RESUMEN
OBJECTIVE: Allergic rhinitis (AR), a prevalent global health concern, is increasingly recognized for its impact beyond physical symptoms, affecting mental health. This research examined the extent of AR's psychological burden and sleep disturbances. METHODS: A systematic search of four databases yielded 49 studies reporting mental health problems in 18,269,265 individuals (15,151,322 AR patients and 3,117,943 controls). The primary outcomes included all mental health problems in AR patients. Subgroup analyses based on outcome and AR severity, country, AR diagnosis, recruitment setting, and age were performed. Secondary outcomes included the risk of these problems compared to controls (healthy or without AR). RESULTS: In AR, depression (25%), anxiety (25%), stress (65%), distress (57%), suicidal thoughts (14%) and attempts (4%), poor sleep quality (48%), insomnia (36%), sleep impairment (33%), and insufficient sleep duration <7 h (59%) were prevalent. The severity of these outcomes differed significantly. Patients' country, AR diagnostic method, recruitment method/setting, and age group were significant effect modifiers. Compared to controls, AR resulted in significantly higher risk of depression, anxiety, stress, suicidal attempts and thoughts, insomnia, and sleep impairment. CONCLUSION: AR patients had significantly lower sleep duration. Mental health problems are very common among AR patients, further exacerbating their sleep quality and duration and intention to suicide.