Are patients aware of their own nasal cycle? A prospective outpatient-based study

Background The nasal cycle is a normal physiological process involving alternating congestion and decongestion of the nasal cavities, yet patient awareness of this phenomenon is poorly understood. The objective of this study was to assess patient awareness of the nasal cycle and its association with nasal symptom perception and anxiety. Methods This prospective observational study included 120 adult ENT outpatients. A structured questionnaire assessed awareness of the nasal cycle, perception of alternating nasal obstruction and anxiety. Nasal symptom severity was measured using the Nasal Obstruction Symptom Evaluation score, and nasal airflow dominance was assessed with the cold spatula test. Results Only 28.3 per cent of patients were aware of the nasal cycle. Although 51.7 per cent perceived alternating nasal obstruction, most considered it abnormal. Poor awareness was associated with higher Nasal Obstruction Symptom Evaluation scores ( p = 0.01) and increased anxiety ( p = 0.003). Conclusion Limited awareness of the nasal cycle leads to misinterpretation of normal physiology. Simple counselling may reduce symptom related anxiety.