Difficulty breathing through the nose, medically termed nasal obstruction, is a common issue that can significantly impact daily life and sleep. The nose plays a fundamental role in respiratory health by conditioning inhaled air. It filters out particles, warms the air to body temperature, and humidifies it before it reaches the lungs. Bypassing this process by breathing through the mouth can lead to irritation and dryness in the lower respiratory tract.
Identifying the Cause of Difficulty
Nasal obstruction occurs when the tissues lining the nasal passages become inflamed and swollen, or when there is a physical blockage within the nasal cavity. Causes are generally categorized as either acute and temporary or chronic and structural. Temporary obstruction frequently results from inflammation caused by viral infections, such as the common cold or flu, or from seasonal allergies. During these events, the body releases inflammatory mediators that cause blood vessels to swell and increase mucus production. Exposure to irritants like smoke, pollution, or strong odors can also trigger a temporary inflammatory response known as non-allergic rhinitis.
When difficulty breathing through the nose is long-lasting or recurs frequently, a chronic or structural issue is often the source. Structural problems involve the anatomy of the nasal cavity, including a deviated septum, where the wall separating the nostrils is crooked, or enlarged turbinates, which swell due to chronic irritation. Other chronic conditions also lead to persistent blockage. These include nasal polyps, which are noncancerous growths, and chronic sinusitis, defined as inflammation lasting more than 12 weeks.
Self-Care Techniques for Immediate Relief
When experiencing nasal congestion, several self-administered techniques focus on reducing swelling and clearing mucus. Saline nasal rinses, or nasal irrigation, are an effective, drug-free method for clearing the nasal passages. The saline solution, typically delivered via a neti pot or a squeeze bottle, flushes out thick mucus, allergens, and irritants while moisturizing the nasal lining. It is important to use distilled, sterile, or previously boiled and cooled tap water for mixing the solution to avoid introducing pathogens.
Increasing the moisture content of the air can also provide significant relief by helping to thin mucus and soothe irritated tissues. Using a cool-mist humidifier in the bedroom at night helps keep the nasal passages moist and reduces irritation from dry air. Similarly, inhaling steam from a hot shower or a bowl of hot water offers a temporary break from congestion and helps reduce swelling.
Over-the-counter decongestant nasal sprays offer rapid, short-term relief by constricting blood vessels in the nasal lining. These sprays must be used cautiously and for no more than three to five consecutive days. Prolonged use can lead to rebound congestion (rhinitis medicamentosa), where nasal tissues swell more severely once the drug wears off. Oral decongestants and oral antihistamines may also be used to manage allergy symptoms without the risk of rebound congestion. Elevating the head of the bed using extra pillows can minimize the pooling of blood in the nasal passages, which often worsens congestion when lying flat.
Knowing When to See a Doctor
While many cases of nasal obstruction are managed with self-care, certain symptoms warrant a professional medical evaluation. Any severe symptoms known as “red flags” should prompt immediate medical attention. These include a persistent high fever, severe facial pain or pressure that does not improve with pain relievers, or the discharge of bloody or foul-smelling greenish mucus. Difficulty breathing that extends to the chest, a rapid heart rate, or swelling of the throat or tongue also require urgent care.
Beyond acute warning signs, consult a doctor if nasal congestion lasts longer than 10 days without improvement. Frequent recurrence of congestion or symptoms that significantly disrupt sleep, such as chronic snoring or suspected sleep apnea, indicate an underlying issue. A medical provider can perform a thorough examination to determine if the cause is chronic inflammation, like a persistent allergy, or a structural problem.
A doctor’s approach may involve prescribing stronger anti-inflammatory medications, such as nasal steroid sprays or antibiotics for a bacterial infection. If a structural issue is suspected, the doctor may order imaging or refer the patient to a specialist, like an otolaryngologist. In cases where chronic congestion is due to an anatomical issue, surgical intervention may be considered to permanently restore airflow.