Intranasal mometasone furoate therapy for allergic rhinitis symptoms and rhinitis-disturbed sleep.
BACKGROUND
Allergic rhinitis (AR) and related nasal congestion cause rhinitis-disturbed sleep (RDS). Intranasal corticosteroids reduce nasal congestion and improve sleep quality in AR but have not been extensively studied in RDS.


OBJECTIVE
To evaluate the efficacy of mometasone furoate nasal spray (NS) on nasal symptoms, nasal patency, sleep variables, quality of life, and daytime functioning in perennial AR (PAR) and concomitant RDS.


METHODS
In this double-blind 4-week study, 30 adults with PAR and moderate RDS were randomized 2:1 to receive mometasone furoate NS, 200 microg, or placebo each morning. The primary end point was the apnea-hypopnea index. Secondary outcome measures included changes in total nasal symptom score (TNSS), nighttime symptom score, daytime peak nasal inspiratory flow, nighttime flow limitation index, Rhinoconjunctivitis Quality of Life Questionnaire-Standardized (RQLQ-S) score, Epworth Sleepiness Scale score, and Work Productivity and Activities Impairment-Allergy Specific (WPAI-AS) questionnaire score. Analysis of covariance was used for all efficacy end points.


RESULTS
The apnea-hypopnea index at study end was not statistically significantly different between groups. However, mometasone furoate NS therapy significantly improved morning (P = .04) and evening (P = .01) TNSSs, morning (P = .049) and evening (P = .03) nasal obstruction/blockage/congestion, daily peak nasal inspiratory flow (P = .03), flow limitation index (P = .02), Epworth Sleepiness Scale score (P = .048), RQLQ-S score (P = .03), and 2 of 5 WPAI-AS domains. Among patients receiving mometasone furoate NS, TNSS improvements were significantly correlated with improved work- and non-work-related productivity.


CONCLUSIONS
In patients with PAR and RDS, mometasone furoate NS use improved nasal symptoms, sleepiness, and impairment in daily activities. Correlated reduced nasal symptoms and improved performance suggest that improving AR symptoms with mometasone furoate NS administration can benefit sleep and daytime functioning.
Meltzer
Eli O
EO
Allergy and Asthma Medical Group and Research Center, San Diego, California 92123, USA. eomeltzer@aol.com
Munafo
Dominic A
DA
Chung
Weiyuan
W
Gopalan
Gokul
G
Varghese
Santosh T
ST
D000203:Activities of Daily Living; D000281:Administration, Intranasal; D000293:Adolescent; D000328:Adult; D018926:Anti-Allergic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D000068656:Mometasone Furoate; D015508:Nasal Obstruction; D011244:Pregnadienediols / Q000008:administration & dosage* / Q000009:adverse effects; D011788:Quality of Life; D012221:Rhinitis, Allergic, Perennial / Q000175:diagnosis / Q000188:drug therapy* / Q000503:physiopathology; D012891:Sleep Apnea Syndromes
D018926:Anti-Allergic Agents; D011244:Pregnadienediols; D000068656:Mometasone Furoate