AR adversely impacts the lives of tens of millions of Americans, and has significant medical, psychosocial and socioeconomic implications. AR, which affects the entire age spectrum and is on the rise in the developed world, is particularly prevalent in the San Francisco Bay area. AR is a surprisingly costly disorder. Symptoms and Diagnosis People with active AR have the classic symptoms of nasal drainage, congestion, sniffling, sneezing, itching of the nose, eyes and palate, headache and sinus pressure, and pain associated with the sinuses and ears. People may experience poor concentration, fatigue, irritability, depression, and interference with outdoor activities, including physical exercise and sports.
Symptoms affect quality of life, mental health and psychomotor performance.
Contributing to these problems is the sleep-disordered breathing often attributable to AR, and the consequent decrease in sleep duration and quality. The resultant cognitive and emotional impairment has been shown to adversely impact work and school performance. In all of these conditions, AR is highly likely to play an exacerbating, if not causative, role. AR often has a subtle diagnosis, since it may mimic or coexist with a number of other clinical disorders, including a variety of nonallergic conditions. Evaluation for AR should include an assessment of symptoms, extensive patient and family history, appraisal of the patient's indoor and outdoor environments, physical examination and, when appropriate, diagnostic testing.