6 Common Reasons Why You Always Wake Up Congested, According to Doctors

Your alarm goes off and as you roll over to smack the snooze button, you take your first deep inhale of the day—only to find that you can't breathe deeply through your nose. Sound familiar? You're certainly not alone: Many people deal with persistent congestion in the mornings, and a handful of culprits can ignite this reaction in your sinuses.

"When the nasal passages are triggered to swell, the internal structures of the nose—called the turbinates—become engorged with blood," says Robert Bocian, MD, a professor of allergy and immunology at Stanford University School of Medicine and Chief Scientific Advisor to Allermi. "These swollen tissues occupy more space within the nasal passages, blocking nasal airflow, and cause us to perceive the nose as obstructed, congested, or stuffy." Some triggers can also cause your body to produce more mucus, which leads to sniffly, cold-like symptoms.

Dealing with that annoying pressure every morning is frustrating, but once you've figured out what's causing the congestion, you can work quickly to nix the source and wake up feeling refreshed—not stuffy. Here are some of the biggest culprits of morning congestion.

Allergens Like Dust, Dirt, and Pollen

One of the most common reasons you wake up congested is because of something referred to as "allergic rhinitis." As you sleep, your body is exposed to an allergen, like dust, dirt, or pollen, and goes into protection mode to defend against foreign invaders, explains Julie Wendt, MD, an allergist and immunologist.

Dust mites are the most common indoor allergen that triggers nasal congestion. "The dust mite is a microscopic animal related to spiders that is harmless, except for its production of an allergenic digestive protein contained in its feces," says Dr. Bocian. Dirt and pollen are other problems, as is fragrance, which shows up in candles, diffusers, skin care products, and laundry detergent.

Treatment

Dust mites love hanging out in your fabrics, including pillows, mattresses, blankets, comforters, stuffed animals, carpets, rugs, and upholstered furniture. Clean these items often and make sure to vacuum, dust, and mop to further eliminate settled dust, dirt, and pollen. Also remove potentially irritating fragrances from your space (that might mean switching detergents when you wash bedding) to see if that helps.

If that's still not cutting it, you may have a heightened sensitivity to these allergens. "Treating allergic rhinitis involves allergy testing and treatment," Dr. Wendt. "Allergy shots can help control the immune system response to allergies. It can also be treated with nasal sprays, antihistamines, and decongestants."

Dryness

When your nasal passage becomes dry, it compensates by producing more mucus, says Dr. Wendt. And when your body produces too much mucus, you can wake up feeling stuffy and congested. Nasal dryness occurs when your environment or climate is dry, but it can also arise from taking antihistamines or other drying medications and treatments, such as nasal sprays.

Treatment

To combat the issue, bring a humidifier into your space to increase natural humidity levels to between 30 and 50 percent. Keep it bedside for even better benefits. It's also important to only use medications and treatments as directed, or to cease usage altogether. Dr. Wendt also suggests using a non-drying saline nasal spray to boost moisture inside the nasal passage. Before making any major changes, though, speak to your doctor about what's best for you.

Upper Respiratory Infection

Upper respiratory infections caused by viruses or bacteria—think colds, flu, and COVID-19—are notorious for creating nasal congestion. And even after the infection has been treated and seems to be mostly cleared up, you could still experience persistent, ongoing congestion, says Dr. Bocian.

Treatment

For the common cold or flu, Dr. Wendt recommends using an over-the-counter treatment that helps provide some relief. This includes sinus rinses and cold medications that contain antihistamines and nasal decongestants. If you're dealing with a bacterial infection, which your doctor will be able to determine, you'll need antibiotics.

If you've had an upper respiratory infection and still aren't seeing improvements in congestion after several weeks, reach out to your doctor about the best path forward. They could put you on a treatment plan, or they may refer you to an ear, nose and throat (ENT) specialist.

Hormone Fluctuations

Strong fluctuations in hormones—which can occur from issues such as low thyroid, low testosterone, and high progesterone—can enlarge your nasal blood vessels and result in a feeling of congestion, explains Dr. Wendt. "We see this in patients with low thyroid, older men, and also pregnant women, in the third trimester," she says. It can even occur more subtly during a person's menstrual cycle as hormones fluctuate.

Treatment

This cause of nasal congestion must be diagnosed by a medical professional. In cases of pregnancy, your doctor will likely recommend treating the symptoms themselves, Dr. Wendt says. For low thyroid or testosterone issues, work with your doctor on calibrating your levels; this should improve morning congestion, as well, she adds.

Environmental Changes

It's less common, but a shift in your environment can make you feel congested in the morning; it's worth looking into if you can't pinpoint the culprit of your stuffy sinuses. This is referred to as "vasomotor rhinitis," (VMR) and it occurs when there's a change in temperature, humidity, and barometric pressure. These shifts "excite nerves in the nose, resulting in engorgement of blood vessels," says Dr. Wendt.

Treatment

Dr. Wendt recommends treating VMR with nasal sprays. It's also helpful to take a holistic approach by making sure the bedroom and your bedding is clean, potential irritants are removed from the space, and humidity levels are stable.

Sleep Position

Many people experience a narrowing of their nasal passages when they're supine, which then goes away once they're back upright. Since you lay down for a big chunk of time during the night, this could be the reason why you wake up feeling stuffy, says Dr. Bocian.

"When sleeping on one's side, the nasal passage closer to the bed can tend to narrow even further," Dr. Bocian says. In this case, the "nasal congestion perceived upon awakening has actually prevailed throughout most of the night's sleep. We simply become more aware of nasal congestion upon awakening."

Treatment

If you suspect this is the source of your congestion woes, Dr. Bocian recommends trying to sleep on an incline. You can do this by using an under-mattress wedge. Another option is to use a bigger pillow that helps keep your head elevated. Strips that open up the nasal passage (including those that minimize snoring) can also help keep your nostrils open throughout the night.