Although the thought of sleeping with millions of dust mites - microscopic arachnids that feast on flakes of skin - is just plain gross, it's something most people can handle without worry. After all, our bodies are inhabited by multitudes of bacteria, to which we seldom give a thought.
For the many people who suffer from allergies, though, the allergens in dust-mite feces and body parts can lead to chronic sinus problems and coughing, among other symptoms. If gone untreated, the problem can escalate to eczema and asthma, particularly in children, according to James Sublett, president-elect of the American College of Allergy, Asthma and Immunology.
"The sooner you intervene, the less likely the problems are to escalate," he said.
Luckily, homes can be made more livable for allergy-sufferers - and less amenable to dust mites - in just a few steps.
About a quarter of Americans suffer from some sort of allergy and of those one-half to two-thirds are sensitive to dust-mite allergens, according to Sublett, making it one of the most common causes of allergies.
"Around the world, dust mites are the most common indoor allergen," said Robert Wood, director of the pediatric allergy and immunology division of Johns Hopkins University.
If dust-mite allergies are suspected, the first step is to get tested by an allergist.
While periodically replacing all your bedding might seem to make sense, experts say it's unnecessary for those without allergies and insufficient for allergy sufferers.
Instead, these tips from allergists can help make any home friendlier to those with indoor allergies, dust mites included:
1. Keep It Dry. "One of the biggest and most common mistakes people make is to install vaporizers and humidifiers," Sublett said. "Moisture can and does cause all kinds of problems." Dust mites can't survive in less than 50 percent humidity, so buy a humidity meter and, if needed, a dehumidifier to keep humidity to between 35 percent and 50 percent. "Just three hours above that level of humidity, though, is enough to keep the dust mites alive," he said.
2. Rip out the rugs and ditch the drapes. Carpet and heavy drapes are a reservoir for allergens like dust mites and should be removed, particularly in bedrooms. If removing them isn't an option, the American College of Allergy, Asthma and Immunology recommends frequent vacuuming using a HEPA (high-efficiency particulate air) filter. Those with allergies should stay away or wear an N95 particulate mask during and immediately after vacuuming, since particles can remain airborne for up to two hours.
3. Just Encase. All mattresses, box springs, pillows and comforters should be encased in well-sealed, tightly woven, microfiber "mite-proof" covers from a reputable company, such as Mission: Allergy or National Allergy Supply, and linens and stuffed animals should be washed weekly, allergists say. "The temperatures and detergents used are much less important than the regularity of washing," Sublett said. "Washing in any temperature dramatically reduces the level of allergens."
4. Opt for smooth. Smooth surfaces that can be wiped clean are generally better for allergy-sufferers than more porous upholstered surfaces on couches, chairs and even car seats, Sublett said.
5. Clear and clean the air. To help keep indoor allergens of any kind at bay, homes should be smoke-free and pets should be kept out of the bedroom. For the very allergy-prone, use a HEPA air filter in the bedroom with a CADR (clean air delivery rate) adequate for the size of the room. Install MERV 11 or 12 disposable, high-efficiency filters in the furnace and air conditioning system that can be changed every few months, according to Sublett. But these steps are less important for those suffering solely from dust-mite allergies, since dust mites burrow deep in bedding and dust-mite particles are generally not airborne.
6. Check the units. Allergists suggest that to minimize indoor allergens, heating and air conditioning units be cleaned and serviced every six months, and that gas appliances and fireplaces be vented to the outside and regularly maintained.