From the FDA Drug Label
Principal Display Panel Compare to Sudafed® Congestion active ingredient Pseudoephedrine Hydrochloride, 30 mg Nasal Decongestant MAXIMUM STRENGTH • SINUS PRESSURE • SINUS CONGESTION 24 TABLETS actual size NON-DROWSY Padagis™ The FDA drug label does not answer the question.
From the Research
For sleep during a sinus infection, I recommend an over-the-counter medication that combines an antihistamine with a decongestant, such as Nyquil or a similar nighttime cold and sinus formula, as the most effective option based on current evidence. These medications typically contain diphenhydramine (an antihistamine that causes drowsiness) along with phenylephrine or pseudoephedrine (decongestants that reduce nasal congestion) 1. Take as directed on the package, usually about 30 minutes before bedtime. Alternatively, you could take a separate antihistamine like diphenhydramine (Benadryl) 25-50mg at bedtime along with a nasal decongestant spray like oxymetazoline (Afrin), but don't use the nasal spray for more than 3 consecutive days to avoid rebound congestion. Elevating your head with extra pillows can also help drainage and breathing while sleeping. A saline nasal rinse before bed may clear mucus and improve breathing. These medications work by reducing inflammation in the nasal passages and sinuses while the antihistamine component has a sedating effect that helps you fall asleep despite discomfort.
Some studies suggest that systemic corticosteroids may be beneficial for short-term relief of symptoms in acute sinusitis, particularly when used in combination with antibiotics 2, 3. However, the evidence is limited, and the use of corticosteroids as a monotherapy appears to be ineffective. The most recent and highest-quality study on this topic, published in 2014, found that oral corticosteroids in combination with antibiotics may be modestly beneficial for short-term relief of symptoms in acute sinusitis, with a number needed to treat to benefit of seven for resolution or symptom improvement 3.
It's also important to note that antibiotics may not be effective for acute sinusitis, and their use should be reserved for cases where a bacterial infection is suspected 4. Topical nasal steroids may be beneficial in patients with less severe symptoms at baseline, but their effectiveness is still debated.
If symptoms persist beyond 7-10 days or are accompanied by high fever, severe headache, or facial pain, consult a healthcare provider as you may need antibiotics for a bacterial infection. In terms of specific medications, pseudoephedrine and phenylpropanolamine are effective decongestants, but phenylephrine is subject to first-pass metabolism and is not bioavailable in currently recommended doses 1.
Key points to consider:
- Over-the-counter medications that combine an antihistamine with a decongestant are the most effective option for sleep during a sinus infection.
- Systemic corticosteroids may be beneficial for short-term relief of symptoms in acute sinusitis, particularly when used in combination with antibiotics.
- Antibiotics should be reserved for cases where a bacterial infection is suspected.
- Topical nasal steroids may be beneficial in patients with less severe symptoms at baseline.
- Pseudoephedrine and phenylpropanolamine are effective decongestants, but phenylephrine is not bioavailable in currently recommended doses.