Blocked Nose at Night: Causes, Symptoms and Treatments

A blocked nose at night can result from various factors, including environmental conditions, underlying medical issues, and the body's natural response to lying down. Below are some common causes:

Allergic Rhinitis

Allergic rhinitis is one of the most common culprits behind nighttime nasal congestion. This condition occurs when your immune system reacts to dust mites, pet dander, or pollen allergens. These allergens are often more concentrated in bedrooms, particularly in bedding, carpets, and curtains. The body’s immune response releases histamines, leading to inflammation and swelling of the nasal passages, which can become more pronounced at night as you settle into bed.

Non-Allergic Rhinitis

On the other hand, non-allergic rhinitis is triggered by factors such as changes in temperature or humidity, exposure to strong odours, or irritants like smoke. At night, environmental changes, such as cooler bedroom temperatures or the dry air from heaters, can exacerbate non-allergic rhinitis, leading to nasal congestion that worsens when you lie down.

Sinus Infections

Sinus infections, or sinusitis, occur when the sinuses become inflamed due to disease or allergies. Sinusitis often causes significant nasal congestion, which can worsen at night due to the effects of gravity and lying down. The pooling of mucus in the sinuses increases pressure, leading to a blocked nose that disrupts sleep. Facial pain, ear pain, headaches, and a feeling of fullness in the face often accompany this condition.

Sleep Apnoea

Sleep apnoea is a severe sleep disorder where a person’s breathing repeatedly stops and starts during sleep. This condition can contribute to nighttime nasal congestion in several ways:

Obstructive Sleep Apnea (OSA) - In OSA, the airway becomes partially or completely blocked during sleep. This can cause swelling in the nasal passages and make it difficult to breathe through the nose, particularly at night. Repeated pauses in breathing can also lead to a buildup of mucus and congestion.

Impact on nasal passages - People with sleep apnea often breathe through their mouths, leading to dry airways and increased nasal congestion. Additionally, the use of continuous positive airway pressure (CPAP) machines, a common treatment for sleep apnea, can sometimes lead to nasal congestion as a side effect.

Environmental Factors

Dry air - Dry indoor air, particularly in winter, can dry out the nasal passages, making them more susceptible to blockage. Heaters used during cold nights can reduce humidity levels, exacerbating this problem.

Bedroom allergens - Dust mites, pet dander, and other allergens common in bedding and upholstered furniture can irritate the nasal passages, leading to congestion that worsens at night.

Blocked Nose in Children: Common Causes

A blocked nose at night is a common issue in children and can be caused by several conditions, some of which are unique to this age group.

Enlarged adenoids - One of the most common causes of nighttime nasal congestion in children is enlarged adenoids. Adenoids are small lumps of tissue at the back of the nasal cavity that play a role in immune defence. However, if they become enlarged—often due to repeated infections or allergies—they can obstruct the airway, leading to a blocked nose, snoring, and mouth breathing during sleep. This can result in restless sleep and fatigue during the day.

Allergic rhinitis - Like adults, children can suffer from allergic rhinitis, which is triggered by exposure to allergens like dust mites, pet dander, or pollen. These allergens can cause the nasal passages to become inflamed and swollen, mainly when a child is lying down at night. This condition can make it difficult for children to breathe through their noses, leading to a blocked nose and disrupted sleep.

Common colds and respiratory infections - Children are particularly susceptible to colds and other upper respiratory infections, which can cause significant nasal congestion. The congestion is often worse at night due to mucus pooling in the nasal passages when lying down. This can lead to difficulty breathing, frequent waking, and a generally uncomfortable night’s sleep.

Deviated septum - Although less common in children, a deviated septum—where the nasal septum (the wall between the nostrils) is displaced to one side—can cause chronic nasal congestion. This condition can be present from birth or result from an injury. A deviated septum can make one side of the nose more prone to blockage, particularly at night.

If a child’s nasal congestion is persistent, interferes with their sleep, or is accompanied by other symptoms such as difficulty breathing, it is essential to consult a healthcare professional to determine the underlying cause and appropriate treatment.

A blocked nose at night can manifest in various ways, affecting adults and children differently. Recognising these symptoms is the first step towards understanding the underlying cause and seeking appropriate treatment.

Difficulty Breathing Through the Nose

One of the most common symptoms is the inability to breathe comfortably through the nose, mainly when lying down. This often leads to mouth breathing, which can cause a dry mouth and throat upon waking.

Snoring

Nasal congestion can contribute to or worsen snoring, as the blockage forces air through a narrower passage, vibrating the throat tissues. This is a common symptom in both adults and children, and in some cases, it may indicate the presence of sleep apnea, especially if accompanied by pauses in breathing during sleep.

Restless Sleep

A blocked nose often leads to frequent waking during the night, difficulty falling asleep, or a general discomfort that prevents deep, restorative sleep. This can result in feeling tired and irritable during the day. Children with a blocked nose may toss and turn, wake up crying, or experience night-time coughing due to postnasal drip.

Headaches and Facial Pain

Sinus congestion can cause pressure in the sinuses, leading to headaches or facial pain, including toothache. This symptom is often worse in the morning or when bending over. In children, this might present as general irritability or complaints of facial or head discomfort.

Coughing and Sore Throat

Postnasal drip, where mucus drains down the back of the throat, can cause a persistent cough or sore throat, particularly noticeable at night and upon waking. Children may not always be able to describe their symptoms clearly, so look for signs like frequent throat clearing, coughing, or a hoarse voice.

The Impact on Sleep and Daily Life

The impact of a blocked nose at night extends beyond the immediate discomfort; it can significantly affect the quality of sleep and overall health. Such as:

• Sleep disruption

• Daytime fatigue

• Worsening of underlying conditions

• Impact on growth and development in children

• Increased risk of infections

Dealing with a blocked nose at night can be frustrating, but various treatment options and preventive measures can help alleviate symptoms and improve sleep quality. The right approach can make a significant difference, whether the congestion is due to allergies, a cold, or structural issues.

If you wish to learn more about how much sleep you need to perform, we have an article here at healthwords.ai.

Treatment options

Several over-the-counter (OTC) decongestants are available to help relieve nasal congestion and make breathing easier at night. These treatments are typically easy to use, but are only for short term use.

Nasal Decongestant Sprays

Nasal sprays containing decongestants like phenylephrine can reduce swelling in the nasal passages, allowing for easier breathing. These sprays are effective for short-term relief but should not be used for more than 7 days continuously to avoid rebound congestion, where symptoms worsen once the medication is stopped.

Saline Nasal Sprays

Saline sprays are a gentler option that can be used regularly without the risk of side effects. They help moisten dry nasal passages and thin mucus, making it clear. Saline sprays like Sterimar are safe for adults and children and can be especially useful before bedtime to ensure a more comfortable night’s sleep.

Steroid Nasal Sprays

Doctors may prescribe steroid nasal sprays for chronic nasal congestion, mainly due to conditions like allergic rhinitis. These sprays reduce inflammation in the nasal passages and are safe for long-term use under medical supervision. However, it may take several days to weeks to notice significant improvement.

Oral Decongestants

Oral decongestants, such as pseudoephedrine, can reduce nasal congestion by shrinking the blood vessels in the nasal passages. They include Sudafed, Sinutab, and Sudafed sinus tablets. These medications can provide longer-lasting relief than nasal sprays, but they may cause side effects like increased heart rate, anxiety, or difficulty sleeping. Oral decongestants should be used with caution, particularly in individuals with high blood pressure or other cardiovascular conditions.

Antihistamines

If allergies cause nasal congestion, antihistamines can help by reducing the body’s allergic response. Non-drowsy antihistamines, such as loratadine or cetirizine, can be taken during the day while sedating antihistamines like diphenhydramine can be helpful at night to both alleviate symptoms and promote sleep.

Antibiotics

Antibiotics may be necessary if nasal congestion is due to a bacterial infection, such as sinusitis. However, antibiotics are ineffective against viral infections like the common cold, so they should only be used when a bacterial cause is confirmed.

5 Natural Remedies and Lifestyle Changes

For those seeking alternative or complementary approaches, several natural remedies and lifestyle changes can help manage a blocked nose at night.

Humidifiers

Using a humidifier in the bedroom can add moisture to the air, which helps to keep nasal passages from drying out and becoming irritated. This can be particularly beneficial during winter when indoor heating can dry out the air.

Steam Inhalation

Inhaling steam from a bowl of hot water or during a hot shower can help to open up the nasal passages and relieve congestion. Adding essential oils like eucalyptus or peppermint to the water can enhance the effect by helping to clear the sinuses.

Elevating the Head During Sleep

Keeping the head elevated while sleeping can prevent mucus from pooling in the nasal passages, making breathing easier. This can be achieved by using an extra pillow or raising the head of the bed slightly.

Hydration

Staying well-hydrated is crucial for keeping mucus thin and easy to clear. Drinking plenty of water throughout the day can help reduce congestion and improve overall comfort at night.

Saline Rinse (Nasal Irrigation)

Nasal irrigation using a saline solution can help flush out mucus and allergens from the nasal passages. Devices like neti pots or saline squeeze bottles are commonly used. Using sterile or distilled water is essential to avoid introducing bacteria into the nasal passages.

Preventive Measures

In addition to treating a blocked nose at night, taking preventive measures can help reduce the frequency and severity of congestion.

Managing Allergies

If allergies are a known trigger, reducing exposure to allergens like dust mites, pet dander, and pollen can significantly help. This might include using hypoallergenic bedding, keeping windows closed during high pollen seasons, and using air purifiers.

Regular Cleaning

Keeping the living environment clean and free of dust and other irritants can help prevent nasal congestion. Regularly washing bedding, vacuuming carpets, and dusting surfaces can reduce allergens in the home.

Avoiding Irritants

Smoke, strong perfumes, and household chemicals can irritate the nasal passages and should be avoided, especially in the bedroom.

Healthy Sleep Environment

Creating a sleep-friendly environment by maintaining a comfortable temperature, using a humidifier, and ensuring the bed is comfortable can all contribute to better sleep and reduced nasal congestion.

While a blocked nose at night is often a minor issue that can be managed with over-the-counter treatments and home remedies, there are certain situations where it’s essential to seek medical advice. Persistent or severe nasal congestion can sometimes be a sign of a more serious underlying condition that requires professional evaluation and treatment.

Persistent or Chronic Nasal Congestion

If nasal congestion lasts for more than ten days or if it frequently recurs without clear triggers like a cold or allergies, it may be indicative of chronic conditions such as:

Chronic Sinusitis - Persistent inflammation of the sinuses can cause long-term nasal congestion, facial pain, and a reduced sense of smell. This condition often requires medical treatment, such as antibiotics or corticosteroids, and sometimes even surgery to alleviate symptoms.

Difficulty Breathing or Sleep Apnoea

If you experience difficulty breathing through your nose at night to the point where it interferes with sleep or causes you to wake up frequently, it could be a sign of sleep apnoea. Sleep apnoea is a severe condition where breathing repeatedly stops and starts during sleep, often due to airway obstruction. Symptoms include loud snoring, gasping for air during sleep, and excessive daytime sleepiness.

If sleep apnoea is suspected, it’s crucial to seek medical evaluation. Treatment options include a continuous positive airway pressure (CPAP) machine, lifestyle changes, or surgery.

Recurrent Infections

If nasal congestion is accompanied by frequent sinus infections, ear infections, or respiratory infections, it may be necessary to see a doctor. Recurrent infections could indicate an underlying issue with the immune system or a chronic condition that needs to be addressed.

For children, recurrent ear infections and nasal congestion may be linked to enlarged adenoids, which can block the nasal passages and lead to ongoing breathing difficulties. In such cases, an ENT (ear, nose, and throat) specialist might recommend adenoidectomy (surgical removal of the adenoids) to resolve the issue.

Signs of Complications

In rare cases, a blocked nose can lead to complications that require urgent medical attention. Seek immediate help if you or your child experience any of the following:

• Severe headache or facial pain: While some discomfort is expected with nasal congestion, severe or worsening pain, especially around the eyes or forehead, could indicate a severe sinus infection or other complications.

• High fever: A blocked nose accompanied by a high fever (above 38°C) may indicate a bacterial infection that needs medical treatment.

• Swelling around the eyes or cheeks: This could be a sign of a severe sinus infection or an abscess and requires prompt medical attention.

• Vision changes or double vision: These symptoms can indicate that the infection has spread beyond the sinuses and is affecting the eyes or brain, necessitating urgent care.

When to Seek Help for Children

For children, it’s essential to monitor symptoms closely and seek medical advice if:

• The child has difficulty breathing, feeding, or sleeping due to a blocked nose.

• There are signs of dehydration, such as dry mouth, crying without tears, or reduced urination.

• The child has a fever that lasts more than a few days or is unusually high.

• Nasal congestion is accompanied by ear pain, which could indicate an ear infection.

• Early intervention can help prevent complications and ensure the underlying cause of nasal congestion is managed correctly.

Conclusion

Nasal congestion at night can be troublesome, but understanding the potential causes and knowing how to manage and treat it can make a significant difference in comfort and sleep quality. While many cases can be resolved with simple home remedies or over-the-counter treatments, it’s important to recognise when the condition may require medical attention. By addressing nasal congestion promptly and effectively, you can reduce the risk of complications and enjoy a better night’s sleep.