“I’m afraid I might bleed to death in my sleep!” my patient said when he called my emergency phone line. The caller, Ken, was having another nosebleed — his third in a month — and he was worried.

Nosebleeds, medically known as epistaxis, are rarely serious. The most common causes are dry mucous membranes of the nose and trauma, either internal (such as picking the nose) or external (such as a blow to the face). Less often, allergies, sinusitis, upper respiratory tract infections (such as a cold or the flu), excessive alcohol consumption, or overuse of nasal sprays or blood-thinning medications, including aspirin or warfarin (Coumadin), can lead to epistaxis. In rare cases, frequent nosebleeds can be a sign of leukemia or a nasal tumor. See your doctor if a nosebleed goes on for more than 20 minutes… or if it occurs more than once in a seven-day period. If a nosebleed occurs with a head injury, fall or serious accident, go to a hospital emergency department.

Even though you may have heard that you should lean your head back when you have a nosebleed, it’s really better to lean your head slightly forward while sitting up and gently pinch the bridge (the area where most nosebleeds originate) of your nose or your nostrils. Leaning your head forward is preferable because it allows the blood to drain out your nose rather than down your throat. If this approach doesn’t reliably stop your nosebleeds, keep this remedy on hand…

Phosphorus 30C. This homeopathic remedy has long been used to help stop many types of acute bleeding episodes. It is not a preventive — in fact, taking it too often can actually increase nosebleed frequency, so use it only when you have a nosebleed. Typical dose: Place two pellets under the tongue. You can take another two pellets after six hours if the nosebleed returns. Do not exceed this dose.

If you get frequent nosebleeds, you most likely need to improve the health of your nasal membranes. Effective natural remedies to try…

Quercetin. This bioflavonoid reduces the frequency of nosebleeds by strengthening blood vessels in the nose and reducing allergic inflammation. Typical dose: 300 mg three times daily for three months. This should restore the health of your nasal tissue. Check with your doctor if you take a blood-thinning drug.

Humidity and hydration. Dry air and inadequate fluid intake are common causes of nosebleeds. What to do: If the humidity in the rooms in which you spend the most time is less than 55%, use a humidifier to bring that number up to 60% to 65%. Also, be sure to drink water regularly. I often suggest one-half ounce of water per pound of body weight per day. Alcohol also tends to have a dehydrating effect — if you get frequent nosebleeds, reduce your alcohol intake or abstain.

As for my patient Ken, hydration and a single dose of phosphorus did the trick for him the night of his call. He also followed my suggestions for improving nasal membrane health and has been nosebleed-free for the past year.