By Dr. Paul Ehrlich
Spring is in the air, and business at our office is humming. At this time of the year, we not only see lots of patients, but receive requests from the media to answer questions. Year in year out, the advice doesn’t change much—avoid pollen if you can, take antihistamines and maybe nasal steroids, and think about getting immunotherpy–allergy shots. This year there are a couple of tablets on the market, which Larry has written about. The tenor of most discussion is highly familiar. People muddle through the season with the excuse, allergies are annoying, but it’s “only” allergies. This too shall pass.
So what is new? Maybe something old. That is, something we have known about for a long time but rarely enters the discussion, and that is the effects of seasonal allergies on your kids’ schoolwork. Are your children having trouble living up to their potential in school? These are the kinds of things I tell pediatricians in my lectures (conveniently borrowed from the pages of our book, Asthma Allergies Children: a parent’s guide):
• Children with perennial allergic rhinitis have significant sleep disturbance.
• Disruption of nighttime sleep impairs daytime wakefulness, cognitive functioning, psychomotor speed and coordination, and mood.
• The presence of nasal congestion associated with allergic rhinitis is a risk factor for obstructive sleep apnea.
• A study of 39 children with habitual snoring found the frequency of obstructive sleep apnea was 50 percent greater for allergic than nonallergic subjects.
• In a study of fifty-four first graders with obstructive sleep apnea, twenty-four underwent tonsillectomy and adenoidectomy. The mean grades of treated students during the second grade increased significantly. No academic improvement occurred in the untreated group.
• A survey of 400 parents with allergic and nonallergic children found that allergic children were significantly more withdrawn and drowsy.
• A common problem in allergic rhinitis is inflammation and fluid in the Eustachian tubes, the tubes that go from the nasopharynx to the middle ear, which was found to be strongly related to inattentiveness and over-talkativeness.
This is an era of hyper emphasis on academics. Even non-classroom activities, especially sports, are organized to the point of becoming stepping-stones to college from the earliest ages. As a pediatrician, I don’t always like what I see in the way of pressure to achieve, but as an allergist, I don’t like to think that kids are running behind because their noses are clogged and they are exhausted from sneezing all night, that they go off to school unrested, inattentive, and disruptive. It is even worse when asthma is also a factor.
I also don’t like it that the symptoms of sleep deprivation, not just from allergies but behavior like late nights in front of computer and TV screens, are nearly identical to those that teachers and caregivers are taught to look for as signs of ADHD. The attention-deficit industry has been more diligent in promoting their products than allergists have been in promoting treatment, but some of these children need Claritin, not Ritalin. They need Allegra, not Adderall. Many of them would benefit from immunotherapy, which is as close as we have come to a proven cure for allergies.
The problem is not confined to springtime. Environmental allergies have other seasons. When your child goes to school for the first time, dusty mats come out of the closet at nap time. When the heating season starts allergens in mouse droppings in heating ducts are propelled into sealed classrooms. Likewise allergens from class pets are trapped by closed windows, and your allergic child’s immune system is activated.
Again, this is not new. It is old, but it is sadly neglected. There is no such thing as “only allergies”.
Image by pollentec.com