Methods: The study comprising 106 consecutive patients (males:60/females:46), 18 to 60 years with AR, diagnosed as per ARIA guidelines, were enrolled from outpatients department of VP Chest Institute, University of Delhi. Patients were categorised into “SR” (group1) and “blockers” (group2) with the help of a visual analog scale (VAS) of 10 centimetres with 0 being “no symptoms” and 10 being “symptoms extremely bothersome”. Scores for global VAS, sneezing, runny nose, nasal congestion, post nasal drip and loss of smell were recorded and patients classified as “SR” and “blockers”. Impact on QoL was assessed with Sinonasal Outcome Test 22 (SNOT-22) and sleep was assessed by Nocturnal Rhinoconjunctivitis Quality of Life Questionnaire (NRQLQ), the Epworth Sleepiness Scale (ESS) and the Pittsburgh Sleep Quality Index (PSQI) instruments.
Results: Just over two thirds (n=73:68.9%) of the patients, were categorised as “SR”(group1) while remaining third (n=33:31.1%) were categorised as “blockers”(group2). The significant features in group1 were: age at onset lower than 20 years (n=60:82.2% P=0.002); birth dates were between June and September (n=42:57.5% P=0.003); family history of atopy (n=59:80.8% P=0.001); itching of skin (n=25:34.2% P=0.002), eye (n=30:41.1% P=0.001), ears (n=28:38.4% P=0.002), and throat and palate (n=42:57.5% P=0.001); and aggravation with dust (n=65:89.1% P=0.001). History of breathlessness (n=28:84.8% P=0.002), mouth breathing (n=28:84.8% P=0.003), loss of smell (n=13:39.4% P=0.004), and prior nasal surgery (n=8:24.2% P=0.001) were significantly higher in group2. Patients in group1 were significantly more sensitised to seasonal allergens like pollens [Kigelia (P=0.045); Salvador (P=0.005)] while patients in group2 had more sensitisation to perennial allergens like house dust (P=0.001), house dust mite (P=0.044) and fungus including Aspergillus species (P=0.001). Mean SNOT-22 scores (group1:60.89;group2:61.66 P=0.763) and mean NRQLQ scores (group1:47.66;group2:50.91 P=0.238) were not significantly different between the groups, while mean ESS (group1:10.52;group2:12.30 P<0.001) and mean global PSQI scores (group1:9.71;group2:11.27 P=0.009) were significantly higher in group2.
Conclusions: The two groups differ significantly in terms of their respective profiles, whether be demographic or clinical. Further, the sensitivity patterns to allergens differ significantly between the groups. “Blockers” experienced significantly more sleep disturbances as compared to “sneezers and runners”.