Why Does My Nose Get Stuffy at Night?

A stuffy nose at night can be more than just an annoyance — it often feels like a persistent blockage that makes it difficult to breathe, causing you to toss and turn. This can leave you feeling groggy and tired the next day.

There are various reasons why a stuffy nose occurs, ranging from allergies to acid reflux. Allergens, in particular, can be a major culprit, with triggers like dust mites, pollen, and pet dander sneaking into your sleep environment.

Here’s what you need to know about the different causes of a stuffy nose at night and ways to find effective relief.

What Causes Stuffy Nose at Night?

A stuffy nose at night can be caused by several factors, including nasal congestion from allergies, sinus infections, dry air, or positional changes while sleeping. Each of these causes can lead to nighttime nasal congestion in different ways.

We’ll explore each factor below:

Allergens

Inhaling allergens such as pollen, dust mites, and pet dander causes a stuffy nose at night by triggering an immune response. The most likely by far being dust mites. The release of histamine causes the blood vessels in the nasal passages to dilate and the surrounding tissues to swell [*].

The mucous membranes in the nose also produce excess mucus as part of the immune defense. This excess mucus can accumulate, further blocking the nasal passages and leading to that characteristic "stuffy" feeling.

Related: Why Do My Allergies Get Worse at Night?

Dry air

Nighttime dry air can contribute to a stuffy nose at night by irritating and drying out the delicate tissues of the nasal passages. This irritation triggers inflammation, causing the nasal tissues to swell and narrow, which makes it harder for air to pass through.

In response, your body may produce more mucus to compensate for the dryness, and this can further clog the nasal passages. This combination of inflammation and excess mucus can create uncomfortable blockages that disrupt your ability to breathe easily during the night.

Sleeping position

When you're upright, gravity helps drain mucus from your sinuses, which helps keep your nasal passages clearer. However, when you lie down, this drainage slows, and mucus accumulates in your nasal passages and causes congestion [*].

Structural problems in the nostrils and nasal cavities can indeed make congestion worse when lying down. These issues can either be congenital (something you’re born with) or acquired through injury. Examples include a deviated septum, cleft palate, concha bullosa, and even aging.

Changes in postural blood flow

Postural blood flow changes can cause a stuffy nose at night by increasing blood flow to the nasal tissues when lying down. This increased blood flow leads to swelling and congestion in the nasal passages as gravity shifts and the body adjusts to the horizontal position.

The enhanced blood flow causes the blood vessels in the nasal passages to expand, which contributes to inflammation and a feeling of nasal obstruction.

Sinus infections

Sinus infections cause inflammation of the sinus lining, which leads to swelling and narrowing of the nasal passages.

During a sinus infection, the body produces excess mucus as part of the immune response to fight off the infection. This excess mucus can accumulate in the nasal passages and sinuses, leading to a blocked or stuffy nose [*].

Cold or Flu

A cold or flu causes a stuffy nose at night by triggering inflammation and irritation in the nasal passages. The body's response to the virus includes increased mucus production to help clear the infection, which can lead to congestion.

Related: Allergies vs. Colds: Which is It?

Acid reflux

Acid reflux causes a stuffy nose at night by irritating the throat and nasal passages with stomach acid that travels up the esophagus. This irritation can lead to inflammation and swelling in the nasal passages, triggering increased mucus production and congestion [*].

How to Relieve Stuffy Nose at Night

Here are some strategies that might help you breathe easier and get a better night’s sleep:

• Avoid irritants. Keep your bedroom free from allergens and irritants, such as pet dander, dust, and strong fragrances, which can exacerbate congestion. Vacuum your bedroom frequently, especially floors, furniture, and hard-to-reach areas. Additionally, wash your pillowcases and blankets in hot water to kill dust mites. For dust mites, the most important thing to do is to get dust mite encasements for the mattress and pillow.
• Manage your allergies. If allergies are causing your congestion, over-the-counter (OTC) allergy medications can help relieve some of the symptoms, but most allergists agree that nasal sprays target the nose more precisely with less side effects. Nasal sprays containing an antihistamine, decongestant, and other clinically proven ingredients can be particularly effective. Allermi nasal spray offers several advantages over standard treatments, such as addressing various allergy symptoms simultaneously while minimizing potential side effects.
• Elevate your head. Sleeping with your head elevated can help prevent mucus from pooling in your nasal passages. Try using a wedge pillow, but avoid stacking pillows. If you have an adjustable bed, you can elevate the head of the bed to the desired angle for optimal comfort and congestion relief.
• Stay hydrated. Drinking plenty of fluids can help keep mucus thin and easier to expel. Aim to drink at least 8 glasses (about 2 liters) of water daily. If you are dealing with high levels of congestion or are in a dry environment, you may need to drink more.
• Saline nasal spray. Over-the-counter saline sprays can help moisten your nasal passages and clear out mucus. They also help rinse away allergens, dust, and other irritants from the nasal passages. Allermi’s moisturizing saline nasal mist offers a convenient way to maintain nasal hydration and is ideal for daily use.
• Apply a warm compress. Applying a warm compress to your face can help relieve sinus pressure and open up nasal passages. Try a warm, damp washcloth placed over your nose and forehead.
• Steam inhalation. Inhaling steam from a bowl of hot water or taking a hot shower can help loosen congestion. The warm, moist air from steam inhalation helps hydrate dry and irritated nasal tissues, which reduces discomfort.

Using a combination of these methods can provide more comprehensive relief.

Related: How to Unstuff Your Nose Instantly

When to See a Doctor for Nighttime Stuffy Nose

You should see a doctor for a stuffy nose at night if your symptoms persist for more than a week despite home treatments, are accompanied by severe pain, high fever, or significant difficulty breathing, or if you experience recurrent or chronic congestion that interferes with daily activities.

If you have underlying health conditions, it’s best to seek medical advice for a proper diagnosis and treatment plan.

Related: What's the Best Nasal Spray for Congestion? 

The Bottom Line

A stuffy nose at night can be really annoying and affect your sleep, but knowing why it happens and trying some effective solutions can help a lot. Managing allergens, staying hydrated, using a humidifier, and trying nasal sprays or steam inhalation can make it easier to breathe.

Remember, if your symptoms persist or cause significant discomfort, it's important to consult a healthcare professional for personalized advice.

References:

1. Professional, C. C. M. (2024a, May 1). Rhinorrhea (Runny Nose). Cleveland Clinic. https://my.clevelandclinic.org/health/symptoms/17660-runny-nose
2. Chronic stuffiness could be rhinitis. (2023, March 27). UCLA Health. https://www.uclahealth.org/news/article/chronic-stuffiness-could-be-rhinitis
3. Sinus Infection (Sinusitis). (2024, August 20). Cleveland Clinic. https://my.clevelandclinic.org/health/diseases/17701-sinusitis
4. Hamizan, A. W., Choo, Y. Y., Loh, P. V., Talib, N. F. A., Ramli, M. F. M., Zahedi, F. D., & Husain, S. (2021). The association between the reflux symptoms index and nasal symptoms among patients with non-allergic rhinitis. The Journal of Laryngology & Otology, 135(2), 142–146. https://doi.org/10.1017/s0022215120002492