Nighttime Congestion: Causes, Treatments and Home Remedies
If you dread laying your head on the pillow each night because you just know your sinuses will soon become stuffy, you’re not alone. Many people experience nighttime congestion, often in the nose or chest. If you experience nightly congestion, it’s worth discussing the situation with your doctor.
Nighttime congestion usually is not due to a serious medical condition, but getting a diagnosis is always valuable. Once you know what might be causing your stuffiness, you can move toward nighttime congestion relief with various treatments, including inexpensive home remedies.
In some circumstances, nightly congestion can be caused by a serious health issue like obstructive sleep apnea (OSA), asthma, or chronic obstructive pulmonary disease (COPD). If you routinely experience nighttime congestion, you should see a healthcare provider to make sure your congestion isn’t caused by one of these issues.
For most people, though, nighttime congestion relates to more benign causes, including:
- Acid reflux, which can travel all the way from your stomach to your sinus cavity—and even be inhaled into the lungs—causing nighttime chest congestion or sinus congestion
- Allergies that keep sinus membranes inflamed throughout the night
- Cold or flu viruses that can cause the production of large quantities of mucus in the sinuses and lungs
- Deviated nasal septum that prevents the nasal passages from completely draining, especially when you’re lying down
- Dry bedroom air, which stimulates mucus production in the airways
- Nasal polyps, which can block the normal flow of mucus out of the nose
- Non-allergic rhinitis (also called vasomotor rhinitis), which causes your nose to run all the time
- Sinus infection causing inflammation of the sinus tissues
- Sleep posture, such as lying flat on your back, that promotes retention of mucus in the nose and sinuses instead of drainage
In general, when you lie down, blood flow increases to the tissues of your upper body, which, in turn, can increase swelling of sinus tissues and cause retention of more mucus in the sinuses. Lying down also makes it more difficult for your body to move secretions out of your lungs, which can cause feelings of chest congestion. Fortunately, you often can find relief with over-the-counter medications and home remedies.
When nighttime nasal or chest congestion is a symptom of another disorder, such as acid reflux, then consider treating the underlying cause. You can use over-the-counter medications for most of these underlying conditions, or your doctor may prescribe a generic version. Of course, you also can directly treat the congestion with medications too. The most effective drug therapies for nighttime congestion include:
- Antacids and proton pump inhibitors (PPIs), such as calcium carbonate chewables or omeprazole, to treat acid reflux
- Antihistamines, such as cetirizine, to treat nasal allergies
- Decongestants like pseudoephedrine to reduce swelling of tissues in the airway
- Guaifenesin, which thins mucosal secretions and allows them to move more freely through the airway (though this medication can cause coughing)
- Saline nasal sprays to moisturize dry airways and thin secretions
- Steroid nasal sprays like fluticasone for allergy treatment
Most people should avoid the habitual use of decongestant nasal sprays, as repeated use of these medicines can cause increased swelling of nasal tissues, which can make nighttime congestion worse. Affected individuals find themselves needing to readminister the nasal spray more frequently yet congestion persists.
Lifestyle changes may improve your nighttime congestion problems dramatically. Start with a few of these self-care tips:
- Avoid eating within two hours of bedtime to minimize the possibility of acid reflux during the night.
- Drink water to stay hydrated throughout the day, as this thins secretions so they can move out of the airway more easily.
- Humidify your bedroom air during furnace season or whenever it seems dry.
- Perform nasal irrigation using a neti pot or another device to gently rinse your nasal passages before bed.
- Purify the bedroom air to help clear airborne allergens and relieve allergy symptoms.
- Sleep on a wedge pillow or slightly elevate the head of your bed to minimize acid reflux while you sleep.
- Take a steamy shower an hour before bed to open nasal passages and promote drainage.
- Use a pillow that supports your spine in a sleep position (on your side) that allows your sinuses to drain during the night
If you try these solutions to your nighttime congestion troubles and still don’t get any relief, make an appointment with your healthcare provider. It’s possible you might need stronger prescription medications or further diagnostic tests to determine the exact cause of your nighttime stuffiness. A primary care practitioner may do an initial evaluation and prescribe medicine, but you may get a referral to an ear, nose and throat doctor (ENT) for additional testing, diagnosis and treatment.