Nasal congestion is a condition where one or both sides of the nose are blocked, making it difficult for individuals to breathe through their nose and often forcing them to breathe through their mouth. Master, Doctor Nguyen Chi Trung, from the Ear, Nose, and Throat Department at Tam Anh General Hospital Hanoi, states that this condition is common across many age groups and is often linked to changes in posture, environment, and underlying ear, nose, and throat conditions.

Sleeping position exacerbates nasal congestion

When transitioning from standing or sitting to lying down, especially on the back, blood tends to pool in the head and neck. This causes blood vessels in the nasal lining to dilate and swell, occupying space within the nasal cavity and obstructing airflow. Sleeping positions also cause sinus fluid to accumulate instead of draining down the throat, leading to congestion. Lying on one side for an extended period can worsen congestion on the lower side as blood and fluid concentrate there.

Dry, cold air in the bedroom

Dry, cold bedroom air causes the nasal lining to dry out, become irritated, and react by increasing mucus secretion, leading to nasal congestion. Continuous air conditioning also reduces humidity in the room, dehydrating the protective mucus layer in the nose. This diminishes the nose's ability to warm and humidify inhaled air, increasing the risk of nasal lining swelling and blockage.

Habitual nose picking

In dry weather, the nasal lining and nasal vestibule lose moisture. Physical actions such as nose picking can damage the nasal lining, leading to increased crust formation. These crusts can block the nostrils and alter airflow during inhalation.

Allergies

Close contact with allergens such as: dust, mites, pet dander, mold, or polluted smoke and tobacco smoke can trigger allergic reactions and inflammation of the nasal lining. This results in itching, a runny nose, swelling, and nasal congestion. Sensitive airways are easily irritated, especially when the weather changes or temperatures are low at night.

Respiratory infections

Upper respiratory infections such as: colds, flu, rhinitis, or tonsillitis cause inflammation, swelling of the nasal lining, and increased mucus secretion. When sleeping, fluid retention and altered blood flow exacerbate nasal congestion. In individuals with sinusitis or chronic rhinosinusitis, inflammatory fluid accumulates in the sinus cavities, increasing pressure and obstructing airflow. This is sometimes accompanied by post-nasal drip, a dry cough, or continuous throat clearing at night.

Nasal cavity structural abnormalities

Abnormalities such as: nasal polyps, a deviated septum, or tumors can narrow or block the airway. This impedes air circulation into the lungs, leading to prolonged nasal congestion.

Trauma, foreign objects in the nose

Nasal trauma can damage internal structures like the mucous membrane, bone, or septum, causing swelling and a deviated septum. This obstructs airflow through the nose. Foreign objects lodged in the nose can block the airway, easily causing local inflammation and prolonged nasal congestion.

When lying down, sinus fluid easily accumulates, causing nasal congestion during sleep. Photo created by AI

Gastroesophageal reflux

When sleeping, stomach acid tends to reflux up the esophagus, spreading to the pharynx and posterior nasal area. This irritates the upper respiratory mucous membrane. This condition causes inflammatory reactions, swelling, and increased mucus secretion. Individuals with gastroesophageal reflux disease also experience accompanying symptoms such as: heartburn, a bitter taste in the mouth, a chronic dry cough, or morning hoarseness.

Hormonal changes during pregnancy

Some pregnant women may experience nasal congestion and difficulty breathing at night. This is due to high levels of estrogen and progesterone increasing blood flow throughout the body. This causes small blood vessels in the nasal area to dilate, and the nasal lining to become more congested and swollen than usual.

Overuse of vasoconstrictor medication

Self-administering vasoconstrictor medications (decongestants) without a doctor's prescription or guidance can gradually disrupt the self-regulatory mechanism of the nasal turbinate nerves. This leads to rebound nasal congestion and turbinate hypertrophy.

Stress

Prolonged stress disrupts hormones, affecting the nervous system and blood vessels. This causes blood vessels in the nasal lining to dilate excessively, leading to congestion and nasal blockage during sleep.

To alleviate nasal congestion, Doctor Trung advises keeping the room clean, regularly washing bedding, avoiding allergens, maintaining 40-60% humidity, elevating the head while sleeping, and rinsing the nose with physiological saline before bed. If nasal congestion persists for more than two to three weeks, recurs with headaches, fever, thick nasal discharge, bleeding, loud snoring, or sleep apnea, seek medical attention for timely treatment.

Trinh Mai