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These symptoms can lead to impaired nocturnal sleep, and this impairment results in daytime fatigue and somnolence, reducing both learning and work efficiency and decreasing quality of life.<\/jats:p><\/jats:sec><jats:sec><jats:title>STUDY DESIGN<\/jats:title><jats:p>In addition, the mediators of AR, including histamine, leukotrienes, cytokines, and prostaglandins, may play a role in sleep regulation and, thus, may be directly involved in this impairment independent of nasal obstruction. Recumbency and\/or diurnal variation augments turbinate swelling, causing nasal blockage during nocturnal sleep. Medications directed toward reversal of nasal congestion often concomitantly work through suppression of inflammatory mediators and constitute the primary therapy for sleep disturbance associated with allergic rhinitis. Some pharmaceutical interventions that reduce nasal congestion have adverse effects on sleep. Decongestants effectively reduce nasal congestion but frequently produce stimulatory effects and even insomnia. Antihistamines reduce sneezing and pruritus, but are less effective in relieving congestion. Earlier, \u201cfirst\u2010generation\u201d antihistamines are associated with significant sedation. They also have anticholinergic properties, which can cause dry mouth and make mouth breathing even more uncomfortable in the allergic individual with nasal obstruction. The absence of anticholinergic properties in second\u2010generation, largely nonsedating antihistamines limits their efficacy in rhinorrhea. Azelastine, a topical antihistamine, significantly reduces rhinorrhea and congestion and improves subjective sleep quality, but is also associated with increased sedation. Intranasal corticosteroids and oral leukotriene receptor antagonists effectively reduce rhinorrhea, congestion, and inflammatory mediators.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS<\/jats:title><jats:p>The efficacy of these medications at improving subjective sleep quality has been established through multiple randomized, double\u2010blind, placebo\u2010controlled clinical trials.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2004.02.001","type":"journal-article","created":{"date-parts":[[2004,5,13]],"date-time":"2004-05-13T09:27:24Z","timestamp":1084440444000},"page":"617-629","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":104,"title":["Influences of Allergic Rhinitis on Sleep"],"prefix":"10.1002","volume":"130","author":[{"suffix":"MD","given":"Berrylin J.","family":"Ferguson","sequence":"first","affiliation":[{"name":"Division of Sino\u2010Nasal Disorders and Allergy University of Pittsburgh Medical Center Pittsburgh Pennsylvania"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2016,5,17]]},"reference":[{"key":"e_1_2_8_2_1","first-page":"94","volume-title":"Manual of allergy and immunology.","author":"Lierl MB","year":"1995"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(97)70124-6"},{"key":"e_1_2_8_4_1","first-page":"625","article-title":"Obstructive apneas during sleep in patients with seasonal allergic rhinitis.","volume":"126","author":"McNicholas WT","year":"1982","journal-title":"Am Rev Respir Dis"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(98)70171-X"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1034\/j.1398-9995.2003.00093.x"},{"key":"e_1_2_8_7_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1749-6632.2001.tb05825.x"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.125300"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(97)70123-4"},{"key":"e_1_2_8_10_1","first-page":"53","article-title":"The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.","volume":"24","author":"Craig TJ","year":"2003","journal-title":"Allergy Asthma Proc"},{"key":"e_1_2_8_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1745-7599.2001.tb00323.x"},{"key":"e_1_2_8_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1081-1206(10)62242-9"},{"key":"e_1_2_8_13_1","first-page":"121","article-title":"Seasonal allergic rhinitis and antihistamine effects on children's learning.","volume":"71","author":"Vuurman EF","year":"1993","journal-title":"Ann Allergy"},{"key":"e_1_2_8_14_1","doi-asserted-by":"publisher","DOI":"10.1183\/09031936.96.09102132"},{"key":"e_1_2_8_15_1","doi-asserted-by":"publisher","DOI":"10.1067\/mhn.2002.124848"},{"key":"e_1_2_8_16_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016480118204"},{"key":"e_1_2_8_17_1","doi-asserted-by":"publisher","DOI":"10.1016\/0091-6749(88)90220-5"},{"key":"e_1_2_8_18_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0091-6749(95)70212-1"},{"key":"e_1_2_8_19_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016486909121582"},{"key":"e_1_2_8_20_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0074-7742(02)52007-9"},{"key":"e_1_2_8_21_1","doi-asserted-by":"publisher","DOI":"10.3109\/00016488109133292"},{"key":"e_1_2_8_22_1","doi-asserted-by":"publisher","DOI":"10.1378\/chest.111.1.170"},{"key":"e_1_2_8_23_1","doi-asserted-by":"publisher","DOI":"10.1097\/00005537-200205000-00027"},{"key":"e_1_2_8_24_1","volume-title":"The Allergy Report. 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