Allergies Keeping You Awake?

Last Editorial Review: 3/3/2005

Allergy symptoms -- or the medication to treat them -- can disturb your sleep. But it is possible to get through allergy season with many a good night's sleep.

By Michael Breus
WebMD Feature

Reviewed By Stuart Meyers

Many of us know the misery of allergies all too well -- the sneezing, runny nose and postnasal drip; watery, itchy eyes, ears, nose, and throat. Whether from the symptoms or the medication we use to treat them, our sleep often suffers. And reduced quality and quantity of sleep wreaks havoc on our daily functioning -- our mood, energy, concentration, performance, sexual function, ability to think and make decisions.

Allergies may be seasonal, year-round, or occupational. They may arise from substances in our environment that we touch or inhale or from the foods we eat. Whatever the cause and whenever they occur, their myriad symptoms can disrupt sleep.

Allergic rhinitis. Commonly referred to as hay fever, allergic rhinitis is an inflammation of the nasal passages that occurs when the body overreacts to an allergen (pollen, dander, house mites, etc.). As the nasal passages swell, they block airflow through them, causing congestion.

Nasal congestion affects sleep in a variety of ways:

  • It simply can be more difficult to sleep while breathing through your mouth; as your body tries repeatedly to breath nasally, it disturbs your sleep over and over again.
  • The air that is normally warmed and moistened when passing through the nose is now re-routed through your mouth, drying out and irritating your lips, mouth, and throat.
  • Pressure or pain can prevent you from falling asleep and staying asleep.
  • There is an increased tendency to snore, which disturbs your sleep, not to mention your bed partner's.
  • Congestion can worsen the symptoms of those suffering from sleep apnea, a serious sleep disorder in which one periodically stops breathing while sleeping.
Infant Insomnia
Chronic insomnia in infants has been linked to allergies to cow's milk proteins. In one study, a group of children with known allergies to cow's milk proteins, as well as a group of children with chronic insomnia but undiagnosed allergies to milk, slept well when milk was removed from their diet and slept poorly when milk was reintroduced. Those children in the chronic insomnia group were tested and found to have allergies to cow's milk proteins. So if your child has chronic insomnia, think about getting him or her tested for allergies.

Postnasal drip, in which mucus and other secretions drip down the back of your throat, irritates the throat and often causes clearing of the throat and coughing as the secretions drip onto the vocal cords or even into the windpipe. These symptoms disturb sleep and may awaken you at night.

Nocturnal wheeze. In certain people, inhaling allergens may induce sleep-disturbing wheezing. This is caused by the constriction of the bronchioles, tubes that carry air to your lungs. Constriction reduces airflow; wheezing occurs as air moves through these narrowed tubes. Similarly, allergens can increase the frequency and severity of asthma attacks.

Non-specific symptoms. Allergens may also cause non-specific symptoms that seem unrelated to allergies. Recurrent headaches, for example, may be caused by food allergies.

What to Do?

The first thing to do is to avoid the allergens that cause the allergy. Though it may not be readily apparent what is causing your allergy, there are a few things you can easily do on your own that may help reduce common allergens, like dust, dust mites, animal dander, down, etc.

  • Get hypoallergenic pillows and bedding. Pillow and mattress covers may help.
  • If you have pets in your bedroom or bed, consider finding someplace else for Fido or Kitty to romp or nap.
  • See if your home's heating and air system is adequate, and consider an upgrade with improved air filtration, if needed.
  • Vacuum carpets and furniture regularly. Newer vacuums have much improved filtration and improved designs.
  • If you use a humidifier, change the water regularly, so it does not breed allergens.
  • If food allergies are suspected, try eliminating certain foods or food types and see if symptoms are relieved.

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.

Copyright © 2005, SoundSleep, LLC.

©1996-2005 WebMD Inc. All rights reserved.

Health Solutions From Our Sponsors