title: Relationship of nasal congestion with sleep, mood, and productivity.
abstract: OBJECTIVE
  To explore the impact of nasal congestion alone relative to a full set of allergic rhinitis (AR) symptoms on sleep, fatigue, daytime somnolence, and work and school productivity in a 15-day prospective, naturalistic study.
  
  
  METHODS
  Patients (N = 404) received a clinical exam to confirm congestion and assess its possible causes, including confirmed allergic rhinitis. They completed a battery of patient-reported outcomes (PROs) that assess the impact of nasal congestion and morning AR symptoms on patients' reports of sleep, daytime sleepiness, fatigue, and work, school, and activity impairment. Data were analyzed using multiple regression. Each PRO was regressed separately on congestion and morning AR symptoms, controlling for patient demographics.
  
  
  RESULTS
  Nasal congestion has a significant (p < 0.05), negative impact on patients' lives. Nasal congestion alone had only a slightly smaller negative impact on sleep adequacy relative to AR symptoms more broadly (congestion: beta = 0.137-0.534; AR: beta = 0.123-0.642). Congestion increases the likelihood of sleep problems, fatigue, shortness of breath, headache, and daytime somnolence.
  
  
  CONCLUSIONS
  A single congestion item by itself is a statistically and substantively significant predictor of patient-relevant outcomes. Although the sample was not randomly drawn from clinics or physician offices, the consistency and strength of the findings suggest the salience of this single symptom for patients' experiences.
authors.affiliation: United BioSource Corporation, Bethesda, MD 20814, USA. Donald.Stull@unitedbiosource.com
authors.forename: Donald E
authors.initials: DE
authors.lastname: Stull
authors.forename: Laurie
authors.initials: L
authors.lastname: Roberts
authors.forename: Lori
authors.initials: L
authors.lastname: Frank
authors.forename: Kim
authors.initials: K
authors.lastname: Heithoff
mesh_terms: D000328:Adult; D000339:Affect; D004526:Efficiency; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D015508:Nasal Obstruction / Q000453:epidemiology* / Q000209:etiology; D011446:Prospective Studies; D011788:Quality of Life; D006255:Rhinitis, Allergic, Seasonal / Q000150:complications / Q000453:epidemiology; D012892:Sleep Deprivation / Q000453:epidemiology* / Q000209:etiology; D011795:Surveys and Questionnaires