Sneezing is natural and everyone does it at some point or another, but the sound, mess, and experience aren’t always the most convenient thing in certain settings. In an effort to be polite, avoid the spread of germs, or avoid drawing attention to ourselves, many of us have been tempted to hold in a sneeze from time to time.

While this simple act might seem harmless, there may be more risk than you think. Many people find themselves wondering “is it bad to hold in a sneeze?”

Here’s seven reasons why you shouldn’t.

Why Do We Sneeze?

Sneezing is a natural reflex that is out of our control. Many different medical conditions can cause sneezing as a symptom, but at the core, we sneeze in an effort to clear things out of our nose and nasal passages that should not be there, such as foreign bodies, irritants, pollutants, allergens, bacteria, viruses, excess mucus, and more.

The body may also trigger a sneeze as a tool to help prevent germs and other harmful substances from entering the body.

When we try to hold in a sneeze, whether to be polite or to avoid spreading germs, serious medical consequences can occur as a result of the buildup of pressure that occurs in the respiratory system.

Is It Bad To Hold in a Sneeze?

We all sneeze from time to time so most people are familiar with the amount of force behind a sneeze. Your body puts tons of power into your sneezes because it uses sneezes as a protective mechanism to get rid of particles and substances that don’t belong in your body, such as viruses, allergens, bacteria, pollutants, irritants, and excess mucus.

The body expels mucus from your nose at a rate of approximately 100 miles per hour when you sneeze. Many people start to recognize the feeling that they need to sneeze because they sense the pressure building up in your respiratory system.

As your body prepares to sneeze, pressure builds in the lungs, throat, sinuses, and nasal cavity before the sneeze is released.

Studies show that sneezing creates approximately 33 times more pressure when measured in terms of pounds per square inch (psi) compared to the pressure exerted when you are breathing hard during exercise. You sneeze with a pressure level of about 1 psi, compared to exhaling at about 0.03 psi. That’s important because it demonstrates the power that is encapsulated in a sneeze, but what does it mean when you hold in a sneeze?

Holding in a sneeze increases the amount of pressure inside your respiratory system even more — about 5 to 24 times more — than the act of sneezing itself. This increasing pressure has the potential to cause serious injuries to the body, including some that are difficult to recover from fully.

While it might seem polite to hold in a sneeze, it can actually be harmful.

Middle Ear Infection

The body uses the sneezing reflex to clear irritants, viruses, excess mucus, allergens, and bacteria from your nose. Therefore, it stands to reason that holding in a sneeze means those foreign bodies will remain inside your nose, potentially causing future problems.

Bacteria that is not expelled from the body during a sneeze may end up making its way from the nasal passages into the middle ear, potentially resulting in a middle ear infection. Additionally, infected mucus that backs up into the ears can also contribute to an infection.

Middle ear infections can be very painful, and while some may resolve on their own, others will require a trip to the doctor.

Damaged Blood Vessels

As noted above, sneezes are incredibly powerful and cause significant amounts of pressure to build up in the body, especially the head. When this pressure gets too high due to holding in a sneeze, you can damage or even burst blood vessels in your eyes, nose, or eardrums.

In addition to being potentially painful at the time the injury occurs, damaged blood vessels often can cause a superficial change in your appearance, such as a bright red blood vessel appearing in the white of the eye or on the nose.

The blood vessels will eventually heal and the discoloration will fade in most people over time.

Ruptured Eardrum

The building pressure that occurs when you try to hold in a sneeze can’t be released from your nose, but it has to go somewhere. One of the places this extra air tends to travel is into the ears via a tube called the eustachian tube that connects the nasal passages to the middle ear and eardrum.

When too much pressure builds up inside the eustachian tube due to trying to hold in a sneeze, one or both eardrums can rupture.

Ruptured eardrums are not only painful, but they can also lead to hearing loss. Some ruptured eardrums heal on their own over the course of several weeks without additional treatment, but eardrums that are severely damaged may require surgery.

Brain Aneurysm

A brain aneurysm is a weak spot in the arterial wall of the brain that bulges out and fills with blood, and an estimated one out of every 50 people in the United States has an unruptured brain aneurysm. However, one of the scariest potential consequences of holding in a sneeze is rupturing a brain aneurysm.

While unruptured brain aneurysms are not considered dangerous, a ruptured brain aneurysm can cause brain damage, a stroke, or even death. The pressure caused by holding in a sneeze can cause a brain aneurysm to rupture, causing bleeding in the brain that could be life threatening.

Diaphragm Injury

It’s also possible to injure your diaphragm, the muscular part of your chest just above the top of your abdomen, while holding in a sneeze. Diaphragm injuries occur when pressurized air backs up from the airways into the diaphragm, which can result in a collapsed lung or collapsed lungs. A collapsed lung is a potential life-threatening injury that requires immediate emergency medical care.

While diaphragm injury due to holding in a sneeze is rare, it has happened. Many people can also experience pain in their chest around their diaphragm when holding in a sneeze.

Throat Damage

The intense buildup of pressure that occurs when holding in a sneeze has, in rare cases, been known to cause a throat rupture or other throat damage. A ruptured throat causes swelling and inflammation and may prevent a person from being able to speak or swallow. The condition also results in a significant amount of pain.

Although throat damage from holding in a sneeze is rare, it is a serious injury that requires immediate medical attention and must be treated right away.

Broken Ribs

The pressure of holding in a sneeze can even cause fractures in people who have particularly low bone density, such as older adults, post-menopausal women, or people with certain medical conditions.

The most common fracture known to result from holding in a sneeze is broken ribs, which occur when the pressurized air builds up in your lungs with excessive force, causing the ribcage to expand out too far.

Can You Die From Holding in a Sneeze?

While holding in a sneeze has not been listed as an official cause of death on any death records, the consequences of holding in a sneeze actually can be deadly.

Some of the consequences of holding in a sneeze, as listed above, can be very serious and even fatal, such as ruptured brain aneurysms, collapsed lungs, or a ruptured throat.

Ruptured brain aneurysms are known to be particularly deadly, causing death in about 50 percent of cases. Of those that survive a ruptured brain aneurysm, approximately two-thirds experience a permanent neurological deficit (brain damage).

Contrary to popular belief, neither sneezing nor holding in a sneeze causes your heart to stop, and holding in a sneeze does not cause a heart attack.

However, sneezing or holding in a sneeze may temporarily change your heart rate.

Summary

While it might seem like holding in a sneeze is the polite thing to do, particularly in the wake of the COVID-19 pandemic, the reality is that holding in a sneeze can be downright dangerous and, in rare cases, even fatal.

Consequences that may occur as a result of holding in a sneeze include a middle ear infection, damaged blood vessels, a ruptured eardrum, brain aneurysm, diaphragm injury, throat damage or rupture, or broken ribs.