Morning sneezing fits is where a person may awake after sleep and break out into a sneezing fit almost immediately or shortly after awaking. It may be accompanied by other signs and symptoms including a runny nose, itchy watery eyes and nasal congestion. Most cases of morning sneezing fits are due to immune related conditions or environmental factors. The sneeze reflex is suppressed during sleep, so many of the same causes of chronic sneezing may be responsible for morning sneezing fits.
Causes of Morning Sneezing Fits
- Allergic rhinitis is the most common cause, particularly perennial rhinitis. It is an immune mediated hypersensitivity often triggered by house dust mite, fungal spores and animal hair. During sleep, the nasal passages may be exposed to the trigger factor for prolonged periods of time but since the sneeze reflex is suppressed while asleep, the symptoms ensue upon waking. In seasonal rhinitis, the symptoms are more pronounced during certain seasons like spring when the pollen count is high.
- Non-allergic rhinitis with eosinophilia syndrome (NARES) is another immune mediated condition but not due to allergies. It may also present with a morning sneeze as a result of fluctuations associated with immune activity during sleep.
- Environmental conditions – exposure to dry air, particularly air conditioning, during sleep may severely dry the nasal passages and trigger a bout of morning sneezing when awake.
- Drug-induced rhinitis may be responsible for morning sneezing fits, if the causative agent is taken prior to sleep. In patients using antihistamines and corticosteroids to suppress rhinitis and sneezing, the symptoms tend to aggravate upon waking, depending on when the last scheduled dose of the day.
- Sinusitis may sometimes result in morning sneezing as the change in position may promote emptying of the mucus. This can cause irritation of the nasal lining.