Effect of second-generation antihistamines on nighttime sleep and daytime sleepiness in patients with allergic rhinitis.

BACKGROUND: The daytime tiredness experienced by the vast majority of allergic rhinitis (AR) sufferers is directly related to the fact that they experience disrupted sleep at night. This study compared the effects of recently marketed second-generation H1 antihistamines (SGAs) on nighttime sleep and daytime sleepiness in patients with AR, with patients grouped into those taking non-brain-penetrating antihistamines (NBP group) and those taking brain-penetrating antihistamines (BP group). METHODS: Patients with AR completed self-administered questionnaire-based surveys to determine Pittsburgh Sleep Quality Index (PSQI) before and after taking SGAs. Statistical analysis was performed on each evaluation item. RESULTS: Of 53 Japanese patients with AR between 6 and 78 years old, median (SD) age was 37.0 (22.4) years old and 21 were men (40%). Of the 53 patients, 34 were the NBP group and 19 were the BP group. In the NBP group, mean (SD) subjective sleep quality score after medication was 0.76 (0.50), which was significantly lower (better) than the score of 0.97 (0.52) before medication (p = 0.020). In the BP group, mean (SD) subjective sleep quality score after medication was 0.79 (0.54), which was not significantly different from the score of 0.74 (0.56) before medication (p = 0.564). In the NBP group, mean (SD) global PSQI score was 3.47 (1.71) after medication, which was significantly lower (better) than the score of 4.35 (1.92) before medication (p = 0.011). In the BP group, mean (SD) global PSQI score was 2.47 (2.39) after medication, which was not significantly different from the score of 3.00 (2.71) before medication (p = 0.125). CONCLUSION: Subjective sleep quality and global PSQI score were improved only in the group taking non-brain-penetrating SGAs.

Taste and acoustic reflex after recovery from facial muscle paralysis in patients with facial nerve palsy.

BACKGROUND: There are few studies on taste or acoustic reflex (AR) in patients after recovery from facial muscle paralysis (FMP). OBJECTIVES: To investigate the recovery of AR and taste in patients who have recovered from peripheral facial nerve palsy (FNP). MATERIALS AND METHODS: The study included 25 patients whose FMP had resolved after treatment for FNP. A difference in taste threshold of ≤4 dB between the affected and unaffected sides in the electric taste test was defined as normal; an AR on the affected side was assessed to be ≥90% of the AR on the unaffected side was defined as normal. RESULTS: Six months after treatment, 8% of patients with FNP who had recovered from FMP still showed taste disorders, and 60% of patients showed abnormal AR. The number of subjects whose electric taste threshold was normal after treatment was significantly higher than the number of subjects whose AR assessment was normal (p < .01). CONCLUSION AND SIGNIFICANCE: This study demonstrates that even among subjects whose FMP is resolved after treatment for FNP, there are some whose taste and AR do not recover. Physicians should be aware of ear symptoms persisting after facial muscle recovery.