Allergies and Obstructive Sleep Apnea

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In my dental practice, I often screen patients for sleep breathing disorders such as obstructive sleep apnea. If I suspect a problem after my oral examination, I often start the conversation by asking, “are you aware that you snore whenever you sleep? or “do you often feel unrefreshed in the mornings when you wake up?” Often, my patients respond by saying, “yes, but only when I have bad allergies.”

How do seasonal allergies affect your sleep?

In general, seasonal allergies are thought to disrupt normal, healthy sleep. Allergies usually cause nasal congestion and impair nasal breathing at night. The nasal passages then to swell up and cause the upper airway to narrow. The result is a blocked or partially blocked airway. This condition can lead to “apneas” — the cessation of breathing during sleep that characterizes obstructive sleep apnea.

For those who suffer from chronic allergies, reactions may cause the tonsils and adenoids to swell and enlarge. The enlargement of these soft tissue structures can cause an obstructed airway, potentially increasing the risk of developing sleep apnea.

In patients with allergic rhinitis, obstructive sleep apneas are longer and more frequent compared to patients without those conditions.1 Allergies generally are not the direct cause of sleep apnea, but they tend to exacerbate the problem. As a general rule, reducing allergic reactions can help improve sleep quality.

In mild cases of obstructive sleep apnea, nasal steroids such as Flonase, could improve symptoms, but cases of moderate or severe obstructive sleep apnea typically require further medical treatment such as CPAP or a sleep apnea oral device to keep the airway unobstructed during sleep.

  1. McNicholas WT, et al. “Obstructive Apneas during sleep in patients with seasonal allergic rhinitis.” Am Rev Respir Dis. 1982 Oct; 126(4):625-8. Retrieved from (accessed February 14, 2014).