From the Guidelines
To treat nasal congestion at night, the most effective approach is to use a combination of saline nasal sprays or rinses, nasal steroid sprays, and oral antihistamines or decongestants, while also implementing simple environmental changes, as recommended by the most recent guidelines 1. When considering treatment options, it's essential to weigh the benefits and risks of each.
- Saline nasal sprays or rinses can help flush out irritants and thin mucus, making it easier to breathe.
- Nasal steroid sprays, such as fluticasone (Flonase) or mometasone (Nasonex), can reduce inflammation, but may take several days to reach full effectiveness.
- Oral antihistamines, like diphenhydramine (Benadryl) or loratadine (Claritin), can help if allergies are causing congestion, but may have side effects like sedation or dry mouth.
- Oral decongestants, such as pseudoephedrine (Sudafed) or phenylephrine, can provide temporary relief, but should not be used for more than 3 days to avoid rebound congestion, as warned by several studies 1. Some key points to consider when using these treatments include:
- The potential for rebound congestion with prolonged use of oral decongestants or topical decongestants, as noted in studies 1.
- The importance of using nasal steroid sprays consistently to achieve full effectiveness, as recommended by guidelines 1.
- The need to monitor blood pressure and heart rate when using oral decongestants, especially in patients with hypertension or cardiovascular disease, as cautioned by studies 1. Simple environmental changes can also make a significant difference:
- Elevating the head with extra pillows to reduce congestion
- Using a humidifier in the bedroom to add moisture to the air
- Avoiding known allergens and irritants
- Staying hydrated throughout the day to thin out mucus A warm shower before bed can temporarily relieve congestion by loosening mucus, and nasal strips that open nasal passages may help those with structural issues. Overall, the most effective treatment plan will depend on the individual's specific needs and medical history, and should be guided by the most recent and highest-quality evidence, such as the 2015 clinical practice guideline on allergic rhinitis 1.
From the FDA Drug Label
Uses • temporarily relieves sinus congestion and pressure • temporarily relieves nasal congestion due to the common cold, hay fever or other upper respiratory allergies Uses Temporarily relieves nasal congestion due to: common cold hay fever upper respiratory allergies sinusitis shrinks swollen nasal membrances so you can breathe more freely. For nasal congestion at night treatment, options include:
- Pseudoephedrine (PO): a non-drowsy oral decongestant that can provide relief from nasal congestion due to the common cold, hay fever, or other upper respiratory allergies 2
- Oxymetazoline (IN): a nasal decongestant that can temporarily relieve nasal congestion due to the common cold, hay fever, upper respiratory allergies, or sinusitis, and can help shrink swollen nasal membranes 3
From the Research
Nasal Congestion at Night Treatment
- Nasal congestion can be caused by various factors, including allergic rhinitis, vasomotor rhinitis, chronic sinusitis, and upper respiratory viral infections 4.
- Treatment options for nasal congestion include decongestant pharmacotherapy, antiallergy measures, and nasal dilation devices, as well as surgical procedures 4.
- Topical nasal decongestants such as oxymetazoline (0.05%) can provide relief of nasal symptoms for up to 12 hours 5.
- A fixed dose combination of Fluticasone Furoate and Oxymetazoline Hydrochloride Nasal Spray has been shown to be effective in managing allergic rhinitis with nasal congestion, providing significant relief of nasal congestion and improvement in nasal airflow 6.
- The combination of mometasone furoate nasal spray and oxymetazoline nasal spray has also been found to be effective in relieving seasonal allergic rhinitis symptoms, including congestion 7.
- Intranasal corticosteroids are recommended as first-line therapy for patients with moderate-to-severe allergic rhinitis and nasal congestion, and have been shown to be more effective than placebo, antihistamines, or montelukast in relieving nasal symptoms 8.
Treatment Options
- Decongestant pharmacotherapy: oxymetazoline (0.05%) can provide relief of nasal symptoms for up to 12 hours 5.
- Antiallergy measures: Fluticasone Furoate and Oxymetazoline Hydrochloride Nasal Spray can provide significant relief of nasal congestion and improvement in nasal airflow 6.
- Nasal dilation devices: can be used to relieve nasal congestion 4.
- Surgical procedures: available for patients who do not respond to conservative treatments 4.
Efficacy and Safety
- Oxymetazoline (0.05%) has been shown to be safe and effective in providing relief of nasal symptoms for up to 12 hours 5.
- Fluticasone Furoate and Oxymetazoline Hydrochloride Nasal Spray has been found to be well-tolerated and effective in managing allergic rhinitis with nasal congestion 6.
- Mometasone furoate nasal spray and oxymetazoline nasal spray combination has been shown to be safe and effective in relieving seasonal allergic rhinitis symptoms, including congestion 7.
- Intranasal corticosteroids have been found to be safe and effective in relieving nasal symptoms, including congestion 8.