Common cold nasal congestion: what to know

Cold viruses irritate the lining inside the nose. Blood flow and immune activity increase there, while mucus helps clear irritants; together, swelling and secretions narrow the airflow passage. Congestion may alternate from one nostril to the other and can be worse when lying down. Allergic rhinitis or a house dust mite allergy is more likely when blockage comes with repeated sneezing, itchy eyes, or a clear runny nose. Facial pressure and symptoms that linger can occur with sinusitis or chronic sinusitis.

Drink fluids, rest, and try saline drops or a saline rinse made with sterile, distilled, or previously boiled and cooled water. Raising the head slightly while sleeping may make breathing easier. Warm moist air can feel soothing, but avoid burns from hot water or steam. A pharmacist can explain whether a decongestant is appropriate; some products are unsuitable with high blood pressure, heart problems, pregnancy, or certain medicines. Do not use a medicated nasal decongestant longer than its label advises, because rebound blockage can follow.

Seek urgent help for severe breathing difficulty, swelling of the face or throat, confusion, or a blue or grey colour around the lips. Arrange an appointment for severe one-sided facial pain, eye swelling, repeated nosebleeds, dehydration, or congestion that is persistent, recurrent, or worsening. Loud snoring, pauses in breathing during sleep, or marked daytime sleepiness may need assessment for obstructive sleep apnoea rather than a simple cold.

Could allergies or sinusitis be contributing to my blockage? Which saline, allergy, or decongestant option fits my health conditions? How long should I continue treatment before arranging a review?