Welcome to the Association of PAs in Allergy, Asthma & Immunology

Bill Sanders, MS, PA-C

This is an interesting and much-needed writeup about sleep considerations for patients with allergy. I was surprised at the high rate of insufficient sleep that a CDC survey found for children (34%) and adolescents (75%). That is significant and underappreciated, I believe. Although it was a small sample size (3.3% response rate), it sheds light on a very important issue.

It wasn’t so surprising to me that many clinicians fail to ask about adequate sleep among their allergy patients. Sleep is probably not a major consideration when practitioners are focusing on diagnoses and treatment. With insufficient sleep being such a problem in the pediatric population as the CDC reports, it makes me wonder how aware pediatricians are of this.

Because we’re accustomed to ask about nighttime cough and wheezing with asthmatics, it is not surprising that respondents inquired most often about sleep in patients with asthma (74% all the time) but less often in those with chronic urticaria/dermatitis and food allergies. The discomfort of those with chronic skin allergies may not be fully appreciated by some specialists (perhaps those with less experience), but these patients often have significant nighttime pruritis that interrupts their sleep.

The difference between those who have been in practice more than 10 years and those in practice less time to ask about obstructive sleep apnea was interesting, likely reflecting the experience one gets in a practice rather than what’s learned in school, residency or fellowship.

I think this report underscores the need for more studies in the awareness, effects and treatment of sleep deprivation. Considering the negative effects of poor sleep, including the reduction of mental clarity and coping mechanisms that can lead to increased stress and potential mental illness, sleep is a necessary topic about which clinicians should inquire.

In my practice, I have the sleep question in the review of systems on my template, so I always ask about sleep with my new patients. I don’t ask about sleep often with my established patients, but after seeing the prevalence in the numbers by the CDC, I will try to ask about it more often.

Bill Sanders, MS, PA-C
Owner and Physician’s Assistant, Allergy & Urgent Care
President, Association of PAs in Allergy, Asthma & Immunology

Disclosures: Sanders reports no relevant financial disclosures.