Synonyms
Epistaxis in sleep
Introduction
Nosebleeds are a widespread phenomenon that usually occurs suddenly and completely unexpectedly. Especially in children and young adults, strong nosebleeds can occur even when they are physically resting, for example while sleeping. The causes for the occurrence of nosebleeds during sleep are largely unknown.
In most cases, however, it is a stressful but nevertheless harmless phenomenon. In general, it can be assumed that there are simply people who tend to get nosebleeds quickly and frequently. In these people, the smallest vessels within the nasal mucosa seem to react more sensitively to stimuli.
In addition, bleeding can occur in the area of the paranasal sinus mucosa. Even a slight increase in pressure in the area of the nose, for example when sneezing or blowing the nose, can lead to nosebleeds in the affected persons. Other people, on the other hand, do not develop bleeding in the area of the nose, even under heavy physical strain or even after violent impacts.
Although nosebleeds, even if they occur during sleep, are completely harmless in most cases, a specialist (ear, nose and throat specialist) should be consulted promptly. Changes requiring treatment, such as anatomical malformations of the nasal septum (nasal septum), high blood pressure (hypertension) or disorders of blood coagulation should be urgently ruled out if there is frequent nosebleed. In addition, patients must observe the color of the blood flowing out of the nose.
A nosebleed is usually a so-called venous bleeding. In these cases, the source of bleeding lies in the area of a small vein of the nasal or paranasal sinus mucosa. The bleeding then appears rather dark red.
In an arterial lesion, on the other hand, the bleeding appears light red. In addition, the flow characteristics of the nosebleed can provide information as to whether the bleeding is venous or arterial. If the venous vessels are impaired, the blood slowly seeps from the nose.
Arterial lesions, on the other hand, are characterized by a rapid, splashing flow of blood. While venous nosebleeds are usually harmless even in sleep, arterial bleeding must always be clarified by a specialist. There can be a variety of causes for the development of nosebleeds during sleep.
In general, a distinction is made between so-called local and global causes. While various diseases of the internal organs that lead to nosebleeds during sleep require urgent medical treatment, most local causes are usually completely harmless. Particularly in the cold seasons, severe nosebleeds can occur more frequently during the day or during sleep.
Infections of the upper respiratory tract often lead to swelling of the nasal mucosa. These swellings cause the mucous membranes to become increasingly irritated. Nosebleeds during sleep can be the result.
It has also been observed that allergy sufferers also suffer more frequently from nosebleeds during sleep. In these cases, too, the causes of the bleeding lie in the area of the swollen nasal mucous membranes. Decongestant nasal sprays, which are frequently used for the symptomatic treatment of flu-like infections, can also damage the nasal mucous membranes and thus lead to nosebleeds during sleep.
One of the most common causes of nosebleeds during sleep is a pronounced malformation of the nasal septum (nasal septum). Protruding bone edges in particular can injure the sensitive nasal mucosa and cause bleeding. In addition, small holes in the area of the nasal septum (so-called septum perforation) can provoke nosebleeds during sleep.
Such perforations can be observed especially in people who suffer from chronic mucous membrane damage or are exposed to certain chemicals. The use of drugs such as cocaine can also cause nosebleeds during sleep due to damage to the nasal mucosa. Nasal polyps or ulcers of the nasal mucosa are also considered to be frequent causes of pronounced nosebleeds during sleep.
Besides these local causes, internal diseases can also lead to nosebleeds. In this context, disorders of blood coagulation and high blood pressure play a decisive role. Furthermore, nosebleeds during sleep can be a possible side effect of various drugs.
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