Q: Allergy patients often say constant coughing and postnasal drip keeps them awake. What can they do to get a good night’s sleep?

Bradley Chipps, MD: In general, there are three ways to manage allergies: 1) avoid the allergen; 2) medication; and 3) allergen immunotherapy, or allergy shots (for specific patients).

  • Avoidance

When in the bedroom, it’s very important that allergy patients avoid or minimize exposure to house dust mites or pet dander. Studies show good environmental control of allergens can make a big difference.

Cover your mattress and pillows with dust mite-proof encasings and keep your dog or cat out of the bedroom at all times. Also, keep the bedroom windows closed to keep pollen outside.

Sleeping with the head in an upright position can also be very helpful to minimize coughing and postnasal drip at nighttime.

  • Medications

Nasal antihistamines, decongestants and corticosteroids can help decrease the cold symptoms such as coughing as well as reduce postnasal drip. Most are available over-the-counter and are available as generics.A prescription medication that can be used is Montelukast, which is now available as a generic. It can reduce inflammation in the nasal passages and can be used in conjunction with the nasal medications. Talk with your doctor about the potential for side effects.

Saline rinses are also sometimes helpful in clearing out and cleansing the nasal passages.

  • Allergen immunotherapy

Immunotherapy helps build the patient’s tolerance to allergens, reducing or eliminating symptoms. The patient is given a gradually increasing amount of the allergen – either by injection or tablet – on a regular schedule, until a maintenance level is reached.

Allergen immunotherapy can be used for pollen, mold, pet dander, cockroach allergens and house dust mites. This allows for the best control we currently have for a very significant problem.


Bradley Chipps, MD, is President of the American College of Allergy, Asthma and Immunology (ACAAI). He is a board-certified allergist and immunologist and pediatric pulmonologist with Capital Allergy and Respiratory Disease Center in Sacramento, California.


Have a medical question? Email editor@allergyasthmanetwork.org or write to Ask the Allergist, Allergy & Asthma Network, 8229 Boone Blvd., Suite 260, Vienna, VA 22182.


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