Left untreated, allergies can interfere with sleep and limit patient quality of life.
They not only disrupt daytime activities but can also lead to sleep issues that prevent patients from getting a full seven to nine hours of sleep. Lack of sleep can compound allergy symptoms by leaving patients more susceptible to other illnesses and conditions that further compromise quality of life. Health care professionals and clinicians have the opportunity to create a partnership with patients so they can effectively manage their condition and live a full active life.
The Dangers of Sleep Deprivation
The tendrils of sleep deprivation reach and affect most aspects of a patient’s life. Sleep deprivation is defined as any time one gets less than the recommended minimum of seven hours of sleep with some restricting that definition to six hours or less of sleep. Definitions aside, patients who don’t get enough sleep experience a long list of symptoms and face long-term consequences that extend beyond the potential of more allergy symptoms.
Without enough sleep, changes take place in the emotional state of the brain. The amygdala, where emotionally salient information is processed, becomes more active and responsive to negative events, thoughts, and emotions.1 The increase in the reactivity of the amygdala often amplifies stress and anxiety. Concurrently, activity goes down in the prefrontal cortex, the portion of the brain responsible for executive functions such as decision-making, logic, and reasoning. These changes alone may make it difficult for patients to successfully manage their allergy symptoms. They may become more likely to overreact when symptoms become problematic, further complicating their situation.
Sleep deprivation also causes metabolism changes. Ghrelin levels, which control hunger, increase while leptin levels, which trigger satiety, go down.2 Lack of sleep also activates the endocannabinoid system, which increases the rewards the brain receives from foods high in fat and sugar.3 Together, these changes can lead to unwanted weight gain and the development of illnesses and conditions such as obesity, diabetes, heart disease, and hypertension.
Sleep deprivation also causes changes in human growth hormone levels, which can affect growth in children and muscle building and recovery in adults.4 An alteration in sleep patterns can also interfere with the immune system and cell regeneration because of their close relationship with circadian rhythms. Without sleep, energy levels go down and the immune system doesn’t have time to regenerate, making patients more susceptible to illness.5
These issues together reduce quality of life and can contribute to a continuing cycle of sleep deprivation and poor health.
Reducing Exposure to Allergens to Increase Sleep Quantity and Quality
Allergy sufferers are twice as likely to experience insomnia or similar sleep disorders.6 Healthcare professionals can help patients reduce exposure to allergens for better sleep outcomes. The first step is identifying which allergens the patient is most likely to be exposed to. Some geographical regions and climates lend themselves to certain allergens, which can help narrow down the source. Others may be seasonal, necessitating knowledge of the local pollens and pollen counts. The most common allergens are pollen, pet dander, dust mite fecal matter, cockroaches, and mold/fungus.
Dust Mites and Dust Mite Fecal Matter: Dust mites thrive in humid conditions located where humans shed a lot of skin cells. Mattresses, pillows, carpets, and upholstered furniture are the most common places for dust mites to hide. Ways to reduce exposure include:
- Reducing humidity to 40 to 45 percent, using a dehumidifier
- Washing bedding and stuffed animals in temperatures over 130 degrees (hot cycle)
- Hypoallergenic mattress and pillow covers
- Hanging washable curtains
- Dusting shades and blinds
- Frequently vacuuming with a vacuum equipped with microfiltration bags
Cockroaches and Cockroach Fecal Matter: Cockroaches can be difficult to eliminate, especially in multifamily dwellings. They like wet, dark areas as well as easily accessible food sources. Their habitat can be eliminated by:
- Storing all open food in the refrigerator or in airtight storage containers
- Properly cleaning and sanitizing food prep areas
- Keeping all food consumption in the kitchen and/or dining room
- Repairing any leaky pipes
- Wrapping pipes that may attract moisture with insulation
- Ventilating all areas where moisture may build up
- Bait traps in areas where cockroaches are prone to hide (keep out of reach of children)
Pet Dander: The easy solution is to not have a pet. However, many patients have bonded with and love their pet as a member of the family. To successfully reduce nighttime allergies, however, certain precautions can help, like:
- Keeping pets outside, if at all possible
- Restricting pets to certain rooms that have washable floors and hard, easily washed surfaces
- Banning pets from the bedroom
- Keeping bedroom doors closed at all times as pet dander can become attached to walls and furniture
- Covering heating and cooling vents with a high-efficiency particulate air (HEPA) filter
- Washing pets weekly
- Washing all hands and clothes after handling the pets
Airborne Allergens – Pollen, Fungus, and Mold: These allergens are often seasonal, which means precautions only need to be taken at certain times of the year. However, once one has been eliminated another may bloom, and the process could start all over again. Precautions include:
- Cleaning away molds as soon as they appear
- Assure proper ventilation to limit moisture
- When pollen counts are high, stay indoors with windows closed
Creating a Partnership with Patients
A collaboration between patients and healthcare professionals is one of the most effective ways to reduce exposure to the allergens that interfere with sleep. Educating patients about the benefits that come from reducing allergens is paramount. Open communication, trust, and the ability to listen to patient concerns can help as clinicians work to improve patient quality of life.
Try asking patients about their personal goals. How are sleeplessness or allergies limiting their activity? What would they like to be able to do that they currently cannot? How are sleep disruptions affecting their daily life? These questions can help clinicians work with patients to discover and establish goals. Patients are more likely to develop the kind of habits and attitudes that will improve their sleep when control is given to them through adequate information. Patients who write down their management plans, either on paper or electronically, are more likely to follow through, as they have a visual reminder of their goals and the steps needed to accomplish them.
Patients who are well-educated in self-management experience higher levels of long-term success. With better sleep comes the ability to make better decisions about all aspects of life, including further management of allergies.
- Yoo, et al. The human emotional brain without sleep – a prefrontal amygdala disconnect. Current Biology. 2007; 17(20); R877-R878.
- Klok, MD, Jakobsdottir S, Drent ML. The role of leptin and ghrelin in the regulation of food intake and body weight in humans: a review. Obesity reviews: an official Journal of the International Association for the Study of Obesity. 2007; 8(1); 21-34.
- Hanlon EC, et al. Sleep restriction enhances the daily rhythm of circulating levels of endocannabinoid 2-Arachidonoylglyerol. Sleep. 2016; 39(3); 653-664.
- Van Cauter, E, Plat L. Physiology of growth hormone secretion during sleep. The Journal of Pediatrics. 1996; 128(5 Pt. 2); S32-S37.
- Schmidt, et al. Circadian control of DRP1 activity regulates mitochondrial dynamics and bioenergetics. Cell Metabolism. 2018; 27(3); P657-P666.
- Damien L., et al. Allergic rhinitis and its consequences on quality of sleep. Arch Intern Med. 2006; 166(16); 1744-1748.