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.
