Everything I Thought I Knew About Nasal Congestion Is Wrong | Hacker News Reader

Everything I Thought I Knew About Nasal Congestion Is Wrong

theatlantic.com

74 pointsyarapavan21 comments

I’ve had a life long struggle with nose breathing. It manifests itself with very dry mouth at night, waking me up frequently.

At one point I went to a prolific ENT surgeon who wanted to align my septum and remove turbinoid tissue (I’m guessing to fund a recent yacht purchase). Most painful surgery I can imagine and did nothing at all except permanent numbness on the bridge of my nose.

I then discovered the breathe right nasal strips (and cheaper clones) which made a massive difference. In allergy season it wasn’t enough though, and nasal steroid spray does the job (fluticasone propionate or similar). I find decongestant tablets (pseudoephedrine) not very useful unless I’m suffering from a proper cold.

I’ve been wanting to stop using the nasal strips after many years because I noticed it was making my nose puffier looking (slowly stretching the skin out).

In the last year I started reading about mouth taping and tried that. It’s actually really great and way cheaper than the nasal strips. A small roll of medical tape lasts 6 months and I just tape my mouth close each night. I was finally able to give up the nasal strips, but still use the steroidal spray if I need it (but cognisant it can cause cataracts so not something I want to use every day forever).

Anyways that’s my story in summary. Not a single doctor helped me and one even injured me. And in the end a small roll of medical tape is all it took.

I was the opposite. Tried nasal strips, sprays, tape on mouth etc. nothing helped my nasal valve collapse. After the septoplasty, turbinate reduction, and sound waves to reform the nasal passage (forget the technical name of the procedure) haven’t really had any issues.

This is a huge problem in medical care where treatment isn’t personalized and there’s not even quantitative measurements for determining procedures so it’s a total crapshoot of trial and error.

Interesting - glad it worked out for you! I agree though - many doctors just jump to a solution without fully understanding the root issues first.

Your comment is basically a summary for this book:

https://en.m.wikipedia.org/wiki/Breath:_The_New_Science_of_a...

I also did the septum surgery, and it worked for a short while and went back to the same within months. The breathe right strips are a godsend.

https://archive.ph/CqyEX

When we are talking about noses, here is my personal anecdote.

Several years ago, I went down with a hardcore cold that just didn't want to end. For weeks and weeks. A lot of heavy, dry cough. (That was well before covid.)

After several weeks of such misery, I went to a specialist who tried to cultivate something from my sputum. Nope, normal flora. "That must be of viral origin," he said, "and the only thing I can recommend you is nasal irrigation with a plastic Rhino Horn. It worked well for many patients. Use this particular mineral water (Czech) and do it twice a day."

I already knew what nasal irrigation was and I was determined to avoid it for my entire life, but that illness brought me down to the "what do I have to lose?" condition. So I bought the horn and started flushing.

Yeah, it was awful at first, but my symptoms were gone 36 hours later. I started doing it regularly. My frequency of colds dropped significantly and so did their duration if they happen at all. I can sing better (some three semitones gained at the top of my range), I can breathe a lot better. And after the initial phase, where old nasty stuff was getting rinsed out of my sinuses, it is not even unpleasant anymore.

Can only recommend. My youth could have been a lot more healthy. I suffered from colds fairly often.

Thanks for the tip! Everyone's physiology is different so one has to try many different things to see what works for them. I'll add this to my list of suggestions.

I don't follow why would the type of mineral water matter for irrigation? Also I thought that you were meant to use saline, no?

The mineral water that I was recommended is: (you will have to translate the page)

https://cs.wikipedia.org/wiki/Vincentka

It is known to have soothing/therapeutic properties on airways etc. It has been used in inhalations and other cures since at least the 17th century.

Anecdotally, I tried a regular saline solution as well (would be cheaper) and Vincentka definitely feels better.

My big takeaway:

> phenylephrine is very effective if you spray it into the nose

I have bad allergies and, what with global warming, pollen season here is most of the year. Pseudoephedrine does the job but it's expensive and a hassle to get, especially since the chronic understaffing common at pharmacies today means it's often a long wait in line. I'm definitely going to at least give phenylephrine spray a try.

I always keep some of this around. Like most of those things, you'll get a bit of "rebound" congestion (ie: the tissue swells once you get used to the spray and stop using it) but I find if I only use it for sleep and only a few times a month when it's worst, I don't run into any issues.

I had some kind of horrific infection in nose/sinus a few months ago. Decongestant, saline, and Fisherman's Friend together worked so well it really did feel like I had a second nose.

I have DNS in one nostril (I guess, you don’t get in both anyway, do you?) and otherwise as well I am very allergic to dust etc. Somedays it’d be tiny amounts that’d be like thick traces of stubborn glue stuck to the nostril wall and I’ll keep blowing, inhaling steam, even spraying with saline (non steroidal) nasal spray jet and what not but finally I get tired and try to just get distracted.

It’s hell! I wish there was a simpler cure or non-addictive spray or just a pill that will make it go away.

Lifelong nose struggler here... one unexpected benefit for me with a CPAP was the constant filtered air. Really helps with dust and allergens. Plus, one of my masks has filters that also add moisture, so my nose, mouth, etc aren't drying out.

Like one of the other posters, years ago I talked to a doctor about fixing my septum and turbinoids, but he offered that there was absolutely no guarantees of any kind that it would make any difference.

I also quite liked the linked article about why decongestant medicines don't seem to do anything!

https://archive.ph/0eT0e

One that I found to be remarkably effective is Oxymetazoline. The effect is so spontaneous you can literally feel your nose opening up within seconds. Unfortunately it's not suitable for long term use and tends to make the problem worse when you stop using it.

But it's good for when you are sick and are willing to trade having a clear nose right now for some annoyance later while you are well.

There also Xylometazoline, which is just a bit less effective but also seems to be a bit less habit forming.

When I have a cold, I use it at night to sleep (and occasional other important times). In the morning I do a sinus rinse with xylitol. It rinses out the medication and the xylitol usually does just enough to make the congestion not absolutely terrible. I can do this for the duration of a cold - which for me, is often 3 weeks - and not have any dependence on the nasal spray.

Only semi-related, but Intake Breathing strips have been life-changing for me, even if expensive I find it worth it and just hope their success would lead to competition and price decrease.

Which strips do you use? The ones that go on the nose or the strips that go inside?

There are strips that go inside?

Intake is a specific brand, its a reusable magnetic plastic band and little adhesive strips you put on either side of you nose with the little piece of metal that the magnetic strip attaches to. Seems to be less harsh on the skin than the breathe-rite strips and also much stronger of an effect of pulling the nostrils open. Intake goes on the outside.

Reply on news.ycombinator.com