Complications

Nosebleeds are completely harmless in most cases. However, especially with heavy nosebleeds that occur during sleep, it can happen that the blood does not flow optimally through the nostrils, but instead enters the trachea or esophagus from the nasopharynx. If large quantities of blood seep through the oesophagus into the stomach, vomiting usually occurs promptly.

Further consequences do not have to be expected in these cases. Nosebleed, which occurs during sleep and during which blood drains via the windpipe, can, however, provoke the development of inflammatory processes in the lung area. For this reason, it should be observed after a nosebleed whether the person affected develops cough, fever and/or other symptoms indicating pneumonia.With normal nosebleeds during sleep, the blood loss is usually so small that it can be easily compensated by the organism.

Strong, insatiable nosebleeds caused by an arterial injury, on the other hand, can lead to high blood loss and therefore require urgent medical attention. Nosebleeds that occur during sleep are also caused in about 80% of cases by injuries to the smallest vessels in the area of the front sections of the nasal septum (so-called locus kiesselbachi). The reason for this is that this area is particularly well supplied with blood and the supplying vessels are located very far from the surface of the mucous membrane.

Nosebleeds, which occur during sleep and whose cause is found in the locus Kiesselbachi, are usually not dangerous and do not require special treatment. In rare cases, however, nosebleeds during sleep are caused by injuries to arterial vessels in the area of the posterior nasal sections. Arterial nosebleeds during sleep usually cause light red blood to emerge from the nose.

In contrast to venous nosebleeds, blood flows out of the nose in large quantities. The loss of blood can even be dangerous in these cases. In addition, arterial nosebleeds during sleep carry the risk of blood from the nasopharynx entering the lungs via the windpipe. As a result, breathing difficulties, inflammation of the lungs or even respiratory arrest can occur.