Why Congestion May Get Worse at Night

Nasal congestion often seems to get worse at night. Congestion, also known as a stuffy nose, is fluid buildup in the tissue lining the nasal passages. This narrows the upper airway, making it difficult to inhale and exhale through your nose.

Part of the reason congestion may feel worse at is night is that you might be too distracted during the day to notice how stuffy you really are. But that's not the whole story. There are a few other factors that contribute to increased stuffiness at night.

This article discusses the different causes of congestion at night. It also provides tips for easing nighttime stuffiness.

causes of nighttime congestion
Verwell / Brianna Gilmartin

Reasons Behind Nighttime Congestion

Stuffiness is caused by excess mucus blocking the nasal passageways. Another culprit is swollen and/or inflamed blood vessels inside the nasal passages. Both of these issues can be worse at night.

Nighttime congestion is sometimes a matter of human anatomy and gravity. With some health conditions, lying down makes symptoms worse. Many people notice that congestion starts to improve an hour or two after they get up in the morning. That's often gravity doing its work once again.

Anatomy and Congestion

When you are standing or sitting upright during the day, mucus is constantly draining naturally due to the force of gravity. It makes its way from your nose and sinuses into the back of your throat, where it is swallowed. You likely don't even notice it's happening.

However, when you are in bed or reclining in a horizontal position, gravity can cause mucus to pool or back up instead of drain.

Blood Flow Changes

When you lie down, your blood pressure changes. And blood flow to the upper part of your body can increase, including the blood flow to your head and nasal passageways.

This increased blood flow can inflame the vessels inside your nose and nasal passages, which can cause or worsen congestion.

Natural alterations in blood flow due to pregnancy is also a common cause of congestion.

Alternate-Side Nasal Congestion

Many people find that one nostril is clogged at certain times of the day, but the congestion switches sides at night. 

If only one nostril is clogged at night, it is likely due to alternate-side nasal congestion. This is due to a normal process known as the nasal cycle. The reason for the cycle is unknown, but it is not a disorder. 

The congestion occurs when a turbinate (a structure along the sinus wall that produces mucus) becomes swollen in one nostril. This blocks airflow on that side.

Acid Reflux

Gastroesophageal reflux disease (GERD) is a condition that causes stomach acid to flow back up into the esophagus, the tube that connects your mouth to your stomach.

Known as reflux, it occurs when the sphincter between the stomach and esophagus (esophageal sphincter) is weak and unable to stay closed. Acid reflux can cause nasal irritation that can lead to congestion.

People with GERD can experience acid reflux at any time of day. And hen you lie down and lose the help of gravity, stomach acid is even more likely to come up the esophagus.

This is why GERD symptoms, including nasal congestion, sore throat, coughing, postnasal drip, wheezing, and hoarseness, tend to be worse at night and first thing in the morning.

Recap

Acid reflux due to GERD can cause nasal congestion. Reflux symptoms tend to get worse at night when you lie down. As a result, your nose may become more congested at night.

Reducing Nighttime Congestion

Studies show that nasal congestion at night can have a big impact on sleep quality. In fact, people with chronic sinusitis are three to nine times more likely to experience sleep disturbances with frequent nighttime awakenings.

Try these tips to help reduce nighttime congestion and sleep better:

  • Elevate the head of your bed instead of lying flat.
  • Don't eat within a few hours before going to bed or lying down.
  • Use a cool-mist humidifier at the side of your bed.
  • Drink plenty of water throughout the day.
  • Stop smoking.

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, or immunotherapy. Medications such as antacids and proton pump inhibitors are commonly used to treat GERD.

Summary

You're 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.

Your healthcare provider can determine the cause of your nighttime congestion, so you can get restful sleep.

Was this page helpful?
5 Sources
Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.
  1. Naclerio RM, Bachert C, Baraniuk JN. Pathophysiology of nasal congestion. Int J Gen Med. 2010;3:47-57. doi:10.2147/ijgm.s8088

  2. Kahana-Zweig R, Geva-Sagiv M, Weissbrod A, Secundo L, Soroker N, Sobel N. Measuring and characterizing the human nasal cycle. PLoS One. 2016;11(10):e0162918. doi:10.1371/journal.pone.0162918

  3. Gaude GS. Pulmonary manifestations of gastroesophageal reflux disease. Ann Thorac Med. 2009;4(3):115-23.  doi:10.4103/1817-1737.53347

  4. 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

  5. Institute for Quality and Efficiency in Health Care. Heartburn and GERD: Treatment options for GERD. 2018. 

Additional Reading