Possible Reasons for Persistent Symptoms

• Environmental factors like dust exposure, incomplete allergy control, or other underlying conditions may cause symptoms to persist.

Role of Dust Allergy and Environmental Triggers

• Dust exposure, especially at night or early morning, can exacerbate symptoms. Consider checking your sleeping environment for allergens.

Medication Effectiveness and Limitations

• Levocetirizine and Montelukast reduce symptoms but may not fully relieve them if exposure to allergens continues.

Other Potential Causes

• Consider infections (viral/bacterial), sinusitis, or other conditions that might cause throat pain and nasal blockage.

Recommendations for Symptom Management

• Improve bedroom air quality, use nasal irrigation, consider a humidifier, and adjust medication timing as advised by your doctor.

When to Seek Further Medical Evaluation

• Consult an ENT specialist or allergist if symptoms persist or worsen, for further tests or treatment adjustments.