A Cross-Sectional Study of SNOT-22 and PSQI Profiles in Allergic Rhinitis: Sleep Impairment and Mental Health Burden in Polluted Urban India

Introduction: Allergic rhinitis (AR) significantly affects sleep quality and psychological well-being, particularly in polluted urban regions of India where fine particulate matter (PM2.5) levels frequently exceed WHO safety limits. The present study aimed to evaluate the burden of AR on sleep and mental health using standardised clinical scales in an urban population from Mathura. Methodology: A cross-sectional analysis was conducted on 200 adults aged 18-60 years diagnosed with persistent AR attending an ENT OPD. Individuals with asthma, chronic respiratory diseases, or psychiatric comorbidities were excluded. Participants completed the Sino-Nasal Outcome Test-22 (SNOT-22) and Pittsburgh Sleep Quality Index (PSQI) questionnaires. Subgroup comparisons were performed between individuals exposed to high versus moderate ambient pollution levels. Results: Most participants were young adults (63% aged 18-35 years). Poor sleep quality (PSQI >5) was reported by 72% of respondents, with 41% experiencing difficulty initiating sleep and 43% reporting frequent nighttime awakenings (≥3 times per week). The SNOT-22 identified nasal blockage in 73%, sleep-related complaints in 68%, and psychological distress- such as frustration, low mood, or poor concentration in 53–61% of participants. Exposure to higher pollution levels was associated with greater symptom severity for sleep (78% vs 51%), psychological domains (65% vs 40%), and overall PSQI impairment (82% vs 58%). Conclusion: Persistent AR in polluted urban environments exerts a notable multisystem burden on both sleep and mental health. These findings emphasize the need for integrated management approaches combining nasal therapy, pollution control, and regular screening for psychological distress in resource-constrained settings. Keywords: Allergic Rhinitis, SNOT-22, PSQI sleep quality, Air pollution India