Why Do I Have Morning Allergies?

Morning allergy symptoms may be the reason for why it seems you wake up every morning with a runny nose and sneezing, congestion, and red, watery eyes. If your symptoms are worse in the morning, they may be caused by dust mites because they tend to live in people’s bedding.

Other factors like mold can cause morning allergies, though. They include pollen and pet dander, but these sources tend to stay in the air, while dust mites (and their waste) settle on surfaces. Lifestyle changes, along with treatment, can help to improve your morning allergy symptoms.

This article explains morning allergies, and their causes and symptoms. It details how healthcare providers diagnose allergies, some of the treatment options, and how you can limit exposures.

What Are the Main Causes of Morning Allergies?

Whether you have hay fever or a dust mite allergy, it is common to wake up sneezing when you have allergies. There are several reasons that can happen, including:

• Pollen counts that are higher in the morning
• Dust mites that live in and around your bed
• Pet dander that accumulates in your bedroom
• Mold in the environment

Pollen

Pollen allergy, also known as hay fever or seasonal allergic rhinitis, is one of the most common allergies. In the United States, it affects 7.7% of adults and 7.2% of children.

Plants release pollen to fertilize other plants of the same species. Pollen allergies are caused by a reaction to the pollen that plants and trees release in the spring, summer, and fall.

Common pollen allergies include:

• Grasses
• Trees
• Ragweed

Symptoms of pollen allergies are often worse in the morning. In addition, pollen may stick to your clothing, which means you carry the allergen around with you throughout the day. Also, if you sleep with your windows open, you may be exposed to pollen all night long. 

Dust Mites

As unpleasant as it sounds, allergies to dust mites aren’t actually an allergy to dust or the mite. Rather, it's the feces of the dust mite that contain the allergen (the substance that triggers an allergic reaction). Unlike pollen allergies, dust mite allergies occur year-round because they live inside your home.

Dust mites can live anywhere, but they especially like carpeting, bedding, curtains, and upholstered furniture. It’s not possible to eliminate dust mites.

Symptoms of dust mite allergies are typically worse in the morning because you are exposed to the allergen while you sleep.

Pet Dander

Allergies to pets often occur in people who have other allergies or asthma. In fact, as many as 30% of people with allergies are also allergic to cat and dog dander.

People with pet allergies react to proteins in a pet’s urine, saliva, or dander (dead skin cells). People often confuse pet hair or fur as an allergen, but it’s not. Pet hair or fur can be a carrier of allergens, though.

Symptoms of pet allergies can occur in the morning, especially if your pet sleeps in your bedroom with you. You may find relief from morning allergies if you keep your pet out of your bedroom and change your clothes before getting into bed.

Mold

Molds can be found both indoors and outdoors, which means you may have mold allergies year-round. When a source of mold is disrupted, spores are sent into the air. For the allergic person, breathing these in can set off a reaction.

Indoors, mold may be found in damp areas, like bathrooms, kitchens, and basements. Common places to find mold outdoors include:

• Logs
• Dead leaves
• Compost 
• Grasses
• Grains

What Are Other Common Causes of Morning Allergies?

Allergens like dust mites aren't the only cause of allergy symptoms. People diagnosed with nonallergenic rhinitis experience the nasal congestion and sneezing for different reasons.

Environmental Conditions

Vasomotor rhinitis happens due to an environmental exposure, like perfume, that leads to a strong physical reaction. In one study, about 10% of the population experienced allergy symptoms due to smoke, spicy foods, changes in temperature or wind, and more.

Medications

Some medications can cause what healthcare providers call drug-induced nonallergic rhinitis. These drugs that lead to side effects include:

• Commonly used nonsteroidal anti-inflammatory drugs (NSAIDs), like Advil (ibuprofen)
• Certain angiotensin-converting enzyme (ACE) inhibitors used to treat heart conditions
• Drugs used to treat mental health conditions, such as benzodiazepines and selective serotonin reuptake inhibitors (SSRIs)

Thyroid medications also can lead to symptoms. Let your healthcare provider know if you experience morning allergy symptoms that may be related to your drugs or their dosage.

Smoking Behavior

People who smoke are more likely to experience nonallergic rhinitis symptoms than those who don't, and heavier smokers (measured in pack years) more so than current smokers at lower levels. For former smokers, the likelihood of symptoms common to morning allergies is comparable to never-smokers.

Symptoms of Allergies in the Morning

Allergy symptoms in the morning are the same as allergy symptoms at any other time of the day. However, sometimes morning allergy symptoms are more severe. They may include:

• Sneezing
• Runny or stuffy nose
• Fatigue
• Itchy, watery eyes
• Puffy eyes
• Itchy ears
• Cough
• Sinus headaches and migraines

In severe cases, you may experience asthma-like symptoms. These may include difficulty breathing, wheezing, and coughing.

Diagnosis of Morning Allergies

Doctors diagnose allergies based on your symptoms and tests that confirm an allergic reaction. Morning allergies are diagnosed when your symptoms present most prominently in the morning. Diagnosis may include:

• Medical history: Your primary care doctor or an allergist (a doctor specializing in allergies and allergy-induced asthma) will take your medical history, including whether you have a family history of allergies or asthma. The doctor will also do a physical exam.
• Assessing symptoms: Your doctor will evaluate your symptoms, including what triggers them and when they most often occur.
• Allergy tests: This may include skin tests, blood tests, or both.

The length of time morning allergies last depends on what is causing them. It can offer a clue into the allergen causing symptoms. Your morning allergies should subside when the pollen counts go down if you have a seasonal pollen allergy, or if you stop taking a medication that leads to symptoms.

Skin Tests

Skin tests are considered the gold standard for determining what a person is allergic to. These tests are done in an allergist’s office. There are two types of skin tests:

• Scratch test: Drops of an allergen are scratched onto the skin, and then the location is observed for a reaction.
• Intradermal test: A small amount of an allergen is injected under the skin, and then the location is observed for a reaction.
  

Blood Tests

With a blood test, a phlebotomist draws your blood, and a lab professional evaluates it. They specifically look for immunoglobulin E (IgE) antibodies in response to allergens.

IgE is a type of antibody that is produced when someone is sensitized to an allergen. A specific IgE test can identify what you are allergic to.

How to Prevent Morning Allergy Symptoms

The good news is that there are steps you can take to limit your morning allergy symptoms. Some things to try include:

• Keep windows closed: When pollen counts are high, close windows and use air-conditioning instead.
• Take allergy medicine: When taken before exposure to pollen, antihistamines can keep your allergy symptoms at bay.
• Shower before bed: Showering will remove pollen from your skin and hair. Be sure to put on clothing that has not been exposed to allergens before getting into bed, too.
• Lower humidity: Use a dehumidifier to lower humidity. It can help reduce dust mite allergies and indoor mold allergies.
• Clean regularly: Cover your mattress and pillows with special dust mite covers and wash your bedding in hot water every week. In addition, dust hard surfaces and vacuum carpets, especially those in the bedroom.
• Don't sleep with pets: Keep your pets away from the bed (and preferably the bedroom) to limit symptoms caused by exposure to pet dander. Bathe them often. Brush them in a separate place. Air filters and cleaners can help, too.
• Protect bedding and pillowcases: There is some evidence of benefit when using mattress and pillow covers that repel dust mites, although the American Academy of Dermatology calls for more study.
• Inspect mold: Contact a certified professional to test for mold, if it may be the source of morning allergy symptoms.
• Replace carpet: Pet dander and dust mites hide in carpets. If you can’t remove all carpets in the home to use hardwood floors, start with the one in your bedroom.
  

Keep in mind that gastroesophageal reflux disease (GERD) can cause some of the symptoms that are similar to morning allergies. Elevating the head of your bed can help to prevent acid from leaving your stomach and entering the throat, but you should see a healthcare provider for a diagnosis.

When to Seek Professional Treatment

Often, morning allergies are a mild, sometimes seasonal, nuisance. Other times, they are more severe. In that case, making an appointment with your doctor is important.

If lifestyle adjustments, natural remedies, and over-the-counter (OTC) antihistamines don’t help, you may want to see your doctor for a formal diagnosis and treatment plan. Your doctor may recommend intranasal corticosteroids, some of which are available over the counter.

Immunotherapy (known as allergy shots) can also help control allergies when it is difficult to avoid triggers. Your allergy doctor will formulate these to help desensitize you to allergens. They are especially useful against the common triggers of morning allergies.

Summary

Allergy symptoms experienced in the morning may be due to pollen, dust mites, pets, or mold. An allergy specialist can help identify the source of your allergy and recommend lifestyle adjustments and medications that may help manage it.

You may be able to reduce your morning allergy symptoms by cleaning your bedroom and bedding often, using dust mite covers for pillows and bedding, showering before bed, removing carpet from your bedroom, and keeping your windows closed at night.