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To investigate the relationships among nasal obstruction, snoring, and excessive daytime sleepiness in people with and without allergies, Nobuaki Hiraki, MD, University of Occupational and Environmental Health, Kitakyushu, Japan, and colleagues analysed responses to a survey of Japanese workers. Of the 1,878 workers asked to complete questionnaires, 1,615 responded (86%) and 1,459 provided sufficient information for the analysis. Participants were divided into 4 groups: those with allergies and nasal obstruction, those with nasal obstruction but no allergies, those with allergies but no nasal obstruction, and those with neither nasal obstruction or allergies, who served as controls. Those in the nasal-obstruction groups (with or without allergies) had higher odds of snoring and daytime sleepiness than the control group, but there was no difference between the allergies-only and control groups. "The present results strongly suggest that nasal obstruction causes sleep-disordered breathing and, thus, daytime sleepiness in individuals without allergic rhinitis as well as in those with allergic rhinitis," the authors said. This is thought to occur through several mechanisms, including changes in pressure that cause portions of the throat to collapse, functional difficulties induced by the shift from nasal breathing to mouth breathing, and changes in signals sent from the respiratory system to the brain. "We speculate that, although nasal obstruction itself is not a life-threatening condition, prompt and appropriate rhinologic treatment would improve sleep quality and, thus, daily and social activities in patients with sinonasal diseases," the authors concluded. "This remains to be further investigated in future studies."
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