Clearing a stuffy nose while sleeping

A stuffy nose is something that bothers us all at one time or another, particularly when we have a cold, and when it gets better, we simply forget about it until the next time. However, there are some people for whom a stuffy, congested or blocked nose is an ever-present problem and they need to see a nose specialist or rhinologist.

Blockage may affect one side only, both sides or alternate from one side to the other. If intrusive enough or sufficiently impacting your daily life there are treatments that work well. In general, medications are tried first and surgery second. Both of these therapies are good at resolving or controlling a stuffy nose. Mr Michael O'Connell, an expert consultant ENT and nasal plastic surgeon explains how to treat a persistent stuffy nose.

What causes a blocked nose at night?

The causes may relate to a number of factors. Arguably the most common is allergy, particularly to house dust mite - a small creature invisible to the human eye, which lives around us, particularly in beds.

Hygiene is not the issue. Some people are genetically susceptible making them allergic to these creatures, resulting in nasal block, itching, a runny nose and sneezing. In such cases, hypoallergenic bed covers from shops, washing bedclothes at 60°C and hoovering the mattress - along with taking antihistamine tablets and nose sprays - make a huge difference.

Some patients report that their nose blocks when they lie on their side in bed, thus lying on the right is associated with right nasal block and the opposite when they lie on their left. Topical sprays which administer a low dose of steroid to the nose or surgery to the turbinates inside the nose can often help.

In addition, some of patients with night time blockage may find they have problems with a deviated nasal septum. This is the central partition dividing the nose into two internal channels and can bend into one or both sides, thus obstructing airflow. Again, nose sprays or straightforward surgery, known as septoplasty, offer effective results.

How do you sleep with a blocked nose?

In most cases, not very easily! Sometimes opening a window, using a humidifier or applying a salt water spray will help. For allergic patients the simple measures of hoovering the mattress, changing sheets weekly, washing bedclothes at 60°C and using protective covers can make a difference.

Medications in the form of low dose steroid nose sprays and antihistamine tablets work well and for the remaining patients surgery can really make a difference.

Some people use decongestant nose sprays but these can only be safely used in short courses for up to a week. Local pharmacies stock a variety of devices to physically open the nostrils, but these are only occasionally beneficial and are mostly irritating. If medications do not work then see a nose specialist.

How does a decongestant work?

Decongestants reduce the blood flow in the nose and shrink the lining, opening up the airway and allowing more air to flow through the nose. They can be taken as tablets or liquid, but mostly are used as sprays.

Decongestants are highly effective however, they can only be used for short periods as they can be addictive and soon start to worsen the nose blockage. Nasal decongestants should not be used for more than a week.

Are saline sprays affective for a stuffy nose?

Yes, they can help, particularly to provide moisture to the nose, especially in dry conditions or in the presence of air conditioning. When the nose is running, say from a cold or an allergy, then steroid sprays are more effective.

How can I tell if my nasal congestion is something more serious?

Nasal blockage is rarely serious, albeit it’s usually annoying, uncomfortable and intrusive in that it can prevent sleep and reduce quality of life.

It can be more serious if you notice pain, if it’s worsening and progressive on one-side or when blood is coming from the nose. If any of these apply, then you should seek the advice of a specialist.

If you want to talk to a specialist about your blocked nose, then don’t hesitate and book an appointment with Mr Mike O’Connell.