Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids☆☆☆★★★

Craig, Timothy J.; Teets, S.; Lehman, Erik; Chinchilli, Vernon M.; Zwillich, Clifford

doi:10.1016/s0091-6749(98)70171-x

Cited by 243 publications

(163 citation statements)

References 26 publications

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“…Poorly-controlled symptoms of allergic rhinitis may contribute to sleep loss or disturbance (94)(95)(96)(97)(98)(99)(100)(101)(102)(103)(104). Moreover, H 1 -antihistamines with sedative properties can increase sedation in patients with allergic rhinitis (105,106).…”

Section: 232mentioning

confidence: 99%

See 1 more Smart Citation

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

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Section: 232mentioning

confidence: 99%

“…In children with uncontrolled allergic rhinitis, learning problems occur during school hours either by direct interference or indirectly by nocturnal sleep loss and secondary daytime fatigue (95,114,116). Seasonal allergic rhinitis may be associated with a reduced ability to learn (1111) and to be successful in examinations (1112).…”

Section: Learning Disabilitymentioning

confidence: 99%

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Bousquet¹,

Khaltaev²,

Cruz³

et al. 2008

Allergy

3,867

1,761

View full text Add to dashboard Cite

“…Several lines of clinical evidence also suggest that the nasal obstruction caused by congestion is an important aetiologic factor for sleep-disordered breathing. [10][11][12]23 This article summarises the relationship between ARinduced nasal congestion and sleep disturbances, as well as various treatment options for AR and their relative impact on congestion-related sleep problems.…”

mentioning

confidence: 99%

“…23,24,[71][72][73][74][75][76][77][78][79][80] Two small similarly-designed placebo-controlled crossover trials in patients with perennial AR demonstrated significant trends toward improvements in nasal congestion, subjective sleep, and daytime somnolence (as recorded in daily diaries) with INS (flunisolide in one study and budesonide in the other) vs placebo (Figure 2). 23,24 The INS fluticasone has also significantly improved subjective sleep quality vs placebo (p=0.04) in 32 patients with perennial AR and chronic sleep problems. 72 In this double-blind, randomised, 8-week crossover study, daytime somnolence, daytime fatigue, all categories of the sleep-related QOL Questionnaire (QLQ, rhinoconjunctivitis specific), and the Epworth sleepiness scale (ESS) also improved, but not to a statistically significant extent.…”

mentioning

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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“…5 Furthermore, if left untreated, allergic rhinitis can potentially exacerbate and contribute to asthma 6 as well as other comorbidities such as conjunctivitis, otitis, dental malocclusions, sinusitis, respiratory infections, and learning problems. [7][8][9][10][11][12] Antihistamines have been a valuable allergic rhinitis treatment for decades, and data from studies in adult populations have been widely reported. Although some studies have assessed symptom relief of SAR in children using antihistamines, [13][14][15][16][17][18] including a postmarketing surveillance program, 19 only one study 13 has used the same end points as assessed in adult clinical studies.…”

mentioning

confidence: 99%

Fexofenadine is efficacious and safe in children (aged 6-11 years) with seasonal allergic rhinitis

Wahn¹,

Meltzer²,

Finn³

et al. 2003

Journal of Allergy and Clinical Immunology

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Background: This is the first prospective, randomized, doubleblind, placebo-controlled study showing statistical improvement of an H 1 -antihistamine in children with seasonal allergic rhinitis in all symptoms throughout the entire treatment period. Objective: This randomized, placebo-controlled, parallelgroup, double-blind study was performed to assess the efficacy and safety of fexofenadine in children with seasonal allergic rhinitis. Methods: This study was conducted at 148 centers in 15 countries. Nine hundred thirty-five children (aged 6-11 years) were randomized and treated with either fexofenadine HCl 30 mg (n = 464) or placebo (n = 471) tablets twice a day for 14 days. Individual symptoms (sneezing; rhinorrhea; itchy nose, mouth, throat, and/or ears; itchy, watery, and/or red eyes; and nasal congestion) were assessed at baseline and then daily at 7:00 AM and 7:00 PM (±1 hour) during the double-blind treatment period. Each total symptom score was the sum of all symptoms, excluding nasal congestion. The primary efficacy variable was the change from baseline in the average of the daily 12-hour evening reflective total symptom scores throughout the double-blind treatment. Safety was evaluated from adverse-event reporting, vital signs, physical examinations, and clinical laboratory data at screening and study end point.Results: Fexofenadine was significantly superior to placebo in the primary efficacy analysis (P ≤ .0001). Individual symptom scores showed statistically significant superiority compared with placebo (P < .05), including nasal congestion in the evening reflective assessment (P < .05). There was no significant difference in adverse events between fexofenadine and placebo, either overall or by causality.

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Nasal congestion secondary to allergic rhinitis as a cause of sleep disturbance and daytime fatigue and the response to topical nasal corticosteroids☆☆☆★★★

Cited by 243 publications

References 26 publications

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

Allergic Rhinitis and its Impact on Asthma (ARIA) 2008*

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

Fexofenadine is efficacious and safe in children (aged 6-11 years) with seasonal allergic rhinitis

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