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NASAL CONGESTION:

When nasal and adjacent tissues and blood vessels become swollen with excess fluid, causing a “stuffy” feeling, which may or may not include a runny nose where discharge accompanies the difficulty in breathing. This is annoyance for older children and adults as well. It can be serious for children at night if it disturbs their sleep or for infants who might have a hard time feeding as keeping their mouth shut is not easy.35

SYMPTOMS:

Difficulty in breathing through the nose.

The constriction in the nasal passages makes it harder to get mucus out of the nose, so it builds up.

Feeling stuffed-up, referred to as stuffy nose.

Nasal congestion may be accompanied by other cold symptoms like headache and runny nose.

Tiredness due to lack of sleep.36

Causes of nasal congestion:

There are explanations to why nasal congestion worsens at night, as well as causes for chronic nasal congestion.

Causes of nasal congestion at night

  • Being distracted during the day.

  • Human anatomy and gravity as during the day mucus is constantly drained by gravity from the nose and sinuses, but when in a horizontal position, mucus can pool or back up.

  • Changes in blood pressure when lying down as the blood flow increases in the upper part of the body including head and nasal passages.

  • Pregnancy, due to increased blood flow.

  • A turbinate, which is a structure along the sinus wall that produces mucus, becomes swollen in one nostril which blocks air flow on that side.

  • Gastro-oesophogeal reflux disease (GERD) is a condition where stomach acid flows back into the oesophagus, which is the tube connecting the mouth to the stomach, this is known as reflux. This can happen at any time of the day, However, lying down hinders the effect of gravity which can lead to night time nasal congestion due to irritation of the nasal mucosa b the acid. It is believed that there is a definite link between GERD, chromic sinusitis and nasal congestion.37

Causes of chronic nasal congestion

  • Acute sinusitis

  • Alcohol consumption

  • Chronic sinusitis

  • Churg-Strauss syndrome, a disorder marked blood vessel inflammation

  • Common cold

  • Decongestant nasal spray overuse

  • Deviated nasal septum

  • Dry air

  • Enlarged adenoids

  • Food specially spicy dishes

  • Foreign body in the nose

  • Granulomatosis with polyangiitis (Wegener’s granulomatosis)

  • Hormonal changes

  • Influenza (Flu)

  • Some medications like the ones treating hypertension depression seizures, ,…..etc

  • Nasal polyps

  • Non-allergic rhinitis

  • Occupational asthma

  • Pregnancy

  • Respiratory Syncytial Virus (RSV)

  • Sleep apnoea

  • Stress

  • Thryroid disorders

  • Tobacco smoking38

Treatment for nasal congestion:

The best way to clear congestion depends largely on its cause. Some options include:

  • Oral or topical antibiotics, if the cause is bacterial infection

  • Corticosteroid nasal sprays

  • Decongestants like Telfast D

  • Mucus-thinning medications to help getting rid of the accumulated serum

  • Immunotherapy

  • Corrective surgery for nasal septum deviation

Home remedies

To clear congestion at home, a person might try:

  • Staying hydrated

  • Taking a warm shower

  • Inhaling steam from a bowl of hot water, with a towel over the head to trap in the steam

  • Keeping the head elevated while sleeping

  • Taking over-the-counter (OTC) antihistamines such as Telfast and decongestants such as Telfast D

  • Trying nasal rinses

  • Taking OTC pain relief medications, if there is sinus pressure or pain

  • Applying a cold compress to painful areas of the face

  • Taking prophylactic probiotics or consuming probiotic-rich foods, such as yoghurt or kimchi

  • Taking supplements that boost immunity, such as Zinc Sulfate, Echinacea, Vitamin C or Geranium extract39

When to see a doctor:

For adults

  • If symptoms last for more than 10 days

  • If accompanied with a high fever

  • If the nasal discharge is yellow or green with sinus pain or fever as this can be a sign of a bacterial infection

  • Bloody nasal discharge or persistent clear discharge after trauma to the head

For children

  • If the child is younger than 2 years and has fever

  • If it causes trouble nursing or if it makes breathing difficult40

References:

35. https://www.mayoclinic.org/symptoms/nasal-congestion/basics/definition/sym-20050644 Last visited on 14th July 2021

36. https://www.medicinenet.com/nasal_congestion/symptoms.htm Last visited on 14th July 2021

37. https://www.verywellhealth.com/why-do-i-get-congested-at-night-1192188 Last visited on 14th July 2021

38. https://www.mayoclinic.org/symptoms/nasal-congestion/basics/causes/sym-20050644 Last visited on 15th July 2021

39. https://www.medicalnewstoday.com/articles/nasal-congestion#treatment Last visited on 15th July 2021

40. https://www.mayoclinic.org/symptoms/nasal-congestion/basics/when-to-see-doctor/sym-20050644 Last visited on 15th July 2021