Doctors Explain Why Only One Nostril Gets Blocked When You’re Sick

HAVING A COLD or other respiratory illness can leave you stuffed up and miserable. For a while, you might only be able to breathe through your right nostril. Then, suddenly, it feels clogged, but the left one opens up.

If there seems to be a back-and-forth between which side of your nose is stuffed up, it’s not your imagination. It’s actually normal, and there’s a scientific reason behind it.

It all has to do with a process known as the nasal cycle, which is a cycle of congestion and decongestion that your nasal pathways go through to manage airflow, according to the Cleveland Clinic. In other words, your nostrils take turns sucking in more air, says Rachel Roditi, M.D., section chief of the division of otolaryngology at Brigham and Women’s Hospital.

“Our noses have a natural cycle such that we are breathing through only one side at any given moment, and this alternates every few hours,” explains Urjeet Patel, M.D., chair of the division of otolaryngology at Cook County Health in Chicago.

It feels worse when you’re sick with a cold or other illness because you’re dealing with inflammation and extra mucous in your nasal passages, says Masayoshi Takashima, M.D., chair of Houston Methodist’s department of otolaryngology. Both of those factors can enhance the feeling of one-sided congestion.

Besides being sick, a few other factors can come into play. Here’s what causes one nostril to feel more clogged than the other, how to treat nasal congestion, and when to see a doctor.

Why One Nostril Gets More Congested

Nasal passages are lined with turbinates, which are small blood vessels that regulate airflow and filter out particles from the air and keep them from getting into your lungs, Dr. Takashima says. These turbinates alternately shrink and swell in your nostrils.

So, when one has increased blood flow, it may become more congested, while the other will open up, he explains. That swelling means there’s less room for air to enter.

It’s pretty subtle, though, and you probably won’t notice it—unless you have a cold, infection, allergies, or a structural problem like a deviated septum, which is the cartilage that separates the nose’s two chambers.

When you’re sick or have allergies, blood flow to your nose increases even more, sparking more swelling and greater mucus production in your nasal region, says Dr. Roditi.

Your nose produces mucus to help flush out irritants. Dr. Takashima says mucus production can cause the nose to swell, and the extra mucus can also clog the nose.

“If anything affects the nose—allergies, a sinus infection, or upper respiratory infection—you’re going to get swelling inside the nose, and it’s just going to be too tight for you to breathe easily,” he says.

Even though you’re congested throughout your entire nose, you typically feel it more strongly in the one nostril where the turbinate is already swollen as part of the normal nasal cycle, Dr. Roditi says.

If you have a deviated septum, one side might be a little tighter than the other, so you’ll feel more congested there, Dr. Takashima says.

You might also notice it if you’re lying down on one side, when blood flows more to one side of the nose and causes more congestion, he adds. “That’s why people typically feel a little bit more congested at night than during the day.”

The Most Effective Ways to Treat Nasal Congestion

There’s really nothing you can do to shut off the nasal cycle, says Dr. Roditi. It’s likely that one nostril will always feel more stuffed up than the other when you’re sick. It’s not always the same one, of course: After about 90 minutes to 4 hours, your nose switches sides. When that occurs, you’ll probably feel some relief when the swelling in the one nostril goes down—but then the other side will start to feel clogged instead.

Your best bet is to work on easing the congestion overall, Dr. Roditi says. Here are some ways to do that:

Steam

Steam from a hot shower or humidifier can help open the floodgates, says Dr. Roditi.

Drinking hot liquids can help, too. It increases the rate at which the little hairs in your nose sweep mucus out of it. Some experts think that’s the mechanism by which chicken soup could help your congestion clear up.

Sinus rinses

Sinus rinses help flush out mucus, as well as allergens and viruses, when you’re sick or just very congested, explains allergist Lakiea Wright-Bello, M.D.

“Two popular ways to do that are with a neti pot or with a squeeze bottle kit from the drugstore,” she says. Both are ways to rinse the nasal passages with saline and distilled water. Most people use the neti pot with their heads tilted over the sink, “and some people like to use the squeeze bottle in the shower,” Dr. Wright-Bello says. “Either way, they’re very effective.”

Just be aware that saline rinses can do their jobs too well sometimes.

“They can make the lining tissue too dry by washing away the mucus layer, much like licking chapped lips makes them dryer,” says John Burgoyne, M.D., an otolaryngologist at Austin ENT & Allergy in Austin, Texas. “Make sure and back off on irrigation if you have dryness or bleeding.”

Allergy medications

Using a steroid nasal spray, like Flonase, can help ease nasal congestion, Dr. Takashima says. Some people also benefit from using an antihistamine.

It’s best to avoid nasal sprays containing oxymetazoline, such as Afrin. Dr. Burgoyne says these can cause rebound congestion, meaning they’ll clear things up for a while, but the stuffiness will come back quickly, and you need more spray. It’s best to use them sparingly, no more than a couple of days in a row.

When to See a Doctor

If your stuffed-up symptoms persist beyond 10 to 14 days, or you notice nasal congestion at times other than when you’re sick, check in with your doctor to make sure that something bigger—like a deviated septum or a nasal growth—isn’t at play, says Dr. Roditi. And if your symptoms include facial pain or thick, colored mucus, check in with a doctor, adds Dr. Burgoyne.

Also, consider that you might not have a cold at all; it might be seasonal allergies. Here’s how to know the difference between colds and allergies. To clear congestion in the case of allergies, you’d want to find the root of the problem—work with a doctor to find out exactly what’s making you sneeze. Then you can strategize on how to avoid the allergen and see if you need something like an antihistamine or a nasal steroid spray.

Keep in mind that you can develop allergies at any age, Dr. Takashima says. “In this day and age, people travel, people move from location to location,” which can trigger allergies.

Finally, if you’ve tried everything and your nose is still stuffy and is compromising the quality of your life, ask a doctor about non-surgical treatments for inferior turbinate enlargement or other issues that might be behind your chronic half-stuffiness, Dr. Takashima adds.