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What Causes Nose Bleeds at Night?

Is this cause for concern?

Waking up to find blood on your pillow or face can be a scary experience. But while nighttime nose bleeds may seem frightening, they’re rarely serious.

Just like any other part of your body, your nose bleeds when it’s cut or irritated. The lining of your nose is especially likely to bleed because it’s lined with many fragile blood vessels that lie very close to the surface. That’s why even minor injuries can cause a lot of bleeding.

Nose bleeds that happen once in a while are usually nothing to worry about. But if you get nose bleeds often, you might have a problem that your doctor needs to check out.

The causes of nighttime nose bleeds are the same as those of daytime nosebleeds. Here’s a rundown of factors that could make your nose bleed at night, and how to prevent them.

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Dryness

1. Dryness

A number of things can dry out the lining of your nasal passages, including nutritional deficiencies.

Just like your skin gets cracked and bleeds when it’s dry, your nasal passages become irritated and bleed when they dry out, too.

What you can do:

  • Turn on a humidifier in your bedroom at night — especially during the winter months. This will add moisture to the air.
  • Use a saline (salt water) nasal spray before bed to keep your nasal passages moist.
  • Apply a thin layer of petroleum jelly like Vaseline, or an antibiotic ointment, to the inside of your nose with a cotton swab.

Picking

2. Picking

Did you know?

There are two types of nosebleeds.

Anterior nose bleed: This type of nose bleed comes from the front part of your nose. It’s the most common type of nose bleed, and it’s usually harmless.

Posterior nose bleed: This type of nosebleed starts at the back of your nasal passage, near your throat. It’s far less common than an anterior nosebleed, but it can cause more blood loss.

Nose picking is one of the most common causes of nosebleeds. Whether you or your child do it as a force of habit or unconsciously while you sleep, you can damage your nose each time you insert your finger. The edge of your nail can tear the delicate blood vessels that lie just under the surface of your nose.

What you can do:

  • To avoid picking, keep tissues close to your bed so you can blow your nose instead.
  • If you pick while you sleep, wear gloves to bed so you can’t put your finger in your nose.
  • Wash your hands every time you pick your nose. Having to get out of bed each time will force you to pay attention to the habit. Then if you do pick, your fingers will be clean and less likely to introduce bacteria to any wounds.
  • You should cut your nails short so, if you do pick, you’ll be less likely to injure yourself.
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Climate

3. Climate

You’re more likely to get nosebleeds during the cold winter months. Heating your home sucks moisture out of the air. Dry air dehydrates your nasal passages, leaving them cracked and bleeding. Living in a dry climate year-round has the same effect on your nose.

What you can do:

  • Turn on a humidifier in your bedroom at night to add moisture to the air.
  • Use a saline (salt water) nasal spray before bed to keep your nasal passages moist.
  • Apply a thin layer of petroleum jelly like Vaseline, or an antibiotic ointment, to the inside of your nose with a cotton swab.

Allergies

4. Allergies

The same allergies that cause sniffling, sneezing, and watery eyes can also make your nose bleed.

Allergies cause nose bleeds in a few different ways:

  • When your nose gets itchy, you scratch it, which can damage blood vessels.
  • Blowing your nose repeatedly can rupture the blood vessels inside.
  • Steroid nasal sprays and other medications you use to treat allergy symptoms dry out the inside of your nose.

What you can do:

  • Try not to blow your nose too forcefully. Be gentle.
  • Use tissues that contain moisturizer to soften the blow.
  • Ask your allergist for an alternative to steroid nasal spray. Saline sprays can also help clear up congestion without drying out your nose.
  • Talk to your doctor about allergy shots or other preventive medication.
  • Try to avoid your allergy triggers, such as pollen, mold, or pet dander.
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Infection

5. Infection

Sinus infections, colds, and other respiratory infections can damage the sensitive lining of the nose. Eventually, your nose can become irritated enough to break open and bleed. Blowing your nose too often when you have an infection can also cause nosebleeds.

Other signs that you have an infection include:

  • stuffed, runny nose
  • sneezing
  • coughing
  • sore throat
  • fever
  • aches
  • chills

What you can do:

  • Use a saline nasal spray or breathe in the steam from a hot shower to clear up congestion.
  • Drink lots of fluids to loosen up mucus in your nose and chest.
  • Get plenty of rest to help you feel better faster.
  • If your doctor says you have a bacterial infection, you may need to take antibiotics to clear it up.
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Other tips

Other tips for managing nosebleeds

To stop bleeding
  1. Sit or stand up, tilting your head slightly forward. Don’t tilt your head back because it will cause the blood to run down your throat.
  2. Using a tissue or cloth, gently press your nostrils closed.
  3. Hold the pressure for 5 to 15 minutes.
  4. You can also place an ice pack on the bridge of your nose to constrict blood vessels and stop the bleeding faster.
  5. After 15 minutes, check to see if your nose is still bleeding. If it’s still bleeding, repeat these steps.

If your nose continues to bleed after 30 minutes — or if you’re unable to stop the bleeding — go to an emergency room or urgent care center.

If you have stopped the bleeding, it’s important to keep your head above the level of your heart for the next couple of hours.

You can also apply petroleum jelly or antibiotic ointment to the inside of your nose with a cotton swab to moisten the area and help it heal.

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See your doctor

When to see your doctor

You don’t need to see your doctor for the occasional nose bleed. Do see your doctor if you get nose bleeds more than once a week or if they’re hard to stop.

Also call if:

  • You bleed a lot, or you have trouble stopping the bleeding within 30 minutes.
  • You get pale, dizzy, or tired during a nosebleed.
  • The nosebleeds started after an injury or surgery.
  • You have other symptoms, such as chest pain.
  • It’s hard for you to breathe during a nosebleed.

Very rarely, nighttime nose bleeds are caused by a more serious condition called hemorrhagic telangiectasia (HHT). This inherited disease makes you bleed more easily. Frequent bloody noses are common with HHT.

People with HHT get a lot of nosebleeds and the bleeding can be heavy. Another sign of HHT is cherry-red spots on your face or hands. These are called telangiectasia. If you have these symptoms, see your doctor for a diagnosis.

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