Sex-Specific Differences in Symptomatology and Quality of Life Impact of Allergic Rhinitis: A Cross-Sectional Study.

BACKGROUND: Allergic Rhinitis (AR) is a widespread condition that significantly affects the quality of life (QOL) of those affected globally. It contributes to sleep disturbances, fatigue, poor concentration, irritability, and can worsen symptoms in individuals with coexisting asthma. This study examines the impact of AR on QOL in adults, with specific attention to sex differences.

MATERIALS AND METHODS: A cross-sectional online survey using a purpose-designed, non-validated questionnaire was distributed via social media using convenience sampling to 1572 Jordanian adults. The questionnaire collected data on demographics, AR symptoms, triggers, and the impact of AR on mental health, social functioning, and daily life. Data were analyzed using descriptive statistics and Chi-square tests. Multivariable logistic regression was used to adjust for potential confounders, and Benjamini-Hochberg false discovery rate (FDR) correction was applied to account for multiplicity.

RESULTS: A total of 1572 respondents participated; 683 (43.4%) had physician-diagnosed AR. AR was reported by 157/419 males (37.5%) and 526/1153 females (45.6%); this sex difference was statistically significant (χ2 = 8.31, p = 0.004; OR = 1.40, 95% CI 1.11-1.76). Most patients lived in urban areas (69.4%). While sneezing and rhinorrhoea were common across sexes, females reported significantly higher rates of nasal itching/congestion (55.5% vs. 43.9%, p = 0.011), headaches (61.0% vs. 43.9%, p < 0.001), and increased stress/anxiety (53.4% vs. 42.7%, p = 0.018, not surviving false discovery rate (FDR) correction). In contrast, snoring was more prevalent in males (40.1% vs. 24.1%, p < 0.001). Regarding QOL, AR severely disrupted sleep (80.7%) and concentration (66.2%) for both sexes. However, females were significantly more likely to report irritability/emotional distress (65.4% vs. 55.4%, p = 0.023), prefer social isolation during symptoms (59.3% vs. 47.8%, p = 0.010), and experience limitations in activities outside the home (55.1% vs. 45.9%, p = 0.041). After adjustment, female sex remained significantly associated with irritability/emotional distress (aOR = 1.50, 95% CI 1.02-2.22, p = 0.039) and preference for social isolation (aOR = 1.53, 95% CI 1.05-2.23, p = 0.028). After Benjamini-Hochberg FDR correction, nasal itching/congestion, snoring, and headache remained statistically significant in symptom analyses; no QOL items survived FDR correction, and these findings should be considered exploratory. Asthma was reported by 80/683 (11.7%) of AR patients, more frequently among males than females (19.7% vs. 9.3%, p < 0.001). Sensitivity analyses showed that the association between female sex and social isolation was robust to adjustment for or exclusion of asthma, whereas the association with irritability was attenuated after excluding participants with asthma.

CONCLUSION: These findings suggest AR's substantial impact on daily functioning and mental well-being, with signals of greater psychosocial burden among women. Improved understanding of sex-specific challenges can support more effective prevention, diagnosis, and management strategies, with tailored strategies to address the distinct symptom burden and QOL impairments experienced by female patients. These findings may provide preliminary insights into the burden of AR in Jordan and should be confirmed in representative, validated surveys.