I’ve always wondered this. Seems like you can constantly shift it from side to side without ever clearing both!
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It could be that any mucus follows gravity and gathers on the lowest side. But afaik the nostrils take turns on regular intervals independent on the position. One is in cleaning mode while the other allows you to breathe.
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The “moving part” inside your nose is called the inferior turbinate. Inferior as in “on the bottom” rather than “not as good.” There is a congestion/decongestion cycle every 6-8 hours going from side to side. Lying down accentuates your perception of this happening.
There are other parts that can swell as well, but the inferior turbinate is the major one. In addition to a deviated septum, this effect can be quite pronounced.
This cycle occurs whether you have had surgery or not, so it must be managed over time. This is a primary reason we prescribe nasal steroids such as Flonase.
It is a nasal cycle, one of the ultradian rhythms.
With or without stuffed nose, this happens naturally. Even applying pressure under the armpits changes the dominant nostril.
For those interested in Yoga there are several books on just this subject called [Swara Yoga](https://www.sanatansociety.org/yoga_and_meditation/swara_yoga.htm)
This is actually a reflex to pressure applied to the underarm, rather than gravity moving your turbinates. Laying on your back and tilting your head will not produce as much of a shift as laying on your side, even if the total rotation of your head is the same.
Citation:
Wilde AD, Jones AS. The nasal response to axillary pressure. Clin Otolaryngol Allied Sci. 1996 Oct;21(5):442-4. doi: 10.1046/j.1365-2273.1996.00823.x. PMID: 8932950.
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