Does steam help a stuffy nose at night?

Steam can make a stuffy nose feel looser and more comfortable for a little while, which is why so many people reach for it at bedtime. The research is thin, though, and it doesn't show that steam clears congestion or shortens a cold. The bigger concern is safety: burns units in several countries treat adults and children scalded by bowls of hot water every year. If you like steam, a hot shower is the safer way to get it.

Does steam actually help a stuffy nose?

Steam for a stuffy nose has weak evidence behind it. Breathing warm, moist air feels soothing to a lot of people, and that comfort is real. But when researchers have tested heated, humidified air in controlled trials, they haven't found a clear, reliable benefit for congestion or for colds overall.

The best summary is a 2017 Cochrane review. It pooled six trials with 387 people who had colds and breathed heated water vapor through a device. Whether it relieved symptoms came out uncertain: one way of analyzing the data suggested a benefit, and another didn't. The reviewers graded the evidence as low quality.

The results on the nose itself were mixed. One trial in the United States found nasal resistance got worse after heated air, while an earlier trial in Israel found it improved. The review also found no significant difference in viral shedding, so the old idea that steam kills the cold virus didn't hold up. Some trials reported minor side effects, such as discomfort or irritation of the nose.

Sinus symptoms tell a similar story. A large 2016 trial in UK general practices randomly assigned adults with chronic or recurrent sinus symptoms to usual care, daily saline rinses, daily steam inhalation or both. Of the 871 people who returned questionnaires at the start, those advised to use steam had less headache, but steam had no significant effect on their other symptoms. Saline rinsing did a bit better and gave modest relief.

None of this means steam is useless. It means it's a comfort measure, not a treatment, and it's worth weighing that small comfort against the risk of a burn.

Why do steam bowls cause so many burns?

Steam bowl burns happen mostly because the hot water tips over, not because of the steam. People sit with a bowl or pan of just-boiled water on their lap or a low table, lean over it with a towel on their head, and a small movement spills it. Burns doctors describe these injuries as common and often serious.

A UK burns centre in London looked back at two years of records and found 19 people admitted with scalds from steam inhalation. They ranged from 2 weeks to 91 years old. Sixteen of the 19 were burned on the lower body, which fits the picture of hot water landing in the lap. Six needed surgery, and a national database found 201 cases across the UK over the same two years.

Children are at the highest risk. A burns centre in Wales treated 16 children for steam inhalation scalds over about five years, with an average age of 7.4, and the most common reason for the steam was a cold. The same study surveyed local family doctors and found 17 of 21 recommended steam inhalation. The authors concluded the practice should no longer be recommended for children, who have less control over their movements and less awareness of danger.

The most recent numbers are from France. A pediatric burns unit in Paris admitted 33 children with steam inhalation burns over five years, with a median age of 6. Most were burned on the thighs or groin area, about half spent time in intensive care, and about half needed surgery. The average hospital stay was 18 days. The authors also noted a rise in cases linked to media coverage of steam as a home remedy.

Steam vaporizers, the electric units that boil water, carry a risk too. An Australian burns clinic treated 10 children for vaporizer burns in 10 months. Their average age was 1.6 years, 8 of the 10 had hand burns, and half needed an operation. Toddlers reach for things, and a vaporizer at floor or bedside level is easy to grab.

How can you use steam more safely?

The safest way to use steam is a hot shower or a steamy bathroom, with no open container of hot water. The NHS suggests breathing in steam to ease a blocked nose by sitting in the bathroom with a hot shower running. It also says not to let children breathe in steam from a bowl of hot water because of the risk of scalding.

The burn studies point to where the danger lies. In the London series, most people were burned on the lower body, and in the Paris series most children were burned on the thighs or groin. That pattern fits hot water spilling into the lap, so the simplest way to lower the risk is to take the open container out of the picture:

• Use the shower, or run it hot with the bathroom door closed and sit in the room for a few minutes.
• Never hold a bowl or pan of hot water on your lap.
• Keep hot water and vaporizers well away from where children can reach them.
• Stop if your nose feels sore or irritated, which some people in the steam trials reported.

For children, follow the NHS advice and skip the bowl. The Welsh and French burns teams both called for steam inhalation to stop being recommended for children, and the Australian vaporizer cases show that toddlers can be burned by hot steam units too.

Is a humidifier a better option than steam?

A humidifier is a gentler, longer-lasting way to add moisture to bedroom air, and some types don't use hot water at all. Cleveland Clinic describes several kinds. Steam vaporizers heat water before releasing vapor, while impeller and ultrasonic humidifiers make a cool mist. Its guidance is to keep indoor humidity below 50% and to keep the unit clean.

Humidifiers don't open a nose blocked by swelling, and there's little direct research on whether they improve sleep. But for dry, irritated nasal passages, especially in winter, moist air can make nights more comfortable. Our guide to using a humidifier for sleep covers setup and cleaning.

What else helps a stuffy nose at night?

Several other options have as much or more support than steam. The same 2016 trial that found steam advice unhelpful found that saline rinsing gave modest relief for sinus symptoms. A saline rinse washes mucus and irritants out of the nose, and it's one of the better-studied home options. Our guide on how to use a saline rinse walks through the steps.

Nasal strips are another drug-free option that works in a different way. They don't add moisture. They lift the sides of the nose to widen the passage just inside the nostrils. In a study of 89 people with nasal blockage, a strip widened the front 3 cm of the nose and gave a gain in nasal airflow comparable to a decongestant spray, along with a similar drop in how blocked people felt. The strip had no effect deeper inside the nose, so it eases breathing more than it clears congestion. How nasal strips work explains the mechanics.

Many people combine a few of these. A warm shower, a saline rinse, a strip and an extra pillow under the head make a reasonable bedtime routine on a congested night. There's a fuller list in how to unblock your nose before bed.

Should you use mouth tape while you're congested?

Mouth tape should wait until your nose is clear. It's meant for people who can breathe comfortably through the nose with their mouth closed, and a cold or sinus flare-up changes that. Cleveland Clinic's sleep specialist says never to use mouth tape with nasal congestion, nasal obstruction or a sinus infection.

Once your nose clears, you can pick up where you left off. We don't recommend mouth tape for children. Our guide to mouth tape with a cold covers when to stop and when to restart.

When should a stuffy nose get checked?

A stuffy nose from a cold usually doesn't need a doctor. The NHS says you can usually treat a cold at home and should begin to feel better in about 1 to 2 weeks. It advises seeing a GP if symptoms get worse or don't improve after 10 days, if you have a high temperature for more than 3 days, or if you feel short of breath or have chest pain.

The NHS also suggests seeing a GP if you're worried about a child's cold symptoms, or if you have a long-term condition or a weakened immune system. Any burn from hot water or steam on a young child should be seen by a medical professional, given how often the children in the burns studies needed hospital care.

If you're blocked most nights with no cold at all, steam won't fix whatever is behind it. Our article on why your nose is stuffy at night goes through the usual causes.

Our pick (paid partner): TitanAir Nasal Strips

If you want a drug-free option to use alongside a steamy shower and a saline rinse, our pick is TitanAir Nasal Strips. Titan says they are drug-free external nasal dilators with flexible, spring-loaded bands, so there's no hot water involved and nothing to spill.

Titan says to put the strip just above the flare of the nostrils, on the soft part of the nose rather than the bony bridge, on clean, dry skin with no moisturizer. That matters after a shower, so dry your nose well first. For removal, Titan says to loosen the strip with warm water and peel slowly from the ends inward. Titan says the strips are third-party tested and certified PFAS-free, and they come with a 30-night guarantee.

Read next

• How to sleep with a stuffy nose
• Do nasal strips help a stuffy nose from a cold?

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.