Allergic rhinitis and associated symptomatic nasal obstruction negatively affect sleep through a variety of mechanisms and may contribute to persistent symptoms and poor adherence with medical device therapy for sleep apnea. A history of sinonasal symptoms, particularly those that occur at night or in the supine position, is the cornerstone of the medical evaluation. Further research into the relationship between allergic rhinitis and sleep disturbance would benefit from improved anatomic and pathophysiologic phenotyping as well as more advanced outcome measures such as spectral electroencephalogram analysis or other polysomnography variables beyond the apnea-hypopnea index.