Pregnancy increases nasal vascularity and fragility. If a patient on intranasal steroids develops recurrent epistaxis, switch to saline irrigation alone or reduce steroid frequency to every other day. Use topical moisturizers (Ayr gel) to prevent crusting.
Pregnancy is already associated with sleep fragmentation. Nasal congestion forces mouth breathing, which reduces sleep efficiency, increases arousals, and exacerbates snoring. A 2019 study in Sleep Medicine found that pregnant women with moderate-to-severe rhinitis had 2.3 times higher risk of excessive daytime sleepiness (Epworth Sleepiness Scale >10) compared to non-rhinitic controls. stuffiness and pregnancy