Many people see nasal obstruction as “just” a stuffy nose or chronic congestion, but for some, it can be a powerful trigger that worsens migraines and even contributes to symptoms of Postural Orthostatic Tachycardia Syndrome (POTS). Understanding this connection can help patients and providers uncover root causes of persistent headaches, dizziness, and fatigue—and find treatments that actually address the underlying problem.

What is Nasal Obstruction?

Nasal obstruction means something is blocking normal airflow through the nasal passages. This can be from swollen turbinates, a deviated septum, nasal valve collapse, chronic sinus inflammation, nasal polyps, or enlarged adenoids. Many people live with nasal obstruction for years, thinking it’s just “allergies” or “sinus issues” when in fact, the impaired airflow affects the entire body.

The Link Between Nasal Obstruction and Migraine

Migraines aren’t just “bad headaches.” They are a complex brain and vascular condition involving abnormal sensory processing and changes in blood vessel tone. When your nose is blocked, you’re forced to mouth-breathe or struggle to pull enough air through narrowed nasal passages.

 This constant effort can:

• Lower oxygen intake at night, worsening sleep quality.
• Increase carbon dioxide retention, which may sensitize the brain’s trigeminal nerve system—a key player in migraine pathways.
• Trigger or aggravate facial muscle tension, TMJ dysfunction, and sinus pressure, all of which can feed into migraine pain.

 Many migraine sufferers notice worsening headaches when they’re congested—especially during allergy season, colds, or when lying down at night.

 The Link Between Nasal Obstruction and POTS

POTS is a form of dysautonomia where the body struggles to control heart rate and blood pressure when standing up. Research and clinical experience show that poor nasal airflow can indirectly contribute to POTS-like symptoms¹:

 Chronic mouth-breathing can lead to poor sleep and fragmented rest, which stresses the autonomic nervous system.

Untreated nasal obstruction can worsen sleep apnea and low oxygen levels at night, both of which place strain on heart rate and blood pressure regulation.

For some patients, improving nasal airflow dramatically helps regulate their autonomic system and reduces POTS flares.

How Do You Know If Nasal Obstruction is Contributing?

Ask yourself:

• Do you always feel stuffy on one or both sides?
• Do you snore or wake up with dry mouth?
• Do you feel more lightheaded or headache-prone when lying down?
• Have you had multiple sinus infections, but treatment never fully resolves your symptoms?

 If the answer is yes, you may benefit from seeing an ENT (ear, nose, and throat) specialist or airway-focused provider.

What Can You Do?

Treatments for nasal obstruction depend on the cause but may include:

- Nasal steroid sprays or allergy management

- Nasal valve repair or septoplasty for structural blockage

- Turbinate reduction to open swollen tissues

- Myofunctional therapy to retrain nasal breathing

- Nighttime humidification or nasal saline rinses

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For patients with migraine or POTS, addressing nasal obstruction can be a game-changer—removing one more daily stressor that keeps the brain and body in “fight-or-flight” mode.

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Key Takeaway

If you suffer from migraines, dizziness, or POTS, don’t overlook your nose. Nasal obstruction is far more than a nuisance—it can be a hidden driver of poor sleep, autonomic stress, and facial pain.

A clear airway helps create a calm nervous system, a healthier brain, and better quality of life. If you’re struggling, talk to your ENT, headache specialist, or autonomic specialist about a simple airway evaluation—it might be the missing piece.

Need Help?

At Exhale Sinus, TMJ, Headache, and Sleep, we specialize in uncovering the link between nasal obstruction, migraine, and POTS. If you’d like to learn more, book a consultation with our team today.

Reference:

1.   Reilly CC, Floyd SV, Lee K, Warwick G, James S, Gall N, Rafferty GF. Breathlessness and dysfunctional breathing in patients with postural orthostatic tachycardia syndrome (POTS): The impact of a physiotherapy intervention. Auton Neurosci. 2020 Jan;223:102601. doi:10.1016/j.autneu.2019.102601. Epub 2019 Nov 12. PMID: 31743851.

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