Waking Up With Sinus Pain, A Doctor's View

October 15, 2017

Waking Up With Sinus Pain, A Doctor's View

Sleeping well can seem impossible if you’re dealing with an ear, nose, or throat problem — you need a healthy nasal airway to breathe soundly through the night.

"Sinus infection, allergies, and other causes of nasal obstruction can make breathing difficult at night,” says Samer Fakhri, MD, associate professor of otolaryngology at the University of Texas Medical School in Houston. “Anything that causes you to breathe through your mouth prevents your nose from warming, filtering, and moistening the air you breathe and can result in a high level of sleep disturbance."

In addition, breathing through your mouth (instead of your nose) can result in more problems. "Breathing through your nose is less work because there is more resistance breathing through your mouth,” says Kathleen L. Yaremchuk, MD, chairman of the ENT department at the Henry Ford Hospital in Detroit.

“When you breathe through your mouth at night, your jaw and tongue can fall back and block your airway, causing increased likelihood of sleep apnea and snoring."

 Three common problems that affect sleep are:

  • Obstructive sleep apnea. Sleep apnea interferes with sleep and causes daytime sleepiness. In extreme cases, it can also cause high blood pressure and heart problems. "Sleep apnea is caused by collapse of the airway at night,” says Dr. Fakhri. “This results in a low oxygen level that triggers arousal from sleep.” Symptoms of sleep apnea include loud snoring and periods of “apnea,” or the absence of breathing. Obstructive sleep apnea, a serious medical condition that affects about 12 million Americans, is more common if you are overweight and over age 65. Many people with obstructive sleep apnea are not aware of its dangers.
  • Mucosal obstruction. Nasal allergies, sinus infections, and the common cold can all cause the linings of your nose and sinuses to swell and make breathing at night difficult. Your nose and sinuses also will react to irritation or infection by producing more mucus, which can cause sinus pain, pressure, and postnasal drip — all making for an uncomfortable night.
  • Anatomical obstruction. Adults who are overweight may have trouble breathing at night because they have broad necks. Children may have trouble due to enlarged tonsils and adenoids. Some people may have an overly long soft palate or uvula that can contribute to snoring and sleep apnea. Deformities of the bony structure of the nose, such as a deviated nasal septum, and nasal polyps are other examples of airway obstructions that can interfere with sleep.

 "The average adult needs seven hours of sleep a night. Less than six hours leads to a lower metabolic rate and an increased likelihood of weight gain," warns Dr. Yaremchuk.

If you are having ENT-related sleep disturbances, the first place to start is with an ENT exam — one that checks out your nose, mouth, palate, and throat.

Says Fakhri, "The most important thing you need to do is to address the underlying cause of sleep issues. “ In addition to doing a thorough ENT exam, your doctor may order allergy testing and a sleep study. It’s important to distinguish between sleep issues that are affecting your quality of life and those that are medically dangerous. “Obstructive sleep apnea, for instance, can interrupt sleep more than 40 times per hour and can be a very serious health issue," says Fakhri.

Tips for a Better Night's Sleep

Once you have addressed the medical issues — allergies, a sinus infection, sleep apnea, or an anatomic abnormality — there are certain things you can do to get a better night's sleep on your own:

  • Cut down on allergy exposures. “That means keeping pets out of your bedroom, using an air filter, removing dust mites from sheets and bedding by using plastic pillow and mattress covers, and washing sheets and bedding frequently in hot water," Fakhri says.
  • Keep your bedroom dark. Also, there should be no disturbances, such as TV, music, computers, or pets. “All those things can prevent you from uninterrupted sleep," Yaremchuk says. She also recommends sleeping on your side instead of on your back.
  • Keep your bedroom between 68 and 70 degrees. Fakhri advises that this is the best temperature for sleep.
  • Make certain lifestyle adjustments. These may include keeping more regular sleep hours, staying active, and losing weight if necessary. Also avoid sleep aids, alcohol before bedtime, heavy meals at night, and caffeine later in the day.


Updated October 15th 2017

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