Nasal congestion is characterised as feeling as though the nose and surrounding areas are stuffy and tight, and that you are struggling to breathe easily. The tissues and blood vessels in the nasal passages fill with fluid and become swollen. It can be mildly painful and extremely frustrating. 

At night, it can be even more infuriating, as it can pose a huge obstacle to getting to sleep. 

In this article, we look at some ways to ease nasal congestion before bedtime to hopefully get some peaceful rest. 

Why does nasal congestion occur? 

Firstly, we look at some common reasons why nasal congestion occurs:

1. Infections: The most common cause is a viral infection, like the common cold or flu. Bacteria and sinus infections can also lead to congestion. Colds and flu typically don’t last longer than 1-2 weeks, so symptoms should ease over this period
2. Allergies: Allergic reactions to pollen, dust mites, pet dander, or mould can cause nasal passages to become inflamed, leading to congestion. If you notice a pattern in when you become nasally congested, it could be an allergy and therefore it’s best to avoid these triggers where possible
3. Environmental irritants: Exposure to smoke, pollution, chemicals, or strong odours can irritate the nasal passages, causing congestion
4. Vasomotor rhinitis: This condition causes the blood vessels in the nose to dilate in response to factors like changes in weather, stress, or spicy foods, leading to congestion without an infection or allergy
5. Deviated septum: A structural issue in the nose, like a deviated septum, can block one side of the nose, making it feel congested. This is often a lifelong condition or due to an injury, and so some decongestant techniques may not work for this structural cause
6. Nasal polyps: These are soft, painless growths in the lining of the nasal passages or sinuses that can obstruct airflow and cause congestion
7. Hormonal changes: Pregnancy, menstruation, or hormonal treatments can cause the nasal passages to swell, leading to congestion
8. Medications: Overuse of nasal decongestant sprays can lead to rebound congestion, a condition called rhinitis medicamentosa. This is why it is extremely important to stick to, or below, recommended use of medical decongestant sprays

Each of these causes involves some form of inflammation or blockage in the nasal passages, which leads to the sensation of congestion.^2,3

How can nasal congestion be eased, especially at night? 

Easing nasal congestion can involve a mix of home remedies, lifestyle adjustments, and over-the-counter treatments. Here are some effective methods:

1. Stay hydrated

• Drink plenty of fluids: Staying well-hydrated helps thin the mucus in your nasal passages, making it easier to expel. Water, herbal teas, and broths are particularly beneficial. Keeping hydrated throughout the day is better than trying to drink a lot of water in one go at night, as this may wake you up to use the toilet and you then might struggle with the same issues

2. Humidify the air

• Use a humidifier: Adding moisture to the air can soothe irritated nasal tissues and reduce congestion. Aim for a humidity level of around 40-60%. You can buy humidifiers in different sizes and at different prices to fit whatever space you sleep in
• Take a warm shower: The steam from a hot shower can help open up nasal passages. Having a warm shower an hour before bed will ease congestion, but give your body enough time to cool down so that you have the best chance of falling asleep

3. Nasal saline sprays and rinses

• Saline spray: Over-the-counter saline sprays can moisten dry nasal passages and help clear out mucus and allergens
• Nasal irrigation (Neti Pot): A saline rinse using a Neti pot or squeeze bottle can flush out mucus and debris, providing relief from congestion. However, these can be quite uncomfortable to use if you have not used one before, so potentially try this out earlier in the day before you use it at night time¹

4. Inhalation of steam

• Steam inhalation: Lean over a bowl of hot water with a towel draped over your head to trap the steam, and inhale deeply. Adding a few drops of eucalyptus or peppermint oil can enhance the effect. This is a very cheap and effective way to clear the nasal passages

5. Warm compress

• Apply a warm compress: A warm, damp towel placed over your face can help soothe sinuses and reduce nasal congestion by loosening mucus

6. Elevate your head

• Sleep with your head elevated: Using an extra pillow or two to prop up your head can help drain nasal passages and ease congestion, especially at night. It might even be best to sleep sitting up if you can

7. Over-the-counter medications

• Decongestants: Oral or nasal spray decongestants can reduce swelling in the nasal passages, but should be used with caution (nasal sprays for no more than 3 days to avoid rebound congestion). These can be bought from your local pharmacy or even supermarket
• Antihistamines: If your congestion is due to allergies, antihistamines can help by reducing the body's allergic response. This can be helpful if you suffer from hay fever, or are spending time with animals that you have an allergy to^2,3

8. Avoid irritants

• Identify and avoid triggers: Stay away from smoke, strong odours, pollution, and allergens that can exacerbate nasal congestion. If you have hay fever, perhaps close the windows in the evening to prevent pollen from entering your house. If you work in an environment that is smoky or contains your triggers, consider wearing a mask which can reduce potential congestion
• Clean your environment: Regularly clean your living space, wash bedding in hot water, and use air purifiers to reduce allergens

9. Peppermint or eucalyptus oil

• Aromatherapy: Adding a few drops of peppermint or eucalyptus oil to a diffuser, or inhaling it from a tissue, can help open up the nasal passages. This is extremely effective and can provide instant relief. Substances from brands such as Olbas oil or Vicks can be helpful too and potentially more accessible. Be sure not to put the substances or oils directly onto your skin or in your nose - they can be very potent. Follow the guidelines on packaging and be cautious

10. Use nasal strips

• Nasal Strips: These adhesive strips can be applied across the nose to physically open the nasal passages, providing temporary relief from congestion. They can be worn hands-free, which means that you can sleep with them on

11. Spicy foods

• Eat spicy foods: Foods containing chilli peppers or horseradish can temporarily clear nasal passages by triggering a release of mucus 

Summary

It can be very frustrating to feel congested at night, but hopefully utilizing some of these techniques may ease the struggle. 

If congestion persists for more than a week and is accompanied by a high fever, severe headache, or facial pain, it may be best to consult a healthcare provider.