A blocked nose at night feels unfair. During the day you never think about breathing, and the moment you lie down one nostril closes. You turn onto your other side, that nostril opens and the first one shuts again. An hour later you are lying there breathing through your mouth.
Usually nothing is wrong. At night a few completely normal things happen in your nose at the same time, and together they make you notice it. Here is what is going on and what you can do about it in the evening.
Why your nose blocks up at night
You are lying flat
As soon as you lie down, the pressure in the blood vessels in your head changes. The lining of your nose swells slightly as a result. Standing or sitting upright, that blood drains away more easily. In bed it does not. This is the simplest explanation for a nose that only closes up after you go to bed.
The nasal cycle keeps running
Your nose alternates all day long. One nostril does most of the work while the other runs at half capacity for a few hours. This is called the nasal cycle and it is normal. During the day you never notice it, because there is plenty of room left and you are busy with other things. In a quiet bedroom it suddenly stands out. If you are searching for "one nostril blocked at night", this is often what you are running into.
The air in your bedroom is dry
With the heating on or the windows shut, humidity drops. Dry air makes the mucus in your nose thicker, and thick mucus gets in the way. You notice it in a dry throat when you wake up too.
Dust mites live in your mattress and pillow
Dust mites live in bedding. If you are sensitive to them, your nose reacts in exactly the spot where you spend seven or eight hours a night. Symptoms that only turn up in bed and disappear during the day often point that way.
A cold or hay fever
With a cold or a pollen allergy your nasal lining is already thicker than usual. Add lying down and dry air, and the difference between day and night becomes large. In pollen season, pollen also travels into your bed on your hair and clothes.
What you can do in the evening
Sleep with your head a little higher
An extra pillow or raising the head of the bed by a few centimetres often helps. Keeping your head higher than your heart counters the swelling. Many people find sleeping on their side more comfortable than flat on their back.
Keep the air a bit more humid
Turn the bedroom heating down and air the room for a quarter of an hour during the day with the window open. A humidifier or a bowl of water by the radiator keeps the air from drying out. Change the water daily, otherwise the device becomes the problem.
Rinse your nose before bed
Rinsing clears mucus, dust and pollen before you lie down. You run a lukewarm salt solution through your nose with a nasal rinse bottle and rinsing salt, over the sink, about half an hour before bedtime. Rinse right before sleeping and some water will still trickle out once you lie down. Always use boiled and cooled or sterile water with the correct dose of nasal rinsing salt. Tap water with a pinch of table salt is not suitable.
Wash your bedding more often
Pillowcases and duvet covers washed at 60 degrees tackle dust mites, and an allergen-proof cover for mattress and pillow helps as well. In hay fever season, showering before bed keeps pollen out of your pillow.
Nasal strips for the night
A nasal strip sits on the outside of your nose and gently lifts the nostrils, so you breathe through your nose more easily. It does not remove the cause of a blocked nose, but it widens the narrowest part of your nose, which is exactly where many people get stuck at night. The Comformidable anti-snoring nasal strips are dermatologically tested and rated very good by Dermatest®. Apply one to a clean, dry nose, otherwise the adhesive lets go as soon as you start to sweat.
One note on mouth tape: it is meant for people who breathe through their mouth while their nose is clear. If your nose is blocked, do not use it.
When to see your doctor
Everything above helps with everyday discomfort. It does not remove a medical cause. Make an appointment with your doctor if your nose stays blocked for weeks without a cold, if it is always the same nostril (that can point to a deviated septum), if your partner hears you stop breathing during sleep, or if you regularly wake up with a headache.
Frequently asked questions
Why is my nose only blocked at night?
Because three things come together in bed: you are lying flat so the lining swells, the air in your bedroom is drier than during the day, and nothing distracts you from your breathing. During the day you are moving around and the same thing goes unnoticed.
Why does it switch from one nostril to the other?
That is the nasal cycle. Your nostrils take turns over a few hours, day and night. If you lie on your side, the lower nostril usually closes up faster as well.
Does a nasal spray from the chemist help?
A saline spray is fine to use. With a decongestant spray the leaflet matters: these are meant for a few days, and with longer use the symptoms can come back as soon as you stop. Ask your pharmacist.
Can I wear a nasal strip all night?
Yes, a nasal strip is designed for a full night. Remove it gently in the morning, ideally in the shower or with a wet flannel, so the adhesive lets go more easily.
Has your nose been keeping you awake for weeks? Start tonight with the simple things: head a little higher, air the room during the day, rinse your nose before bed. If that only half works, have a look at Breathe & Sleep for what else can help.