Rhinitis, sinusitis, and ocular diseases
How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis?

https://doi.org/10.1016/j.jaci.2005.10.009Get rights and content

Therapy for rhinitis improves sleep quality and symptoms of daytime sleepiness. This improvement with therapy may be secondary to anti-inflammatory effects, leading to a reduction of inflammatory mediators, or to a mechanical reduction of congestion directly leading to improvement in sleep disturbance. We combined our data from 3 placebo-controlled studies of intranasal corticosteroids in patients with perennial rhinitis to determine whether a correlation between the reduction of congestion and improved sleep and daytime somnolence existed. The pooled data of budesonide, flunisolide, and fluticasone demonstrated significantly decreased nasal congestion, sleep problems, and sleepiness in treated patients. The data demonstrated a correlation between a reduction in nasal congestion and an improvement of sleep (P < .01) and daytime somnolence (P = .01). Thus, topical intranasal corticosteroids should be used to decrease nasal congestion and to improve sleep and daytime somnolence in patients manifesting these symptoms.

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Supported by General Clinical Research Center, Penn State University, Hershey Medical Center; Methapharm; GlaxoSmithKline; and AstraZeneca.

Disclosure of potential conflict of interest: Dr Craig has conducted research for AstraZeneca, GlaxoSmithKline, Schering, Boerhringer Ingelheim, Baxter, Merck, Genentech, Dyax, Lev, and Novartis. His consultation services have been provided to Dyax and Aventis. He serves on speakers' bureaus for GlaxoSmithKline, Schering, Pfizer, Merck, Dyax, Genentech, and Novartis. Dr Fisher and Mr Hanks do not have conflicts of interest to report.

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