What should you know about nose always blocked at night?

Dust, bedroom allergens and animal dander can irritate the nasal lining, especially while you are in bed. Allergic rhinitis may also bring sneezing, itching or a watery discharge. A cold can temporarily swell the nasal passages, while sinusitis may add facial pressure, reduced smell or thick mucus. Chronic sinusitis can keep symptoms going. Some people notice one side feels more closed because the nasal passages naturally alternate in congestion. Night-time blockage can also worsen mouth breathing and snoring; pauses in breathing, choking sounds or marked daytime sleepiness need medical assessment for possible obstructive sleep apnoea.

Keep the sleeping area free from smoke, strong fragrances and visible dust. Washing bedding regularly and reducing bedroom dust may help when house dust mite allergy is suspected. Saline spray or a saline rinse can loosen mucus; use sterile, distilled or previously boiled and cooled water for a rinse. Raise your head slightly during sleep and drink enough fluid to avoid a dry mouth. A pharmacist or clinician can advise whether allergy medication is suitable. Do not use a decongestant nasal spray for longer than its label allows, because overuse can make congestion return.

Arrange a medical review if the blockage persists, keeps disturbing sleep, is mainly on one side, or comes with repeated nosebleeds, facial pain, fever, reduced smell or foul-smelling discharge. Seek urgent help for severe breathing difficulty, swelling around an eye, confusion, a severe headache with neck stiffness, or symptoms after a significant injury. A clinician can examine the nose and consider allergies, structural narrowing, sinus disease or sleep-related breathing problems.

Could this be allergic rhinitis or sinusitis? Should I use a saline rinse or allergy medication? Do my snoring, mouth breathing or daytime tiredness suggest a sleep-related breathing problem?