Twenty-four hour pattern in symptom intensity of viral and allergic rhinitis: Treatment implications

• Published in: Journal of allergy and clinical immunology Vol. 95; no. 5; pp. 1084 - 1096
• Main Authors: Smolensky, Michael H., Reinberg, Alain, Labrecque, Gaston
• Format: Journal Article Conference Proceeding
• Language: English
• Published: New York, NY Mosby, Inc 01.05.1995; Elsevier
• Subjects: allergic rhinitis; Anti-Inflammatory Agents - therapeutic use; Biological and medical sciences; chronotherapeutics; Circadian Rhythm - physiology; Circadian rhythms; colds; Drug Administration Schedule; Ent. Stomatology; Female; Histamine H1 Antagonists - therapeutic use; Humans; influenza; Influenza, Human - complications; Male; Medical sciences; Nasal Mucosa - metabolism; Pharmacology. Drug treatments; Rhinitis - drug therapy; Rhinitis - physiopathology; Rhinitis - virology; Rhinitis, Allergic, Perennial - drug therapy; Rhinitis, Allergic, Perennial - physiopathology; Rhinitis, Allergic, Seasonal - drug therapy; Rhinitis, Allergic, Seasonal - physiopathology; rhinorrhea; Circadian rhythms; influenza; rhinorrhea; chronotherapeutics; colds; allergic rhinitis
• ISSN: 0091-6749; 1097-6825
• DOI: 10.1016/S0091-6749(95)70212-1

The symptoms of rhinorrhea secondary to influenza and cold virus or seasonal and perennial allergic rhinitis are circadian rhythmic. Cough frequency and handkerchief use by persons suffering from virus-induced rhinorrhea are more prominent during the daytime, especially during the initial hours after awakening from nocturnal sleep. The elevation in sublingual temperature as well as the decrement in mental alertness associated with influenza in particular are more profound at this time. Sneezing, blocked nose, and runny nose secondary to allergic rhinitis are also greater in intensity during the morning in approximately 70% of sufferers. The day-night variation in symptom intensity amounts to approximately 20% of the 24-hour mean level. The treatment of these diseases and their symptoms has traditionally involved equal-interval, equal-dose (homeostatic) medication schedules. The effects of antihistamine and antiinflammatory medicines may be enhanced by timing them to the day-night temporal pattern in symptom manifestation and intensity to achieve an optimization of their beneficial effects with control of toxicity, that is, as a chronotherapy. (J A LLERGY C LIN I MMUNOL 1995;95:1084-96.)