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Comment by polishdude20 | Hacker News Reader

I've been to an allergist a few times and I've got seasonal allergies for pollen as well as dust mites and such. I usually sleep with my mouth open because my nose is always blocked at night which causes me to wake up in the middle of the night with a dry mouth to get water. What did you get immunotherapy for? Which allergies did it help with and how did you convince your doctor you needed it?

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I started having this too a decade ago for no good reason. As soon as I’m lying down my nose clogs and I can’t breathe well. I’d wake up groggy, with heavy legs. It also happened randomly during the day, my nose would just start clogging. Or with alcool intake. There is no mucus clogging, it’s just the sinus les tightening and it feels like breathing through pinholes. And when I bend down, I almost always sneeze from my sinuses swelling but again no mucus.

What I’m doing is that before sleeping I’m using a spray that is 1 part mometasone to 1 part xylometazoline. 1 spray in each nostril before sleep, angled towards the opposite eye (otherwise you get nosebleeds) and now I sleep very well.

This mixture doesn’t exist ready made, I had to buy it from pharmacies that could mix medicine (it cost 100$ for a small bottle in Canada… insurance was paying but yeah). In Europe, they let you buy the two ingredients OTC or with a prescription and they’re ver cheap (like 5 eur a bottle). I then open one of the sprays and mix it 1:1.

It has the potential for tolerance so I’m very careful to use it only at night or exceptionally during the day if it’s really bad. Sometimes I can get away with 3/4 of a spray instead of a full spray in each nostril.

Of course check with a doc, but not many seem to know about this recipe. I had to see many many before one came up with it.

It could be non-allergic rhinitis like in my case. USC head of sleep surgery recommended I try the “Afrin test” which is trying Afrin for a night or two (avoid more to prevent rebound effect). Lying down can engorge nasal passages. Try elevating head via pillows or bed elevation. Use humidifier and take large dose vitamin D. Mouth tape and sleep on your side

I've been using Afrin on and off and recently went off of it because of the rebound effect. What does the test indicate though? Afrin will clear your nose regardless of allergies or not. I don't see how this test would tell me anything.

Assuming you’re cleared for allergies, it can show that it’s positional. I wouldn't use Afrin on a regular basis, or even more than two days. Try corticosteroid like flonase instead

Also hepa air purifier, vacuuming/avoding carpets, and replacing and continuously running HVAC filter/fan has helped.

What does the Afrin test indicate?

I have persistent rhinitis since I was a kid. Only two things I've tried so far help:

Afrin, which of course you can't use often due to rebound congestion but it's nice to get the occasional break.

Secondly, holding my nose shut then blowing hard against it, as if to pop your ears. For some reason this clears my airways for about 20-30 seconds which is enough to at least blow my nose.

Steroids, surgery (tonsils + adenoids) and sinus irrigation have not fixed it, but antihistamines do help a little.

Besides my nasal passages, inflammation is also noted in my eyes and gums by opticians and dentists respectively.

Speaking about inflammation in the gums, I feel like I get that too. Like sometimes the gums around my teeth taste kinda metallic or "raw" is the best way to describe it. I also get super itchy all over my body if I don't take an allergy pill at least once a week or so.

That sounds like mild food or pet allergies.

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