Tuesday, 7 June 2011

I'm allergic to the morning

Summer is on its way, and for 1 in 3 of us this will mean hayfever too. I haven’t suffered from hayfever for a few years, although I do sneeze quite a lot throughout the year, and this is mainly when I wake up in the morning. It appears I’m not alone.

Two medical school students monitored the sneezing patterns of one of their classmates. The majority of their sneezes occurred at around 8.20am, and this shifted by 1 hour when daylight savings came on. After recording 118 sneezing episodes over the course of half a year, they admitted to their colleague what they had been up to and asked permission to publish their results [1].

A larger study of around 800 hayfever suffers has also showed that symptoms are most severe in the early morning. Around 60% suffered from sneezing, stuffy nose, blocked nose and runny nose when they woke up, and there was a clear daily rhythm of these symptoms [2].

Most hayfever sufferers show a daily peak in symptoms upon waking up (Adapted from Reinberg et al, 1988)

Hayfever symptoms are part of the immune system responding to an allergen, in most cases pollen. Histamine is one of the key chemicals produced by your body to communicate this response around the body. When the immune system is activated it produces a lot of histamine. Histamine interacts with the H1 receptor in the nose, causing inflammation to remove the allergen.

Antihistamine medication can relieve the symptoms of hayfever by reducing inflammation in the nose. However, the same H1 receptor that histamine interacts with is found in the posterior hypothalamus in the brain, where histamine plays another role in maintaining alertness. Early antihistamine medication often caused drowsiness by also interacting here.

It is often recommended to take antihistamines at night to counteract drowsiness during the day. If you are taking a once-a-day antihistamine tablet it is also advised to take it in the evening so the dose is being most effective in the morning when you wake up and it’s most needed [3].

It would be great to hear from any other morning sneezers.

[1]        A. C Grant and E. P Roter, “Circadian sneezing.,” Neurology, vol. 44, 1994, pp. 369-375.
[2]        A. Reinberg, P. Gervais, F. Levi, M. Smolensky, L. Del Cerro, and C. Ugolini, “Circadian and circannual rhythms of allergic rhinitis: an epidemiologic study involving chronobiologic methods.,” The Journal of allergy and clinical immunology, vol. 81, Jan. 1988, pp. 51-62.
[3]        M. Smolensky and L. Lamberg, The Body Clock Guide to Better Health, Holt Paperback, 2000, p260-5 


  1. Helen, I am the same, I find it's when I wake up in the morning that my hayfever is at its worst! thanks for helping me understand why :-) x

  2. Hi Emmy, It's always good to hear that you aren't the only one, my family always teased me for being allergic to the morning (in a loving way).

    The morning surge in inflammation coincides with the sudden rapid expression of cortisol, which has been low throughout the night. http://sleepless-days.blogspot.com/2011/05/nocturnal-asthma.html

    So it seems the same with hayfever, colds, flu, asthma etc. symptoms are worse in the morning.


  3. Hi Helen,
    My girlfriend Liz always wakes up with a blocked or runny nose. I have have to chisel her face off the pillow some mornings!
    I don't know much about this research but I was thinking, couldn't the symptoms be exacerbated by the fact that your in a horizontal position for 8 or so hours (if your lucky!)and so gravity may have an added effect on the lovely gunk that gathers in your nose? What if we slept standing up?


  4. Hey Lloyd,
    I'm sure Liz really appreciates your concern.

    As you know there is a difference between a daily and a circadian rhythm, and I'm not yet aware of any literature examining a blocked nose under constant routine.

    There is a circadian rhythm in cortisol and adrenaline. Overnight a lowering of these hormones makes the airways prone to inflammation.

    I imagine you are correct and that lying in a supine position would also cause the airways to have a lot of pressure and therefore for mucus to build up.

    I think the standing up experiment would be very conclusive - it would be a great experiment to do, I'm sure someone must have thought of it to try!