Why Do Your Allergy Symptoms Get Worse at Night, and Can Bedding Changes Help?

You’ve got a stuffy nose that also drips and itches. Your eyes itch too, making you want to claw your face off—all just in time for lights out. You tuck yourself in only to have a sneezing fit.

With your airways aggravated, you find yourself breathing through your mouth and begging your body to just go to sleep. When you do finally nod off from sheer exhaustion, you wake up in the middle of the night with a parched and scratchy throat and swollen eyes. By the time your alarm goes off in the morning, you’re more tired than you were when you went to bed the night before, and you slog through the day feeling subpar. If this sounds all too familiar, nighttime allergy attacks might be messing with your sleep.

“Even mild nasal stuffiness can disrupt the deep restorative sleep by increasing nighttime awakenings or snoring,” says Kara Wada, MD, quadruple board-certified adult and pediatric allergy, immunology and lifestyle medicine physician. “Fragmented sleep can make allergies feel even worse the next day.”

But that doesn’t mean you’re at the mercy of your allergy triggers or your body’s immune response to them. In this article, we explore why allergies sometimes worsen at night, how they disrupt your sleep, options for finding immediate relief and how to prevent nighttime allergy attacks for the long haul.

To explain why allergies may seem worse at night, we first must dive into what’s happening during an allergy attack. On a basic level, an allergic reaction is your immune system overreacting to a trigger (allergen), something it perceives as a threat that is generally harmless.

Common nighttime allergy triggers:

• Dust mites 
• Mold 
• Pet dander 
• Pollen (from an open window or stuck on your hair or clothing) 
• Cockroach or other pest or rodent droppings 
• Household chemicals (cleaning products, laundry detergents, etc.) 

When you encounter an allergen, a chain reaction occurs that causes specific types of white blood cells to release histamine. Histamine is a chemical that causes your blood vessels to widen, leading to swelling. Hence, that stuffy nose or puffy eyes.

When airway tissues swell, your sinus passages and lungs may constrict, leading to congestion or breathing issues. Histamine also boosts mucus production, which can cause a runny nose or eyes, a tickle in your throat and more.

“Sometimes, in rare circumstances of anaphylaxis,” says Amiirah Aujnarain, MD, a board-certified allergist, pediatrician and immunologist, “it can cause severe symptoms, such as losing consciousness from a drop in blood pressure and abdominal pain and vomiting.”

Although anaphylaxis can occur, more often people with allergies experience mild, but frustrating symptoms, such as the classic sneezing, itching, congestion and more.

If you have allergies, your symptoms might flare at night for several reasons, including more exposure to allergens, the change in position from sitting or standing to lying down, and a natural increase in histamine throughout the night.

Yes, your bedroom can be a hotbed for allergens. It plays host to dust mites, which are microscopic critters that love to live in mattresses, bedding, pillows, carpets and curtains. Additionally, if you have an en suite bathroom, mold spores can up the indoor allergen ante. But indoor allergens aren’t the only ones to think about, even when you’re tucked in for the night.

Outdoor allergens, such as pollen from flowers, grasses and trees, can make their way inside on your hair and clothing, through an open window and by hitching a ride on your pet’s hair or fur. Pet dander itself might also be an allergen for you.

When you get into bed, you’re typically changing from an upright position to lying down, which can ramp up allergy symptoms. “When you’re horizontal, nasal congestion worsens because blood flow increases to the head and sinuses,” Dr. Aujnarain says.

Your body has an internal clock, known as its circadian rhythm, or your sleep-wake cycle. This clock regulates your body’s histamine production, the chemical implicated in your allergy symptoms. Levels begin to rise in the middle of the night, peaking as you get closer to dawn. But an allergy attack can flood you with more histamine and worsen your symptoms.

Understandably, these symptoms can keep you from falling asleep or even wake you up mid-sleep session.

Histamine acts as a neurotransmitter, a chemical messenger that sends signals from one nerve cell to another. It is a wake-promoting neurotransmitter, encouraging alertness. That’s why many prescription and over-the-counter sleep aids are antihistamine drugs. Blocking histamine helps you fall asleep.

Generally, normal amounts of histamine peak in the early morning hours, preparing you to wake up. But if you have allergies and your triggers are wreaking their havoc, then your histamine production may ramp up earlier, causing you difficulty falling asleep or staying asleep.

Another chemical may also play a role in your nighttime allergy attacks. “Hormones like cortisol, which naturally lower inflammation levels, are at their lowest levels overnight,” Dr. Wada explains.

Cortisol is one of your stress hormones. It peaks in the morning to give you that get-up-and-go and generally decreases throughout the day, though it can fluctuate. An allergic response causes inflammation, but with a lower level of cortisol to counteract the inflammation, your allergy symptoms can surge. Inflammation and worsening symptoms can also disrupt your sleep by impacting your breathing, causing you to wake up.

“Allergies can make it harder to breathe through your nose, which leads to snoring, mouth breathing and restless sleep,” Dr. Aujnarain says. “You might also wake frequently from congestion or postnasal drip.”

Allergies may also affect the quality of your sleep, sometimes leading to less rapid-eye-movement (REM) sleep and a longer time until you reach REM. All these factors can impact your day ahead. “Poor sleep quality then contributes to daytime fatigue, irritability and decreased concentration,” Dr. Aujnarain adds.

If you’re doing some late-night scrolling, trying to figure out what to do to combat your allergy symptoms so you can sleep, we have some tips for immediate or fast relief.

• Take an over-the-counter antihistamine if you have a stash in your medicine cabinet. 
• Prop yourself up with pillows, which can help open airways for easier breathing. 
• Change your pillowcase or throw a clean towel over your existing one. 
• Gargle with salt water if a tickle in your throat keeps you awake. 
• Use a saline nasal rinse. 
• Close your window if it’s open. 
• Run your air purifier if you have one. 
• Send your pets out of the room if they’re sleeping with you. 

Although the above options offer quick solutions for when you can’t sleep because of allergies, long-term preventive strategies will serve you even better.

Many people with allergies note that their symptoms follow a seasonal pattern, such as worsening in the spring when tree pollen season begins, or in mid-summer when ragweed season starts, or in autumn when falling leaves mold, releasing spores. But allergies can affect people year-round, especially as cooler temps lead to spending more time indoors and heating systems kick up dust.

About 20% of people with allergies say their symptoms are seasonal, while 40% report chronic allergies and another 40% report both chronic and seasonal. Regardless of whether your allergies occur all year or just at certain times, the following strategies can ease your symptoms.

Bedroom basics

• Vacuum and dust your bedroom regularly, at least every two weeks, but more often if needed. 
• Wash your bedding and pillowcases in hot water regularly, such as once a week. 
• Wash your pillows regularly, such as once a month. 
• When you’ve got your bedding in the wash, vacuum your mattress at least once a month. 
• Try an air purifier to reduce allergen accumulation. 
• Keep your windows closed to keep pollen and dust out. 
• Keep pets out of your bedroom. 
• Keep indoor plants out of the bedroom, since they can breed fungus. 
• Use blinds instead of curtains or wash curtains frequently. 
• Avoid rugs or carpet in the bedroom if possible. 
• Run the ventilation fan while bathing in your en suite to reduce moisture buildup. 
• Keep tile, grout and other surfaces in your bathroom clean and free of mold. 
• Use pillow or mattress protectors to reduce dust mite and mold accumulation. 
• Use a dehumidifier if you live in a damp environment. 
• Keep food out of your bedroom, as it can attract allergy-triggering pests. 
• Replace your home’s heating, ventilation and air-conditioning (HVAC) filters regularly. 
• Use allergy-safe cleaning products. 

Self-care

• Shower or bathe (washing hair) before bed, especially if you’ve been outside. 
• Try a saline nasal rinse to irrigate sinuses and flush out allergens before going to sleep. 
• Take all prescribed allergy medications as directed. 
• Talk to a healthcare provider about any recommended over-the-counter medications, such as corticosteroid nasal sprays or antihistamines. 

“For severe or persistent symptoms, see an allergist to evaluate environmental triggers or consider immunotherapy (allergy shots or tablets),” Dr. Aujnarain says.

You should seek immediate medical attention for symptoms of anaphylaxis, a severe, life-threatening reaction.

Anaphylaxis symptoms:

• Confusion or agitation 
• Dizziness, fainting or loss of consciousness 
• Difficulty breathing 
• Facial swelling of the tongue, lips or eyes 
• Hives or rash 
• Nausea or vomiting 
• Rapid or slow heart rate 
• Throat or chest tightness 
• Trouble speaking or swallowing 
• Wheezing or noisy breathing 

You should also talk to a healthcare provider if you suspect you have sleep apnea, a condition in which your airways collapse, leading to intervals where you stop breathing or are not getting enough oxygen. Sleep apnea is a serious condition that can have negative health consequences if left untreated. People with allergies may have an increased risk of sleep apnea.

Yes, the following products may come in handy in your arsenal against allergies.

Sleepy’s Signature Total Defense Mattress Protector

This mattress protector defends your mattress against moisture and other nasties. Its Silvadur technology also helps maintain mattress freshness by banishing bacteria, which keeps odors at bay. As a bonus, you can toss this protector in the wash to rid it of any allergens that accumulate.

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Sleepy’s Deluxe Comfort Cool Mattress Protector

Five-sided waterproof protection helps keep your mattress in tip-top shape, while giving you the added comfort of a built-in mattress pad. The cooling technology is a bonus when allergies get you fired up. The Silvadur treatment defends against bacteria and odors, so you can avoid that musty mattress scent that can lead to sniffling. It’s also easy to toss in the wash.

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Sleepy’s Deluxe Cool Stretch Sheet Set

These sheets offer breathable comfort, while the stretch factor helps you avoid that annoying fitted sheet slippage that can occur if you move a lot during sleep. The Egyptian cotton and TENCEL modal blend offers durability for frequent washing and is best for folks with allergies.

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Sleepy’s Signature Silky Smooth Sheet Set

Lyocell feels silky smooth against your skin, a bonus if itchiness strikes at bedtime. Plus, the fabric’s durability holds up to frequent wash and dry cycles for reducing dust mite exposure. Breathability keeps you cool yet cozy, so you can rest.

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Sleepy’s Deluxe Charcoal Cool Pillow

This pillow, made of fiber fill and memory foam, helps keep your head cool, a bonus during warmer weather that correlates with peak allergy seasons. The charcoal-infused pillow also helps keep microbes out, while also drawing away moisture.

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Purple Harmony Pillow

This pillow, made with a Talalay Latex Core, maintains a bouncy, airy feel that responds to your sleeping position. The classic Purple Grid ensures durability and breathability, both must-have features for allergy sufferers.

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Sleepy’s Deluxe Cool Stretch Pillowcases

Regardless of which pillow you use, your choice of pillowcase can make a difference in how well you sleep. The last thing you want is a case that slips off your pillow, leaving your head vulnerable to germs and allergens. This case, featuring a flexible Egyptian cotton and TENCEL modal blend, envelops your pillow and stays put, no matter how much you move mid-sleep.

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Sleepy’s Signature Silky Smooth Pillowcases

When your face feels itchy and hot from allergies, the last thing you want is a scratchy pillowcase that further irritates sensitive skin. Lyocell feels soothing and cooling against your cheeks. As a bonus, these cases can also help prevent you from waking up with those annoying pillow creases.

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When you’re in the sanctuary of your bedroom, you don’t expect allergies to strike. But bedtime is actually a prime time for allergy symptoms to flare. Your room can be a hotbed for lurking allergens, such as dust mites, pet dander and pollen that’s made its way inside. But you don’t have to be at the mercy of your allergies. Rest easier with the strategies and products listed in this article.