Nov 10, 2025
Prospero Protocol
- Nirav Nayak1,
- jnayak 2,3
- 1Brentwood College School;
- 2Stanford University School of Medicine;
- 3Palo Alto VA Medical Center
Protocol Citation: Nirav Nayak, jnayak 2025. Prospero Protocol. protocols.io https://dx.doi.org/10.17504/protocols.io.bp2l6zwzrgqe/v1
License: This is an open access protocol distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited
Protocol status: In development
We are still developing and optimizing this protocol
Created: November 10, 2025
Last Modified: November 10, 2025
Protocol Integer ID: 231948
Keywords: Nasal Obstruction/psychology, Nasal Obstruction, Nasal Blockage, Nasal Congestion, nasal decongestion, nasal patency, nasal breathing, nasal airway collapse, Empty Nose, nasal cavity, Psychological Well-Being, wellness, wellbeing, patient-reported outcome, patient-reported outcome measures, Quality Life nose, Quality Life nasal, psycholog*, mental health, reactive depression, Depressive Disorder, depressive disorder, Somatoform Disorders, somatiz*, clinicalstudy, clinicaltrial, comparativestudy, dataset, interview, meta-analysis, multicenterstudy, observationalstudy, practiceguideline, randomizedcontrolledtrial, scopingreview, systematicreview, prospective, retrospective, cross-sectional, longitudinal, cohort, multicenter, muticentre, random*, controlled, psychological effects from nasal obstruction, psychological side of nasal obstruction, effects of nasal obstruction, chronic nasal obstruction, nasal obstruction, nasal congestion, including nasal congestion, such as anxiety, psychology of patient, anxiety, psychological effect, many patient, patient
Abstract
Introduction: Around the world, a quarter of the global population experiences chronic nasal obstruction, including nasal congestion and blockage. As a result, many patients experience psychological effects from nasal obstruction, such as anxiety, depression, and mood swings. While there are some recent developments in research, there is still an overall lack of research on the psychological side of nasal obstruction in the literature. Methodology: The review used various indicators, keywords, and key phrases to uncover research in various medical databases, such as Embase, PubMed, and Web of Science. Two reviewers scanned the titles and abstracts of different papers based on the inclusion and exclusion criteria. Disagreement on the status of an article or paper would be decided by a third reviewer. To ensure that information on this subject is represented, sources were manually uncovered and underwent the same selection process in the review. Conclusion: Based on the information presented in the literature, recommendations and possible solutions can be provided to future care regarding the effects of nasal obstruction on the psychology of patients and the general population.
Troubleshooting
Background 26 Rationale
Approximately one quarter of the world’s population suffers from general nasal congestion and obstruction, blockage, or general obstruction of the nasal cavity (Stewart et al., 2010). While there has been significant research on surgical techniques and effective treatments for nasal congestion, recent developments have focused on the psychological impact of this condition.
The psychological impact of nasal congestion is, in fact, poorly understood since many of the symptoms and complaints that patients associate with nasal congestion are not always consistent with nasal examinations or endoscopic evaluations (Akkoca, 2023). However, recent research and studies have shown that the effects of nasal congestion and obstruction on patients’ psychology. For instance, Lee et al. (2021) states that patients with nasal septal deviation (NSD) experience greater cycles of anxiety, somatization, obsession, depression, and even psychoticism. These symptoms also lead to negative feelings and mood changes for sufferers. For chronic rhinitis with nasal polyposis (CRSwNP), according to Arslan et al. (2018), cognitive functions, such as remembering information, learning information, organization, planning, and problem solving are impeded. Lack of sleep and other symptoms are attributable to lack of concentration, social inhibitions, and mood defects.
In a larger context, these chronic health issues have implications for the general well-being of patients and result in reduced productivity, depression, anxiety, and more. Therefore, it is important to conduct a review of the available modern literature to examine the current understanding of the possible psychological impacts of nasal congestion to bring greater awareness and action to support these individuals.
Objectives
The objective of this scoping review is to understand the psychological effects of nasal congestion and obstruction, such as chronic viral, allergy, rhinitis, and empty nose syndrome (ENS), and make recommendations for future research based on the literature.
Methods
The publications were derived from using various indicators to search for relevant articles on different databases, such as PubMed, Web of Science, Embase, Scopus, Biosis, and PsycINFO. Relevant resources and articles not found in databases were manually retrieved.
Eligibility Criteria
For this review, the inclusion criteria will include all studies regardless of date, studies gathering primary data, including case reports and observational studies, most forms of chronic nasal obstruction, such as ENS, chronic viral infections, medical-related, and allergy, that are caused by many factors, including deviated septum, turbinate hypertrophy, chronic rhinitis, studies that include possible treatments and interventions, and they must include assessments or measurements of wellness, and/or wellbeing, and/or depression, and/or anxiety, and/or related psychological/psychiatric disorders.
However, papers examining portions of upper airway not involving the nose (pharynx, mouth, throat), review articles, opinion articles, studies on exclusively surgical techniques for the nasal airway, students involving subjects years of age, acute cause of nasal obstruction (acute sinusitis, acute viral infection), rhinitis during pregnancy, papers that assess efficacy of methodological assessments, papers that focus solely on the olfactory sense, studies that focus on nasal obstruction as solely a side effect of a treatment, such some antihypertensives, rebound effects of OTC topical decongestants, studies regarding overall quality of life (QoL) and studies involving participants that have a pre-existing psychiatric/psychological primary diagnosis will be excluded from this review.
Data Extraction
After finding various papers from different databases using specific indicators, two reviewers will determine whether each paper meets the inclusion and exclusion criteria based on the title and abstract. If there is a disagreement about the inclusion and exclusion of a paper, discussion will be open to a third reviewer.
Protocol references
Akkoca, Ö, Haldun, O, Ünlü, C. E., Aydin, E., Ozdel, K., 6 Kavuzlu, A. (2020). Association between nasal obstruction symptoms and anxiety. Ear, Nose 6 Throat Journal, 99(7), 448-452. https://journals.sagepub.com/doi/pdf/10.1177/0145561319900747
Arslan, F., Tasdemir, S., Durmaz, A., 6 Tosun, F. (2018). The effect of nasal polyposis related nasal obstruction on cognitive functions. Cognitive Neurodynamics, 12(4), 385-390. https://pmc.ncbi.nlm.nih.gov/articles/PMC6048009/
Lee, K., Min S., Kim, J., Houng, J., Han, K., Kim J., 6 Jung, G. Y. (2021). Association of nasal septal deviation with the incidence of anxiety, depression, and migraine: A national population-based study. PLoS, 16(11), pp. https://pmc.ncbi.nlm.nih.gov/articles/PMC8568183/
Stewart, M., Ferguson, B. J., Fromer, L. (2010). Epidemiology and burden of nasal congestion. International Journal of General Medicine, 3: 37-45. https://pmc.ncbi.nlm.nih.gov/articles/PMC2866547/pdf/ijgm-3-037.pdf
Acknowledgements
JVN is a consultant with Aerin Medical, Acclarent/Integra, Everis Inc, and Spirair Inc. He has a patent and equity with Spirair, and equity with Sound Health. No conflicts are relevant to this work.