Allergic Diseases and Cognitive Impairment
Sneezing, wheezing, watery eyes and runny nose aren't the only symptoms
of allergic diseases. Many people with allergic rhinitis also report
feeling "slower" and drowsy. When their allergies are acting up, they
have trouble concentrating and remembering.
For instance, allergic rhinitis can be associated with:
- Decreased ability to concentrate and function
- Activity limitation
- Decreased decision-making capacity
- Impaired hand-eye coordination
- Problems remembering things
- Irritability
- Sleep disorders
- Fatigue
- Missed days at work or school
- More motor vehicle accidents
- More school or work injuries
Many
parents of children with allergic rhinitis observe increased bad moods
and irritability in their child's behavior during the allergy season.
Since children cannot always express their uncomfortable or painful
symptoms verbally, they may express their discomfort by acting up at
school and at home. In addition, some kids feel that having an allergic
disease is a stigma that separates them from other kids.
It
is important that the irritability or other symptoms caused by ear,
nose or throat trouble are not mistaken for attention deficit disorder.
With proper treatment, symptoms can be kept under control and
disruptions in learning and behavior can be avoided.
Causes
Experts
believe the top two culprits contributing to cognitive impairment of
people with allergic rhinitis are sleep interruptions and over the
counter (OTC) medications.
Secondary
factors, such as blockage of the Eustachian tube (ear canal), also can
cause hearing problems that have a negative impact on learning and
comprehension. Constant nose blowing and coughing can interrupt
concentration and the learning process, and allergy-related absences
can cause people to miss school or work and subsequently fall behind.
Sleep Disruption
Chronic
nasal congestion can cause difficulty in breathing, especially at
night. Waking is a hard-wired reflex to make you start breathing again.
If you have bad allergic rhinitis, you may waken a dozen times a night.
Falling back asleep can be difficult, cutting your total number of
sleep hours short.
The
average person needs about eight hours of sleep per night to function
normally the next day. Losing just a few hours of sleep can lead to a
significant decrease in your ability to function. Prolonged loss of
sleep can cause difficulty in concentration, inability to remember
things, and can contribute to automotive accidents. Night after night
of interrupted sleep can cause serious decreases in learning ability
and performance in school or on the job.
Over-the-Counter Medications
Most
allergy therapies don't take into account the effects of allergic
rhinitis on mental functioning — they treat the more obvious physical
symptoms. Some allergy therapies may even cause some cognitive or
mental impairment.
In
a recent poll in which allergy sufferers were asked how they treat
their symptoms, about 50 percent responded that they use
over-the-counter (OTC) medications. The most commonly used OTC
medications for allergy symptoms are decongestants and antihistamines,
both of which can cause sleep disturbances.
Decongestants Decongestants
constrict small blood vessels in the nose. This opens the nasal
passageways and lets you breathe easier. Some decongestants are
available over-the-counter, while higher strength formulas are
available with a prescription. In some people, oral decongestants can
cause problems with getting to sleep, appetite loss and irritability,
which can contribute to allergy problems. If you have any of these
symptoms, discuss them with your doctor.
Antihistamines Antihistamines
block the effects of histamine, a chemical produced by the body in
response to allergens. Histamine is responsible for the symptoms of
allergic rhinitis, including an itchy runny nose, sneezing and itchy
eyes. OTC antihistamines are an inexpensive choice when it comes to
treating the symptoms of an allergy, but some OTC antihistamines also
can cause drowsiness. Regularly taking OTC antihistamines can lead to a
feeling of constant sluggishness, affecting learning, memory and
performance.
Non-sedating antihistamines, such as Allegra®
(fexofenadine), are available with a prescription. These antihistamines
are designed to minimize drowsiness while still blocking the effects of
histamine.
Solutions
With
all the allergic diseases, the best way to control your symptoms is to
avoid coming into contact with your triggers (the substances that cause
you to have an allergic reaction). This is often easier said than done.
Sometimes it is impossible to avoid the substances that cause symptoms,
especially when you are not in control of your environment.
If
your allergens can't be avoided, your doctor can help you to create an
allergy treatment plan. People who are allergic to indoor things like
dust mites or animal dander may need medication on a daily basis, while
people who have seasonal symptoms may only need treatment at certain
times during the year. An allergist-immunologist can help you determine
to which substances you are allergic.
Several
types of non-sedating medications are available to help control
allergies. In addition to the antihistamines discussed above, your
doctor also may prescribe nasal steroid sprays to treat nasal
inflammation. Nasal steroid sprays are highly effective in treating
allergy symptoms. The most common side effect associated with nasal
sprays is headache.
If
medications are not effective or cause unwanted side effects, your
doctor may suggest immunotherapy, or "allergy shots." Immunotherapy is
used to treat allergy to pollen, ragweed, dust mites, animal dander and
other allergens. This process gradually desensitizes you to these
substances by changing the way that your body's immune system responds
to them. For example, if you are allergic to ragweed, immunotherapy
treatments would involve injecting a tiny amount of ragweed pollen
extract under your skin every week. Immunotherapy treatments usually
last three to five years or longer. Once your body is able to tolerate
the substance without producing the symptoms of an allergy,
immunotherapy can be stopped, and the need for oral medications should
be gone or greatly reduced.
Remember
If
allergies are affecting your ability to concentrate or function,
several treatment options may be beneficial. Getting allergy symptoms
under control can help you sleep at night and function during the day.
If
you suspect that you or a family member may have an allergic disorder,
make an appointment with your doctor for proper diagnosis. Treating
allergies sooner rather than later can help prevent disruptions in
learning and behavior.
© Copyright Medem, Inc. and American College of Allergy, Asthma and Immunology
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