Suffering from a blocked nose and struggling to get a good night’s sleep is one of those frustrating winter ills and chills. Spending the night breathing through your mouth, waking up with a dry throat, or breaking into coughing fits.
Night-time nasal congestion is very common, especially during winter, when colds, flu and other respiratory illnesses are spreading. The good news is that you don’t have to put up with it. Read on to learn what you can try before bed to soothe your symptoms and make breathing and sleeping more comfortable.
You’re not imagining that your blocked nose gets worse when you try to sleep. Nasal congestion occurs when the tissues lining your nasal passages become inflamed or swollen. Your nose may also produce excess mucus, further restricting air flow.
After struggling through the day and laying down to sleep, your nose might feel even more congested. This is because when you lie flat the natural drainage slows, causing mucus to build up in your sinuses. It also causes blood flow to increase to the sinuses, along with more white-blood cells, further adding to inflammation.
Some of the most common causes of nasal congestion include:
Good quality sleep is important to recovery, but nasal congestion can make this feel impossible to achieve. The following steps may make it easier to breathe and sleep when your nose is congested.
Using saline nasal spray, drops or rinses can help loosen and thin mucus, clear irritants, moisten and soothe a stuffy nose. Saline products do not contain medicated decongestants and can generally be used safely in adults, children and babies. There is also no risk of rebound congestion.
Using saline shortly before bed may help clear your nasal passages before you lie down. Follow the instructions provided with the product, particularly if you are using a sinus-rinsing bottle.
Sleeping flat can make your nasal congestion worse. Keeping you head slightly elevated can help to assist sinus drainage and reduce swelling of nasal tissues. Try to raise your head, neck and upper back rather than just your head to avoid putting strain on your neck.
Side sleeping can also help, particularly if one side of the nose is more congested than the other. Keep the blocked side elevated and sleep on your clearer side.
A hot and steamy shower before bed may help loosen thick mucus in your nose as you breath in the warm steamy air. Some people add a few drops of eucalyptus or peppermint essential oil in the shower tray or on a washcloth.
Along similar lines, a humidifier in the bedroom may also help some people.
If the mucus in your airways is thick, it can be more difficult to clear. Staying hydrated and having lots of fluids help thin mucus and ease congestion, making it easier for your nose and sinuses to drain.
Warm liquids like tea, broths or soups may provide further relief to sore and dry throats.
A blocked nose could be caused by hay fever or other allergies, which will require a different treatment from congestion caused by a cold or flu.
Steroid nasal sprays can reduce inflammation inside the nose and are often used for nasal congestion caused by allergies. Antihistamines can also treat congestion caused by allergies; however, they are generally less effective at treating congestions caused by an infection. Ask your pharmacist which option is most appropriate for your symptoms.
Reducing exposure to allergens and irritants should also be a consideration.
6. Decongestant nasal sprays
Nasal decongestants are medicines that help to temporarily relieve a stuffy or blocked nose or sinus congestion. Nasal sprays commonly contain ingredients such as oxymetazoline and xylometazoline.
These medicines should only be used short term (usually 3 days). Always check the product packaging and used as instructed.
Using a medicated nasal decongestant spray for too long can cause rebound congestion, where your nose becomes more blocked as the medicine wears off.
Oral decongestant medicines can also be used for the temporary relief of a stuff or blocked nose or sinus congestion. The decongestant medicines phenylephrine and pseudoephedrine are primarily used in oral cold and flu medicines.
Products containing phenylephrine can be purchased over the counter from a pharmacy. In recent years there has been conflicting evidence about the effectiveness of phenylephrine for nasal decongestion.
Pseudoephedrine returned to shelves in New Zealand in 2024 as a pharmacist-only medicine. It works by narrowing the swollen blood vessels in your nasal passages, reducing swelling and making it easier to breathe through your nose. You must consult with a pharmacist before you can purchase pseudoephedrine.
Most congestion caused by a cold improves as the infection clears. Arrange an appointment with your healthcare provider if:
Seek medical help promptly if you develop difficulty breathing, wheezing, chest pain, rapid heart rate, confusion or blue-looking lips.
Before using a cold, allergy or congestion product, tell your pharmacist about your health conditions and any prescription, pharmacy, complementary or herbal medicines you already use. This can help you choose a treatment that eases your symptoms without creating an unnecessary medicine interaction or duplicate dose.
Our service is designed to make managing multiple medicines easy. Our Monthly Medicines Service is free to eligible patients taking three or more regular medicines.
