Effect of second-generation antihistamines on nighttime sleep and daytime sleepiness in patients with allergic rhinitis

Sleep Breath. 2023 Dec;27(6):2389-2395. doi: 10.1007/s11325-023-02857-6. Epub 2023 Jun 29.

Abstract

Background: The daytime tiredness experienced by the vast majority of allergic rhinitis (AR) sufferers is directly related to the fact that they experience disrupted sleep at night. This study compared the effects of recently marketed second-generation H1 antihistamines (SGAs) on nighttime sleep and daytime sleepiness in patients with AR, with patients grouped into those taking non-brain-penetrating antihistamines (NBP group) and those taking brain-penetrating antihistamines (BP group).

Methods: Patients with AR completed self-administered questionnaire-based surveys to determine Pittsburgh Sleep Quality Index (PSQI) before and after taking SGAs. Statistical analysis was performed on each evaluation item.

Results: Of 53 Japanese patients with AR between 6 and 78 years old, median (SD) age was 37.0 (22.4) years old and 21 were men (40%). Of the 53 patients, 34 were the NBP group and 19 were the BP group. In the NBP group, mean (SD) subjective sleep quality score after medication was 0.76 (0.50), which was significantly lower (better) than the score of 0.97 (0.52) before medication (p = 0.020). In the BP group, mean (SD) subjective sleep quality score after medication was 0.79 (0.54), which was not significantly different from the score of 0.74 (0.56) before medication (p = 0.564). In the NBP group, mean (SD) global PSQI score was 3.47 (1.71) after medication, which was significantly lower (better) than the score of 4.35 (1.92) before medication (p = 0.011). In the BP group, mean (SD) global PSQI score was 2.47 (2.39) after medication, which was not significantly different from the score of 3.00 (2.71) before medication (p = 0.125).

Conclusion: Subjective sleep quality and global PSQI score were improved only in the group taking non-brain-penetrating SGAs.

Keywords: Allergic rhinitis; Daytime sleepiness; Nighttime sleep; Questionnaire self-survey; Second-generation H1 antihistamine; Sleep quality.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Child
  • Disorders of Excessive Somnolence*
  • Fatigue
  • Female
  • Histamine H1 Antagonists, Non-Sedating* / pharmacology
  • Humans
  • Male
  • Middle Aged
  • Rhinitis, Allergic* / drug therapy
  • Sleep
  • Young Adult

Substances

  • Histamine H1 Antagonists, Non-Sedating