NASAL CONGESTION SECONDARY TO ALLERGIC RHINITIS AS A CAUSE OF SLEEP DISTURBANCE AND DAYTIME FATIGUE AND THE RESPONSE TO TOPICAL NASAL CORTICOSTEROIDS

Background: Allergic rhinitis (AR) is a frequent disease affecting up to 20% of the population. AR causes a hypersensitivity reaction, which results in inflamed nasal mucosa and nasal congestion. Negative press ure generated during inspiration in the nasal airway secondary to nasa l congestion may lead to nasal collapse, airway obstruction, and an in creased number of sleep microarousals. Sleep disturbances and microaro usals can detrimentally affect daytime energy levels, mood, and daytim e function. It is unknown whether treatment directed to reduce congest ion may reduce these microarousals, sleep problems, and, consequently, associated daytime fatigue. Objective: We sought to determine whether reducing nasal congestion with nasal steroids will reduce sleep compl aints and daytime sleepiness. Method: We enrolled 20 subjects in a dou ble-blind, placebo-controlled study using Balaam's Design. Patients we re treated with topical nasal corticosteroids or placebo. Subjective d ata were collected by use of a daily diary, which focused on nasal sym ptoms, sleep, and daytime sleepiness. Results: The results demonstrate d that nasal congestion and subjective sleep improved significantly in the topical corticosteroid-treated subjects but not in the placebo gr oup. Sleepiness improved, but not significantly (p = 0.08). Conclusion : Often, people with perennial allergies may attribute their daytime f atigue to causes such as the side effects of medications, when in fact , the fatigue may be a result of nasal congestion and associated sleep fragmentation. Decreasing nasal congestion with nasal steroids may im prove sleep, daytime fatigue, and the quality of Life of patients with AR.