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Disturbed sleep: linking allergic rhinitis, mood and suicidal behavior
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Recent research has consistently shown an association between inflammation and sleep, with Th1 cytokines promoting NREM sleep and increasing sleepiness and Th2 cytokines (produced during allergic inflammation) impairing sleep. As sleep impairment is considered a treatable suicide risk factor strongly associated with mood disorders, we review the literature leading to the hypothesis that allergic rhinitis may lead to mood and anxiety disorders and an increased risk of suicide via worsening sleep. Allergic rhinitis can impair sleep through mechanical (obstructive) and molecular (cytokine production) processes. The high prevalence of mood and anxiety disorders and allergy, the nonabating suicide incidence, the currently available treatment modalities to treat sleep impairments and the need for novel therapeutic targets for mood and anxiety disorders justify multilevel efforts to test and better understand this pathophysiological link where, relatively limited if timely, interventions may have large beneficial effectgs.