Table of ContentsView AllTable of ContentsCausesTreatment
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Table of Contents
Causes
Treatment
Nighttime congestion often involves a combination of environmental triggers and abnormalities of the sinus and nasal passages that cause the swelling of tissues and/or build-up ofnasal mucus(snot).
Most cases of stuffy nose are relatively harmless and easy to treat. But some may be a sign of a serious medical condition in need of specialist treatment.
This article describes the reasons why you may have a stuffy nose at night. It also explains how nasal congestion is treated and offers tips to ease nighttime stuffiness.
Verwell / Brianna Gilmartin
Reasons Behind a Stuffy Nose at Night
A stuffy at night is generally caused when nasal tissues become swollen and inflamed and/or nasal mucus is produced in excess. Structural problems in thenostrils or nasal cavitycan also increase a person’s vulnerability to nighttime congestion.
The possible causes of a stuffy nose at night can be broken down into broad categories:
Airborne Allergens
An allergy occurs when the immune system overreacts to an otherwise harmless substance called anallergen.
When this happens, the body will release inflammatory chemicals that cause blood vessels to widen. This causes fluid to leak from the blood vessels into surrounding tissues, causing swelling.The swelling ofmucosal tissuesin the nose is what causes congestion.
A stuffy nose can occur at night due to dust mites that thrive in pillows and mattresses. Airborne allergens like pollen also tend to settle in cooler nighttime temperatures.
Allergic conditions associated with nighttime congestion include:
How to Manage Tree Pollen Allergy Symptoms
Gravity and Sleep Posture
When you are standing or sitting upright during the day, mucus is constantly draining from your nose and sinuses into the back of your throat due to gravity.
However, when you lying are in bed, gravity is working against you. In some cases, this can cause mucus to back up and pool in the nasal passages.
This is more likely to occur in people with structural problems in the nostrils and nasal cavities. Some of these conditions are congenital (meaning something you are born with), while others may be due to an injury to the nose or face.
Older age can also cause structures within the nasal passages to change, weaken, or collapse.
Conditions in which postural changes to your body trigger nasal congestion include:
7 Home Remedies for Stuffy Nose
Postural Blood Flow Changes
When you lie flat, blood flow to the upper half of your body increases, including to the head and nasal passageways.The increased flow can cause pressure that leads to nasalinflammation, swelling, and the increased production of mucus.
But gravity alone is not the only cause of this. Other conditions can directly or indirectly affect blood flow to the nasal passages and cause congestion.
Examples include:
Nasal Obstruction
Changes in Cortisol
There are manyupper respiratory tract infections (URTIs)that can cause nasal congestion. These tend to get worse at night due to your horizontal sleep position.
But nasal congestion from a URTI can also worsen at night because levels of the stress hormonecortisolare naturally lower.
Cortisol is the hormone associated with the “fight-or-flight” instinct during which blood vessels, pupils, and airways will widen (dilate) in response to threats.These include actual physical threats and diseases that place your body on high alert.
The reduction of cortisol at night can make symptoms of URTIs more pronounced, including ones like:
How to Lower Cortisol
Climate
The nose warms and humidifies the air you breathe as it passes through the nasal passages. When exposed to cold and dry air, the lining of the nose becomes irritated and inflamed.
The inflammation leads to swelling, increased mucus production, and nasal congestion.
The risk of this is greater in winter, particularly at higher altitudes which inherently increase blood pressure.
Medications
Many medications can cause nasal stuffiness. These include commonly prescribed drugs, such as:
Acid Reflux
Acid reflux occurs when the ring-shaped muscle between the stomach and esophagus (called theesophageal sphincter) is weak and unable to stay closed. This can cause acid to leak into the esophagus, triggering heartburn, nausea, chest pain, coughing, and an unpleasant taste.
Nasal irritation and nighttime congestion are two of the lesser-known symptoms. The risk of these is greatest at night because your sleep position allows acid to backflow closer toward the throat and nasal passages.
Reducing Nighttime Congestion
Studies show that a stuffy nose at night can have a big impact on sleep quality. People with chronic sinusitis are three to nine times more likely to experience sleep disturbances with frequent nighttime awakenings.
These tips can help adults reduce nighttime congestion and sleep better:
If a medical condition is causing your stuffiness, your healthcare provider may recommend additional strategies and medications to ease your symptoms and help you sleep.
For example, allergies can be treated with antihistamines, nasal steroids, orimmunotherapy. Medications such as antacids andproton pump inhibitorsare commonly used to treat GERD.
Easing a Child’s Stuffy Nose at Night
Saline nasal drops and a bulb syringe can help relieve bedtime congestion in babies and toddlers.
Treat one nostril at a time until it is clear, then switch to the other nostril. Stop if you notice blood in the mucus or nose.
Older children can benefit from the same tips as adults: Use a cool-mist humidifier, elevate their head in bed, and push fluids during the day to keep the child hydrated.
Check with your pediatrician to determine if antihistamines or cold medicine should be given.
Summary
You are not imagining that your nasal congestion gets worse at night. There are a few different reasons you could be experiencing this, and more than one may be at play. Some, like your sleep position, can be easily fixed. Others, like GERD, may need medical treatment.
Visit your healthcare provider to determine the cause of your nighttime congestion so you can get the sleep you need.
12 SourcesVerywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Immune response.UCLA Health.Chronic stuffiness could be rhinitis.Calvo-Henríquez C, Abelleira R, González-Barcala FJ.Positional nasal congestion. Sleep apnea’s forgotten cousin. La congestión nasal posicional. El hermano olvidado de la apnea del sueño.Arch Bronconeumol (Engl Ed). Published online January 4, 2021. doi:10.1016/j.arbres.2020.12.011Mohamed S, Emmanuel N, Foden N.Nasal obstruction: a common presentation in primary care.Br J Gen Pract. 2019;69(689):628-629. Published 2019 Nov 28. doi:10.3399/bjgp19X707057University of Rochester Medical Center.Fear: body alert!Northwestern Medicine.Quick dose: Why does the cold weather make my nose run?Alromaih S, Alsagaf L, Aloraini N, et al.Drug-induced rhinitis: narrative review.Ear, Nose & Throat Journal. Published online November 15, 2022. doi:10.1177/01455613221141214Penn Medicine Becker ENT & Allergy.GERD treatment.Mahdavinia M, Schleimer RP, Keshavarzian A.Sleep disruption in chronic rhinosinusitis.Expert Rev Anti Infect Ther. 2017;15(5):457-465. doi:10.1080/14787210.2017.1294063Institute for Quality and Efficiency in Health Care.Heartburn and GERD: treatment options for GERD.DailyMed.Label: CHILDRENS BENADRYL ALLERGY- diphenhydramine hydrochloride solution.American Academy of Pediatrics.Can I give my 5-year-old over-the-counter cough medicine?Additional ReadingSleep Foundation.Allergies and sleep.
12 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.MedlinePlus.Immune response.UCLA Health.Chronic stuffiness could be rhinitis.Calvo-Henríquez C, Abelleira R, González-Barcala FJ.Positional nasal congestion. Sleep apnea’s forgotten cousin. La congestión nasal posicional. El hermano olvidado de la apnea del sueño.Arch Bronconeumol (Engl Ed). Published online January 4, 2021. doi:10.1016/j.arbres.2020.12.011Mohamed S, Emmanuel N, Foden N.Nasal obstruction: a common presentation in primary care.Br J Gen Pract. 2019;69(689):628-629. Published 2019 Nov 28. doi:10.3399/bjgp19X707057University of Rochester Medical Center.Fear: body alert!Northwestern Medicine.Quick dose: Why does the cold weather make my nose run?Alromaih S, Alsagaf L, Aloraini N, et al.Drug-induced rhinitis: narrative review.Ear, Nose & Throat Journal. Published online November 15, 2022. doi:10.1177/01455613221141214Penn Medicine Becker ENT & Allergy.GERD treatment.Mahdavinia M, Schleimer RP, Keshavarzian A.Sleep disruption in chronic rhinosinusitis.Expert Rev Anti Infect Ther. 2017;15(5):457-465. doi:10.1080/14787210.2017.1294063Institute for Quality and Efficiency in Health Care.Heartburn and GERD: treatment options for GERD.DailyMed.Label: CHILDRENS BENADRYL ALLERGY- diphenhydramine hydrochloride solution.American Academy of Pediatrics.Can I give my 5-year-old over-the-counter cough medicine?Additional ReadingSleep Foundation.Allergies and sleep.
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read oureditorial processto learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
MedlinePlus.Immune response.UCLA Health.Chronic stuffiness could be rhinitis.Calvo-Henríquez C, Abelleira R, González-Barcala FJ.Positional nasal congestion. Sleep apnea’s forgotten cousin. La congestión nasal posicional. El hermano olvidado de la apnea del sueño.Arch Bronconeumol (Engl Ed). Published online January 4, 2021. doi:10.1016/j.arbres.2020.12.011Mohamed S, Emmanuel N, Foden N.Nasal obstruction: a common presentation in primary care.Br J Gen Pract. 2019;69(689):628-629. Published 2019 Nov 28. doi:10.3399/bjgp19X707057University of Rochester Medical Center.Fear: body alert!Northwestern Medicine.Quick dose: Why does the cold weather make my nose run?Alromaih S, Alsagaf L, Aloraini N, et al.Drug-induced rhinitis: narrative review.Ear, Nose & Throat Journal. Published online November 15, 2022. doi:10.1177/01455613221141214Penn Medicine Becker ENT & Allergy.GERD treatment.Mahdavinia M, Schleimer RP, Keshavarzian A.Sleep disruption in chronic rhinosinusitis.Expert Rev Anti Infect Ther. 2017;15(5):457-465. doi:10.1080/14787210.2017.1294063Institute for Quality and Efficiency in Health Care.Heartburn and GERD: treatment options for GERD.DailyMed.Label: CHILDRENS BENADRYL ALLERGY- diphenhydramine hydrochloride solution.American Academy of Pediatrics.Can I give my 5-year-old over-the-counter cough medicine?
MedlinePlus.Immune response.
UCLA Health.Chronic stuffiness could be rhinitis.
Calvo-Henríquez C, Abelleira R, González-Barcala FJ.Positional nasal congestion. Sleep apnea’s forgotten cousin. La congestión nasal posicional. El hermano olvidado de la apnea del sueño.Arch Bronconeumol (Engl Ed). Published online January 4, 2021. doi:10.1016/j.arbres.2020.12.011
Mohamed S, Emmanuel N, Foden N.Nasal obstruction: a common presentation in primary care.Br J Gen Pract. 2019;69(689):628-629. Published 2019 Nov 28. doi:10.3399/bjgp19X707057
University of Rochester Medical Center.Fear: body alert!
Northwestern Medicine.Quick dose: Why does the cold weather make my nose run?
Alromaih S, Alsagaf L, Aloraini N, et al.Drug-induced rhinitis: narrative review.Ear, Nose & Throat Journal. Published online November 15, 2022. doi:10.1177/01455613221141214
Penn Medicine Becker ENT & Allergy.GERD treatment.
Mahdavinia M, Schleimer RP, Keshavarzian A.Sleep disruption in chronic rhinosinusitis.Expert Rev Anti Infect Ther. 2017;15(5):457-465. doi:10.1080/14787210.2017.1294063
Institute for Quality and Efficiency in Health Care.Heartburn and GERD: treatment options for GERD.
DailyMed.Label: CHILDRENS BENADRYL ALLERGY- diphenhydramine hydrochloride solution.
American Academy of Pediatrics.Can I give my 5-year-old over-the-counter cough medicine?
Sleep Foundation.Allergies and sleep.
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