# The Impact of Allergic Rhinitis on the Quality of Life Among Adult Patients in Alahsa, Saudi Arabia: A Case-Control Study

## TL;DR

This study shows that allergic rhinitis significantly affects mental health, sleep, and quality of life in Saudi adults.

## Contribution

The study is the first to explore the impact of allergic rhinitis on quality of life in Alahsa, Saudi Arabia, using a case-control design.

## Key findings

- Adults with allergic rhinitis had significantly higher psychological distress and insomnia compared to controls.
- Sleep difficulty and tiredness/fatigue were the most affected quality-of-life domains in AR patients.
- AIS scores correlated moderately with quality-of-life scores in allergic rhinitis cases.

## Abstract

Background and objective

Allergic rhinitis (AR) is highly prevalent in Saudi Arabia, yet its broader consequences on adult well-being remain underexplored. In this study, we aimed to compare health-related quality of life (HRQoL), psychological distress, and insomnia between adults with and without AR in Alahsa, Saudi Arabia.

Methods

A retrospective case-control study was conducted from December 2024 to May 2025. Fifty adults (≥18 years) with the International Classification of Diseases, 10th revision (ICD-10)-confirmed AR were randomly selected from Al Jabr Eye and ENT Hospital records; 150 controls without AR or chronic illness were recruited from the general community (1:3 ratio). Participants completed the General Health Questionnaire-12 (GHQ-12), Athens Insomnia Scale (AIS), and mini Rhinoconjunctivitis Quality of Life Questionnaire (miniRQLQ). Between-group differences were analysed with χ² or independent t-tests; Pearson correlations were employed to assess associations among scales.

Results

Cases and controls were comparable in age (mean age: 35.5 ± 11.2 vs. 34.6 ± 11.6 years, respectively) and sex distribution [23 males (46%)]. A significant difference was noted in educational level (p=0.023). AR cases scored significantly worse on all GHQ-12 items (p<0.001); 19 (38%) met the threshold for mild-to-moderate psychological distress vs. eight (5%) among controls. Clinically relevant insomnia (AIS ≥6) was present in 39 (78%) of cases and 34 (23%) of controls (p<0.001). Mean miniRQLQ domains most affected were tiredness/fatigue (2.98 ± 1.73) and sleep difficulty (2.80 ± 1.98). AIS scores correlated moderately with miniRQLQ scores in cases (r=0.40, p=0.006).

Conclusions

Based on our findings, AR imposes substantial burdens on mental health, sleep quality, and daily functioning among Saudi adults. Multidisciplinary management, including behavioural sleep counseling and psychological support, should accompany pharmacotherapy to reduce the societal impact of AR.