Hay fever symptoms worse at night

Patient

Q: I have hay fever, and during the day, I'll have the occassional sniff or sneeze, but nothing really bothersome. However, at night and first thing in the morning, my hay fever is at its worst, and I can't understand why. It makes it difficult to sleep, and I feel embarrassed about sleeping round people's houses, as I feel my constant sniffing and sneeing is annoying them. I sometimes take tablets before bed, but as a teenager I can't really afford to buy them for every night. Why does it only occur at night?

Doctor

A:   Hay fever (allergic rhinitis) is an immune mediated reaction of the nasal airways to various allergens in the environment. The most common allergens include dust mites, pet danders, cockroaches, molds, and pollens. If your symptoms only occur at night, this may be due to allergens such as dust mites or bed clothing, for example a feather pillow. A detailed history of your symptoms is vital, to understand triggers in your case, timing of symptoms, and whether symptoms occur all year round or only during specific seasons. I would advise attending your family doctor to help identify triggers (allergens) in your case, referral for allergy testing or to an immunologist if appropriate, and if symptoms are having a large impact on daily activities.

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