Stuffy Nose, Sleepless Nights: How Sinus Issues May Affect Sleep Apnea

Quick takeaways

• Sinus issues, such as chronic sinusitis or allergic rhinitis, may
  be associated with worsened obstructive sleep apnea (OSA)
  symptoms.³³
• Sinus and nasal conditions may lead to inflammation and nasal
  blockages that restrict airflow, making you more likely to breathe
  through your mouth during sleep.
• Breathing through your mouth can cause your upper airway to
  collapse, which may affect OSA.
• Addressing sinus and nasal issues may support better breathing
  during sleep for some people with OSA.

Understanding the link between nasal problems and obstructive sleep apnea

If you have obstructive sleep apnea (OSA), you may find your symptoms
become more noticeable during sinus infections. Or, you might find that
using your continuous positive airway pressure (CPAP) machine feels less
comfortable when you have a stuffy nose.

You’re not imagining it; nasal problems such as sinusitis and
allergies can affect your airway and breathing patterns. At night, these
changes can interfere with your OSA treatments for CPAP therapy and
leave you feeling exhausted in the morning.

When you understand how nasal and sinus problems can affect OSA, it’s
easier to spot potential issues and work with your doctor to find a
solution. By addressing both conditions, you may experience improvements
in nighttime breathing and comfort.

This article is for educational purposes only. Certain treatment
options discussed in this article, such as CPAP, require a prescription.
Consult your doctor for medical advice.

What is obstructive sleep apnea (OSA)?

Obstructive sleep apnea (OSA) is a condition where your upper airway
becomes blocked repeatedly during sleep, making it harder for air to
flow. ¹ These blockages can reduce or completely stop the
flow of air, causing your breathing to pause throughout the night.¹

Many people with sleep apnea experience: ¹

• Excessive daytime sleepiness
• Morning headaches
• Irritability or mood swings
• Difficulty concentrating
• Snoring or gasping for air while sleeping

Over time, untreated sleep apnea can increase the risk of serious
health problems such as high blood pressure, heart disease, and
stroke.

What is sinusitis?

Sinusitis happens when your sinuses — small spaces around your nose
that are filled with air — become swollen or inflamed.² When
your sinuses are blocked, you might have a hard time breathing through
your nose.

Common symptoms of sinusitis include:

• Congestion or trouble breathing through your nose
• Difficulty smelling
• Deep, dull, aching pressure in the face
• Discomfort around your nose, forehead and eyes
• Postnasal drip
• Headache
• Fever

When sinusitis is caused by a cold or flu virus, symptoms usually go
away within a couple of weeks. If you’re still experiencing symptoms
after 12 weeks, your doctor may diagnose you with chronic
sinusitis.²

How chronic sinusitis and obstructive sleep apnea (OSA) are related

Chronically inflamed sinuses can make it more difficult to breathe
through your nose. A blocked nose can make you more likely to breathe
through your mouth while you’re sleeping. Breathing through your mouth
can narrow the upper airway and increase the risk of airway collapse — a
key characteristic of obstructive sleep apnea.³

• If you have OSA, chronic sinusitis may make your symptoms feel
  more noticeable. Breathing interruptions may occur more frequently at
  night, affecting your sleep quality. You might notice increased daytime
  sleepiness and difficulty focusing, and your loved ones might report
  frequent snoring that keeps them awake.²⁶

Other nasal and sinus issues that can affect obstructive sleep apnea

Sinusitis is just one condition that may be associated with
obstructive sleep apnea (OSA). Other health concerns affecting the nose
— such as rhinitis, postnasal drip, nasal polyps or deviated septum —may
also affect your upper respiratory system and may make OSA symptoms more
noticeable.

Chronic nasal congestion and stuffy nose

Nasal congestion (a blockage of the nasal passages) can contribute to
OSA. As with sinusitis, a persistently stuffy nose can limit airflow and
make you more likely to breathe through your mouth while sleeping. You
might notice more frequent breathing interruptions during sleep, which
may make OSA symptoms feel more noticeable.⁴

Rhinitis (allergic and nonallergic)

Rhinitis is a condition where the inside of your nose becomes swollen
and irritated, which can make it harder to breathe through your nose.
There are three main types of rhinitis: allergic, infectious and
nonallergic. ²⁷

Allergic rhinitis is caused by allergens such as dust, pollen or pet
dander. You might experience it consistently or have occasional
flare-ups.

Nonallergic rhinitis, also called vasomotor rhinitis, is often caused
by irritants such as smoke, pollution, or perfume. It can also result
from shifts in the weather or reactions to certain foods and
medications. Infectious rhinitis can be caused by colds and other
viruses.⁴

If you experience rhinitis regularly, treating it may help you sleep
more soundly. Reducing nasal congestion may also make continuous
positive airway pressure (CPAP) therapy more comfortable to use.
²⁸

Postnasal drip

Chronic sinusitis and rhinitis commonly lead to postnasal drip —
mucus that drips down the back of your throat. ^29,30 The
mucus can trigger a cough, irritate soft tissues and increase your
chance of developing a sore throat.

Postnasal drip tends to get worse when you lie down. Mucus pools in
your throat, leading to nighttime coughing that can affect your sleep
and make OSA symptoms worse.⁷

The best way to manage postnasal drip is usually to treat what’s
causing it in the first place. For example, if allergies are triggers,
avoiding allergens may help. Using a humidifier or doing gentle nasal
rinses can also help thin mucus and ease symptoms.⁸

Nasal polyps and other structural issues

Sometimes, the structures in and around your nose may influence your
breathing and OSA symptoms. Nasal polyps (harmless growths inside your
nose) are an example. ²⁹ They may contribute to ongoing
congestion and make it harder for air to flow freely through your nasal
passages.⁹

You might also struggle to breathe through your nose if the wall
between your nasal passages is angled or off-center. This condition,
called a deviated septum, can affect airflow, restrict mucus drainage,
and make you more likely to breathe through your mouth. If medications
don’t resolve your symptoms, your doctor may discuss whether surgical
options are appropriate.¹⁰

How sinus and nasal issues make sleep apnea worse

For people living with obstructive sleep apnea (OSA), sinus and nasal
issues can make symptoms worse. Whether you’re dealing with chronic
sinusitis or allergic rhinitis, there are a few ways that your condition
can affect OSA.

Reduced airflow and breathing through the mouth

When your nose is blocked by swelling, mucus or the shape of your
nasal passages, it can be hard to breathe through your nose. As a
result, your body may begin to rely on breathing through your mouth
while sleeping. This may make the airway in your throat (known as the
pharyngeal airway) less stable and can increase its risk of
collapsing.¹¹ If you already have obstructive sleep apnea
(OSA), this may lead to more frequent breathing pauses during the
night.

What’s more, breathing through your mouth is associated with
persistent dryness and poor sleep quality.¹²

Inflammation and airway sensitivity

Many nasal and sinus conditions are associated with inflammation
inside your sinuses and nasal passages. When swelling lasts for long
periods of time, such as with chronic sinusitis, it can irritate the
soft tissues throughout your upper airway.² Allergies and
infections can make swelling worse, sometimes even narrowing the space
in your throat.¹³

Inflammation and sleep are closely linked. Persistent inflammation
can disrupt your sleep cycles and make it difficult to rest. Over time,
ongoing inflammation may contribute to poor sleep
quality.⁴

Overlapping symptoms and diagnosis

Sinus issues and obstructive sleep apnea (OSA) have similar symptoms,
including poor sleep quality, daytime fatigue and headaches. This
overlap can make both conditions more challenging to diagnose. For
example, your doctor might diagnose you with OSA while conditions like
sinusitis may also be contributing to your symptoms.

Your doctor will use a sleep test to help diagnose sleep apnea. A
sleep test collects information from your body as you sleep. Your doctor
can use this information to determine if you have a sleep condition.

If you’re still experiencing congestion after starting treatment, it
may be helpful to see an ear, nose and throat (ENT) specialist to
identify nasal and sinus issues.¹⁵ In addition to a physical
exam of your nasal passages, your ENT may recommend allergy tests, blood
tests or a computed tomography (CT) scan. They may also use a tool
called an endoscope — a thin tube with a camera and light on one end —
to understand what’s causing your nasal or sinus symptoms.

Treatment options for sinusitis and obstructive sleep apnea

If your doctor determines that you have both sinusitis and OSA, they
may recommend a variety of treatments to reduce your congestion and
inflammation.

Once you’re diagnosed with OSA, your doctor may recommend continuous
positive airway pressure (CPAP) therapy. ³¹ CPAP therapy is a
sleep apnea treatment that helps people breathe while they sleep. It
uses a small machine placed by your bed to gently deliver a steady flow
of air through a mask.

CPAP is a drug-free treatment with zero medication-related side
effects. ³⁵ A typical CPAP system includes three parts: a
CPAP device, a flexible tube, and a mask that fits over your nose or
over both your nose and mouth. The gentle air pressure helps keep your
airway open, so you can breathe steadily throughout the night.

Treating nasal problems may ease symptoms and make CPAP more
comfortable, but it typically does not replace standard sleep apnea
therapy.

Medical treatments for nasal and sinus health

The following medical treatments can help with nasal and sinus
issues:

• Nasal sprays: Nasal sprays made with
  corticosteroids or antihistamines can help reduce the swelling and
  inflammation associated with rhinitis, nasal polyps and
  sinusitis.^2,16
• Saline rinses: A saline rinse may help clear
  mucus and wash away irritants to help reduce
  inflammation.¹⁷
• Antibiotics: If your nasal congestion is caused
  by a bacterial infection, your doctor may recommend
  antibiotics.²
• Allergy management: When you have allergies that
  cause rhinitis, managing your exposure to allergens can help reduce
  flare-ups and make it easier to breathe through your nose. That might
  include avoiding allergens, using high-efficiency particulate air (HEPA)
  filters and taking antihistamines, steroids or
  decongestants.⁵

Tips for CPAP users living with sinus issues

Sinus issues may make it feel more challenging for people to use
their CPAP. Sinus issues can make it difficult for CPAP devices to
deliver pressurized air and may make CPAP feel less comfortable.

Even if you’re dealing with sinus problems and nasal congestion, it’s
important to continue your CPAP therapy to treat your OSA. Here are some
ways to improve CPAP use when you have sinus issues:

• Use a heated humidifier. These systems add
  moisture and heat to your CPAP, which support comfort if you experience
  dry mouth, congestion or a sore throat.¹⁹
• Switch to a new mask. If you’re struggling to
  use a nasal pillow mask when you’re congested, some people find it
  helpful to switch to a full-face or nasal CPAP mask. Talk to your
  doctor; the right CPAP mask can depend on your congestion
  level.
• Treat your nasal issues. Talk to an ear, nose,
  and throat (ENT) specialist about resolving congestion with medicine or
  other treatments. Addressing underlying conditions that contribute to
  nasal blockages may make CPAP therapy easier to use for some
  people.

Surgical options for sinus issues

When medicine and other treatment options don’t improve your sinus or
nasal issues, your doctor might suggest surgery.

• Functional endoscopic sinus surgery (FESS):
  Designed for chronic sinus issues, this procedure aims to open the sinus
  passages to support better airflow and mucus
  drainage.²⁰
• Septoplasty or turbinate reduction: These
  procedures address issues with the internal structures of the nose. A
  septoplasty straightens the septum, while a turbinate reduction removes
  some of the tissue around the bones inside the
  nose.^10,21
• Polyp removal: Removing nasal polyps may help
  reduce blockages in your nose and support easier breathing. Studies show
  that this process may help reduce symptoms in people with obstructive
  sleep apnea.²²

It’s important to note that while surgery may help make CPAP therapy
more comfortable and easier to use, ²⁶ it typically doesn’t
cure OSA. Make sure to continue using your CPAP machine as recommended
by your doctor.

Lifestyle and home remedies

If you’re dealing with nasal blockages or sinus problems that are
affecting your obstructive sleep apnea (OSA) treatment, home remedies
may help. Try these tips:

• Use a humidifier in your bedroom to add moisture to the air,
  which may help support nasal comfort.

• Elevate your head at night or try sleeping on your
  side.²³

• Avoid alcohol, cigarettes, and heavy meals within 3 hours of
  bedtime.
• Do your best to maintain a healthy weight, which may be
  associated with lower OSA severity.²⁴

Working with your doctors

When you’re managing both OSA and sinus issues, it’s important to
partner with the right doctors. Consider meeting with an ear, nose and
throat (ENT) specialist and a sleep doctor. By working together, they
can coordinate care and discuss approaches that address your symptoms
and conditions.

For some people, treating nasal or sinus conditions can make CPAP
easier to use. If you have OSA and think you might also have a sinus
condition, it’s important to talk to your doctor. Addressing sinus
issues may help reduce inflammation and support nasal breathing, which
can help improve OSA symptoms and create a more comfortable CPAP
experience. Regardless of your treatment plan, make sure to schedule
regular follow-up appointments. That way, your doctors can monitor your
progress and adjust treatment as your health evolves.

To learn more about your sleep health, take our online sleep assessment.

References:

1. Source: What Is Sleep Apnea? National Heart, Lung, and Blood Institute https://www.nhlbi.nih.gov/health/sleep-apnea
2. Source: Overview: Sinusitis. National Library of Medicine National Center
   for Biotechnology Information (2024) https://www.ncbi.nlm.nih.gov/books/NBK279485/
3. Source: Kim, E.J. et al., (2011). European Archives of
   Oto-Rhino-Laryngology https://pubmed.ncbi.nlm.nih.gov/20957487/
4. Source: Fitzpatrick, M.F. et al., (2003). European Respiratory Journal https://publications.ersnet.org/content/erj/22/5/827
5. Source: Tran, N, P. et al., (2011). Allergy, Asthma & Immunology
   Research https://pmc.ncbi.nlm.nih.gov/articles/PMC3121056/
6. Source: Zheng, M. et al., (2017). Journal of Clinical Sleep Medicine https://jcsm.aasm.org/doi/pdf/10.5664/jcsm.6694
7. Source: Chiu, J. and Rowan, N.R., (2025). JAMA Otolaryngology – Head and
   Neck Surgery https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2830355
8. Source: Treatments for postnasal drip. Harvard Health Publishing https://www.health.harvard.edu/blog/treatments-for-post-nasal-drip-201804133109
9. Source: Nasal Polyps. National Library of Medicine National Center for
   Biotechnology Information (2025) https://www.ncbi.nlm.nih.gov/books/NBK560746/
10. Source: Deviated Septum. American Academy of Otolaryngology – Head and
    Neck Surgery https://www.enthealth.org/conditions/deviated-septum/
11. Source: Suzuki, M. and Tanuma, T., (2020). PLOS One https://pubmed.ncbi.nlm.nih.gov/32282859/
12. Source: Magliulo, G. et al., (2019). Acta Otorhinolaryngologica Italica https://pmc.ncbi.nlm.nih.gov/articles/PMC6734203/
13. Source: Orzell, S. and Suryadevara, A., (2018). Introduction to Clinical
    Infectious Diseases: A Problem-Based Approach https://pmc.ncbi.nlm.nih.gov/articles/PMC7153042/
14. Source: Engert, L. and Besedovsky, L., (2025). Somnologie https://link.springer.com/article/10.1007/s11818-025-00495-6
15. Source: Kapur, V. et al., (2017). Journal of Clinical Sleep Medicine https://pubmed.ncbi.nlm.nih.gov/28162150/
16. Source: Nasal corticosteroid sprays. MedlinePlus https://medlineplus.gov/ency/patientinstructions/000404.htm
17. Source: Park., D-Y. et al., (2022). Clinical and Experimental
    Otorhinolaryngology https://pmc.ncbi.nlm.nih.gov/articles/PMC8901942/
18. Source: Yu, C-C. et al., (2013). Sleep and Breathing https://pmc.ncbi.nlm.nih.gov/articles/PMC3575558/
19. Source: Al-Mujaini, A. et al., (2009). Oman Medical Journal https://pmc.ncbi.nlm.nih.gov/articles/PMC3273939/
20. Source: Mallen, J.R. et al. Radiofrequency Turbinate Reduction. Medscape
    (2021) https://emedicine.medscape.com/article/1580603-overview
21. Source: Schoustra, E. et al., (2022). Brain Sciences https://pmc.ncbi.nlm.nih.gov/articles/PMC9688553/
22. Source: Stuffy or runny nose – adult. MedlinePlus https://medlineplus.gov/ency/article/003049.htm
23. Source: Kaleelullah, R.A. and Nagarajan, P.P., (2021). Cureus https://pmc.ncbi.nlm.nih.gov/articles/PMC7920220/
24. Source: Allergic rhinitis: Clinical manifestations, epidemiology,
    pathogenesis, and diagnosis. UpToDate. https://www.uptodate.com/contents/allergic-rhinitis-clinical-manifestations-epidemiology-pathogenesis-and-diagnosis
25. Source: Slowik, Jennifer M., et al. “Obstructive Sleep Apnea.” StatPearls,
    StatPearls Publishing, 2025. PubMed,. http://www.ncbi.nlm.nih.gov/books/NBK459252/
26. Source: Liva GA, Karatzanis AD, Prokopakis EP. Review of Rhinitis:
    Classification, Types, Pathophysiology. J Clin Med. 2021;10(14):3183.
    Published 2021 Jul 19. https://pmc.ncbi.nlm.nih.gov/articles/PMC8303640/
27. Source: Skirko JR, James KT, Shusterman DJ, Weaver EM. Association of
    Allergic Rhinitis With Change in Nasal Congestion in New Continuous
    Positive Airway Pressure Users. JAMA Otolaryngol Head Neck Surg.
    2020;146(6):523–529. https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2764149
28. Source: Keswani A, Holbrook EH. Chronic rhinosinusitis: Clinical
    manifestations, pathophysiology, and diagnosis. UpToDate.. https://www.uptodate.com/contents/chronic-rhinosinusitis-clinical-manifestations-pathophysiology-and-diagnosis?search=POSTNASAL+DRIP&source=search_result&selectedTitle=6~57&usage_type=default&display_rank=6
29. Source: Ellis, Anne. Pharmacotherapy of allergic rhinitis. UpToDate. https://www.uptodate.com/contents/pharmacotherapy-of-allergic-rhinitis?search=POSTNASAL%20DRIP&source=search_result&selectedTitle=5~57&usage_type=default&display_rank=5#H25107326
30. Source: Continuous Positive Airway Pressure 2025 The National Library of
    Medicine https://www.ncbi.nlm.nih.gov/books/NBK482178/
31. Source: Kaleelullah RA, Nagarajan PP. Cultivating lifestyle
    transformations in obstructive sleep apnea. Cureus. 2021;13(1):e12927.
    doi:10.7759/cureus.12927. https://pmc.ncbi.nlm.nih.gov/articles/PMC7920220/
32. Source: Fueyo GO. Chronic rhinitis treatment: effects on obstructive sleep
    apnea. Curr Treat Options Allergy. 2022;9:292-301.
    doi:10.1007/s40521-022-00307-4. https://link.springer.com/article/10.1007/s40521-022-00307-4
33. Source: Leung RS, Katial R. The diagnosis and management of acute and
    chronic sinusitis. Prim Care. 2008;35(1):11-24.
    doi:10.1016/j.pop.2007.09.002. https://pubmed.ncbi.nlm.nih.gov/18206715/
34. Source: Liva GA, Karatzanis AD, Prokopakis EP. Review of rhinitis:
    classification, types, pathophysiology. J Clin Med. 2021;10(14):3183.
    doi:10.3390/jcm10143183. https://pmc.ncbi.nlm.nih.gov/articles/PMC8303640/
35. Source: Chronic rhinosinusitis with nasal polyposis: Management and
    prognosis. UpToDate. Updated March 8, 2026. https://www.uptodate.com/contents/chronic-rhinosinusitis-with-nasal-polyposis-management-and-prognosis