Nocturnal Nasal Congestion Treatments

Nocturnal nasal congestion is uncomfortable and may keep you from getting the sleep you need. If this is a chronic problem, you should visit your primary-care doctor or specialist. Your doctor will try to determine the cause of the congestion and recommend medications such as an antihistamine, a decongestant or an anti-inflammatory.

Work With Your Doctor

• You should develop a symptom diary that notes when you have nocturnal nasal congestion and what you were doing that day, the medications you take and any other symptoms such as face pain, a greenish nasal discharge, chronic bad breath or tooth pain (which could indicate a sinus infection). Let your doctor know if you are continually exposed to pollutants, chemicals or irritants.
  Your doctor may suggest that you get allergy testing. Allergy shots may be warranted.
  If your doctor thinks that you may have a nasal obstruction such as a deviated septum or polyps, you may need to have a CT scan to determine if surgery is warranted.

Medications

• An over-the-counter nasal decongestant such as Afrin can relieve your nasal stuffiness. Do not use it any longer than three days in a row, or your nasal congestion could worsen. Decongestant pills such as Sudafed can be purchased without a prescription, but they can make you jittery and keep you awake. Take this medicine in the morning so it won't affect your sleep. Decongestants can worsen high-blood pressure, so consult your doctor before using one.
  If allergies are the cause of your nocturnal nasal congestion try using an antihistamine such as Sudafed or Benydryl, which can relieve your runny nose and mucus in your sinus passages. Antihistamines do cause drowsiness, but if taken before you go to bed will help you sleep.
  You can also purchase nonsedating antihistamines over the counter such as Claritan or Zyrtec to use during the day. The nonsedating antihistamine Allegra D requires a prescription but will also open your nasal passages. The prescription antihistamine nasal spray Astelin is another medicine to ask your doctor about.
  The nasal spray cromolyn sodium coats your nasal passages and sinuses, preventing allergens from causing nasal congestion. It is important that you begin using the spray before the start of allergy season. Cromolyn sodium nasal spray is available by prescription, as well as over-the-counter.
  A newer allergy medication is a leukotriene inhibitor such as Singulair. For many people it will stop the chemicals that cause nasal allergy symptoms.
  No matter what the cause of your nocturnal nasal congestion, most doctors recommend treating the inflammation in your sinuses with corticosteroid sprays such as Flonase, Rhinocort or Nasonex. In order for them to work you must use them every day, and sometimes twice a day for more than two weeks.

Before Bedtime

• Use a saltwater spray or wash every night to clear allergens and mucus from your nasal passages and sinuses. You can purchase nasal saline or you can make it at home with one pint of distilled water, two teaspoons of kosher salt and one teaspoon of baking soda. You can also use a neti pot (available at health stores or on the Internet) a waterpik with a nasal irrigation attachment or a plastic squirt bottle. Just lean your head over the sink and pour the saline into one nostril and allow it to drain out the other nostril.
  Take a shower and wash your hair before you go to bed if you have pollen allergies and you've been outdoors during high-pollen-count days. Otherwise, you'll be sleeping in the pollen, which can worsen your nocturnal nasal congestion. If you are allergic to dust mites, allergy-proof your bedding by using mattress covers that keep the dust mite count down. And wash your bedding in hot water. If you are allergic to animal dander, don't let your pet sleep in your bedroom. You can also try putting a high-efficiency air filter in your bedroom, or if humidity is low, a cool-air humidifier.