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I'm just getting over a cold, but my nose remains very stuffy / blocked. This makes sleeping difficult: I toss and turn or simply can't fall asleep at all. I've tried blowing my nose and using various decongestants, but nothing seems to do the trick.

What can I do to help clear my nose/sinuses so I can sleep?

  • 4
    Better hydration thins mucus, so have lots of water. If it persists for more than a few days, see a doctor. – Jesvin Jose Mar 19 '15 at 12:13
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    I like those little sticky thing that are put on the nose and opens up the nostrils. – the_lotus Mar 19 '15 at 12:57
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    @the_lotus Breathe Right strips. :) – Trish Ling Mar 19 '15 at 16:24
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    gonna sound crazy saying this, but sit down on the floor cross legged, with your back straight, and breathe deeply and slowly for 7-15 minutes. the posture alone will help your sinuses clear out. it really works. – sova Mar 22 '15 at 6:07
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    @sova I'm no longer sick (thankfully) so I can't really try it. But it's still a valid answer. – Mooseman Mar 22 '15 at 22:21

16 Answers 16

42

For immediate relief, there are two similar things that I will try.

First, I take a hot shower (make the shower as hot as you can withstand). Make sure to breath in and out deeply to fill your nasal passages and your lungs with steam. If that doesn't immediately make me feel better, I will also use a pot of boiling water. Just boil the water, drape a towel over your head (helps trap steam) and breath in the steam. This will help a lot.

One last tip is to keep your head elevated while sleeping. Don't use extra pillows, try to elevate your entire body from the waist up, or you can use books under your bed to make it like a hospital bed.

  • 2
    Im surprised you are not familiar with steam inhalers. I use it for my chronic allergies. – Jesvin Jose Mar 19 '15 at 12:02
  • When it gets really bad, I like to turn the shower on as hot as it goes, close the bathroom doors and windows, open the shower curtain and sit next to the shower for a while. – Captain Obvious Mar 20 '15 at 15:31
  • @CaptainObvious sounds like an awful waste of drinking water. – johnildergleidisson Mar 31 '17 at 13:24
  • @JoaoMilasch Depends on your water source. When I trace through the water supply and wastewater treatment path where I live, unless it stops raining, it's not really possible to waste drinking water. I do not recommend long hot showers when your source is e.g. a well, or if you otherwise live in an area without modern wastewater treatment and recycling, or if you live in an area where wastewater does not make it back into the water supply. – Captain Obvious Mar 31 '17 at 13:58
28

Your sinuses are suffering from vasodilatation or nasal congestion. There's nothing to blow out that will unblock them because the passages themselves are shrinking due to the blood vessels increasing in size, and the nasal passages shrinking as a result.

Normally your sinuses do this throughout the day following a nasal cycle that allows one side to rest and remoisten while the other side handles the majority of the airflow. The frequency of this cycle depends on the environmental factors.

But now your body is fighting an infection and it's decided to play Madagascar and shut down everything. Both nostrils are not only congested, but severely so, to the point where you can't use them.

Some of the treatments suggested do provide some relief. Sitting up decreases blood pressure in the head, decreasing vasodilation. Hot steam provides very temporary relief. A nasal strip can pull the nasal passages open a little more widely. If your congestion isn't severe, or if you fall asleep quickly, then these might be sufficient.

It sounds like your congestion is bad enough, though, that you should look at vasoconstricting medications, otherwise known as decongestants. I recognize you've tried some decongestants, but there're two things you need to understand - first, one very common, over the counter decongestant in the US may not be effective, and second, a nasal spray decongestant should be tried if you've only taken oral decongestants so far.

Typically nasal decongestants will work in most cases. Pseudoephedrine is the most common over the counter oral decongestant that people indicate works, though in the US it is controlled so you'll have to ask your pharmacist for it (no prescription required). Note that if you're buying an over-the-counter decongestant in the US that doesn't require you to visit the pharmacist, it's probably Phenylephrine, and "clinical studies suggest that phenylephrine is ... not more effective than placebo". Make sure you try Pseudoephedrine before you give up on oral decongestants. Check your medicine ingredients, and talk to your pharmacist if you have any questions.

When that doesn't work, however, I've found that a direct decongestant spray, oxymetazoline, works very quickly and effectively. This is common enough that you can find it in many brand names and generics, such as Afrin. There are a number of nasal sprays that claim decongesting effects, but some are simply saline spray. Make sure you try one with oxymetazoline.

They all work the same way but use different routes to the affected area. Direct nasal spray application works very quickly, but can't be timed release, so may need to be used more frequently than an oral decongestant. Further, they are different drugs, so if one doesn't work, it's worth trying another to see how your body reacts. For me, oxymetazoline beats Pseudoephedrine which beats phenylephrine.

There is an issue where if you consistently use them your body starts to work harder to close your nasal passages, which means that once you stop you become congested even if you would normally not be congested at that point. As such, I've limited my use to only when I need to get to sleep, and usually only one spray (1/2 to 1/3 the recommended dose) in one nostril (I don't need both open to sleep), and alternate nostrils each night. Usually, I've only needed it for a day or two. If it appears you need it for more than a few days in a row, you should probably consult your doctor or GP to check for bacterial infection or other causes, or a plan to wean you from the medication once the cause is resolved.

  • 1
    The one, the only: pseudoephedrine. – Mazura Mar 20 '15 at 5:06
  • Phenylephrine is excellent decongestant when applied directly, in form of a nasal spray (just like oxymetazoline). It's destroyed in digestive tract, that's why phenylephrine pills are placebo (but easily backed up by direct application studies for advertisement purposes). – Agent_L Mar 20 '15 at 14:46
  • @Agent_L Interesting! I'll have to keep an eye out for that at the store. – Adam Davis Mar 20 '15 at 14:50
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    "There is an issue..." may be an understatement. Be very careful when using oxymetazoline (Afrin, etc.), phenylephrine (Sinex, etc.), or others. They can be very physically addictive and the cycle can be vicious and can do significant, although generally reversible, damage to your sinuses (I've experienced Afrin withdrawal myself a few times and it is not pleasant). Great for a day or two but heed the warnings on the box, and expect some rebound. – Captain Obvious Mar 20 '15 at 15:22
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    @Agent_L I've found that only 3-5 days of usage (box warning limits) is enough to guarantee stuffiness for at least a day or two afterwards. The worst experience I had was before I understood the issue, where I had gotten stuck in a cycle for about four weeks. This took just under a month for me to return to normal, and for the first week I could not breath through my nose at all (hot showers and saline spray helped somewhat) and sleeping was difficult. I imagine it varies significantly from person to person. Check out fauquierent.net/afrin.htm for some info and treatment as well. – Captain Obvious Mar 21 '15 at 19:16
16

Instead of a decongestant take a cheap anti-histamine like diphenhydramine (Benadryl). In addition stopping the flow of mucus, the first generation anti-histamines make you so drowsy you'll have hard time staying awake even if you wanted to.

  • I suggest , in addition to above, that you put a hanker chief on you nose n try to breathe. That way the temperature of nose will rise and you'll feel better after sometime. It works for me. – Abhishek Tripathi Mar 19 '15 at 3:16
  • Antihistamines won't do anything for the sinuses if the problem isn't caused by a histamine reaction (i.e. allergies). – hobbs Mar 22 '15 at 23:35
  • @hobbs Actually first generation anti-histamines do help reduce the symptoms of the common colds. en.wikipedia.org/wiki/Common_cold#Symptomatic aafp.org/afp/2007/0215/p515.html – Ross Ridge Mar 22 '15 at 23:42
10

I have just finished dealing with this same problem last week, here are a few things that helped me get over it:

  1. Put on some chap stick and breath through your mouth.
  2. Don't go too crazy with the decongestants, you could end up "crashing hard" and prolonging the congestion period.
  3. Wasabi and horseradish are really good at decreasing the swelling in your nasal passages.

And no, I'm not some "all natural against western medicine" person, if it works I do it and horseradish works!

  • For me in general the worst effect of mouth-breathing is on my uvula, not my lips. I've woken up a few times with it swollen and had trouble breathing and swallowing all day. – Random832 Mar 20 '15 at 19:30
8

I would recommend using some form of nasal irrigation before going to bed.

The idea is to run a mild salt solution through your nasal passages which clears stuffiness out and helps disinfect and thus de-inflame. It sounds kind of gross, but it really works well for me.

Without making any specific product recommendations, there are several inexpensive products available usually available in your local pharmacy (assuming US).


Additionally you may have a deviated septum which will make your situation worse. It might be worth getting it checked out by an ENT specialist.

  • A mild salt solution works usually great. – kenorb Mar 22 '15 at 18:51
  • You can actually buy ready to go sets: Netipot – CustomX Mar 23 '15 at 12:04
  • This is what I use when I am congested. It works like a miracle. I used to have a lot of stuffiness, and trouble sleeping until my brother introduced me to nasal irrigation. – JGTaylor Oct 20 '15 at 15:53
8

My mother used to cut an onion and place it on a plate near my bed. You could try that.

I also like to have something soft like a towel under my pillow. That way my head is a bit more upwards, instead of lying down flat. It makes sleeping more comfortable for me.

  • A clear nose and runny eyes. lol! – Mooseman Mar 19 '15 at 10:57
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    @Mooseman You shouldn't put it that close. – Izzo Mar 19 '15 at 10:59
5

I tend to create nose plugs out of tissue paper... it's not pretty, but its the running mucus which keeps me awake not the stuffy part. Once they're in my nose (big enough so they are easy to pull out).. then it gives me the chance I need to fall asleep.

Good luck.

  • This works great! – Chris May 11 '15 at 0:33
5

I have this problem most of the time because of allergic rhinitis - I do use a steroid spray, but sometimes, the sinuses get blocked because of a cold or because the pollution's high, and I start to feel muzzy and a bit dizzy. I put off doing the following, its such a faff and makes my fringe (bangs for folks from the USA) frizzy, but when I do force myself to do it, it works really well.

It's an old fashioned thing - an inhalation. Just means boiling a kettle of water, pouring some into a bowl, adding whatever you've got handy (Vick, Olbas Oil, Karvol, or the cheapest, a teaspoon of menthol and eucalyptus in a brown bottle from the pharmacy), throwing a towel or something large over your head and the bowl to make a tent, leaning forward over the bowl and inhaling the vapours as deeply as possible for a few minutes. You usually find you have to emerge after a minute or two to blow your nose, but then continue the procedure. Tedious - but it does work. Best done within a couple of hours of going to bed, although repeated treatments during the day do no harm. Its also important to make sure you sleep with the window slightly open, so the air's cooler and is moving.

  • Olbas Oil is great, few drops on the tissue and place it on the pillow. Mixing it with Tea Tree Oil is not so bad as well. – kenorb Mar 22 '15 at 18:50
4

In addition to the tips regarding trying to clear everything out before going to bed, I sometimes have to resort to sleeping in a good chair in a rather upright sitting position with support for my head (and usually with a leg rest).

This way I'm able to get some sleep, although the quality of sleep is better in a bed when the nose is clear.

4

You can try the following:

  • Ginger Tea: Just add a small (crushed) piece of ginger to your tea. And you can also add crushed clove, in addition to ginger.

  • Spicy Food: Some hot and spicy foods can relieve sinus congestion because they help to keep your mucous thin. Food with mucokinetics, or mucous-thinning activity, include chilli peppers, garlic, black pepper and curry spices. Capsaicin found in pepper makes your nose run helping you clear your nasal passage.

  • Vicks Vapor rub: Apply it on your nose just before you sleep and cover you face with blanket, leave a very small space for breathing. This will let the rub work more better. You can buy it from Amazon.

I have tried all the above methods. It helped me. But you should choose the one that suits you the best.

  • Also chicken soup with ginger. For quick & easy, a package of chicken flavor ramen, some chopped chicken, about a tablespoon of chopped ginger root, plus green onion, celery, pepper, or whatever veggies you have to hand. – jamesqf Mar 20 '15 at 5:20
  • @jamesqf - I haven't tried it. If doing so helps you , then it's nice. – Vibhu Mar 20 '15 at 6:51
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    Vicks Vapor Rub is the stuff. Rub it onto your chest and neck, and put a dab under your nose if you can bear it. Sleep propped up on several pillows. – RedSonja Mar 23 '15 at 14:48
3

The main problem with OTC decongestants is that your sinuses basically become "addicted" to them very quickly, giving a rebound effect when you attempt to quit using them which is often more severe than the initial problem, this is a condition called Rhinitis Medicamentosa.

One approach is to dilute the spray with saline solution over a period of time, weaning the tissue off the drug. You might also try substituting one of the corticosteroid sprays which have recently become available OTC and they are said to have less of this rebound tendency for a period of time until your sinuses readjust.

  • A friend of mine didn't even use a OTC decongestant (including any kind of medicine) in the first place. He just uses a saline solution (sea salt). Not diluted drugs or anything. Just a plain old sea salt solution in a nasal spray container. – Alex Mar 20 '15 at 8:21
  • "Addiction" and rebound effect become problematic only with extended use. Few days (up to a week) are not a problem. Diluting decongestants can increase those adverse effects, as instead of "shock dose" that constricts blood vessels rapidly you're applying low concentrations over longer time, letting resistance to build up. – Agent_L Mar 20 '15 at 15:03
3

Oh, I know what you mean. I have the same problem. There are two important factors to this:

  • air quality
  • position of the head

I noticed that the position of the head may hinder the breathing. If I move my head a little backwards the nostrils open up and it's easier to breathe. As for the air: keep it clean (no dust - open your windows for a while before you go to sleep) and keep it humid. Humidity is so important, especially in winter when the heaters make the air very dry. I bought some air humidifiers and the problem is gone.

When that doesn't work, you may have an allergy (dust, mites) and it would be a good idea to consult a doctor.

3

I use an oral decongestant like time released generic sudafed. A nasal steroid spray only after I spray or snort a nasal saline solution to loosen mucus and irrigate the nasal passages.

Last I use a breathe rite strip (clear works better, easier to remove in the morning).

Sleeping with the head elevated or upright in a recliner also helps.

  • From the question: "I've tried [...] using various decongestants." – Mooseman Mar 19 '15 at 10:56
  • +1 for mentioning recliner. they do wonders. I could sleep even though I had some nasal congestion. – Madhu V Rao Feb 16 '17 at 2:33
2

Try taking a paracetamol. Although it is mainly a painkiller, it also has an anti-inflammatory action too. This can help by reducing swelling and that can affect the nasal membranes.

What we consider to be a "blocked nose" is usually nothing of the sort, it is soft tissue of the nose swollen up and blocking the airway all on its own.

I used to suffer from hayfever and once or twice tried paracetamol to help with sleep and it seemed to work for me.

  • Could you expand on this more? Many people probably do not know what paracetamol is or how to use this. It may get flagged as low-quality if you don't explain more. – michaelpri Mar 19 '15 at 0:54
  • paracetamol is not an anti inflammatory drug, simply an analgesic - ibuprofren based drugs should be of more help in that regard. You may have slept better because the drug made you feel a bit better. – Bamboo Mar 19 '15 at 17:53
  • According to Wikipedia, it does have a weak antiinflammatory action, and I don't think I took enough (1 500mg) to make me feel better. Hayfever didn't give me PAIN, just irritation. However, I take your point, after all, it was not uncommon for me to spontaneously shed the symptoms and sleep well having taken no drugs. Nonetheless, I still feel it's worth a try because most people will have paracetamol around the house, they're virtually free, very safe, and it might work. – Lefty Mar 19 '15 at 23:38
  • Paracetamol is somewhat useful only against fever and pain. OTC anti-inflammatory drugs are called NSAIDs: ibuprofen, acetylsalicylic acid (asprin), naproxen. – Agent_L Mar 20 '15 at 14:57
  • Wikipedia's entry on paracetamol: "Though paracetamol is used to treat inflammatory pain, it is not generally classified as an NSAID because it exhibits only weak anti-inflammatory activity." – Lefty Mar 20 '15 at 15:03
1

I would suggest taking a eucalyptus/menthol lozenge or inhalation of Menthol & Eucalyptus Oil to clear your nose.

  • You might want to explain this more. What is eucalyptus/menthol lozenge? How do you use it? Answering these questions in your answer will help improve it's quality. – michaelpri Mar 20 '15 at 1:30
0

Some have found that a sexual climax has the side effect of clearing the sinus. More fun than spray decongestants.

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