Jordan C Stern, MD
Nasal Congestion and Sleep
We really don’t appreciate the nose until we have a cold and cant breathe through it. We have to open our mouth, get a dry throat, and just not get that sensation that we are really breathing. That’s because the nose has receptors in it that tell the brain that we are breathing, and this makes us feels comfortable. So when we’re not breathing through the nose, the brain is not really sure what’s happening, and this can give us the sensation that we are not getting enough air or oxygen (although we are). The nose also has an important role in filtering air that we breathe to get rid of the impurities, and things like dust and pollen. It also warms and humidifies the air, so that when air enters the lungs it is close to body temperature and humidified.
There are many causes for nasal congestion including, a cold or flu, allergies, trauma like a broken nose, or other problems like a deviated septum, sinus infections, or chronic sinusitis, or enlargement of the turbinates in the nose, changes in temperature or humidity in the air, pollution, strong odors and perfumes, changes in temperature perceived by the body even when feet are touching a cold surface.
We sleep better when we can breathe through the nose. Nasal congestion, can cause an increase effort in breathing and this can be a cause to wake up either consciously, or not throughout the night. This can cause interruptions in our normal sleep cycle and can interfere with getting deep sleep and REM sleep.
Nasal congestion can cause snoring. In many cases the snoring comes from having to open the mouth while sleeping, and this can change the position of the tongue in the throat and actually narrow the breathing passages.
WHAT CAN YOU DO?
Keep your nose clear, and keep the air in the room cool, and relatively humid. Try a humidifier if the air is too dry. Make sure nothing in your bed is causing congestion from nasal irritation or allergies. Start with your pillows, mattresses, and sheets. You may be allergic to something in your bed … your pets?, down feather in the pillow?, something in the mattress?, or maybe an additive in your soap or detergent.
Check all these things out …
During the allergy season, make sure you are not bringing pollen from the outside into your bed. Its on your body and your hair … so if you have allergies make sure you take a bath or shower before getting into bed to get rid of all that pollen …
Being horizontal can often increase blood flow to the nose, and if your nose is narrow or even if it isn’t, you may develop nasal congestion when lying down. You may want to see your ENT doctor about this as you may have a deviated septum or enlarged turbinates. Over the counter medications like Flonase, Nasonex, can sometimes help, but best to see your doctor first to make sure there are no contra-indications to taking these medications (like pregnancy, diabetes, glaucoma, to name just a few).
Some other over the counter medications like Afrin, oxymetazoline, and others can be very addictive and cause increase in blood pressure and heart rate, so again, check with your doctor …
Nasal rinses with water, Neti pots, saline, are a good way to clean the inside of the
nose and remove excess dust , debris, and pollen that have accumulated during the day. Some people cannot tolerate these treatments, as the water gets stuck in the sinuses, this can be very painful.
If you’ve tried these remedies with no improvement, you need to see an ENT specialist who can look inside the nose with special nasal endoscopes, and make sure you don’t have a narrow nose from deviated septum, large turbinates, nasal polyps, or other abnormalities causing the nasal congestion. You may also need to see an allergist especially if your nasal congestion is associated with sneezing.