One of the main manifestations of allergic rhinitis is congestion. Nasal congestion can predispose the individual to sleep apnea and microarousals. This sleep disturbance can result in daytime somnolence and fatigue. The use of nasal steroids has been effective at reducing congestion, both objectively and subjectively. Presently, no study is available that shows objective decrease in nasal resistance, sleep arousals, and daytime fatigue in association with nasal steroids. The key objectives of this study are to demonstrate that nasal steroids can decrease congestion resulting in less sleep disturbances and that reduction of sleep disturbances will result in a reduction of daytime fatigue and somnolence. 28 candidates with perennial allergic rhinitis will be selected for participation. They must have subjective findings of nasal obstruction and of sleep disturbances with associated daytime fatigue. This study will be a cross-over, double-blinded placebo controlled study over eight weeks. Each participant will begin the active phase of the study for four weeks with a crossover to the alternative arm of the study for four weeks. Procedures include a medical history, complete physical exam, rhinitis severity questionnaire, prick allergy skin testing, scale for sleep disfunction (Hoddes 1978) and daily diary for sleep, daytime fatigue and nasal symptoms.
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