Why Congestion May Get Worse at Night

Nasal congestion often seems to get worse at night. Congestion, also known as a stuffy nose, is due to fluid buildup in the tissue lining the nasal passages. This shrinks the 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 are too distracted during the day to notice how stuffy you really are. But that's not the whole story.

With some health conditions, lying down makes symptoms worse. Nighttime congestion could simply be a matter of human anatomy and gravity.

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

Reasons Behind Nighttime Congestion

Many people think that a feeling of stuffiness is caused by excess mucus blocking the nasal passageways. But that is not the only reason.

The real culprit of congestion is swollen and/or inflamed blood vessels inside the nasal passages.

There are several possible reasons that are specific to nighttime activities.

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, which is harder to ignore.

Many people notice that congestion starts to improve an hour or two after they get up in the morning. That's gravity doing its work once again.

Blood Flow Changes

When you lie down, your blood pressure changes. You may have increased blood flow to the upper part of your body, including 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.

Increased blood flow due to pregnancy is also a common cause of congestion.

Alternate-Side Nasal Congestion

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.

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

Acid Reflux

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

Known as reflux, it occurs when the valve between the stomach and esophagus (esophageal sphincter) is unable to stay closed.

People with GERD can experience acid reflux at any time of day. However, when lying down and losing the help of gravity, the valve is even less likely to keep stomach acid from coming up the esophagus.

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

GERD can lead to nighttime nasal congestion as well because the back of the throat is connected to the nasal passageways. Acid reflux can cause nasal irritation that can lead to congestion.

Some medical professionals believe there's a link between GERD, chronic sinusitis, and nasal congestion.

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 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 possible reasons for 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.