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Allergic rhinitis may also be classified as Mild-Intermittent, Moderate-Severe intermittent, Mild-Persistent, and Moderate-Severe Persistent. Intermittent is when the symptoms occur <4 days per week or <4 consecutive weeks. Persistent is when symptoms occur >4 days/week and >4 consecutive weeks. The symptoms are considered mild with normal sleep, no impairment of daily activities, no impairment of work or school, and if symptoms are not troublesome. Severe symptoms result in sleep disturbance, impairment of daily activities, and impairment of school or work. [27]

Perennial allergic rhinitis is most commonly associated with allergy to house dust mite. A Cochrane systematic review examined whether effective reduction of mite levels was achieved with avoidance measures. Many trials were of poor quality but it was found that the use of acaricides and extensive bedroom-based environmental control programmes may be of some benefit. Isolated use of house dust mite impermeable bedding was unlikely to be effective. [ 15 ] Therefore, extensive house dust mite avoidance strategies are not worth investing in unless treatment is failing. If needed, advise:

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