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- A sudden, uncontrollable expulsion of air via the mouth and nose is known as a sneeze.
- Sneezing can be mildly discomforting and may have an impact on routine life.
- In rare cases, sneezing may be symptomatic of a serious ailment.
- Self-care and avoiding the triggers can help in managing the condition.
- Medical treatment after diagnosing the underlying cause may be required in some cases.
- The speed of a sneeze can be up to 100 miles per hour.
- Exposure to sunlight may trigger sneezing in some people.
What Is Sneezing?
An uncontrollable burst of air that comes out forcefully and suddenly via the nose and mouth is termed as a sneeze. Medically known as sternutation, it is part of the body’s natural defense.
Sneezing helps eject foreign particles in the nose, such as pollen, dust, and other minute irritants, out of the body. This mechanism protects the lungs and other organs from being affected by such particles.
Although sneezing is a common problem that may cause irritation if it recurs frequently, it is rarely indicative of a serious condition. It can be accompanied by a runny nose, red eyes, stuffy nose, nasal irritation, fatigue, and lack of concentration.
How Do You Sneeze?
The entry of a foreign particle in your nose irritates the nasal lining and produces a tickling sensation in the nerve endings. This interaction generates an electric signal that informs the brain that the nose needs to be cleared.
As a response, the brain sends signals to various body parts to prepare for a sneeze.
First, you take a deep breath, which expands the lungs and tightens the chest muscles. As the pressure inside the lungs increases, your eyes close, and your tongue moves to the roof of the mouth. Finally, the air held inside the lungs is released suddenly with force.
All of these happen in just a few seconds.
Causes of Sneezing
Sneezing is usually caused by the entry of particles that irritate the mucous membrane in the nose or throat. It may be discomforting but is rarely indicative of a severe problem.
Various factors that can cause sneezing include:
- Nasal sprays
- Common cold or flu
- Allergic rhinitis caused by exposure to allergens, such as:
- Pollen (hay fever)
- Drug withdrawal
- Sudden temperature change
- Certain medications
- Exposure to triggers, including:
- Air pollution
- Dry air
- Spicy foods or spices such as pepper
- Strong emotions
- Exposure of the eye to sudden bright light (known as photic sneeze syndrome) (1)
- Unusual triggers that cause psychogenic sneezing, including:
- Full stomach
- Sexual ideation
- Orgasm (2)
Always cover your mouth while sneezing to maintain hygienic conditions and prevent the spread of germs.
Is Diagnosis Needed?
The severity and duration of the symptoms help diagnose the cause behind sneezing. These findings are aided by physical examination and patient history, which are major determiners for the diagnosis.
Laboratory tests are generally not required. However, for some cases, direct examination of the nasal cavities may be performed through:
- Nasal Endoscopy: This procedure is performed using an endoscope, which is a flexible tube with a light and a camera. It is used to inspect the septum and lateral nasal wall for any deformity.
- Anterior Rhinoscopy: This test helps in examining the nasal cavities for swelling in the turbinate, nasal secretions, properties of the mucosal surface, septum position, and ulcerations. It is performed only after inspection without instruments.
Further evaluation through a sinus radiograph (x-ray) or computed tomography (CT) may also be helpful.
If allergies are suspected, allergy skin testing or blood testing may be done. If infectious causes are suspected, a nasal or throat culture may be ordered by the physician.
Medical Treatment for Sneezing
Sneezing can generally be managed by avoiding allergens or triggers. However, medical intervention may be needed when the symptoms do not subside with preventive measures.
Sneezing can be managed in several ways:
- Sneezing, and other symptoms triggered by allergies can be treated with allergy medications, including:
- Leukotriene modifiers
- Topical and systemic steroids
- Allergy shots can help in preventing future allergic reactions.
- Systemic antibiotics can be used for patients with secondary bacterial infection (developed during or after a viral infection).
- Agent-specific antibiotics are used for patients with rhinitis secondary to specific bacteria.
- For fulminant fungal infections, diagnosis followed by immediate treatment is vital. (3)
- The treatment for sneezing caused by viral infections such as the common cold or flu has limited options as antibiotics remain ineffective in these cases. However, the use of antipyretics and decongestants may provide mild symptomatic relief.
The following measures may be helpful in the management and prevention of sneezing:
- Avoid exposure to triggers and allergens:
- Stay away from animal dander and relocate pets if needed.
- Lower the pollen content indoors by using air filters and keeping windows closed on high-pollen days.
- Replace furnace filters regularly to prevent dust in the air.
- Kill dust mites by washing linens with hot water (54 °C or 130 °F).
- Use dust-mite-proof pillow and mattress covers.
- Avoid strong fragrances.
- Clean your surroundings to keep them free of mites and insects.
- Take measures to control any mold spore problem and change houses if necessary.
- Check your showerhead for mold growth, as it can trigger a sneezing bout after bathing.
- Avoid the use of other triggers such as metal and latex if they are known to be an issue.
- Use over-the-counter (OTC) medications such as antihistamines and decongestants to help alleviate the problem.
- Treat the root cause. In the case of viral infections such as the flu or common cold, it may be helpful to:
- Use saline nasal rinses or sprays to get relief from a runny or congested nose.
- Take antiviral medications.
- Use nasal sprays that contain a corticosteroid and/or antihistamine to reduce inflammation and prevent sneezing.
- Drink ample fluids.
- Take proper rest.
Some General Queries
What is snatiation?
Snatiation, coined by fusing the terms “sneeze” and “satiation,” refers to a medical condition characterized by the occurrence of a sneeze or sneezing fits after having a large meal. Also known as a stomach sneeze reflex, it is triggered when the stomach is full and stretched.
The reason behind this reflex is unknown, but it may have a genetic component.
Why don’t people sneeze while sleeping?
While sleeping, the nerves are at rest due to a process known as rapid-eye-movement (REM) atonia. As a result, no nerve reflex is initiated even in the presence of irritants in the nose and no sneezing impulse is generated.
Does the heart stop when you sneeze?
The heart does not stop when a person sneezes. However, increased pressure in the chest may affect your blood flow and temporarily change the rhythm of your heartbeat.
Why do people sneeze while plucking eyebrows or nasal hair?
While plucking the eyebrows or nasal hair, the nerve endings in the face get stimulated and send signals to the brain, leading to a sneezing reflex.
Can one sneeze with their eyes open?
The brain sends signals to different body parts, including the eye muscles, to prepare for a sneeze. This generates an involuntary reflex and forces the eyes to shut. Therefore, sneezing with your eyes open is a difficult task.
However, making a concerted effort to open your eyes or holding your eyelids open with your hands may enable you to sneeze with open eyes.
The jaw can be affected by any problem in the head, nose, or throat. During a cold or sinus infection, you may experience pain in the temporomandibular joint (TMJ), which connects the jawbone to the skull. This pain may worsen when your mouth is forced open due to sneezing or coughing.
Can sneezing cause back pain?
Turning your head away from people while sneezing is a commonly expected courtesy.
However, twisting your neck while sneezing can affect the spinal joints. This happens because the contraction of the diaphragm while preparing for a sneeze is accompanied by the tightening of the muscles supporting your neck and spine.
The sudden violent expulsion of air can stress or strain the contracted muscles, resulting in pain.
Additionally, sneezing causes pressure buildup in the abdomen, which leads to increased pressure in the spinal canal. If you have a pinched nerve or a spinal injury such as a herniated disc, sneezing can worsen the pain.
Is sneezing common during pregnancy?
Rhinitis is commonly prevalent in pregnant women (also known as pregnancy rhinitis). It can occur anytime during the gestation period and subsides after delivery.
The common symptoms of pregnancy rhinitis include sneezing, nasal congestion, and runny nose. It can affect fetal development as well as the quality of life of pregnant women. (4)
Is it normal to sneeze every morning?
Having sneezing fits every morning may be a result of allergic rhinitis. It is important to identify and avoid the allergens to manage the condition.
Can holding back a sneeze lead to hearing loss?
Though extremely rare, holding in a sneeze can result in hearing damage.
If a sneeze is stopped midway, the pressurized air in the lungs may get forced back into the ear through the Eustachian tube. This can cause damage in the middle and inner ear or even rupture the eardrum.
Injury to the membranes of the middle and inner ear may result in conductive hearing loss, severe sensorineural hearing loss, and vertigo.
Complications Associated with Holding Back a Sneeze
Holding back a sneeze can lead to various complications, including:
- Diaphragm injury
- Burst blood vessel in the white part of the eye
- Ruptured eardrum
- Temporarily elevated blood pressure due to rupturing of a weak blood vessel in the brain
Rarely, a held-back sneeze may also lead to:
- A brief incontinence
- A neck injury due to the sudden extension of the neck
Certain unusual medical conditions can also lead to an injury when holding back a sneeze.
When to See a Doctor
Generally, sneezing resolves on its own or by using self-care measures. However, if your condition persists for more than a few days and is affecting your lifestyle, you should seek medical attention.
What you may ask your doctor:
- What may be the reason behind my continuous sneezing?
- What treatment should I follow?
- Should I get any tests done?
- How can I identify possible allergens?
- Do I need to undergo surgery if the condition persists?
What your doctor may ask you:
- Since when have you been sneezing?
- Have you identified any triggers?
- Did you have the flu or a cold recently?
- Does your sneeze occur singularly or as fits?
- Do you use any medicines that may cause sneezing?
- Have you had any changes to your environment or diet?
- What treatments have you tried for the sneezing and how effective were they?
Sneezing is a reflex action that occurs in all humans and is also common among animals. It plays a major role in preventing the body from foreign particles.
While it may be irritating, sneezing is rarely symptomatic of severe disease. Acquiring proper information about this involuntary phenomenon can help in diagnosing other related ailments.
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