Effect of Oxymetazoline Hydrochloride in Combination With Fluticasone Propionate on the Apnea Hypopnea Index (AHI) in Subject With Persistent Nasal Congestion and Mild Obstructive Sleep Apnea

Inclusion Criteria:

1. Male and female subjects 18 - 65 years of age.

2. At least a one year history of perennial allergic or non-allergic rhinitis.

3. Subjects must be on the maximum recommended doses of one of the following NGCS forat least one month. (See Table I)

4. AHI per hour of sleep > 5 and <15, minimum SpO2 88, indicating mild obstructivesleep apnea).

5. Average Nasal Congestion VAS of > 3-10 indicating moderate to severe nasalcongestion between visits 1 and 2 based on daily symptoms (average of 7 scores).

6. Average Congestion Quantifier 7 score of 7 between visits 1 and 2 based on weeklysymptoms (average of 2 scores).

7. Willingness to participate as indicated by signed informed consent.

Exclusion Criteria:

1. Presence of hypersensitivity to oxymetazoline or fluticasone propionate.

2. Subjects receiving allergen immunotherapy but not on a stable maintenance regimenfor at least 30 days before the first study visit.

3. If the subject has perennial allergic rhinitis, he/she should not be entered intothis study eight weeks before, during, or six weeks after any seasonal exacerbation.

4. Women who are pregnant or lactating.

5. Other known nasal diseases likely to affect deposition of oxymetazoline such assinusitis, nasal polyps, or major nasal structural malformations.

6. Respiratory tract infections in the last 14 days.

7. Infections requiring antibiotics in the last 14 days.

8. Asthma or chronic obstructive pulmonary disease (COPD) requiring roflumilast or morethan the recommended doses of inhaled corticosteroids, beta agonists, orantimuscarinic agents.

9. No systemic glucocorticosteroids for one month prior or during the study.

10. Cardiovascular disease with uncontrolled hypertension (BP160/80), arrhythmias and/orcongestive heart failure.

11. Insulin-dependent diabetes mellitus and/or diabetic retinopathy.

12. Subjects with mild OSA (AHI 5-14) and SpO2 <88 for > 5 min during sleep that isidentified during the screening portable sleep study.

13. Hypertension requiring more than two drugs, with the exception ofhydrochlorothiazide, to achieve control.

14. A history of drug or alcohol abuse within the past 5 years.

15. Subjects who are currently abusing alcohol, illicit drugs, benzodiazepines, ornarcotics.

16. Inability to cooperate, comply with study procedures or communicate with theinvestigator to successfully complete the study.

17. A history of benign prostate hypertrophy necessitating treatment.

18. A history of psychiatric problems which, in the opinion of the investigators, wouldimpair participation in the study.

19. Subjects with a planned hospitalization during the study.

20. An infirmity, disability, or geographical location which seems likely to preventregular attendance for subject visits.

21. Subjects with obstructive sleep apnea syndrome requiring CPAP therapy.

22. Subjects diagnosed with central sleep apnea (> 5 central events per hour) ormoderate to severe OSA (AHI > 15) and SpO2 <88 for > 5 min during sleep identifiedduring screening.

23. Use of the following medications within the time period specified below prior to Day -7 (Table 2).