Stuffy noses are never fun. But they're especially bothersome first thing in the morning, when mucus and congestion can sap your energy and turn you into a dripping, zombie-like mess.
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Often the problem has a straightforward answer, like a cold or another viral infection that'll usually ease up on its own within a week. But there are plenty of other things that can inflame and irritate your nasal tissues, leaving you with a stuffy nose in the morning, says Abbas Anwar, MD, a board-certified otolaryngologist and head and neck surgeon at Providence Saint John's Health Center in Santa Monica, California.
Here are 11 reasons why you might be waking up congested that have nothing to do with a cold. Plus, the expert-recommended strategies to help you breathe a little easier.
1. You've Got a Sinus Infection
Plagued by morning congestion along with facial pain or tenderness, thick green or yellow snot and bad breath? Chances are, a sinus infection is the culprit. These infections, which often develop from a common cold or allergies, happen when bacteria, viruses, or fungi irritate the sinuses, causing them to swell and become blocked, according to the Cleveland Clinic.
Fix it: Most sinus infections will clear up on their own within seven to 10 days, says Minyoung Jang, MD, assistant professor of otolaryngology-head and neck surgery at Columbia University Medical Center in New York. In the meantime, you can find relief with natural remedies for sinus infections like a nasal saline rinse.
"While it does not cure the problem, it helps clear out any irritants inside the nose or sinuses, preventing buildup that can exacerbate symptoms," Dr. Jang says.
But if you're still dealing with symptoms after a week or two, call your doctor. You may have a bacterial sinus infection that needs to be treated with antibiotics.
2. It's Allergies or Environmental Irritants
It's no secret that seasonal allergens like pollen or grass can make you stuffy in the morning. But if your bedroom is home to environmental irritants, you might also find yourself waking up congested, Dr. Jang says.
Dust mites, pet hair, cockroaches and mold are some of the most common culprits, but for some people, cigarette smoke, strong odors (think: perfume or air fresheners), cleaning products and air pollution or smog can also pose problems, per the American College of Allergy, Asthma, & Immunology (ACAAI).
Fix it: If you know seasonal allergens are the problem, get serious with your allergy-management strategies.
If you suspect an environmental irritant like dust is to blame, improving your indoor air quality by getting rid of the culprit should solve your congestion problem. For instance, you can minimize your exposure to dust or pet dander by encasing your bedding in sealed covers, eliminating fabrics that tend to collect dust particles (like bedskirts) and keeping pets out of your bedroom, Dr. Jang says.
3. It's Dry Indoor Air
Those desert-like conditions inside your home during the winter aren't only doing a number on your skin. They can also cause a.m. congestion.
"Air with little moisture will often cause our bodies to increase mucus production to compensate for the dry air entering our lungs. This mucus can lead to congestion," Dr. Anwar says.
"Forty to 50 percent humidity is considered ideal," Dr. Anwar says. "It will help keep your nasal lining hydrated and prevent congestion caused by excess mucus production."
4. You Smoke
Smoke is an environmental irritant that can cause chronic inflammation of the airways and decrease the nose's ability to clear mucus, explains Dr. Jang. So if you're lighting up regularly, that could be the source of your morning congestion.
Fix it: Quitting will solve the problem, and more importantly, it'll reduce your risk for serious problems like heart disease, lung cancer and lung disease, according to the Centers for Disease Control and Prevention (CDC). It's not easy, of course, but these proven strategies can help.
5. It's Acid Reflux
Acid reflux doesn't just irritate your throat — it can also make your nose stuffy.
"While the exact mechanism is unknown, it is hypothesized that the stomach juices, when present in the throat, cause increased inflammation of both the nose and throat," Dr. Jang explains. "This may manifest as nasal congestion, dry cough or frequent throat clearing."
And because reflux and symptoms like heartburn tend to be worst at night, when you're laying down, you might notice the congestion the most when you wake up in the morning.
Fix it: Avoiding foods that trigger your reflux, nixing eating at least three hours before bed and elevating the head of your bed so you aren't lying flat when sleeping can all help curb heartburn and ease related symptoms like congestion, notes the Mayo Clinic.
If lifestyle changes aren't enough, see your doctor, who may recommend taking medications like antacids, H-2-receptor antagonists or a proton pump inhibitor.
6. You Sleep on Your Back
If you're waking up congested without any other symptoms and are struggling to pinpoint a cause, your sleeping position might be to blame.
"When you lie flat on your back, there is more blood flowing to your head and nose," Dr. Anwar explains. "This causes your nasal lining to become engorged with more blood than usual and can lead to nasal obstruction."
Lying flat on your back can also worsen other causes of congestion, like acid reflux, according to the Mayo Clinic.
Fix it: The simplest fix, as you might guess, involves making a position change. To reduce excess bloodflow to your head and nose, "try to sleep propped up with an extra pillow or two," Dr. Anwar recommends.
7. It's Your Medications
Notice an increase in stuffiness around the time you started a new prescription? The drug may be to blame. Medications used to treat high blood pressure, erectile dysfunction, depression and seizures all have the potential to trigger chronic congestion, according to the Mayo Clinic. Oral contraceptives and even OTC pain relievers like aspirin and ibuprofen are also possible culprits.
Fix it: If you suspect a new medication is giving you a stuffy nose in the morning (or at other times of day), bring it up with your doctor. In some cases, you may be able to have your dosage adjusted or try a different drug with fewer side effects.
8. You've Got a Deviated Septum
Sometimes congestion can be the result of a structural issue in the nose that's causing a physical blockage. "The most common anatomic issue is a deviated septum, which is when the cartilage that separates the two nostrils is pushed to one side or the other," Dr. Anwar says.
Deviated septums are common, and they often go unnoticed, according to the Cleveland Clinic. (Many people are born with them, but they can also be the result of a nasal injury.) But in addition to potentially causing congestion, in some cases, they can result in frequent headaches or facial pain, noisy breathing, nosebleeds or snoring, the Cleveland Clinic notes.
Fix it: If you think you have a deviated septum, bring it up with your doctor, who can refer you to an otolaryngologist. "They are uncommon causes of chronic nasal congestion, but should be ruled out when congestion is persistent or associated with other concerning symptoms," Dr. Jang says.
9. You're Using Nasal Decongestants Too Often
Certain nasal decongestant sprays like Afrin or Phenyleprhine can quickly ease stuffiness, but when used for more than a few days in a row, they can actually trigger nasal inflammation that may lead to rebound congestion, according to the National Library of Medicine.
Fix it: Limiting these sprays to occasional use can keep rebound congestion from happening, Dr. Jang says. If you need to use a decongestant regularly, like to manage seasonal allergies, use a nasal corticosteroid spray (like Zicam or Flonase) instead. It won't cause rebound congestion, and it actually becomes more potent when used every day, per the National Institutes of Health.
One thing to note? While nasal corticosteroid sprays are generally safe, they can cause uncomfortable nasal dryness, Dr. Jang notes. "Saline can be used before the steroid spray to keep the nasal cavities moist," she says.
10. You're Pregnant
Here's one to file under weird pregnancy side effects: Around 1 in 5 pregnant people will experience a chronically stuffy nose that's not caused by an infection or allergies, according to a review in the August 2012 issue of The American Journal of Respiratory Medicine.
Pregnancy hormones are thought to be the culprit, but smoking or having a sensitivity to dust seem to make the problem more likely, the review notes.
Fix it: Pregnant people can safely use nasal corticosteroid sprays, per the National Library of Medicine. But if you'd prefer to avoid medication, there are plenty of other options: Running a humidifier, doing nasal saline rinses, elevating your head while you sleep and even exercising regularly can all help, according to experts at UT Southwestern Medical Center.
11. It's Another Health Condition
Less commonly, chronic congestion (in the morning or at other times of the day) can be caused by an underlying health problem like hypothyroidism, chronic fatigue syndrome or diabetes, the Mayo Clinic notes.
Nasal polyps — benign growths in the lining of the nose — may also be to blame, especially if they're large enough to block airflow, per the Mayo Clinic.
Fix it: Tell your doctor that you're waking up with a stuffy nose every morning and note any other symptoms you're having to help them make a diagnosis.
When to See a Doctor
Most causes of morning congestion should ease up within a week or two, either on their own or with simple lifestyle changes. But if your symptoms aren't getting better after 10 to 14 days, see your doctor to have the problem evaluated, Dr. Jang says.
Pay attention to congestion paired with any of the following red flags, too:
- Persistent high fever
- Eye swelling or vision changes
- Unexplained headaches
- Nosebleeds that don't stop after 10 minutes
Any of these may warrant emergency medical attention, notes Dr. Jang.
Is This an Emergency?
- Cleveland Clinic: "Acute Sinusitis"
- American College of Allergy, Asthma & Immunology: "Hay Fever"
- Cleveland Clinic: "How to Tell If You Need a Humidifier"
- Centers for Disease Control and Prevention: "How to Quit Smoking"
- Mayo Clinic: "Heartburn"
- Mayo Clinic: "Nonallergic Rhinitis"
- Cleveland Clinic: "Deviated Septum"
- U.S. National Library of Medicine: "Rhinitis Medicamentosa"
- National Institutes of Health: "Nasal Corticosteroid Sprays"
- The American Journal of Respiratory Medicine: "The Etiology and Management of Pregnancy Rhinitis"
- UT Southwestern Medical Center: "Baby (and tissues!) on board: Tips for managing pregnancy rhinitis"