Purpose: To assess prevalence of self-reported nasal congestion and its association with sleep-disordered breathing (SDB) and excessive daytime sleepiness (EDS) in Pakistani adults employed at a medical university. Methods: All full-time employees of a medical university (n=3,470) were delivered a questionnaire that elicited demographic data, symptoms of nasal blockage and SDB and Epworth Sleepiness Scale score. Overnight pulse oximetry was performed on self-reported snorers and a random sample of non-snorers. Supervised polysomnography was performed on subjects with oxygen desaturation index \u3e5/h. Logistic regression analysis was used to assess the association of nasal blockage with SDB and EDS. Results: Of 2,497 (72%) responders, 45.2% reported nasal congestion. Self-reported nasal blockage was significantly associated with an increased risk of SDB symptoms: snoring (odds ratio [OR] 1.9), witnessed apnoea (OR, 2.2) and unrefreshing sleep (OR, 1.7). Those with nasal blockage had higher Epworth Sleepiness Scale score (5.5 +/- 3.6 vs. 3.9 +/- 3.3, pConclusion: Self-reported nasal blockage is a common symptom in employed Pakistani adults. Self-reported nasal blockage is significantly associated with symptoms of SDB and EDS but not with respiratory variables on overnight sleep monitoring