Blocked nose at night only: what should you know?

Night-only symptoms can reflect exposure to bedding dust, dust mites, mould, pets, or fragrances in the sleeping area. Lying flat can increase the sensation of congestion, while the normal alternation between nostrils may become more noticeable when one side swells. Allergic rhinitis may cause sneezing, itching, and watery mucus. Reflux, dry air, or nasal irritation can also disturb the nose without producing a cold. A pattern limited to one room or one bed is worth mentioning because it can narrow the discussion with a clinician.

Keep a brief diary of bedtime, room, bedding, pets, air-conditioning, symptoms, and whether congestion changes after getting up. Ventilate the room when practical, keep smoke away, and wash bedding according to its care instructions. Saline spray can moisturise and clear the nasal passages. If allergy symptoms accompany the blockage, ask a pharmacist about suitable allergy medication rather than borrowing someone else’s prescription. Do not keep using a medicated decongestant spray beyond its instructions.

See a clinician if night-only blockage persists, repeatedly wakes you, causes regular mouth breathing, or remains on one side. Get urgent help for serious breathing trouble, blue lips, facial or eye swelling, confusion, or severe illness with fever. Loud snoring, choking or gasping in sleep, and daytime sleepiness should prompt discussion of obstructive sleep apnoea.

Ask whether the timing suggests allergic rhinitis or sinus disease, whether your bedroom needs an environmental change, and how long to try a treatment. Mention any pets, recent decorating, new cleaning products, nasal sprays, snoring, and the side that blocks most.