Nosebleed at Night
Nosebleeds may be uncomfortable when sleeping, especially if it happens at night, although it is frightening and not usually very dangerous. Nasal bleedings are common at night and are seen at least once in most people. "Epistaxis" is used as the medical term for nasal bleeding. Finger trauma and dry air are usually responsible for nasal bleeding at night.
When there is not enough moisture in the air, the mucous membrane covering the nostrils can dry out. In this way, the dry nasal mucosa is prone to bleeding.
In addition, night nosebleeds in children are usually seen in children who shuffle or rub their nose during sleep.
The main causes of epistaxis
Nasal is covered with mucosa, a moist, sensitive tissue with many blood vessels close to the surface. Even when there are minor injuries in this tissue, these veins may become damaged, and nasal bleeding may start, sometimes too much blood may drain. This is called anterior or anterior nasal bleeding. Nasal bleeding is the most common type and is usually not serious. In some people, the superficial veins in the anterior portion of the nasal septum make anastomosis to form a regional intense vascular network. The medical names given to this region and the capillary plexus are: Kiesselbach Triangle - Little's Area - Locus Kiesselbachi - Kiesselbach Plexus - Little Field.
Anterior nosebleeds start in front of the nose where the mucosa is most accessible and the blood flows out of the nostrils. They are seen as unilateral nasal bleeding. It can rarely be bilateral and the blood can reach the oral cavity. The blood is usually in the anterior part of the mucosa that covers the nasal septum, the thin wall between the two sides of the nose.
Posterior nasal bleedings are more rare and tend to be more serious. Next to the throat, they start behind the nasal passages. In the case of a posterior nosebleed, the blood usually comes from a higher, deeper artery in the nose and can flow out of the back of the throat or through the nostrils.
Children usually do not have nosebleeds. If a person has a condition such as high blood pressure or a bleeding disorder, the probability of a life is higher.
Causes of nasal bleeding at night?
The most common causes and risk factors for nosebleeds at night are:
1. Dry climate or home environment
Dry air can break sensitive mucosa in the nose and cause bleeding.
Nasal bleedings occur as the seasons change and the nasal tissues are used before the moisture gets up or down. Running a heater in colder months dries the air in the house.
2. Colds and allergies
Nasal bleedings at night make it easier when you have a cold. A cold can cause nose bleed as a result of nasal irritation. Colds and other upper respiratory infections can cause mucus as well as frequent nasal blowing and sneezing. Allergic reactions may have the same effects. These may irritate the inside of the nose and may increase the risk of bleeding, especially if the symptoms worsen at night.
In addition, nasal congestion can cause blood vessels to expand and become more vulnerable to injury.
3. Exposure to chemicals
A person may encounter pollution in the air or in the workplace. These chemicals may irritate or damage the inside of the nose, which is prone to bleeding. Cigarette smoke can have the same effect.
4. Heavy alcohol use
Drinking alcoholic beverages intensively can contribute to the risk of night nosebleeds in two ways:
First, alcohol acts on the activity of blood platelets, which are cells that cause blood clotting.
Second, alcohol can enlarge the superficial blood vessels in the nasal cavity, making them more prone to injury and bleeding.
5. Medications
Some drugs affect blood clotting ability. These include:
• Prescription blood thinners or anticoagulants
• nonsteroidal antiinflammatory drugs such as aspirin and ibuprofen
A person taking any of these drugs has a higher risk of nosebleeds.
Nasal bleedings are also a side effect of some nasal sprays containing steroids to treat allergies.
When using the nose spray, carefully follow the instructions to minimize the risk of nosebleeds and other side effects.
Some homeopathic remedies and nutritional supplements contain hemorrhagic chemicals. The following components may have this effect:
• Danshen or Red Sage
• Sage tea
• Other ginseng types
• Chrysanthemum
• Garlic
• Ginger
• Ginkgo Biloba
• Vitamin E
6. Nasal surgeries
After nasal surgeries such as rhinoplasty and septoplasty, it is normal to have bleeding in the form of leakage and dripping from the front and back of the nose, especially in the first 3 days. As in the photo above, active blood leakage and clots that can block the air holes of the internal silicone splints in the nose can be seen 1 day after the septoplasty operation. During this period, we recommend that patients sit upright as much as possible, keep the room temperature cool and avoid lifting heavy loads. If nose bleeding increases despite all this, cold application may also be recommended. We also recommend that our patients stay away from spicy and hot foods and not strain or blow their nose with pressure. There will generally be a significant decrease in the risk of nose bleeding 10 days after the operation. From the 3rd day onwards, nose bleeding in the form of leakage will decrease. In this regard, consider the recommendations of your operating surgeon.
How to stop the nosebleed at home?
To stop most nosebleed bleeding, follow these steps:
1. Slightly perpendicular to the waist, tilt the head forward. Tilting or tilting your head from the back can cause swallowing and choking or vomiting.
2. Grasp the soft portions of the nostrils at the base of the nose by applying pressure to both sides. Remember that understanding the nose bone will not stop the bleeding.
3. Children should tighten the nostrils and close for 5 continuous minutes. Adults should do the same for 10 minutes. Don't forget to breathe through your mouth
4. Applying a cold compress or ice pack on the nose may help slow the bleeding by narrowing the blood vessels.
5. If bleeding does not stop, repeat the previous steps. Apply pressure for at least 30 minutes.
6. Ice can be drawn into the nose water
7. Nasal septum can be squeezed into the nose
When should a doctor visit for nosebleed?
Repeated persistent nosebleeds require a doctor's examination at night.
Most people are able to treat nose bleeding quickly and easily at home.
However, if blood loss is high or in the person:
• difficulty breathing
• pale, tired, or deformed
• Bleeding from other areas or multiple bruises
• recently underwent nose surgery
• if there is a nasal tumor
• other serious symptoms, such as chest pain
• frequent nosebleeds
• if there is a smelly discharge
• should take the steps listed in the previous section and see a doctor if bleeding does not stop.
A person receiving one of the following drugs should take extra precautions to prevent nosebleeds:
• warfarin
• clopidogrel
• dabigatran
• rivaroksaban
• fondaparinux
• daily aspirin
If a person taking one of these drugs cannot stop the bleeding, they should see a doctor.
How to prevent nosebleed at night?
How to prevent nasal bleeding?
To prevent nasal bleeding:
• avoid mixing the nose
• gently blow your nose
• avoid smoking
• use a humidifier in winter, when the indoor air is dry in the environment
• use nasal gels, drops or sprays to moisturize the nostrils before going to bed
• use protective equipment at work to protect chemicals and other irritants from inhalation.
Nasal bleeding is common especially in children. Usually, a person can treat them easily at home.
Tissues in the nostrils are sensitive and easy to damage. Nose mixing or inhalation of dry air is usually responsible for this damage.
Dry air from a heater can, for example, irritate the blood vessels and cause nosebleeds overnight.
Murat Enoz, MD, Otorhinolaryngology, Head and Neck Surgeon - ENT Doctor in Istanbul
Private Office:
Address: İncirli Cad. No:41, Kat:4 (Dilek Patisserie Building), Postal code: 34147, Bakırköy - İstanbul
Appointment Phone: +90 212 561 00 52
Appointment Phone: +90 212 561 00 52
Fax: +90 212 542 74 47
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