Dr. Shyam Kalyan. N
Otolaryngology (E.N.T)
The following is an actual conversation between an iCliniq user and a doctor that has been reviewed and published as a Premium Q&A.
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Patient's Query
Hi doctor,
I recently sustained a groin injury while cycling. And found the best relief for the injury with an anti-inflammatory (Advil) and lying down on a bed. I suppose I overdid the amount of time I would spend in bed. Because after a week, I noticed my nose becoming congested upon waking up, and there was minor swelling along my left upper eyelid. Symptoms would subside after an hour or two of sitting up straight. After a week of dealing with this issue, I have now reached this point where waking up is with no symptoms at first, but at least an hour or two after waking up and sitting up in a chair, I get a congested left nasal passage, swelling in the same left upper eyelid. And what eventually follows from that is an intense headache, minor tooth pain that can last for up to three hours. The only relief that can be found within this time period is using a nasal decongestant spray (Oxymetazoline Hydrochloride 0.05%). If I try to position myself to sit up against a wall before I go to bed, I wake up with less severe symptoms, but if I drift left or right or begin to slump into my bed while sleeping, the symptoms are worse after waking up. Kindly help me.
Hello,
Welcome to icliniq.com.
Are there any associated symptoms like runny nose, mouth breathing, or snoring? Was there any change in surroundings during these days? Any chance that you could be inhaling air different from what you were earlier? Usually, such a problem should not occur at your age after overdoing the bed rest. Please do not use the Oxymetazoline Hydrochloride for a long duration as it can lead to rhinitis medicamentosa. The spray must not be used for more than four days continuously. Please answer the above questions so that I can guide you accordingly.
Patient's Query
Hi doctor,
Thank you. I do not have a runny nose. But after the symptoms have subsided, there is minor drainage, and I can breathe through the nostril fine. I do not breathe through my mouth when the symptoms flare up, and I do not snore. The only change to my surroundings was removing a computer from the room that I sleep in. I thought this was notable because the computer featured three 140 mm intake fans mounted to the front. I suspect that the computer was dealing with the filtering of dust in my room. So I decided to purchase an air purifier, but it did not relieve my symptoms. After the symptoms subside, I no longer experience any significant nasal congestion in the left nasal passage, and no headache follows for the rest of the day. Oddly enough, if I happen to miss out on sleep for twenty-four hours, I do not have any symptoms for that day. My symptoms only seem to flare up when I wake up after sleeping for hours. Kindly help.
Hi,
Welcome back to icliniq.com.
Waking up with nasal congestion could indicate some house dust mite allergy. We need to rule that out. They are perennial allergens, and you should have had these symptoms for since long. Second, removing the computer could have stirred up some dust in the room which would not have settled down fully and hence you are feeling the problem. Lastly, there could be some vasomotor component to your symptoms. That means that there are some errors in the nervous feedback, which makes the nose get congested or produce mucus. This can develop suddenly and particularly when your sleep pattern is not alright. Now, for all these, the medical management is somewhat similar. I suggest you take the antihistaminic drug and start on a steroid nasal spray. For the first two issues, I would like to see if you have any allergies. The simplest way is to do blood-specific IgE (immunoglobulin) testing for allergens. However, the test is not always accurate. So you can go for skin prick allergy testing. The latter is more accurate, although slightly time-consuming and tedious. However, we will do the allergy testing only if we feel that your symptoms have been occurring or recurring for a long time. If it is the vasomotor indeed, you need to regularise your sleep pattern. Additionally, take care of diet also. It would be best if you also avoid smoking and drinking. If these things are taken care of, then your problem should get resolved. I hope this was helpful.
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Otolaryngology (E.N.T)
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