The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.
The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.
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发表时间：
2003
影响因子：
2.8
通讯作者：
T. Craig;C. Mende;K. Hughes;S. Kakumanu;E. Lehman;V. Chinchilli
中科院分区：
文献类型：
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作者：
T. Craig;C. Mende;K. Hughes;S. Kakumanu;E. Lehman;V. Chinchilli
最近的数据表明，过敏性鼻炎患者白天嗜睡是由于鼻塞引起的睡眠中断继发的。减少充血的药物有望改善睡眠和白天嗜睡。之前，我们证明鼻用类固醇可以改善所有三种症状。目前，我们尚未进行客观的睡眠测试来确定充血、睡眠和白天嗜睡的主观改善之间是否存在相关性。这项为期 8 周的双盲安慰剂对照研究的目的是确定局部鼻用氟替卡松是否能有效减少主观充血和白天嗜睡并改善睡眠，以及这种改善是否与夜间睡眠测试（多导睡眠图）的变化相关。我们招募了 32 名患有常年性过敏性鼻炎的受试者，并以双盲、交叉的方式将他们随机分组，接受安慰剂或氟替卡松（每次喷雾 50 微克），每天每侧喷雾 2 次，采用 Balaam 的设计。使用问卷、生活质量工具、日记、Epworth 嗜睡量表和多导睡眠图夜间睡眠测试作为工具。通过 SAS 中的 PROC MIXED 对每个 4 周治疗期的最后 2 周进行总结、评分和比较。进行了睡眠测试和主观测试的唤醒之间的相关性。与安慰剂相比，氟替卡松改善了主观睡眠（p = 0.04）；然而，接受治疗的患者的呼吸暂停/呼吸不足指数没有差异。治疗组白天的嗜睡和疲劳减少了 10% 以上；然而，这在统计上并不显着。然而，以批准剂量使用氟替卡松可以改善常年性过敏性鼻炎患者的主观睡眠，而不会改变呼吸暂停/呼吸不足指数。
Recent data suggested that daytime somnolence in patients with allergic rhinitis was secondary to disrupted sleep caused by nasal congestion. Medications, which decreased congestion, would be expected to improve sleep and daytime somnolence. Previously, we showed that nasal steroids improved all three symptoms. Presently, we have not performed objective sleep testing to determine if there is a correlation between subjective improvement of congestion, sleep, and daytime somnolence. The objective of this 8-week, double-blind, placebo-controlled study was to determine if topical nasal fluticasone is effective at decreasing subjective congestion and daytime somnolence and improving sleep and if this improvement correlated with a change in overnight sleep testing (polysomnography). We recruited 32 subjects with perennial allergic rhinitis and randomized them in a double-blinded, cross-over fashion, to receive placebo or fluticasone (50 micrograms a spray), 2 sprays each side everyday, using Balaam's design. Questionnaires, quality of life instruments, daily diary, Epworth Sleepiness Scale, and an overnight sleep test with polysomnograms were used as tools. The last 2 weeks of each 4-week treatment period were summarized, scored, and compared by PROC MIXED in SAS. Correlations between arousals on sleep tests and subjective tests were performed. Fluticasone improved subjective sleep when compared with placebo (p = 0.04); however, there was no difference in the apnea/hypopnea index in those that were treated. Daytime sleepiness and fatigue were decreased by > 10% in the treated group; however, this was not statistically significant. However, fluticasone used at approved doses improves subjective sleep in patients with perennial allergic rhinitis without a change in the apnea/hypopnea index.