Nasal congestion occurs when airflow through the nose is obstructed, forcing individuals to breathe through their mouth. This condition can stem from various causes: allergic rhinitis, rhinosinusitis, or structural abnormalities such as a deviated septum or turbinate hypertrophy. Other contributing factors include nasal and sinus tumors, foreign bodies, enlarged adenoids, and excessive use of vasoconstrictive nasal sprays.

Lying down increases blood flow to the head and neck, which in turn boosts blood circulation to the nasal lining. This causes the turbinates, structures within the nose, to swell as they adapt. Individuals with sensitive nasal linings, existing rhinosinus conditions, or structural nasal abnormalities are more prone to significant turbinate swelling, which narrows the airway and leads to severe nasal congestion. People with normal nasal structures typically do not experience this.

Mucus in the nasal and sinus cavities can easily accumulate while lying down, obstructing airflow and necessitating mouth breathing. Furthermore, lower nighttime temperatures, particularly with air conditioning or cold weather, can cause the nasal lining to constrict abnormally. This increases swelling and exacerbates congestion.

Doctor Hang performs a nasal endoscopy for a patient. Photo: Tam Anh General Hospital

To alleviate nighttime nasal congestion, several measures can be adopted before sleep: maintain moisture in the nasal and sinus areas, and clean the nose and throat with warm saline solution. Inhaling steam with essential oils, elevating your pillow, and massaging specific facial points can help reduce frontal sinus pressure, promoting clearer airways. Additionally, maintain bedroom humidity using a humidifier or mister, and ensure you drink two liters of water daily. Regular bedroom cleaning and frequent washing of bedding help keep the space well-ventilated, reducing dust and bacteria.

If nasal congestion persists despite these home remedies, it is advisable to consult an Ear, Nose, and Throat (ENT) specialist for an endoscopic examination and appropriate treatment to prevent complications. For congestion caused by inflammation, treatment typically involves medication, including nasal sprays that reduce swelling and improve airflow. When congestion results from structural issues like a deviated septum, foreign bodies, post-traumatic injuries, or chronic rhinosinusitis unresponsive to medication, a doctor may recommend surgery.

Dr. Tran Thi Thuy Hang

Head of Ear, Nose, and Throat Department

Ear, Nose, and Throat Center

Tam Anh General Hospital, TP HCM