Sinus Congestion when lyiing down/sleeping

[Jerry_NJ]

I have some but not much sinus congestion when awake and on my feet or sitting up, but I stop up "big time" whenever I lie down.  It appears to be some swelling and may be related to an allergy, but it occurs even when I am away from home and sleeping in a hotel, so I assume it is not an allergy to something in my house/bedroom.  

The over the counter sinus sprays, like Afirin really clear me up, and I often use that once a day before bedtime.  I also have a prescription spray (I can look it up if this post gets some responses) which helps not not as much as the Afirin. Yes, I know one is not to make regular use of these sprays and I have gone months without using them to try to break any downside to their use.  

I also not the congestion is fluid, it is always worse, maybe only, on the lower side, gravity moves it to the side I am lying on.  Roll over, the congestion shifts sides.

[Lesismore1969]

I feel bad for you. I have read the responses you have gotten and it is very frustrating. The answers you have gotten have completely overlooked that your blockage happens when you lie down. THAT is the trigger. I recommend researching it yourself. I have the same problem as you and I have just started searching on Google for "sinus congestion when I lie down" and there are lots of interesting pages to read. Pick and chose ones that are from reputable sites and that sound closest to your situation.  I am thinking that all the meds you mentioned are probably not necessary. So far, from what I've read, it may be as simple as adding an extra pillow at night. Good luck!

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Yes, if the regimen helps it could most probably rule out an infection and go more in favor of an allergic reaction. Try observing what's triggering the response. It could sometimes be due to Environmental triggers. Environmental triggers for allergic reactions like changes in weather, temperature and water sources are difficult to avoid, but being aware can help you take adequate precautions.

The aim of the therapy for allergic reactions is identification and removal of trigger factor. It is the most important and the only effective long-term therapy. If you are already aware of the triggering factors, avoid them or desensitize yourself.

Hope this helped and do keep us posted.

[Jerry_NJ]

Status, still to talk with my doctor - need to call for an appointment.

I have completely stopped using the Afrin type spray and use the prescription as directed, one shot in each nostril twice a day (about 10am/10pm).  I have been using saline spray several times a day/evening and the stuffy condition when sleeping is a little better.

Today I started using a Zicam Allergy Relief Gel a couple of times a day - hope this isn't too much to add to the prescription spray, I'm confident the saline can't cause a problem.

In any case I now plan to use some of the Gel too, but not within less than  2 hours before using the prescription spray.. then as I am trying to sleep the only spray I will add over the next 8 to 10 hours is saline spray.

If this regiment helps I wonder if that means no infection.

[Meldauc]

Hello, I suffer for the exact same congestion that you described. I’m so miserable.
This has been going on for a couple years now. I see an ENT every 3 months, but I still feel the same and it seems to be a waste of money. Also, I tend to get sinus infections every couple of months due to this congestion.

Have you found a relief from this congestion?

[Jerry_NJ]

Hi, the "new" to me Webmed way of handling posts is confusing to me.  Yes I am a long time contributor to several Medhelp topics over the past 10 years+, but have been a rare visitor since my wife's loss of the battle with cancer about 3 years ago.  The new method now sends emails when an old typic is hit again... e.g., the post I made about 6 years ago.   Sadly, I have not found a solution I can share.  I continue to use saline spray when I get up at night, being an old guy I have to visit the toilet at least once a night.  I sometimes still use a over the counter like Afrin, and it generally holds me clear  throughout the night.    I assume you've read the reply about searching the web on the subject of this post.  I have not yet done so myself.  Good luck

[Jerry_NJ]

Drs, Anitha and Santos,

Thanks for you very helpful responses.  

My late response is due to the fact I do not check this particular Medhelp Community, I spend most of my Medhelp time on the Heart Rhythm Community.

The prescription nose spray I have is Fluticsone 1 spray in each nostril twice a day. This I have not been doing mainly because it has only marginal value... perhaps I have already hit the "rebound".  I have used this spray as well as Afrin-like sprays for a couple of years (or longer).  If I use Afrin I use it only once before going to bed. It seems to give close to 12 hours relief.

I do not take a decongestant tablet/pill as I suffer from Atrial Fibrillation and take medication to lower/control my heart rate.

I always have saline spray but don't use often.  I have also used a netipot irrigation but never every night and I haven't used it at all in a month or more.

I have discussed the nasal condition with my primary care doctor, at each of the last two annual physical examinations.  That is where the Fluticasone prescription came from, or I got it from the Nurse Practitioner who works with him.  My nasal condition has been examined by her at least once.

I assume you are referring to an Ears Nose and Throat specialist (ENT).  I'll ask for a recommendation from my primary care.  

In the mean time I read you collective advise is to give the saline a lot more use, perhaps the netipot too?  I have read the advice to not use tap water to for the netipot flush.

Again, thanks you both for your help.  I don't recall a long term infection being suggested, I can discuss that with my primary care doctor too.  

[Dr Santos]

Hi,
How are you?  How long have you been experiencing these symptoms? What diagnostic tests were done in the past? Sinusitis or inflammation of the sinuses may occur with an infection from a virus, bacteria, or fungus and can be acute or chronic ( long-term). It can present with loss of smell, cough that is often worse at night, fatigue , fever, headache, and nasal stuffiness and discharge. If it persists, you may need to have this checked by your doctor or ENT for proper evaluation. Additional diagnsotic tests and imaging studies may need to be done to determine the underlying cause. Drinking plenty of fluids, steam inhalation, using a humidifier and spraying with  nasal saline several times per day may also help provide relief. Try to avoid use of prescription nasal spray too much to prevent rebound congestion. To rule out allergy issues, allergy test may also be done. Take care and do keep us posted.

[Paderla Anitha, DNB]

Hello and hope you are doing well.

Understand your predicament. Sinus infection causes blockage of flow especially when a person lies down. The blockade is affected by the side to which the person turns also. Sinus infections also cause stuffiness of the nose with nasal blockage, which can make breathing through the nose difficult. The best way to get to the bottom of your sinus issues is to see an ENT.  A good examination inside the nose with a camera might give the ENT more information as well as a CT scan of the sinuses.  If it is a chronic sinus infection, 4-6 weeks of antibiotics are pretty standard in addition to nasal steroid sprays, oral steroids, and salt water irrigations of the sinuses.  If this fails to solve the problem, sinus surgery is usually recommended.

Hope this helped and do keep us posted.