Never conk out on a Zoom meeting again.
by Emily Cieslak Sep 7, 2020
Waking up with a stuffy nose and red eyes has never been scarier. Since March, we’ve closely followed the symptoms of coronavirus, so your first reaction might be to panic. Don’t. While congestion and runny nose are possible symptoms of COVID-19, you could just be experiencing allergies—because yes, seasonal allergies are still a thing in autumn.
“Allergies, in contrast to an upper respiratory infection such as the common cold, are rarely accompanied by fever, muscle aches, or fatigue,” Howard Smith, MD, a pediatric otolaryngologist, tells Intrigue. While there’s no way to know for sure without testing, the American Academy of Allergy, Asthma, and Immunology (AAAAI) uses a chart to compare the symptoms of COVID-19 to those associated with allergies, influenza, and the common cold, to indicate which you're likely experiencing.
Even if what you’re experiencing are just allergies, symptoms can still make you pretty miserable. From sneezing to itching, it’s hard to live your life without treating them. But feeling like you’re going to conk out on a Zoom sesh after taking an antihistamine isn’t great either.
Here, experts chat the best ways to ditch your allergies along with the meds that make you sleepy.
Before you can treat your allergy symptoms, it’s important to understand what it is you’re experiencing and why. To do this, Dr. Smith relies on IPA: identify, prevent, and aid.
You want to first identify what triggers your allergies. Before your symptoms appeared, maybe you were visiting with a friend who owns a pet, or you spent the afternoon outdoors. Write it down. Next, you want to determine how you were affected. Did your eyes start to itch or your nose become runny? Jot that down, too.
According to Harvard Medical School, most seasonal allergies result from inhaling a harmless substance like pollen—in autumn, we’re talking ragweed pollen, which is highest in mid-September—and your immune system incorrectly perceiving it as dangerous. When that happens, your body releases histamines, which can trigger symptoms like sneezing and itching, to quickly remove whatever it perceives as foreign.
Just be mindful that the allergy triggers and symptoms you experience now can change over time. If you’re someone who’s never had allergies, this could mean developing them as you age. “It’s not rare for adults to get allergies all of a sudden,” says Evan Li, MD, a board-certified allergist and assistant professor of immunology, allergy, and rheumatology at Baylor College of Medicine. “No one is born with allergies. We develop them as we [gain] exposure to the allergens in our lives.’’
In order to accurately prevent and treat allergen exposures, it’s important to track any changes to your triggers and symptoms.
You want to take preventive measures by avoiding allergens when possible aka not hanging with that friend whose cat makes you sneeze like crazy, or staying indoors when pollen counts are high. And hey, we realize some situations aren’t avoidable forever. So, if you must hang with that friend in their house of fur or chill outdoors for a family BBQ (keeping social distancing in mind), we got you covered.
Local weather channels and websites like Pollen.com allow you to check the pollen count in your area before you leave the house, so you can choose to avoid the outdoors when pollen’s high, or take meds in advance to help manage symptoms before they erupt.
Once you’re back inside (especially if you’re visiting that pet-loving friend of yours), Dr. Li suggests changing out of clothing worn outdoors, keeping windows closed when possible, and turning on the AC to reduce humidity as well as the spread of dust mites and other possible allergens.
According to the Asthma and Allergy Foundation of America, wearing your face mask can also help prevent allergy symptoms by protecting fur and other allergens from entering your mouth and nose.
When allergy symptoms can’t be prevented, consider antihistamines, topical nasal corticosteroids, or systemic anti-inflammatories such as ibuprofen or aspirin, to help manage them.
Here are some ways you might treat your allergy symptoms.
Saltwater rinses help moisturize and cleanse the lining of the nose by removing excess and dry mucus and washing away allergens, per the Hudson Valley Science Center. “If you think you have been exposed [to allergens], use the saline spray [as a] rinse before they can start a reaction,” says Dr. Smith.
Studies indicate that children and adults who used saline sprays over the course of three months noticed a reduction in allergy symptoms without adverse side effects. Use the spray two to three times a day, especially after spending time outdoors, or at night before bed if congestion tends to keep you up, says Dr. Smith.
That stuffy nose still won’t budge? Try a nasal steroid spray, like over-the-counter Flonase, to further reduce inflammation. “Nasal steroid sprays are a hallmark of managing nasal allergies, which otherwise can manifest with nasal congestion, drainage, or even a sinus infection,” says Puneet Shroff, MD, a board-certified allergist and immunologist, clinical associate professor of the Department of Medicine at The University of Arizona, and a fellow of the AAAAI.
Just be sure not to immediately inhale, warns Dr. Smith. Otherwise, only the back of your upper throat will be coated. He suggests instead first cleansing your nasal passages with a saline solution, then spraying the steroid into your nostrils and waiting a few moments before inhaling.
If you’re someone who’s prone to allergic responses, allergens that are on or around your eyes can easily trigger adverse reactions, says Dr. Shroff. To minimize itchy, watery, and red eyes as well as swelling or skin inflammation like hives or eczema, he recommends splashing your face with cool water, especially after time spent outdoors.
If washing your face isn’t enough, Dr. Shroff suggests the use of over-the-counter saline eye drops for dryness or antihistamine-like eye drops such as ketotifen (frequently sold as generic or under brand names Alaway or Zaditor) up to twice a day. Prescription eye drops are also available at increasing doses and potency if you and your medical provider determine that ketotifen drops don’t offer enough relief.
Antihistamines have been used to treat allergies since 1946 when Benadryl (diphenhydramine) was first approved by the Food and Drug Administration (FDA). While effective, studies show it's best to stray from these early, first-generation antihistamines if you want to maintain alertness, as they can cause sedation, poor sleep quality, and decreased cognitive performance.
As result, second-generation antihistamines like Claritin, Allegra, and Zyrtec were developed. While proven to be just as effective and less sedative than, say, Benadryl, they still bare the potential to make you drowsy, according to Dr. Li. If you find yourself sleepy after the recommended dosage, he suggests limiting use to just a few hours before bed, so by the time you wake up, drowsiness has subsided along with your allergy symptoms.
Customize your regimen.
When it comes to combating allergies, there’s no “one size fits all” solution. A combination of methods might be needed to feel your best. If you find it challenging to relieve symptoms on your own, an allergist can help determine what’s causing your reactions and discuss additional options like allergy shots.
“The idea is a gradual exposure of airborne allergens through a series of injections that often begin weekly before being spread out to a monthly treatment schedule,” says Dr. Shroff. The therapy also typically requires a three- to five-year commitment to recognize long-term benefits, so allergists tend to recommend aids like saline sprays and over-the-counter medications before jumping to allergen immunotherapy.
Still, the best way to be proactive with allergy prevention, says Dr. Smith, is to listen to your body and patterns of allergic reaction. Both can help you identify trends and how to treat them, so you don’t have to play catch-up with treatments later.