If avoidance or controlling the exposure to allergens does not work, some over-the-counter and prescription treatments include:

• Saline nasal flushes. This is a more "natural," drug-free way to relieve congestion. Their effects may be of limited duration.
• Nasal decongestant sprays (typically containing the active ingredient oxymetazoline). When used as directed for a limited time, these sprays work quite well and can really clear up your congestion. However, it is very important to follow the directions carefully, use the minimal amount needed to relieve your congestion, and not use too much or too often. Overuse can lead to precisely the same symptoms that you are trying to relieve, like sneezing and congestion. You can also develop a dependence on the sprays if used inappropriately.
• Nasal decongestant pills or liquids. These also work well and can provide long-lasting relief. But with any medication, they may have some side effects, namely keeping you awake at night, especially those containing pseudoephedrine. So they are best used during the day.
• Antihistamines. They will dry up your runny nose and postnasal drip. Many over-the-counter antihistamines can cause you to feel a bit "fuzzy." They may also negatively impact the quality of your sleep, keeping you from getting into the deeper, more restorative stages of sleep.
• Steroid or other similar-acting nasal sprays. They act not to treat the symptoms, as do decongestants and antihistamines, but to decrease the immune response that causes the allergic reaction. So they do not work instantly, like other types of remedies, but do provide effective prevention, when used regularly over time.

If you remain miserably allergic and medications do not work well or cause unacceptable side effects, see an allergist for a complete evaluation and treatment options. The results may surprise you and provide some new options that may provide relief and allow you the sound sleep you need to be at your best.

Originally published Feb. 27, 2004.

Medically updated March 3, 2005.

SOURCES: Kahn, A., Sleep, vol 11: pp. 291-297. Sleep Medicine, Kryger, Meir, et al., Third Edition, 2000, p.956. WebMD Medical Reference: "Allergic Rhinitis." Kahn A., Sleep, vol 10: pp 116-121. The Merck Manual, 17th Edition, Beers and Berkow, Merck Research Laboratories, 1999, pp. 1277-1286.

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