Why is sinus headache worse at night?

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Written By Dr. Marcus Yu Bin Pai

MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

Why Do Sinus Headaches Get Worse at Night?

If you frequently experience sinus headaches that seem to intensify in the evening hours, you’re not alone. Many people with sinusitis find their symptoms aggravated at night

Sinus headaches can feel worse at night due to several reasons:

  1. Sleeping Conditions: Your sleeping environment can contribute to the worsening of sinus symptoms. When you lie down, your blood vessels may become more inflamed, and drainage issues can worsen, leading to increased discomfort[1].
  2. Increased Blood Flow: When you sleep, there is an increased blood flow to the brain, which can lead to sinus congestion and, in some cases, sinus pain[4].
  3. Gravity: As you lay down, gravity helps your blood circulate easier to the head. However, gravity also works to drain your sinuses, which can lead to increased congestion and discomfort[4][7].
  4. Allergies: Allergies can be worse at night in general, and they can cause sinus congestion, which can make your head hurt[8].
  5. Lack of Distractions: At night, you’re less distracted and may pay more attention to how you feel, which can make your sinus problems seem worse[1].
  6. Fluid Drainage: When you lie down, fluids no longer drain as they do when you’re standing or sitting. This can result in increased discomfort[7].

Strategies to try

To alleviate sinus congestion and sleep better, you can try several strategies:

  • Elevate Your Head: Sleeping with your head elevated on a few pillows can help with congestion relief[6].
  • Use a Humidifier or Vaporizer: Dry air can irritate your sinuses, so using a humidifier or vaporizer can help[3].
  • Nasal Irrigation: Flushing out your sinuses with salt water can moisten and help clear mucus from your nasal passages[3].
  • Medication: Over-the-counter painkillers, decongestants, and antihistamines can help alleviate the pain and underlying causes of your sinus headache[3].
  • Warm Compress: Applying a warm towel over your forehead and nose can help to reduce swelling and inflammation in your sinus passages. The heat from the warm towel helps to open up your nasal passages, reduce swelling, and aid in mucus flow
  • Massage: Massaging your cheeks and the bridge of your nose can also relieve your sinus pain as it helps ease tension and pressure in the area. However, remember to not use too much force as you may end up hurting yourself. Your touch should be firm yet gentle.

Remember, it’s important to consult with a healthcare provider if your sinus headaches persist or worsen, as they may be a symptom of a more serious condition like sinusitis[5].

Over-the-Counter Medications

Some over-the-counter medications that can help with sinus headaches at night include:

  1. Painkillers: Drugs like acetaminophen (e.g., Tylenol), ibuprofen, or naproxen sodium may help alleviate sinus headache pain.
  2. Decongestants: Decongestants, such as Sudafed (pseudoephedrine) or phenylephrine, can help ease the tension in your head by reducing inflammation and narrowing the blood vessels in your nose.
  3. Antihistamines: If your sinus headache is caused by allergies, antihistamines can help by blocking histamines, the chemical associated with immune and inflammatory responses.
  4. Steroid nasal sprays: Nasal sprays containing steroids, such as fluticasone (Flonase), can help reduce inflammation in the nasal passages and minimize congestion symptoms and headaches.

Can Nasal Irrigation be done at night to relieve sinus headache?

Yes, nasal irrigation can be done at night to relieve sinus headaches. Nasal irrigation is an at-home treatment that can rinse your sinuses, thin the mucus that’s causing the clog, and rinse away substances causing the swelling. 

It can be an effective way to relieve sinus symptoms when used along with standard treatments.To perform nasal irrigation, you can use a neti pot or a bulb syringe to gently rinse your nose with slightly salty water. This can moisten and help clear mucus from your nasal passages. 

You can buy premade solutions meant for use in the neti pot or other nasal irrigation devices, or you can also make a saline solution at home.

However, it’s important to note that nasal irrigation isn’t for everyone. You shouldn’t try nasal irrigation if you have an ear infection, have pressure in one or both ears, have a nostril that’s completely blocked, or have had surgery on your ears or sinuses.

Also, remember to always use distilled, sterile, or boiled and cooled water for nasal irrigation to avoid the risk of infection.

[1] https://www.sinusofsf.com/sinusitis/sinuses-worse-at-night/
[2] https://www.cedars-sinai.org/health-library/diseases-and-conditions/s/sinus-headaches.html
[3] https://www.webmd.com/allergies/sinus-headaches
[4] https://www.detroitsinuscenter.com/sinus-pressure/sinuses-may-worse-night/
[5] https://my.clevelandclinic.org/health/diseases/9641-sinus-headaches
[6] https://www.everydayhealth.com/sinus-health-guide/get-better-sleep-with-sinus-pain-and-congestion.aspx
[7] https://www.americansinus.com/blog/sinus-infection-worse-at-night
[8] https://www.webmd.com/migraines-headaches/sinus-headaches
[9] https://www.verywellhealth.com/headache-at-night-5220207
[10] https://www.mountsinai.org/health-library/condition/sinus-headache
[11] https://www.mayoclinic.org/diseases-conditions/chronic-daily-headaches/expert-answers/nighttime-headaches/faq-20057919
[12] https://www.enthear.com/hearing-loss-articles/ent-issues/why-is-my-sinus-infection-worse-at-night/
[13] https://www.houstonsinussurgery.com/blog/what-are-the-best-sinus-headache-treatments
[14] https://www.mayoclinichealthsystem.org/hometown-health/speaking-of-health/your-sinus-headache-may-not-be-what-you-think
[15] https://www.louisvillefamilyent.com/hearing-loss-articles/ent-issues/why-is-my-sinus-infection-worse-at-night/
[16] https://www.mayoclinic.org/diseases-conditions/sinus-headaches/symptoms-causes/syc-20377580

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MD, PhD. Physical Medicine & Rehabilitation Physician from São Paulo - Brazil. Pain Fellowship in University of São Paulo.

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