What Causes Nasal Congestion at Night?

We all know how important it is for us and our children to get a good night’s sleep. Unfortunately, nasal congestion at night can make sleeping difficult, if not almost impossible. It can leave you or your children feeling stuffy and exhausted when it is time to get up in the morning. Fortunately, waking up in the middle of the night with a stuffy nose does not necessarily indicate that you are coming down with something, but that does not mean that you should let your symptoms go unaddressed.

Below, we take a look at what causes your nose to become stuffy at night and what you can do to relieve your congestion. The information below is for educational purposes only and should not be construed as medical advice. Please consult your physician for a diagnosis before making medical decisions.

Why does nasal congestion get worse at night?

A congested or stuffy nose primarily happens when the tissues in your nasal cavity become swollen. This swelling is due to inflamed blood vessels and fluid buildup in the tissues, and often becomes worse when you lie down. This could be because your movements and positions (such as sitting upright compared to lying down) affect your bodily functions, including blood circulation, causing you to experience certain symptoms, such as nasal congestion or shortness of breath at night, even if you felt perfectly healthy during the day.

In addition to contributing to nasal inflammation, your posture can also affect how mucus builds up in your nasal cavity. While you are standing or sitting upright, you have gravity helping you drain the mucus from your nasal cavity, but when you lie down, it becomes easier for mucus to accumulate and cause congestion.

Nasal congestion at night can become especially noticeable when you have a cold, the flu or a sinus infection. You will notice how quickly a daytime runny nose can quickly turn to a stuffy nose once you lie down to go to sleep. According to the NIH, nasal congestion may be caused by:

  • Respiratory infections—A cold, flu or sinus infection are common causes.
  • Hay fever or other allergies—If you have respiratory allergies and you breathe in allergens such as mold spores, dust mites, pet dander or pollen, your body may release chemicals that cause allergy symptoms, including nasal congestion.
  • Nasal polyps—These small, sac-like growths can grow in the lining of your nasal cavity. Though benign, bigger nasal polyps can obstruct the airway.
  • Nonallergic rhinopathy—This term refers to nasal irritation caused by foods, odors or atmospheric conditions, rather than by allergies or infection. For example, cold, dry air can cause the mucus in your nose to become dry and thick, as well as prevent sinus drainage, causing nasal congestion.
  • Pregnancy—Hormonal changes during pregnancy can affect the blood flow to the nasal cavity, causing inflammation and congestion.

What causes nighttime congestion in children?

Children and infants have narrower nasal passageways than adults, making them more susceptible to nighttime congestion caused by inflammation or excess mucus. Very young children and especially infants, who mostly breathe through their nose, cannot blow their noses as adults can. For adults, nasal congestion is a serious annoyance that can keep us from getting a good night’s sleep, but for children, it has the potential to lead to even bigger health risks. For example, Stanford Children’s Health states that a stuffy nose could affect your child’s hearing, in addition to keeping them from getting the sleep that they need for their still-developing bodies. Other long-term effects of nasal congestion, as described by the NIH, include speech development, while mucus drainage could lead to ear and sinus infections in children.

It can be difficult to determine just why your child is experiencing nasal congestion at night because children cannot always clearly explain the type and severity of symptoms that they are experiencing (Meltzer et al., 2013). Overall, the NIH lists some of the reasons behind your child’s stuffy nose around bedtime are similar to those for adults:

  • Common cold or flu, which can fill the nasal cavity with mucus
  • Sinus infection
  • Hay fever or other allergies
  • Nonallergic rhinopathy

However, with younger children, more sudden nasal congestion (especially when confined to a single nostril) may also be caused by a foreign object obstructing the nasal cavity.

Allergies and nighttime nasal congestion

Not only does lying down increase your symptoms of nasal congestion, but your allergy symptoms can also worsen during the night, causing a runny or stuffy nose as well as coughing or sneezing that make it difficult to get a good night’s sleep. The body’s production of certain allergy-regulating hormones differs, depending on where it is in the sleep-wake cycle. When you are fully awake, you produce more of these hormones, and when we are getting close to sleeping, the production of these hormones starts to dip, leaving our bodies more susceptible to allergic reactions (Koinis-Mitchell et al., 2012).

Your body’s reactions to pollen, pet dander, mold and dust mites can become more severe during the night. While partly caused by the dip in allergy-regulating hormones, there are other factors that contribute to this as well. For instance, dust mites are typically concentrated in mattresses and pillows, meaning that you are exposed to them consistently all night long. Because of this, someone with a dust mite allergy may notice that their symptoms become worse at night and when they first wake up in the morning. Additionally, if you have a pet that has a habit of sleeping on your bed, there will be a higher concentration of pet dander there. The hours of nighttime exposure may cause an allergic reaction.

Preventing nasal congestion at night

Experiencing periods of nighttime nasal congestion does not mean that you have to resign yourself to nights filled with restless sleep. No matter the reason that you or your children experience a stuffy nose around bedtime, there are steps that you can take to help you and your family breathe more easily during the night and get better, more restful sleep.

For adults, here are some common home care tips: 

  • Arrange your pillows so that you can sleep with your head elevated. This can reduce the blood pooling in your nasal cavities and, in turn, reduce congestion-causing inflammation.
  • Use a humidifier to keep the air from becoming too dry in your bedroom. This will help keep your nasal cavity from drying out.
  • Drink clear fluids throughout the day, especially those without sugar, alcohol or caffeine, to keep mucus thin and help drain it from your nose.
  • Remove mucus with the help of a nasal wash, using a saline nasal spray.
  • If you have allergies, you can avoid allergy triggers by decreasing the presence of allergens in your room with regular cleaning. Additionally, an air purifier can help reduce airborne allergens in your bedroom. During a pilot study of the impact of the Molekule air purifier, participants who reported allergy-like symptoms used the unit for 4 weeks and reported changes with regards to sleep quality as well as nasal and eye symptoms. Find out more here.

For children, the NIH offers some of the following home care tips:

  • Place a pillow under the head of your child’s mattress or find another way to raise the head of your child’s bed so that their head is elevated while they sleep.
  • Consider adding a cool-mist vaporizer to your child’s room, though you should take care to avoid adding too much extra moisture to the air. The vaporizer should be cleaned and disinfected every day.
  • Use your shower to steam up the bathroom before your child goes to bed. Bring them in there to breathe the warm, moist air for a little bit to help add moisture to their nasal passages before they go to sleep.
  • Encourage your older children to drink extra sugar-free fluids during the day.
  • Use gentle saline nasal drops or sprays. You can find these products at drugstores or make them at home with common household ingredients like water, salt, and baking soda.
  • Try nasal suctioning with a bulb syringe for infants, which works well for babies under a year old.

Getting a good night’s sleep is one ingredient to leading a happy, healthy life. By finding the cause of the nighttime congestion affecting you or your child and taking steps to fix it, you are inviting more restful sleep back into your life. You cannot always avoid a stuffy nose around bedtime, but, with the steps above, you should be able to alleviate your symptoms enough to sleep through the night.

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