Why might my sinus infection be worse at night?


We’ve all experienced sinus symptoms that we think are getting better, then when we go to bed all of a sudden our throats hurt, we can’t stop sniffling, and we can’t breathe well again. This is infuriating, it can make it feel like the sinus infection is never going to get better, and it can affect our quality of life (if we can’t sleep well, we can’t function well).

What’s behind this nocturnal nuisance, and what can we do to stop it?

Blood flow means more inflammation

One possibility is that the change in blood flow may increase inflammation.1,2,3 When you lie down, blood pressure changes and blood may remain in the upper body longer than it does when you sit or stand. In addition, the pull of gravity on the body’s internal tissues can compress blood vessels in the sinuses. This can cause tissue to swell up, leading to worse sinus symptoms.

We tend to lie down toward the end of the day, particularly when we go to bed. It’s the change in physical position that can contribute to a worse sinus infection at night.

Lying down makes it hard to clear sinuses

When we stand or sit upright, gravity is pulling downward from our sinuses to our esophagus. This means that when mucus drips down the back of the throat, it can go down the esophagus and drain effectively, simply because that’s the way gravity works.

But when we’re lying down, gravity is still pulling toward the ground—which means that it isn’t pulling mucus down the esophagus anymore. Rather, mucus may pool in the back of the throat, irritating the tissue and causing a worse sinus infection.

Have you experienced any of the following symptoms for 12 consecutive weeks or longer and are over the age of 18?

  • Facial pain, pressure, or fullness
  • Difficulty breathing through nose
  • Descreased sense of smell
  • Drainage of cloudy or colored mucus
See if my symptoms are chronic sinusitis arrow

Fewer distractions means it’s easier to notice symptoms

Another factor might just be distraction—during the day, you’re busy at work or school, taking care of the family and household, and doing all the various things that make up our daily activity. But after dinner, we usually have more of an opportunity to relax, and there are fewer things competing for our attention. Without all these demands, we may suddenly notice that our sinuses aren’t working as they should be. This can give the impression that the condition is worse. This is not to say that it’s “in your head,” or that your symptoms aren’t genuine, and it is definitely not the whole story. It’s just one of several possible explanations.

How to handle the issue

Sleeping with a humidifier near the bed (because dry air can contribute to sinus problems) and taking over-the-counter nighttime decongestants may help with sinus symptoms.4 However, in the case of a serious infection, they may not completely resolve the problem.

If you have a sinus infection, or any sinus symptoms that are severe or that persist for longer than a couple of weeks, then you may want to see a doctor. They will have the ability to diagnose the problem, recommend a solution, and get you breathing correctly—day and night.


  1. https://www.scielo.br/scielo.php?pid=S0034-72992005000400014&script=sci_arttext&tlng=en
  2. https://www.verywell.com/why-do-i-get-congested-at-night-1192188
  3. http://emedicine.medscape.com/article/874171-overview
  4. http://www.webmd.com/allergies/sinus-congestion

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The purpose of the site is to help create awareness about sinusitis and treatment options for the disease. Please note that information contained on this site is not medical advice. It should not be used as a substitute for speaking with your physician. Always talk with your physician about diagnosis and treatment information.