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

The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.

Medically reviewed by

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Published At June 18, 2021
Reviewed AtDecember 19, 2023

Patient's Query

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 icliniq.com.

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, 1. Tablet Levocetirizine 5 mg orally at night for seven days. 2. 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.

Patient's Query

Hi doctor,

Thanks for the reply. Can I take the 24-hour Pseudoephedrine with Afrin?


Welcome back to icliniq.com.

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.

Same symptoms don't mean you have the same problem. Consult a doctor now!

Dr. Sandeep Shrestha
Dr. Sandeep Shrestha

Otolaryngology (E.N.T)

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