What’s the Best Sleep Position for Sinus Drainage?

You had a long day and are finally lying down to get some rest. But now your sinus congestion is worse! Instead of drifting off to sleep, you’re awake and struggling to find a comfortable sleeping position. 

It’s not your imagination — sinus congestion really can get worse at night. If you’re wondering why, we’ve got you covered. Here’s why sinus congestion gets worse at night and how you can change your sleeping position to get a good night’s rest. 

Why does sinus congestion get worse at night?

Sinus congestion that doesn’t bother you much during the day can become impossible to ignore at night. That’s because the position of your head can affect sinus congestion. 

When you’re standing or sitting upright, gravity helps to pull mucus down and out of your sinuses through small drainage openings called sinus ostia. But when you lie down, these openings are blocked and your mucus can’t flow out as easily. This causes mucus to pool in your sinuses. This leads to a buildup of mucus that then increases pressure inside your sinuses. This can worsen your congestion. It can also worsen sinus pressure and pain. 

Lying flat also increases blood flow to the head. And more blood flow can mean more infection-fighting cells arrive in your sinuses. This has pros and cons. On the one hand, these cells help fight off viruses and bacteria that cause sinus infections. But on the other hand, these same cells also cause inflammation. More inflammation can mean more pressure, congestion, and pain inside your sinuses.

Sleep positions that can help your sinuses drain

Now that you know why sinus congestion is worse at night, you can use that information to your advantage at bedtime. Here’s what you can do.

1. Elevate your head and shoulders

Elevating your head and shoulders helps gravity do its job again. When you’re upright, the small drainage openings in your sinuses (sinus ostia) sit at the bottom of your sinus cavities, making it easier for mucus to flow out. You can think of your sinuses like a funnel: When the funnel is tilted sideways, nothing drains well. But when upright, everything inside can flow out more easily.

You can put yourself in a more upright position to sleep by elevating your head and shoulders. Try using a wedge pillow to evenly prop up the top half of your body. Sleeping with a wedge pillow can keep you in the right position overnight to promote mucus drainage.

2. Avoid sleeping on your stomach 

Another group of researchers compared back sleeping with stomach sleeping for sinus congestion. They found that people experienced more sinus congestion when they lie on their stomach compared to when they lie on their back. 

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If you’re normally a stomach sleeper, consider sleeping on your back when you have a stuffy nose. You may need to use pillows, like wedge pillows. This keeps you in the right position, as you may tend to roll onto your stomach.

3. Sleep on your side with the ‘bad side’ up 

If you can’t sleep on your back, you can try side sleeping. Side sleeping can be particularly helpful if only one side of your nose is congested or if congestion is worse on one side. Lie with the congested or “bad side” up so that mucus can drain more easily from that side. Choose a pillow that elevates your head and shoulders to improve drainage even more.

Tips to improve sinus drainage while you sleep

If changing your sleeping position isn’t enough to relieve sinus congestion, there are other things you can do to reduce stuffiness overnight. Try these tips for relieving sinus pressure:

• Turn on a humidifier. Dry air can irritate the sinuses. Humidifiers increase moisture in the air to help relieve congestion. 

• Keep pets out of the bed. Pet dander is another common sinus irritant. Keeping your dog or cat out of the bed can help reduce nasal congestion.

• Reduce exposure to allergens. Allergens like dust mites, pollen, and mold can build up on bedding. Reduce your exposure to allergens by regularly washing your sheets and covering mattresses and pillows with allergy-proof encasements. 

• Try a neti pot. Evidence suggests that nasal irrigation (using a neti pot and saline solution to rinse out the sinuses) can help reduce sinus congestion. 

• Use a nasal spray. Over-the-counter (OTC) nasal sprays include steroids — like fluticasone (Flonase) and triamcinolone (Nasacort) — that help reduce nasal inflammation. You can also try a decongestant spray, like oxymetazoline (Afrin), for a few days. 

• Take an oral decongestant. Pseudoephedrine (Sudafed) is a well-known OTC decongestant. Antihistamines like loratadine (Claritin) or cetirizine (Zyrtec) can help clear sinus congestion caused by allergies.

• Sleep with a nasal strip. Nasal strips help open the nostrils and can improve symptoms of a stuffy nose.

When should you get care for sinus congestion?

Most cases of sinus congestion can be treated at home. But you may need treatment with a prescription medication if your sinus congestion is from a bacterial infection.

See a healthcare professional for sinus congestion if you have:

• Fever that lasts more than 3 to 4 days

• Severe pain in the sinuses 

• Symptoms that last more than 10 days

• Symptoms that get a bit better and then suddenly worsen 

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Written by:

Christine Giordano, MD

Christine Giordano, MD, is board-certified in general internal medicine. She received her medical degree from Rutgers New Jersey Medical School and completed residency at Thomas Jefferson University.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Farzon Nahvi, MD, is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works at Concord Hospital in Concord, New Hampshire, and teaches at the Geisel School of Medicine at Dartmouth.

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