Differential Diagnosis for Nasal Congestion at Night
- Single Most Likely Diagnosis
- Allergic rhinitis: This is often the most common cause of nasal congestion, especially if it occurs at night. Allergens like dust mites, pet dander, or pollen can trigger symptoms.
- Other Likely Diagnoses
- Vasomotor rhinitis: This non-allergic condition can cause nasal congestion due to sensitivity to environmental factors like temperature, humidity, or strong odors.
- Deviated septum: A physical obstruction in the nasal passage can lead to chronic nasal congestion, which may worsen at night due to increased blood flow.
- Sinusitis: Inflammation or infection of the sinuses can cause nasal congestion, and lying down at night can exacerbate symptoms.
- Cold or upper respiratory infection: Viral infections can cause nasal congestion, which may be more noticeable at night.
- Do Not Miss Diagnoses
- Nasopharyngeal cancer: Although rare, this type of cancer can cause nasal congestion, especially if it obstructs the nasal passage. It's crucial to rule out this diagnosis, especially in older adults or those with a history of smoking.
- Angioedema: A severe allergic reaction can cause rapid swelling of the nasal tissues, leading to congestion and potentially life-threatening airway obstruction.
- Rare Diagnoses
- Granulomatosis with polyangiitis (GPA): A rare autoimmune disorder that can cause inflammation and congestion in the nasal passages.
- Sarcoidosis: An autoimmune disease that can affect the nasal tissues and cause congestion, although this is a less common manifestation.
- Foreign body: In children, a foreign object lodged in the nasal passage can cause congestion, which may be more noticeable at night.