Q. My nasal congestion is worsening even after medications, and I am not able to sleep. Please help.

Answered by
Dr. Sandeep Shrestha
and medically reviewed by iCliniq medical review team.
This is a premium question & answer published on Jun 18, 2021

Hi doctor,

I have been having too much nasal congestion recently. And for the past three days now, I cannot get more than five to six hours of sleep due to my congestion. About five days ago, I had taken Afrin just once (twice in each nostril). While Afrin cleared me up and helped me sleep that night, I have not had a great night of sleep since. My congestion seems to be worse, but I did not use Afrin for more than three days. Is it possible that I developed rebound congestion because I started and stopped Afrin suddenly as I only took it once? And if so, should I retake Afrin tonight (it would be five days now since my last dose)? I am afraid of developing rebound congestion, which the box indicates can occur if taken for more than three days in a row. But at the same time, I have tried many other options (though not all). I have tried doing a sinus rinse with Budesonide four hours before bedtime, but that rinse did not help. I have also been using a spray with Azelastine and Fluticasone daily. My congestion is worse on the side I am not sleeping on (if I sleep on the left side, my right nostril is usually more plugged). Currently, I am using Dymista, sinus rinse with Budesonide, and Xyzal 5 mg. Please help.



Welcome to

As per your concern, you will not get rebound congestion after using it once. You do not have to worry. You can use it three times a day for seven days. You can also use it along with Fluticasone. As per your history, it seems you are suffering from allergic rhinitis. I suggest the following,

  • Tablet Levocetirizine 5 mg orally at night for seven days.
  • Nasal drop Oxymetazoline 0.05% two drops three times a day for seven days.

Steam inhalation twice a day will help. I hope this will help you. Thank you.

Hi doctor,

Thanks for the reply.

Can I take the 24-hour Pseudoephedrine with Afrin?



Welcome back to

Yes you can use it. But do not use for a prolonged period. Not more than seven days. If your symptoms improve you can use only Pseudoephedrine. Thank you.

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