Storms William, Yawn Barbara, Fromer Leonard
The William Storms Allergy Clinic, Colorado Springs, CO, USA.
Curr Med Res Opin. 2007 Sep;23(9):2135-46. doi: 10.1185/030079907X219607.
Patients with inflammatory disorders of the upper airways, such as allergic rhinitis, rhinosinusitis, and nasal polyposis, often have significant sleep disturbances. Poor sleep can lead to fatigue, daytime somnolence, impaired daytime functioning as reflected in lower levels of productivity at work or school, and a reduced quality of life. Although the exact mechanisms by which these inflammatory nasal conditions disturb sleep is not fully understood, congestion appears to be a key factor and is generally the most common and bothersome symptom for patients with these conditions. Successful therapy should improve patients' sleep and well-being without introducing any negative effects on sleep. SCOPE OF LITERATURE SEARCH: Literature searches of Medline, Embase, and abstracts from medical/scientific conferences were conducted for the period of 1995 through mid-2006 for primary and review articles and conference presentations about sleep disturbance related to allergic rhinitis, rhinosinusitis, and nasal polyposis. These searches also sought to identify articles examining how treatments for those diseases improved sleep and, consequently, patients' quality of life. Surveys of the impact of congestion on patients' quality of life and their sleep also were consulted. Clinical studies were selected for discussion if they were randomized, double-blind, and placebo-controlled. Limitations of this review include the absence of any direct comparisons of the effectiveness of different drugs on improving sleep and shortcomings in the statistical methods of the patient surveys.
Intranasal corticosteroids (INSs) are the most effective medication for reducing congestion in patients with inflammatory nasal conditions. There is a growing amount of evidence that a reduction in congestion with INSs is associated with improved sleep, reduced daytime sleepiness, and enhanced patient quality of life.
Relief of sleep impairment associated with inflammatory disorders of the nose and sinuses can be addressed with INS therapy.
患有上气道炎症性疾病的患者，如过敏性鼻炎、鼻窦炎和鼻息肉病，常常存在严重的睡眠障碍。睡眠不佳会导致疲劳、日间嗜睡、工作或学习效率降低所反映出的日间功能受损，以及生活质量下降。尽管这些炎性鼻部疾病干扰睡眠的确切机制尚未完全明了，但鼻塞似乎是一个关键因素，并且通常是这些疾病患者最常见、最困扰的症状。成功的治疗应改善患者的睡眠和健康状况，而不会对睡眠产生任何负面影响。
对1995年至2006年年中期间的Medline、Embase以及医学/科学会议摘要进行文献检索，以查找有关与过敏性鼻炎、鼻窦炎和鼻息肉病相关的睡眠障碍的原始文章、综述文章及会议报告。这些检索还旨在找出研究这些疾病的治疗方法如何改善睡眠以及进而改善患者生活质量的文章。还查阅了关于鼻塞对患者生活质量及其睡眠影响的调查。如果临床研究是随机、双盲且安慰剂对照的，则选择进行讨论。本综述的局限性包括缺乏对不同药物改善睡眠有效性的任何直接比较，以及患者调查统计方法的缺陷。
鼻内用糖皮质激素（INSs）是减轻炎性鼻部疾病患者鼻塞最有效的药物。越来越多的证据表明，使用INSs减轻鼻塞与改善睡眠、减少日间嗜睡以及提高患者生活质量相关。
INS治疗可缓解与鼻和鼻窦炎性疾病相关的睡眠损害。
