Why Your Allergies Are Worse When You Wake Up, and What Can Help

Have you ever woken up—either from a nap or a full night’s rest—and been unable to stop sneezing? Or maybe you spent more time blowing your nose than putting your makeup on this morning. Neither is exactly a great way to start the morning (or rest of the day, if you love a daily midday nap).

If you’ve experienced these not-so-fun symptoms, you might be wondering: Why are my allergies extra annoying after sleeping? According to allergists, several factors could be at play. But there are ways to keep the guilty parties in check.

Lying down increases congestion

The position we use to sleep isn’t doing us any favors when it comes to feeling stopped up. “When lying down, gravity can lead to accumulation of fluids in the nasal passages and sinuses,” says Shyam Joshi, MD, chief medical officer at allergy care company Nectar. “Not only will this lead to increased mucus, but the veins in the nose can also become engorged, leading to a feeling of fullness.” Fortunately, he says, that over-full sensation starts to go away after a few moments upright.

What helps: Try adjusting the angle of your head with pillows. Dr. Shyam suggests aiming for at least a 30-degree angle to help your nose drain.

Inflammation goes up

Our levels of cortisol—what most of us think of as the “stress hormone” but also a natural anti-inflammatory hormone—decreases overnight to allow us to sleep, says Jeanne Lomas, DO, director of allergy and immunology at WellNow Allergy. “Thus, allergy symptoms (and any inflammation) tends to worsen over night,” she says. As a result, you’ll notice allergies more in the morning.

What helps: Here’s the good news: Cortisol levels peak right before you wake up, so it anti-inflammatory effects should kick in shortly after. A study in Stress suggests sunlight can increase cortisol and possibly speed up the process You can also take advantage of moderate- to high-intensity exercise to encourage the body to secrete cortisol. A morning run, anyone?

Dust mites and allergens in your bedroom

Even though you can’t see them, dust mites can live in beds and cloth couches. So, when you’re lying down, your eyes and nose are (obviously) quite close to them.

“In those that are allergic to dust mites, this close encounter will lead to increased inflammation in the nose with associated congestion, runny nose, and sneezing,” Dr. Joshi says. He notes sneezing rapidly first thing in the morning is an especially common sign.

Dr. Lomas mentions pet dander as another allergen that can gather in your home, as well as seasonal allergies, such as pollen, that can stick to your clothing.

Speaking of, pollen counts tend to rise in the mornings, which could be another factor (especially if you keep your windows open when you sleep).

What helps: While a couple squirts of steroid nasal sprays, such as Flonase, before bed can help, it’s more of a short-term fix, according to Dr. Joshi. More long-term, consider allergen immunotherapy. “Immunotherapy helps the body develop tolerance to dust mites, which reduces or eliminates the inflammation that occurs with subsequent exposure,” he says. Examples he lists include Nectar’s prescription allergy drops and allergy shots.

Other suggestions from Dr. Lomas include limiting your pet’s access to your bedroom as well as washing bedding regularly and drying it in high heat. “Items that cannot be washed regularly, like pillows and mattresses, should be fully encased with impermeable covers that provide a barrier between you and the dust mite allergen,” she adds. She also recommends vacuuming regularly using a vacuum that has a HEPA filter.

Dry air or a lack of ventilation

Do you have your heater or A/C on at night? That can unfortunately lead to dry air, Dr. Joshi says, which is common. “The dry air can irritate the nasal passages, causing them to become inflamed and congested,” he explains.

Tania Elliot, MD, FAAAAI, FACAAI, an internal medicine doctor and chief medical officer of virtual care at Ascension, also points to how high humidity levels and poor ventilation can cause mold to grow in your home, worsening allergy symptoms.

What helps: When it comes to dry air, you have two pretty easy fixes: adding a humidifier to the room, or using a nasal spray before bed, according to Dr. Joshi.

As far as the mold and humidity go, Dr. Elliot recommends keeping the humidity level at less than 50 percent and performing mold remediation. More generally, she’s a fan of Flonase, too.

If you try all these fixes and are still having problems, book an appointment with your doctor. “A visit to the allergist can help you pinpoint exactly what you are allergic to,” Dr. Lomas says, “and whether you might benefit from a more specific allergy treatment.”

—reviewed by Angela Holliday-Bell, MD