimes to wait a short time in case of reaction. Allergy drops are also effective, and are placed under the tongue six days/week by the patient at home. In short, there are many treatment options for patients with allergies, and these treatments can and should be tailored to each patient’s particular symptoms and needs.