Nosebleeds at night: Causes and home remedies

When there is not enough moisture in the air, it can dry out the lining of the nostrils. This leaves the lining cracked and prone to bleeding.

Also, nosebleeds occur most frequently in children, who often pick or rub their noses while sleeping.

This article will explore:

• why noses are vulnerable to bleeding
• the main causes of epistaxis
• how to stop nosebleeds at home
• how to prevent nosebleeds at night

It will also describe when to seek medical care.

What causes nosebleeds?

The inside of the nose is covered with mucosa, a moist, delicate tissue with a large number of blood vessels that are close to the surface. Even minor injuries to this tissue can make these vessels bleed, sometimes a lot.

This is called an anterior nosebleed. It is the most common type and not usually serious.

Anterior nosebleeds start in the front of the nose, where the mucosa is most accessible, and the blood flows out of the nostrils.

The blood usually comes from the nasal septum, which is the thin wall between the two sides of the nose.

Posterior nosebleeds are rarer, and they tend to be more serious. They start at the back of the nasal passage, near the throat.

In the case of a posterior nosebleed, the blood usually comes from an artery higher and deeper in the nose, and it may flow down back of the throat or out through the nostrils.

Children do not usually experience posterior nosebleeds. A person is more likely to experience one if they have a condition such as high blood pressure or a bleeding disorder.

The common cold and other upper respiratory tract infections can lead to an increase in mucus, as well as frequent nose-blowing and sneezing. Allergic reactions can have the same effects.

These can irritate the inside of the nose, and increase the risk of bleeding, especially if symptoms are worse at night.

Also, nasal congestion can cause blood vessels to widen, making them more vulnerable to injury.

3. Chemical exposure

A person may encounter airborne chemicals in pollution or at work.

These chemicals can irritate or damage the inside of the nose, making it prone to bleeding. Cigarette smoke can have the same effect.

4. Heavy alcohol use

Drinking heavily can contribute to the risk of nocturnal nosebleeds in two ways.

First, alcohol interferes with the activity of the blood’s platelets, which are the cells that cause blood to clot.

Second, alcohol can enlarge the superficial blood vessels in the nasal cavity, making them more prone to injury and bleeding.

5. Medications

Some medications interfere with the blood’s ability to clot. These include:

• prescription blood thinners, or anticoagulants
• nonsteroidal anti-inflammatory drugs, such as aspirin and ibuprofen

A person taking any of these types of medications may have a higher risk of nosebleeds.

Nosebleeds are also a side effect of some nasal sprays, such as those that contain steroids to treat allergies.

When using a nasal spray, carefully follow the instructions to minimize the risk of nosebleeds and other side effects.

Some homeopathic medications and dietary supplements contain chemicals that prolong bleeding. The following ingredients can have this effect:

• danshen, or red sage
• dong quai, or female ginseng
• other types of ginseng
• feverfew
• garlic
• ginger
• ginkgo biloba
• vitamin E

People can treat most nosebleeds quickly and easily at home.

However, doctors recommend seeking urgent medical attention if the blood loss is extensive, or if the person:

• is having difficulty breathing
• is pale, fatigued, or disorientated
• is bleeding from other areas or has multiple bruises
• has recently undergone nasal surgery
• has a nasal tumor
• has other serious symptoms, such as chest pain
• has frequent nosebleeds
• has foul-smelling discharge
• has taken the steps listed in the previous section and the bleeding has not stopped

A person taking any of the following medications should take extra steps to prevent nosebleeds:

• warfarin
• clopidogrel
• dabigatran
• rivaroxaban
• fondaparinux
• a daily aspirin

If a person taking any of these medications cannot stop a nosebleed, they should see a doctor.

How to prevent a nosebleed

To prevent a nosebleed:

• refrain from picking the nose
• blow the nose gently
• refrain from smoking
• use a humidifier during the winter, if the indoor air is dry
• apply dabs of nasal gel or petroleum jelly inside the nostrils before bedtime
• use protective equipment at work to avoid inhaling chemicals and other irritants

Takeaway

Nosebleeds are common, especially in children. Usually, a person can easily treat them at home.

The tissues inside the nostrils are delicate and easy to damage. Picking the nose or dry air is usually responsible for this damage.

Dry air from a heater, for example, can crack the blood vessels and lead to nosebleeds during the night.

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