title: Findings from a 1000-patient internet-based survey assessing the impact of morning symptoms on individuals with allergic rhinitis.
abstract: BACKGROUND
  Although the severity of allergic rhinitis symptoms might depend on the degree of exposure to the triggering allergen, it has also been noted that symptom severity varies over the course of the day.
  
  
  OBJECTIVE
  The aims of this study were to investigate the reported impact (influence on behavior and/or feelings) of morning symptoms on individuals with allergic rhinitis and determine their perception of the effectiveness of allergy treatment.
  
  
  METHODS
  In January 2005, online interviews based on a 16-item questionnaire were presented to adults (aged >or=18 years) with physician-diagnosed allergic rhinitis in the United States. Participants were recruited from the Roper Public Affairs and Media US national online panel. The survey sample was balanced to reflect the US population by Census Division, ethnicity, sex, and presence of children living at home. Data were weighted by sex (65% female, 35% male) based on previous research of the adult population suffering from allergies.
  
  
  RESULTS
  The first 1000 respondents (sex, female,550 [55%]; age, >or=55 years, 378 [38%], race, white, 883 [88%]) that met all inclusion/exclusion criteria were included in the study results. There was no significant difference in the regional distribution of participants: South (34%), Midwest (25%), West (22%), and Northeast (19%). The majority of the sample (83%) reported experiencing morning symptoms of allergic rhinitis; 49% reported that their symptoms were most severe during the morning hours. The most common symptom on awakening was nasal congestion, reported by 85% of those with symptoms when they first woke tip. Of those with symptoms on awakening, the majority reported that these affected their feelings (96;/0) or behavior (87%). Among respondents who experienced symptoms on awakening, the majority reported that their symptoms affected the rest of their day "somewhat" or "a great deal" (51% and 24%, respectively). Of those respondents using allergy medication, 33% reported that its effectiveness wore off before the next dose most or all of the time. A majority of respondents reported feeling that it was very important for an allergy medication to maintain effectiveness until the next dose (68%), provide relief all day and into the next morning (62%), and enable them to wake tip with their symptoms render control (63%).
  
  
  CONCLUSIONS
  Based on the results from this large Internet-based survey, the morning symptoms of allergic rhinitis have a negative impact on individuals, both emotionally and in terms of disruption of daily activities. Medication used for treating allergic rhinitis was reported as not always effective for the whole time interval between doses. This suggests that it might be important, when considering management options in allergic rhinitis, to select medications that offer sustained effectiveness throughout the 24-hour period.
authors.affiliation: Division of Rheumatology, Department of Medicine, Massachusetts General Hospital, Boston, Massachusetts 02114, USA. aalong@partners.org
authors.forename: Aidan A
authors.initials: AA
authors.lastname: Long
mesh_terms: D000203:Activities of Daily Living; D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage / Q000627:therapeutic use*; D001294:Attitude to Health; D001519:Behavior; D002940:Circadian Rhythm; D004334:Drug Administration Schedule; D004644:Emotions; D005260:Female; D006306:Health Surveys; D006801:Humans; D020407:Internet; D008297:Male; D008875:Middle Aged; D015995:Prevalence; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D006255:Rhinitis, Allergic, Seasonal / Q000188:drug therapy / Q000453:epidemiology / Q000503:physiopathology*; D012720:Severity of Illness Index
chemical_list: D018926:Anti-Allergic Agents