Allergies worsen at night because of dust mites in bedding, lying flat, and pollen or pet dander on your hair or bed.
Why
- Dust mites in bedding.
- Pet dander.
- Lying flat causes mucus to pool.
- Pollen settles on hair and skin.
- Cortisol is lowest at night.
Fixes
- Wash sheets weekly at 130°F.
- Use dust mite covers.
- Shower before bed.
- Keep pets out of the bedroom.
- Use a HEPA filter.
See an allergist
For persistent symptoms.
Why symptoms increase at night
Allergy symptoms often feel worse at night because of lying flat, which pools mucus, dust mites in bedding, pet dander in the bedroom, and circadian changes in cortisol and histamine that peak at night. Pollen counts can also rise in the evening, and pollen carried on hair and clothing enters the bedroom.
- Dust mites live in mattresses, pillows and carpets and feed on dead skin cells. Hot water washing at 130 F (54 C) kills them.
- Allergen-proof covers for pillows and mattresses reduce exposure.
- A HEPA filter in the bedroom can reduce airborne allergens.
Fixes
Shower before bed, change bedding weekly, keep pets off the bed, and keep windows closed during high pollen. Take a second-generation antihistamine such as cetirizine or fexofenadine, nasal steroid spray or saline rinse as directed. Elevate the head slightly. An allergist can do skin or blood testing and offer immunotherapy, which can reduce symptoms over 3 to 5 years of treatment.
Why symptoms increase at night
Allergy symptoms often feel worse at night because of dust mites in bedding, pet dander in the bedroom, pollen carried indoors on hair and clothes, and lying flat that increases nasal congestion. Natural cortisol, an anti inflammatory hormone, is lowest at night. Dust mites are found in most US homes.
Fixes
Wash bedding weekly in hot water (at least 130 F), use allergen proof mattress covers, shower before bed, keep pets out of the bedroom and use a HEPA filter. Antihistamines or nasal steroid sprays can help, as advised by a doctor or pharmacist.
Environmental factors at night
Dust mite allergen accumulates in mattresses and pillows and 8 hours of exposure raises symptoms. Pollen counts can be higher at night in some regions, and closed windows trap indoor allergens. Cooler air at night can irritate airways. Reflux may worsen cough at night.
Treatment options
Nasal corticosteroid sprays like fluticasone are the most effective maintenance therapy. Second generation antihistamines like cetirizine or loratadine help with sneezing and itching. Saline rinses clear allergens. Allergy immunotherapy (shots or tablets) over 3 to 5 years can reduce symptoms long term. Raise the head of the bed and use mite proof covers.
Based on data from the American Academy of Allergy, Asthma and Immunology
