Efficacy of the topical nasal steroid budesonide on improving sleep and daytime somnolence in patients with perennial allergic rhinitis.
BACKGROUND
Improving quality of life is considered to be a major endpoint and motivation for clinical intervention in patients with perennial allergic rhinitis (PAR). In addition to classical symptoms of congestion, pruritus, and rhinorrhea, patients will often complain of not being able to sleep well at night and of feeling fatigued during the day. Like sleep apnea, PAR has also been shown to cause sleep disturbance and consequently worsen daytime fatigue and somnolence.


OBJECTIVE
It is proposed that by decreasing nasal obstruction due to allergic rhinitis by treating with the topical steroid budesonide, symptoms of daytime fatigue and somnolence can be improved.


METHODS
Twenty-two subjects were enrolled in a double-blind, placebo-controlled, crossover study using Baalam's design. Patients were treated with either budesonide 128 g/day or placebo. Subjective data include the Epworth Sleepiness Scale, Functional Outcomes of Sleep Questionnaire, Rhino-conjunctivitis Quality of Life Questionnaire, and a daily diary recording nasal symptoms, sleep problems, and daytime fatigue.


RESULTS
The results illustrated that the topical nasal corticosteroid significantly improved daytime fatigue (P = 0.03), somnolence (P = 0.02), and quality of sleep (P = 0.05) compared to placebo in patients suffering from PAR.


CONCLUSIONS
Budesonide is able to improve congestion, sleep, and daytime somnolence.
Hughes
K
K
College of Medicine, Hershey Medical Center, Hershey, PA, USA.
Glass
C
C
Ripchinski
M
M
Gurevich
F
F
Weaver
T E
TE
Lehman
E
E
Fisher
L H
LH
Craig
T J
TJ
D000287:Administration, Topical; D000328:Adult; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D019819:Budesonide / Q000627:therapeutic use*; D018592:Cross-Over Studies; D006970:Disorders of Excessive Somnolence / Q000188:drug therapy* / Q000209:etiology*; D004311:Double-Blind Method; D005260:Female; D005938:Glucocorticoids; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000150:complications / Q000188:drug therapy / Q000209:etiology; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000150:complications* / Q000188:drug therapy*; D011795:Surveys and Questionnaires; D016896:Treatment Outcome
D000893:Anti-Inflammatory Agents; D005938:Glucocorticoids; D019819:Budesonide