Nasal obstruction, commonly known as a stuffy or blocked nose, occurs when nasal passages are partially or completely blocked, making it difficult to breathe. This restricted airflow can affect one or both nostrils, impacting daily life and sleep. It can range from a mild, temporary annoyance to a severe, persistent problem.
Temporary Obstruction Triggers
Allergies frequently cause temporary nasal obstruction. When allergens like pollen or pet dander enter the nasal passages, the immune system releases inflammatory chemicals, including histamines. This leads to swelling of nasal tissues and increased mucus, resulting in congestion. These reactions can be seasonal or perennial.
Common infections also trigger nasal obstruction. Viral infections, such as the common cold or influenza, cause inflammation and swelling of the nasal lining, along with excessive mucus. Acute sinusitis, viral or bacterial, involves sinus inflammation, leading to stuffiness and pressure. These infections typically resolve within one to two weeks.
Vasomotor rhinitis, or non-allergic rhinitis, is another cause of temporary congestion. It produces allergy-like symptoms, such as a runny or stuffy nose, without an allergic trigger. Environmental factors like temperature changes, strong odors, or humidity can cause nasal tissues to swell.
Persistent Structural and Inflammatory Issues
A deviated septum is a common structural cause of chronic nasal obstruction. The nasal septum is the cartilage and bone wall that divides the nasal cavity into two passages. When crooked, it can impede airflow in one or both nostrils. It can be present from birth or result from injury.
Nasal polyps are non-cancerous growths in the lining of nasal passages or sinuses. These soft growths can block airways as they enlarge, causing persistent congestion and a reduced sense of smell. Polyps often arise from chronic inflammation, such as with asthma or recurring infections.
Turbinate hypertrophy involves the swelling of turbinates, which are bony structures inside the nose responsible for warming and humidifying inhaled air. When enlarged, often due to chronic inflammation or allergies, they can obstruct airflow. This narrows nasal passages, making breathing difficult.
Chronic sinusitis is long-term inflammation of the sinuses, lasting 12 weeks or longer, even with treatment. This persistent inflammation prevents mucus from draining, leading to continuous congestion. Unlike acute sinusitis, chronic forms often involve ongoing swelling and can be associated with nasal polyps.
Enlarged adenoids can cause nasal obstruction, particularly in children. Adenoids are lymphatic tissues at the back of the nose. When these tissues swell, they can block the nasal breathing pathway, making it harder for children to breathe through their nose.
Other Contributing Factors
Medication-induced rhinitis, or rhinitis medicamentosa, results from overuse of decongestant nasal sprays. This can lead to a “rebound effect,” causing chronic swelling and worsening obstruction once the medication wears off. Other medications, such as some for blood pressure, can also cause nasal stuffiness.
Foreign bodies lodged in the nasal passage are another cause of obstruction, most common in young children. An object can cause unilateral blockage and may be accompanied by a foul-smelling discharge.
Nasal valve collapse occurs when the narrowest part of the nasal airway weakens and collapses inward during inhalation. This physical collapse restricts the passage of air into the lungs, leading to breathing difficulties.
Although rare, growths or tumors in the nasal passages or sinuses can also cause persistent nasal obstruction. These can be benign (non-cancerous) or malignant (cancerous) and may lead to a blocked sensation, often affecting only one side of the nose.