Bülent ÇİFTÇİ, Eylem YILDIRIM, Yavuz Selim İNTEPE

UYKU ve ALLERJİK HASTALIKLAR

Astım, alerjik rinit (AR) ve atopik dermatit (AD) gibi atopik hastalıklar, uyku kalitesini etkileyen veuykuda solunum bozukluklarının patogenezinin bir parçası olabilen hastalıklardır. Kortizol seviyelerinin gece saatlerinde düşerek inflamatuvar sitokin seviyelerinin etkilenmesi ile astımlı hastalarda hava yolu obstrüksiyonu, AR hastalarında burun tıkanıklığı ve AD’li hastalarda kaşıntı hissigece boyu artar ve sabaha karşı zirve yapar. İnflamatuvar sitokinlerin apne hipopne oluşumunudirekt olarak arttırması yanısıra AR’de nazal obstrüksiyonun hava yolu kollapsını arttırması veastımın obstrüktif uyku apne sendromu (OSAS) ile aynı predispozan faktörleri (örn. obezite) taşıması, atopik hastalıklar ve OSAS birlikteliğinde patogenezde düşünülmektedir. OSAS ile atopikhastalıklar arasındaki ilişki ile ilgili çalışmalar azdır. Yine de güncel çalışmalar, OSAS ve allerjik hastalıkların bir arada bulunmasının, birbirlerinin semptomlarını şiddetlendirdiğini ileri sürmektedir.Özellikle, yeterli tedavi almasında rağmen kontrol altında olmayan astım hastalarında OSASaraştırılması ve tersine OSAS’lı hastalarda tedavinin etkinliğinin arttırılması için rinit ve astımıntedavi edilmesi gerekmektedir.

Sleep and Allergic Disorders

Atopic diseases, such as asthma, allergic rhinitis (AR) and atopic dermatitis (AD), are common conditions that can affect sleep quality and can be part of the pathogenesis of sleep breathing disorders. Airway obstruction in patients with asthma, nasal congestion in patients with AR, and an increased sensation of itching for patients with AD, are often worse overnight and peak at early morning hours because of the decrease in cortisol levels at night that affects inflammatory cytokines. In addition to enhancing apnea and hypopnea formation of inflammatory cytokines, nasal obstruction that increase airway collapse in AR and same predisposing factors (i.e. obesity) of asthma and OSA are thought to be involved in pathogenesis. The association between obstructive sleep apnea (OSA) and atopic conditions has been minimally studied. Nevertheless current studies suggests that coexisting OSA and allergic diseases may exacerbate each others symptoms. In particular in patients with difficult to control asthma despite the adequate treatment, OSA should be investigated and vice versa rhinitis and asthma should be treated in patients with OSA.

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