What Causes Nosebleeds While Sleeping?

Waking up to a bloodstain on your pillowcase for no apparent reason can be gross, unsettling and downright scary.

But don’t worry: If a nighttime bloody nose has ever disrupted your beauty sleep, chances are you’re not alone. And chances are you’re perfectly fine.

Nosebleeds at night are common and, usually, nothing to worry about. Pediatric otolaryngologist Swathi Appachi, MD, explains why nosebleeds happen when you sleep and what you can do about it.

Causes of nosebleeds while sleeping

Nosebleeds (also known in medical terms as epistaxis) usually happen for specific reasons. And you can often fix these problems with home remedies.

Here’s why they happen.

1. There’s some nose picking going on

Kids are particularly prone to “digging for gold,” but adults do it, too — sometimes in our sleep without realizing it. And the area in the middle of the nose, known as the septum, is especially prone to irritation and bleeding if you touch it.

“There are five different blood vessels that meet in the septum, and they’re very sensitive,” says Dr. Appachi. “If you touch the blood vessels, they can crack and bleed.”

Take a preventive approach to nose-picking. Dried-up mucus (aka “boogers”) in the nose is uncomfortable and hard to blow out, so people often resort to, well, manual removal. Instead, use drug-free nasal moisturizers, such as saline spray, gel and ointment, to solve this issue.

“Keep the inside of the nose moist, and you won’t have as much desire to pick,” says Dr. Appachi. “Nasal moisturizers can soften mucus and make it easier to clear with gentle blowing.”

To use nasal spray correctly, place the nozzle in the nostril and direct it toward your ear. “Don’t point nasal spray toward the middle of your nose,” Dr. Appachi advises. “You want to avoid direct contact with the septum.”

And if your kids run away screaming when they see a bottle of nose spray, try gels or ointments. They don’t feel quite as invasive.

2. It’s dry in your bedroom

If you use heat or air conditioning or live in a dry climate, your home might have a low humidity level. If the humidity drops below 30%, you’re setting yourself up for dry skin and mucus membranes, including the membranes inside your nose.

“The septum’s blood vessels are very sensitive to dryness,” says Dr. Appachi. “When the mucus membranes in the nose dry out, the blood vessels are exposed. They can crack, causing bleeding. This is more likely to happen at night when you’re not drinking water and breathing through your mouth.”

Other signs your home is too dry:

• Chapped or cracked lips.
• Dry, itchy skin.
• Sore, dry throat, especially when you wake up.
• Static electricity on fabrics and hair.
• Dry or itchy eyes.

You may want to purchase a hygrometer, a device that measures humidity levels. Ideal humidity levels are 30% to 50%. Then get a humidifier for your home or run a vaporizer in your bedroom each night. These devices are filled with water and moisturize the air. Clean them on the regular to avoid nasty issues like mold, bacteria and mildew.

For double defense against nighttime nosebleeds, pair your humidifier with a nasal moisturizer. “Use saline spray, then some ointment before going to bed,” says Dr. Appachi.

3. You have a cold or allergies

Runny noses cause irritation and dehydration in the nose, often leading to an unexpected nosebleed. And if you’re blowing your nose forcefully and frequently, your nose will get even more irritated.

“Forceful nose blowing can cause trauma to the septum, causing it to bleed,” Dr. Appachi explains. “Use saline spray regularly when you have a cold to make nasal secretions softer. When you have to blow your nose, do it gently.”

What about decongestant nasal sprays? Unlike saline sprays, decongestant sprays contain medication or active ingredients. If you’re really stuffy from a cold or allergies, you can use them, but for no longer than three days in a row. Decongestant sprays can cause a rebound effect, making you feel more congested, says Dr. Appachi.

See your doctor if you’re always congested so you can find out the cause and explore other treatment options.

How do I stop a nosebleed?

Despite our best efforts to avoid them, though, nosebleeds can still happen and stopping them is important.

The best way to stop a nosebleed is to pinch the soft part of the nose. “Lean forward and pinch the nostrils for at least five minutes without stopping,” says Dr. Appachi. “Many people stop applying pressure after a minute or two, before the blood has clotted. Resist the urge to let go too soon.”

Everyday nosebleeds should stop after 10 to 15 minutes of gentle pressure.

When to see a doctor

An occasional nosebleed is usually nothing to worry about. But seek medical care if you:

• Have bleeding that lasts longer than 30 minutes.
• Lose a large amount of blood.
• Have a bleeding disorder.
• Take blood thinners.

“With a little prevention, you can save your pillowcases and get the rest you deserve,” Dr. Appachi emphasizes.