What causes a nosebleed at night?

While a nosebleed can be bothersome, especially if it happens at night, the cause is not usually dangerous. Nosebleeds are common, and most people have had at least one. The medical term for a nosebleed is epistaxis, and dry air is typically responsible for epistaxis at night. 

When there is not enough moisture in the air, it can dry out the lining of the nostrils. This leaves the lining cracked and prone to bleeding. 

Also, nosebleeds occur most frequently in children, who often pick or rub their noses while sleeping. 

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. Even minor injuries to this tissue can make these vessels bleed, sometimes a lot. 

This is called an anterior nosebleed. It is the most common type and not usually serious. 

Anterior nosebleeds start in the front of the nose, where the mucosa is most accessible, and the blood flows out of the nostrils. 

The blood usually comes from the nasal septum, which is the thin wall between the two sides of the nose. 

Posterior nosebleeds are rarer, and they tend to be more serious. They start at the back of the nasal passage, near the throat. 

In the case of 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 a condition such as high blood pressure or a bleeding disorder. 

Causes of nosebleeds at night

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

1. A dry climate or home environment

Dry air can crack the delicate skin inside the nose, causing it to bleed. 

Nosebleeds are more likely to occur as the seasons change and before the nasal tissues have acclimated to a rise or fall in humidity. 

Running a heater during colder months can dry out the air inside the home. 

2. Colds and allergies

Nosebleeds at night can be caused by colds 

The common cold can cause a nosebleed, as a result of nasal irritation. 

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

These can irritate the inside of the nose, and increase the risk of bleeding, especially if symptoms are worse at night. 

Also, nasal congestion can cause blood vessels to widen, making them more vulnerable to injury. 

3. 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. 

4. Heavy alcohol use

Drinking heavily can contribute to the risk of nocturnal nosebleeds in two ways. 

First, alcohol interferes with the activity of the blood's platelets, which are the cells that cause blood to clot. 

Second, alcohol can enlarge the superficial blood vessels in the nasal cavity, making them more prone to injury and bleeding. 

5. Medications

Some medications interfere with the blood's ability to clot. These include: 

prescription blood thinners, or anticoagulants 

nonsteroidal anti-inflammatory drugs, such as aspirin and 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, carefully follow the instructions to minimize the risk of nosebleeds and other side effects.

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