Chronic nasal congestion at night interferes with my sleep.

It could be allergies to dust mites or it could be caused by Gerd. If it’s been 10 years, it could be a chronic condition now. Have they checked for nasal polyps, enlarged adenoids or deviated septum? Have you ever been allergy tested or had an EGD. You can also have something called silent reflux without any other symptoms. You could try elevating the head of your bed and placing a mattress cover over your mattress. If you don’t see any improvement, you could ask your provider about trying an acid reducer. They sell it over-the-counter.

@roca
I have empathy with you as I have had it for over 20 years. I had sinus surgery in 2001 where the surgeon opens my sinus passages to keep me from getting so many sinus infections that were blocking sinuses.

It worked but created another problem with constant and heavy sinus drainage down my throat and out my nose. Real pain in butt but better than sinus infections.

There is one nasal spray (prescription) that dries up your sinuses. It does work but I don't like that much dryness so don't use mine.

Not a ENT so this is just coming from my experience. My nasal congestion was due to polyps blocking my drainage holes. Did they do a nasal scope on you? If not asked for one.

You say sleeping in recliner helps. This would be with your head up. Is your issue drainage coming down or blocked sinus and no drainage. If it is drainage what I do is sleep with my bed up at head ( I have a bed where you can raise head and/or feet) and additional pillows to keep my head up and not drain down.

If you have nasal congestion, is it all the time? Or does it come at certain times of day? If it comes on certain times of day, what are you doing, then? If it is worse at night, you may have an allergen in your bedroom. Mine comes on when the wind is high and pollen is in the air. Not only get nasal congestion but bronchial too.

My suggestion is to ask ENT (are you seeing a ENT if not need to) to do a nasal scope (painless) to see what is blocking sinuses. If open probably a allergen causing it. That comes with allergen test or like I mentioned when does the congestion come on the most as probably where you are is the cause of congestion.

Again, I have had two sinus surgeries and have been seeing a ENT for 35 years so the above is not me as a medical professional but what my ENT specialist have given me as causes and solutions.

Have you considered that you might have nasal fungus/mold in your sinus passages? ENT doctors in my experience don't consider this. After seeing three ENT doctors who all just gave me steroid sprays (which are not good for my glaucoma) which just treat symptoms and not the cause, I then went to a naturopath and she found that I had an intolerance of certain molds by intolerance tests (or you can get an expensive blood test to confirm the existence of molds in your blood). I am now being treated for the molds and am having some good results. I have had bad sinuses and eustachian tube disfunction cause loss of hearing for more than two years.

I sympathize with you because I went through similar issues, albeit not for 10 years. I have seasonal allergies, in particular pollens, dust mites and cats against which I have been getting shots every months for over 15 years which keeps it under control. However, after I got Covid in Sept 2022, I developed a recurring sinus infection that also significantly affected my hearing (I have worn hearing aids for 18 years). Getting antibiotics every 6-8 weeks became routine. Sleeping was interrupted every few hours. Immunologist, ENT and Primary Care Physician indicated it was Long Covid. Gradually, I started having annoying skin rashes, and I got from the Dermatologist about 8 different prescription creams and ointments - it was a trial and error game, sometimes there was relief for a week or two, and it would come back. In March of 2025, I got Covid for the second time. The sinus infections intensified and my hearing deteriorated further to severe. Since conventional medicine apparently was not helping, I went to see a DO who suggested I try Nicotine Patches (I am not a smoker!), starting with 14 mg patches for several weeks, than continuing with 7 mg patches. Reluctantly, I started using patches daily. After about 3 weeks, I noticed that the skin irritations and rashes were rapidly vanishing. So did the sinus infections. They are all gone. The hearing loss cannot be reversed, reason why I am going through a series of tests to get a cochlear implant (I posted about it in the ENT discussions).
I am continuing with the 7 mg patches. I had no side effects like dizziness, restlessness etc. others had experienced and gave up. I only have minor temporary redness of the skin where a patch was placed, but nothing that bothers me. I make sure I don't place a patch were there is still some redness. Regarding nicotine patches in general, I found a few research studies were done in Europe and in Korea, some using lab animals, others with relatively small groups of participants that showed an improvement of the immunity system.

Thank you for trying, unfortunately I’ve done it all and have tried all kind of inhalators with no success. I’m on allergy shots. Just saw a pulmonologist and everything is clear. Last resort is biological therapy injection, Tezspire. Not sure if I feel comfortable going that direction. Acupuncture? Perhaps homeopathy route? I’m desperate!!

Is the nasal scope an in office procedure? I think that it sounds like it would be beneficial to me. I have severe sleep apnea, so I use a CPAP machine for sleep and I get blocked nasal passages, either side I sleep on. And there is nothing to blow out my nose! I do have major allergies and a referral to get tested again so I can restart the allergy shots. Thanks!

How interesting! I'm curious what effects the nicotine patch offered that the DO thought might help with the sinus infections? Glad it's been working for you!

@vkzimmer50
Yes the nasal scope is an in office procedure. It starts with a nasal spray that numbs your nasal passages. You have to wait about 10 minutes for it to work.

At that point ENT will bring a catherter type camera (it is very small) that generates a video of your sinuses as they move in and into your sinus cavities. It is displayed on a large screen as ENT maunavers it. I can see it as it is being done.

Depending on your symptoms they will look for causes. At the end they will replay the video and show you any areas of concern and then discuss treatments. I have polpys but have been kept retarded by a nasal spray. The ENT could see my prior two surgeries where they opened up my sinus drainage.

They have noticed increased mucus and changed my nasal sprays to help with that and it did.

It is completely painless. The only thing I have felt is a funny tiggleing type feeling. I have one done every 6 months.

Thank you for the information!

I had a series of blood test prescribed by my Allergy/Immunologist Dr which confirmed not only my sensitivity to pollens, dust mites and pets, but also a long list of fragrance and food colorant, and very low immunity against Tetanus, Diphtheria and Pertussis and Pneumonia. So I got the DTP and pneumonia vaccines. However, regarding all the rashes and recurring sinus infection there was no particular recommendation other than to try to identify and avoid food, detergents, soaps containing fragrances. I showed the DO all the lab results and he suggested to try to apply nicotine patches because they would improve the immune system. His suggestion certainly worked for me and I am thankful for it.

If you have the time for it, you may want to enter into Google Search "using nicotine patches to improve immunity" and read only those that are not linked to any commercial purposes!
Here are two links about the subject:
https://pubmed.ncbi.nlm.nih.gov/36650574/
https://www.verywellhealth.com/nicotine-patches-long-covid-treatment-8705089