What Causes Nosebleed at Night?

A nosebleed, also called epistaxis, can be worrisome, especially if it happens at night. Nosebleeds are common and usually not a cause for alarm.

When there is not enough moisture in the air, it can dry out the lining of the nostrils, leaving the lining cracked and exposed to bleeding.Nosebleeds occur most frequently in children who often pick or rub their noses while sleeping.

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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. A slight injuries to this tissue can make these vessels bleed.

This is called an anterior nosebleed which is the most common type and not usually severe. Anterior nosebleeds begins in the front of the nose, and the blood flows out of the nostrils.

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The blood usually comes from the nasal septum, which is the thin wall between the two sides of the nose. Posterior nosebleeds are infrequent, and they tend to be more serious. The bleeding begins at the back of the nasal passage, near the throat.

In 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 high blood pressure or a bleeding disorder.

Possible Causes of Nosebleeds at Night

The most common causes and risk factors for nosebleeds at night are:

  1. Colds and allergies

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

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These can cause irritation on the inside of the nose, and increase the risk of bleeding, especially if symptoms get worse during the night. Also, nasal congestion can cause blood vessels to broaden, making them more susceptible to injury.

  1. 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.

  1. A dry climate or home environment

Dry air can crack the delicate skin inside the nose, making it to bleed. Nosebleeds are more prone to occur as the seasons change and before the nasal tissues have acclimated to a rise or fall in humidity. Putting on the heater during colder months can dry out the air inside the home.

  1. Heavy alcohol use

Excessive consumption of alcohol can contribute to the risk of nosebleeds at nights in in two ways:

First, alcohol inhibits with the activity of the blood’s platelets (cells that cause blood to clot).

Secondly, heavy intake of alcohol can enlarge the superficial blood vessels in the nasal cavity, exposing them to injury and bleeding.

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  1. Medications

Some medications can lead to inability of the blood to clot. These include:

  • prescription blood thinners, or anticoagulants
  • nonsteroidal anti-inflammatory drugs, such as aspirinand 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, follow the instructions to reduce the risk of nosebleeds and other harmful side effects.

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

  • ginger
  • danshen, or red sage
  • dong quai, or female ginseng
  • garlic
  • feverfew
  • ginkgo biloba
  • vitaminE

How to treat a nosebleed at home

Take the following steps to stop most nosebleeds:

  • Older children and adults should blow their noses to remove any clots that may have formed in their nostrils. This step may not be used for toddlers and younger children because it can temporarily increase the bleeding.
  • Sit, bending slightly at the waist. Don’t lie down or tilt the head backwards because it can lead to swallowing blood and choking or vomiting.
  • Grip the soft parts of the nostrils at the base of the nose, applying pressure to both sides. Gripping the bony bridge will not prevent your nose from bleeding.
  • Children should squeeze their nostrils shut for 5 continuous minutes. Adults should do the same for 10 minutes and breathe through the mouth.
  • Apply a cold compress or ice pack to the bridge of the nose. This may help slow the bleeding by constricting the blood vessels.
  • If the bleeding persist, repeat the previous steps. Apply pressure for at least 30 minutes

When to see a doctor

People can treat most nosebleeds quickly and easily at home. However, seek urgent medical attention if the blood loss is extensive, or if the person:

  • has difficulty breathing
  • is pale and fatigued
  • is bleeding from other areas or has multiple bruises
  • has persistent chest pain
  • has recently undergone nasal surgery
  • has a nasal tumor
  • has frequent nosebleeds
  • has smelly 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

How to prevent a nosebleed

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


Disclaimer: The content provided on healthdiary365.com is purely informative and educational in nature and should not be interpreted as medical advice. Please use the content only in consultation with an appropriate certified medical doctor or healthcare professional.


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