Effect of topical nasal azelastine on the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis

Golden, Stanley; Teets, S.; Lehman, Erik; Mauger, Elizabeth A.; Chinchilli, Vernon M.; Berlin, Joshua M.; Kakumanu, Sujani; Lucus, Timothy; Craig, Timothy J.

doi:10.1016/s1081-1206(10)62434-9

Cited by 44 publications

(29 citation statements)

References 16 publications

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“…Nonsedating oral antihistamines are widely used to treat AR and relieve nasal symptoms such as rhinorrhea, sneezing, and pruritus but have less effect on nasal congestion, although some studies have shown an improvement in sleep and quality of life following therapy with an oral or topical antihistamine [58,59]. Although nonsedating antihistamines are tolerated well and often improve sleep and quality of life, data have suggested that the increased sedation secondary to firstgeneration antihistamines and topical intranasal administration of sedating antihistamines may exacerbate daytime somnolence [58,59].…”

Section: Effects Of Therapymentioning

confidence: 99%

Congestion and Sleep Impairment in Allergic Rhinitis

Craig

Sherkat

Safaee

2010

Curr Allergy Asthma Rep

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Allergic rhinitis is a prevalent disease in developed nations, and its prevalence has been increasing throughout the world. Nasal congestion is the most common and bothersome symptoms of rhinitis. Congestion is associated with sleep-disordered breathing and is thought to be a key cause of sleep impairment in individuals with rhinitis. The end result is a decrease in quality of life and productivity and an increase in daytime sleepiness. Treatment with intranasal corticosteroids has been shown to reduce nasal congestion. Data on sleep-related end points from clinical trials of intranasal corticosteroids indicate that this reduction is associated with improved sleep, reduced daytime fatigue, and improved quality of life. Other therapies, such as montelukast, also have a positive influence on congestion and sleep. This review examines nasal congestion and the associated sleep impairment of allergic rhinitis patients. It explores the adverse effects of disturbed sleep on quality of life and how these conditions can be reduced by therapies that decrease congestion.

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Section: Effects Of Therapymentioning

confidence: 99%

Congestion and Sleep Impairment in Allergic Rhinitis

Craig

Sherkat

Safaee

2010

Curr Allergy Asthma Rep

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“…42,53,54 Azelastine, an intranasal antihistamine with anti-inflammatory properties, has reduced nasal congestion and improved subjective sleep quality in small studies, but was also found to cause somnolence. 55,56 Decongestants are sympathomimetic drugs that constrict capacitance vessels in the turbinates and decrease nasal congestion. 46 Intranasal formulations act quickly, but their utility is limited by congestion rebound (rhinitis medicamentosa) that can occur after just a few days of regular use.…”

Section: 24mentioning

confidence: 99%

Allergic rhinitis-induced nasal congestion: its impact on sleep quality

Storms¹

2008

Primary Care Respiratory Journal

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Allergic rhinitis (AR) is an extremely common health problem affecting 20 to 40 million Americans and between 10-25% of the world's population. Patients with AR suffer from both nasal symptoms (congestion, rhinorrhea, itching, and sneezing) and ocular symptoms (itching, redness, and tearing). The negative impact on sleep quality and quantity, and consequently on various aspects of the patient's life, is an under-recognised and under-treated component of AR morbidity. Nasal congestion, which is one of the most bothersome and prevalent symptoms of AR, is thought to be the leading symptom responsible for rhinitis-related sleep problems.In addition to reducing clinical symptoms, pharmacologic therapies for AR that specifically reduce inflammatory cells and mediators -and therefore nasal congestion and other symptoms -should also improve sleep quality and overall quality of life (QOL). Intranasal corticosteroids (INS) are the current mainstay of therapy for AR. Results of a number of clinical trials demonstrate that INS effectively reduce nasal congestion and ocular symptoms, improve sleep quality, and decrease daytime somnolence. Intranasal corticosteroids have also proved to be effective in reducing symptoms of acute rhinosinusitis and nasal polyposis, both of which also negatively impact on sleep quality. Intranasal corticosteroids are considered safe due to their low systemic bioavailability.

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“…Azelastine used topically reduced rhinorrhea but failed to reduce congestion in one study, 44 although not in another. 45 Thus the debate on the benefits of antihistamines on nasal congestion continues. Because antihistamines are not historically very effective against congestion, they are often combined with a decongestant.…”

Section: Therapy Of Allergic Rhinitis Improves Associated Sleep Distumentioning

confidence: 99%