Question: I have allergies and acid reflux. I find during night nose stuffs up and a large amount of mucus collects in the throat effecting the quality of my sleep and I am coughing up clear mucus.
Answer: First of all, thank you for your question. Waking up at night with large amounts of mucous in the throat can be quite uncomfortable, as you know. There are several possible causes for this, and allergies and acid reflux are two of them.
The nasal cavities and sinuses make mucous, which helps trap potentially harmful particles in the nose. The natural cleaning mechanism of the upper respiratory tract then takes this mucous and brings it back down the throat into the stomach, where stomach acid destroys these particles. (Dust, bacteria, viruses, mold, etc). We normally make about a quart of mucous a day. It should be like motor oil, a thin layer of protection that we rarely feel. However, when the mucous is either the wrong consistency (thick and dry- or sometimes too watery) or too much (made in response to irritation or allergies)- then we feel this mucous and are uncomfortable.
Treatment of your problem with mucous needs to be directed at the cause. Quite commonly, stomach contents can reflux up the esophagus all the way to the nose and sinus cavities. This irritates the lining and causes the tissues to make more mucous as a protective layer. Lying down can increase reflux, especially after a late meal. If that is the cause, then treatments such as antihistamines would be not only not necessarily beneficial, but could make the symptoms worse by drying this mucous.
I would suggest following a good “reflux” diet- please see our site, but you should really be evaluated with a thorough ENT exam. I would probably suggest testing for reflux with a 24 nasal pH monitoring. This evaluation would accurately indicate whether acid is coming up that high and causing your symptoms and help tailor the appropriate therapy for your symptoms.
Robert L. Pincus MD
Associate Professor Otolaryngology
NY Sinus Center
NY Otolaryngology Group
Frequently Asked Questions
Excessive mucus production at night can be caused by allergies, acid reflux, or irritation in the nasal and sinus cavities. When mucus becomes too thick, too watery, or is produced in large amounts, it can accumulate and cause discomfort, particularly during sleep.
Acid reflux can cause stomach contents to move up the esophagus to the nasal and sinus cavities, irritating the lining and triggering excessive mucus production as a protective response. Lying down, especially after late meals, can worsen this reflux and mucus accumulation, affecting sleep quality.
Antihistamines can dry out mucus membranes, which might worsen symptoms if acid reflux is the underlying cause of mucus buildup. In such cases, drying the mucus can make it thicker and more uncomfortable instead of providing relief.
A thorough ENT examination is recommended, along with specialized testing like 24-hour nasal pH monitoring. This test helps detect if acid is reaching the nasal cavity and causing symptoms, which informs appropriate treatment.
Following a reflux-friendly diet, which typically involves avoiding late meals and foods that trigger reflux, can significantly reduce acid exposure and subsequent mucus production. Elevating the head during sleep and other reflux management strategies may also help.
The body normally produces about a quart of mucus daily, which acts as a thin protective layer trapping dust, bacteria, viruses, and other particles. This mucus is typically thin and goes unnoticed as it is cleared from the nasal passages to the stomach where stomach acid neutralizes trapped particles.
