Nasal sprays are one of the options which people have for using sinus medications, although they certainly aren’t the only options. To deal with the symptoms of congestion and facial pressure or headaches, there are several things which can be done, including home remedies as well as prescription medications. In this article, some of the options for dealing with sinus problems will be described, with special emphasis on nasal sprays as one of the most common treatment options.
Possible Options for Sinus Treatment
Treatments for sinus problems fall into three general categories, those being home remedies and over-the-counter medications, daily prescription sinus medications, and medications for sinus infections. The first group of treatment options starts with drinking more water, which is something that every sinus sufferer can do right at home.
If you can drink between eight and 12 glasses of water every day, it will help to thin out the material which needs to drain, and will improve your sinus function. For people using antihistamines or nasal sprays, this can be especially important, because those treatments will have the effect of drying out your throat and your nose, making hydration more important.
A second over-the-counter option is to use sinus rinses, usually comprised of distilled water and salt, and which you can easily prepare yourself. These are available in all drugstores as sinus rinse kits, and all you have to do is follow the instructions on the label in order to prepare your sinus rinse. The instructions will generally call for you to prepare your sinus rinse over a sink two times a day, those being in the morning after you wake up, and at night before you go to bed.
One thing that’s important to remember about using sinus rinses, is that they have to be used before you use any kind of antihistamine spray or nasal steroid, because otherwise these would be washed away, and would lose their positive effects.
One last thing you can do in the way of over-the-counter treatment is to purchase from your drugstore an antihistamine, of which there are several very effective name brands on the market, including Zyrtec, Mucinex, and Claritin-D.
The next category of sinus treatments are daily prescription sinus medications. Among the nasal steroid sprays, some of the most effective are Flonase, Omnaris, Veramyst, and Nasonex. Your doctor might also prescribe an antihistamine nasal spray such as Patanase or Astepro to deal with your sinuses. Another prescription treatment would be a combination antihistamine spray and steroid, such as Singulair or Dymista.
The last grouping of sinus treatments are those which are intended to deal with sinus infections. These include antibiotics, oral steroids such as prednisone, brand-name medications such as Sudafed or Afrin, and sinus rinses.
The Difference Between Over-the-Counter Sprays and Prescription Nasal Sprays
Some nasal steroids are available both as over-the-counter medications and as prescribed medications from your doctor. These are recommended to be used only for conditions which tend to be chronic in nature, for instance seasonal rhinitis or chronic sinusitis.
These kinds of sprays can help remediate many of the symptoms associated with those two conditions, including the runny nose, the itchy nose, the persistent sneezing and the congestion which is frequently experienced by a sufferer. In addition to sinus infections, these nasal sprays can also handle seasonal allergies and the symptoms of a common cold, although it usually requires up to two weeks of daily use before the maximum benefits of these sprays are realized.
Some over-the-counter nasal sprays take affect much more quickly, but these are only intended to be taken on a short-term basis. Such decongestants will ease any discomfort, and effectively reduce swelling in the nasal passageways, but should not be used for any more than about three days consecutively.
The medication in these nasal sprays actually causes tiny blood vessels, situated in the mucous membranes, to temporarily constrict, and that causes a temporary shrinkage in the nasal lining. This will immediately result in much better breathing and a general feeling of relief for the sinus sufferer.
The downside of this is that after a few days, the medication will wear off and those same blood vessels will then become severely congested, and that will require the use of more nasal spray, and on a much more frequent basis.
Can Nasal Sprays Become Addictive?
Given the description above, wherein the continued use of nasal sprays may lead to more frequent usage just to maintain the same level of free breathing, it’s natural to wonder whether such nasal sprays can become addictive.
According to the formal definition of addiction, that condition only occurs when a person is “enslaved to a habit or practice, or to something that is psychologically or physically habit-forming, as narcotics, to such an extent that its cessation causes severe trauma”.
Since over-the-counter nasal sprays contain no habit-forming ingredients whatsoever, and they do not trigger any of the cravings which are associated with addiction, they are not considered to be addictive drugs.
That being said, it is at least possible to develop an increased tolerance to nasal sprays over time, which means the nasal membranes become less responsive to the treatment. When that happens, you may find yourself using the nasal spray more frequently, in order to experience relief from congestion. While this is not a dangerous condition medically, it will probably become at least inconvenient, and it will of course become more costly for the patient.
Most people are aware that sinus infections and sinus inflammations occur frequently during the springtime and the summer when pollen counts are on the rampage, and seasonal allergies are in full force. However, many people who persistently suffer from allergies can tell you that symptoms don’t always go away when the first freeze of the season hits, and pollen count theoretically takes a nosedive.
It can still happen that even during wintertime, sinus symptoms such as congestion, postnasal drip, coughing, runny noses, sinus pressure, and troublesome headaches occur with practically the same regularity as they might during spring or summer.
There are a number of reasons why this can happen, even in the absence of one of the biggest contributors to allergy symptoms, which is pollen from various plants. Here are some of the reasons why allergy sufferers may be just as miserable during the wintertime.
Mold and Various Kinds of Fragrance
Although they are seemingly innocent sources, holiday decorations such as plants, wreaths, and even Christmas trees and ornaments can trigger allergies, and all the associated symptoms, because of the dust which settles on them, and the mold which may be growing on them.
When decorations are stored for an entire year in the basement or somewhere else, it’s very easy for dust to accumulate on them, or for mold to begin growing on them. To prevent this, decorations should be stored in airtight containers, so that when they’re reopened at holiday time, you aren’t introducing fresh allergens into the household.
When you bring a Christmas tree into the household, make sure that it has been thoroughly shaken down, so it doesn’t have dried leaves or other material in the branches because these might contain mold.
Also, since windows and doors are generally tightly shut during the wintertime, it can intensify the fragrances from decorations and specially scented candles, which can act as irritants for your sinuses. It’s probably best to avoid using scented candles like this during the wintertime when doors and windows keep all those irritants inside.
Cold and Influenza
Extra mucus is generally produced when you have a cold or influenza, and it can also cause swelling inside the nasal passages. All this contributes to unusually difficult drainage, which promotes the buildup of mucus. When that happens, bacteria development is sure to follow, and a sinus infection may not be far behind.
The best way to avoid getting colds or flu is to conscientiously observe good hygiene throughout the entire wintertime, especially as it relates to washing your hands. You should also make a point of getting plenty of rest to help out your immune system, and when it’s available, you should always get a flu shot to protect yourself against the particular strain which is most prevalent this year.
Excessively dry Air
There is always considerably less humidity in the air during wintertime, than there is during summer, and as a result, the air in homes and in offices also becomes much drier. When the breathable air inside a building is that dry, it will have the effect of irritating nasal linings and the lining of the throat, which in turn will also trigger irritation in the sinuses.
To avoid the predominately dry air of wintertime, remember to use a humidifier to increase the moisture level in breathing air throughout the home. A good rule of thumb is to set your humidifier for about 50% humidity, so that dryness doesn’t bother your sinuses and trigger symptoms which are going to make you miserable through the holidays.
Pet Dander, Allergens, and Dust
It happens quite frequently that pet dander, dust, and other allergens become trapped indoors during the winter time, due to the fact that doors and windows are routinely kept tightly shut to keep the cold out. While it can be a bit of an undertaking to ensure that all these allergens are removed or suppressed, it will be worth it, in terms of your ability to enjoy the holiday season.
In the case of pet dander, you should make a point of bathing your cat or dog at least weekly, because allergens will naturally be attracted to fur, and they’ll stay there until removed. If you allow your pet to go outdoors regularly, you may want to perform the bathing routine even more frequently, because every time your pet goes outside, it will be a magnet for whatever’s floating through the air.
To eliminate, or at least reduce allergens elsewhere in the home, you can take such steps as vacuuming the carpets thoroughly, especially using a vacuum with a HEPA filter, that can pick up even the smallest allergens. You should also vacuum furniture and draperies to remove allergens which may have built up on those surfaces.
It’s a good idea to dust all around the home every few days, but when you do this, it should be with a damp cloth that retains the allergens, rather than using a feather duster which will simply relocate any allergies present.
Lastly, by changing your own clothes whenever you’ve come inside from the outdoors, you can be relatively sure you aren’t tracking in a number of allergens, which will be lying in wait to torment you during the wintertime.
People who aren’t usually affected by sinus problems such as inflammation and infections probably think that the worst time for sinus flareups is either the spring or summer, when seasonal allergies kick in as a response to increased pollen in the air, as well as other triggers. However, almost anyone who is subject to seasonal allergies and sinus issues can tell you the real truth of the matter: many of the worst symptoms associated with sinus infections actually occur during the winter.
That means that the whole catalog of sinus issues, i.e. congestion, facial pressure, post-nasal drip, headaches, stuffy nose, runny nose, and headaches, are all as likely as not to be more severe during the cold season. Below you will find some of the reasons why that is true, and why there’s really no respite from the effects of sinus infection, despite what the calendar might say.
Less Humidity in the Air
During the cold winter months, there is usually far less moisture in the air, and far less in the home or office setting as well. Part of the reason for this is that furnaces or other heating systems are running so frequently that they dry the air out. When the air becomes that dry, it has a tendency to irritate the lining of your throat and of your nose, which in turn will exacerbate any issues with your sinuses. The best way to manage this situation is to install a humidifier in your home or in your area at the office, that will supply moisture to the air, and cause much less irritation to your nose and throat.
Increased Presence of Mold
Surprisingly, there are a number of triggers which can worsen your allergies or sinus symptoms during the winter time, especially around holiday season. At that time, most people will actually bring into the household some of the very items that can lead to a worsening of sinus symptoms. For instance, the fragrances given off by scented candles, which are very common during the holidays, can actually cause significant irritation to your sinuses.
The same is true of many holiday decorations such as wreaths, plants, Christmas trees, poinsettias, and a whole host of other decorative but potentially irritating sinus triggers. All these have the potential to develop mold growth, which can cause noticeable problems for your allergies and sinus condition.
It’s also very possible that tree decorations and ornaments which you have stored in the basement for the past 11 months can develop mold, while just sitting in a damp area out of sight. The best prevention for eliminating mold on holiday decorations is to store them in plastic containers which are airtight, and will not allow moisture inside. Before you bring a Christmas tree into the household, you should shake it down vigorously so unwanted debris will fall off. The best way to avoid the irritation that comes from scented candles and similar materials is to stop using them entirely if you notice that they are beginning to irritate your nose and throat. You should also keep in mind that any of the symptoms you might potentially experience from mold growth or fragrances burning in the household, will be made worse by having all the windows and doors closed.
Increased Likelihood of Colds and or Influenza
It’s much more common for people to contract influenza or common colds during the wintertime than it is during the summer or spring. Because this is so, it often causes the lining of your nose to swell up, and an increased amount of mucus is produced by the nose as well. All of this contributes to reduced efficiency of drainage, and it also causes an accumulation of mucus. If mucus is allowed to build up at any specific site in the body, it will invariably trigger the development of bacteria, and once that happens, you can expect a sinus infection to follow shortly thereafter, with all the nasty associated symptoms.
The best way to protect yourself against contracting influenza is to make sure that you are vaccinated with the seasonal strain of flu vaccine. Good hygiene is a must during winter times for preventing colds, because that’s one of the most common ways for bacteria to be spread among people. That means it’s very important for everyone in the household to wash their hands frequently, and to make sure noses are covered up when sneezing, such as into the elbow. When everyone in the household practices good hygiene, the chances for contracting colds and/or the flu diminish significantly.
It is especially easy during the winter months for pet dander, allergens, dust, and debris to become trapped inside the household, where they can all become triggers for sinus symptoms. There are a number of ways that you can address this, in order to minimize the impact of all those miscellaneous trapped substances.
Rugs, for instance, are known to be very effective traps for all these kinds of materials, and that means they should be frequently vacuumed and/or shaken outside so that as much debris as possible can be removed from the household. Old furniture is another major trap for debris, so these pieces should also be scoured to whatever extent is practical, to remove debris. Air filters are obvious traps for dust and debris, and they should either be cleaned regularly or replaced entirely, so that clean air is always circulating in the interior. If you have pets, they should be groomed regularly, so that they can be kept free of all kinds of harmful material that could be become a trigger for your wintertime sinus symptoms.
When it comes to the sinuses, the most common issue seems to be excess mucus. When the sinuses aren’t acting as they should and sinusitis (a sinus infection) is experienced, it generally leads to mucus overproduction and this can be a difficult issue to live with. However, as many will tell you, dry sinuses are an equally difficult problem.
During the colder months especially, we tend to look towards artificial sources of heat to stay warm. With a pellet stove, for example, we’ve found a solution that keeps costs to a minimum while also not getting too hot for any children or pets in the house. However, one of the biggest benefits of this system is also one of its greatest downfalls.
Back in the day, people would keep a pot of water on the stove to keep moisture in the air. Today, we’re doing the opposite because the stoves are sucking all the moisture from the room for every second they’re working away. For many, this lack of humidity dries the sinuses and causes all sorts of problems as a result.
Is This a Problem?
First and foremost, having dry sinuses is unpleasant so it quickly becomes uncomfortable. The longer the problem goes untreated, the bigger it becomes. Additionally, the sinuses need moisture because bacteria, fungi, and viruses are normally kept at bay by a protective layer of mucus. If this mucus has disappeared, the protection does the same and the sinuses are left vulnerable.
As you may know, this all leads to many problems, one of the biggest being a lack of smell. At first, people tend to attribute the loss of smell to something else because they can’t imagine that a stove (or any other source of artificial heat without the ability to keep moisture in the air) would cause the damage. Soon enough, a medical professional will assess their sinuses and find the problem.
Over the years, people have developed their own solutions for this issue and we have three of the most popular here today. If one doesn’t work for you, try another because the theory behind them is very positive!
- Anti-Fungal Tea: If you’re suffering from a dry nose or dry sinuses, your liquid intake should be increased anyway so long as the liquid is water or any other responsible drink. If you can get your hands on it, there’s also anti-fungal tea and this just might prove to be a fantastic addition to your diet.Known as calendula tea, it comes from the orange calendula flower and offers all sorts of advantageous properties. For example, it acts as an anti-inflammatory, anti-fungal, and antiseptic solution. Alone, the tea should start to improve your sinuses but it becomes even more valuable when partnered with some herbs of your choosing.Since all the ingredients are natural, you can have this tea two or three times in a single day and you should notice a change to your breathing as the day goes on. If this doesn’t work, play around with the herbs you’re using or move on to another suggestion.
- Steam Inhalation and Room Humidifiers: As we addressed earlier, they had a simple solution back in the day and it came from a pot of water. Therefore, why not take from their lead and do the same thing? Nowadays, the market holds some fantastic room humidifiers (and even whole home humidifiers!) to add moisture to the air.If you feel comfortable, you could even try steam inhalation in combination with a neti pot. Before we get ahead of ourselves, steam inhalation is where you hold your face as close to hot water as possible. With a towel over your head to increase the intensity, the idea is to inhale the steam without getting so close you harm yourself. To improve the results, add some essential oils whether this comes from tea tree oil, eucalyptus, lemon, or peppermint. As a starting point, this steam should make the walls of the sinuses a little softer (and looser).From here, you can finish with a neti pot and this is a small container used to rinse any debris you may have from the nasal cavity. With a simple saltwater solution, you leave your sinuses in a great position to become healthy once again.
- Anti-Bacterial Tincture: If you want to fight infection and improve your sinuses, we recommend echinacea and boneset as a two-herb tincture. With a little of the tincture added to water, this should allow you to fight active infection. If you’ve never made a tincture previously, there are plenty of guides online that’ll show you how to get it right.
Regardless of which solution you try first, we urge you to keep going even if you don’t see any results the first time. Over the many years of people suffering with this issue, all three of these solutions have fantastic support in the community so they’re worth your persistence. Typically, you’ll notice a change within a few days and you don’t have to contend with the loss of smell any longer!
Quite often, the term ‘sinuses’ is used in relation to certain medical conditions. However, there aren’t too many people who know the role of the sinuses or how they’re made up. Today, our goal is to answer both of these questions so you’re aware the next time the term is used in conversation!
Commonly shortened to ‘the sinuses’, the paranasal sinuses are small cavities filled with air inside the bones of the face; the bones of note are also found in the eyes and nasal cavity. With each sinus, it has a name that represents the bone in which it can be found.
- Frontal: With one per side, the frontal sinuses can be located in the forehead right above the nasal bridge and eyes.
- Maxillary: Found on each side, the maxillary sinus is inside the bone in the cheek.
- Ethmoid: With the ethmoid sinuses, they sit just under the corner of each eye where the bone lies. In many medical diagrams, they’ll show the ethmoid sinus as one sinus but it’s actually made up of several smaller sinuses in a honeycomb shape; it can only be seen properly in CT scan images of the face.
- Sphenoid: Again, the sphenoid sinus is located on both sides but this time behind the ethmoid sinuses. When looking head-on, they won’t be visible so a side view is required instead.
Physiology of the Sinuses
For each sinus, pink membrane will line the outside and it’s responsible for producing mucus to flush the sinus cavities. With a plate of bone and cartilage commonly known as the nasal septum, the two nasal passages are separated. However, the biology of each passage is the same starting with three small ridges of tissue which can be called a concha or turbinate. Depending on whether it’s referring to the upper, middle, or lower structure, they’re designated as superior, middle, or inferior.
When it comes to the draining, the majority of sinuses use the middle turbinate and the drainage occurs below this point. From here, it goes into the osteomeatal complex. For the system to work correctly, air needs to flow uninterrupted through both sides of the nasal passage since this allows for streaming between the nasal septum and turbinates (via the crevices).
For both the mucus and the airflow that started the process, they should end up in the nasopharynx which is a connecting part of the throat towards the back of the nose. As air continues its journey through the windpipes and into the lungs, the mucus takes a different journey and is swallowed instead.
Structures within the Nasal and Sinus Tract
As you probably know, the human body is quite simply amazing and evolution has allowed it to survive on a day-to-day basis using complex scientific principles. Therefore, it probably won’t surprise you to hear that there are some fascinating structures inside the nasal and sinus tract. Below, we have three very important examples:
- Adenoids: As a collection of tissue much like the tonsils, the adenoids are found behind the farthest nasal cavity accessible at the very top of the nasopharynx. While most body parts and important features of the body grow as we get older, this tissue actually starts larger and then disappears during puberty. However, discrepancies in this process can leave it in tact which has the potential to require surgery.
- Tear Duct: Often called the nasolacrimal duct, this is important for our eyes since, without it, tears would continue to build on the inside corners. When it’s in place and functioning as expected, the tears drain into the nasal cavity and this prevents excess moisture within the eyes.
- Eustachian Tube: As our last example, the eustachian tube is required for removing any build-ups that occur within the ears; with the system all interconnected, the opening is found towards the back of the nasopharynx sidewall.
The Role of the Sinuses
Ultimately, the sinuses have many responsibilities within the ear, nose, throat, and beyond but their main role is to produce mucus. When the system is working as it should, the mucus creates a lining on the inside of the nose and this keeps it free from bacteria, fungi, and viruses. If you were to experience dry sinuses, the lack of mucus would leave the nose vulnerable to these pollutants and this leads to irritation and illness.
Over time, cilia, which are tiny hair cells, gradually move the mucus backwards towards the throat where it’s swallowed. Therefore, the steady supply of mucus always takes the same journey while protecting your nose and remaining clean at all times.
After this main function, we should also note that the sinuses are also important for our voices and to lighten the skull. With everything having a purpose, we’re able to enjoy life without consciously worrying about replacing the mucus or producing the right amounts at the right times. As we learn more about the sinuses and how they work, we get an insight into just how fascinating the human body can be!
A new study proves that your taste buds may predict post-surgery results for sinusitis surgery patients, according to a Penn study.
Taste buds pickup what is called biomarkers, that is, the existence of a certain biological state or condition, such as bitter or salt. The researchers from Penn Medicine and the Monell Chemical Senses Center reported their findings in International Forum of Allergy & Rhinology.
It might sound strange but the team discovered that a genetic biomarker—the receptor for bitter taste—could better predict post-surgery results for patients who underwent surgery for chronic sinusitis. Remember that this seasonal-related condition afflicts around 37 million Americans each year. The condition reduces daily productivity in lost worktime, and is associated with a lower quality of life. In the US, sinus infections cost more than $13 billion in lost productivity each year.
The study found people sensitive to a certain bitter compound reported breathing more easily through their nose, having fewer subsequent infections, and sleeping with ease six months after surgery than those less sensitive to the bitter compound.
Bitter taste receptors are proteins that are found in taste cells of the tongue, where they protect against the ingestion of toxic plant and bacterial products. The collaborative Penn Medicine/Monell team had earlier identified these cells lining the passages of the nose and sinuses and contributing to the natural defenses against certain bacteria.
For the study, patients were asked to taste a specific bitter chemical and report their sensations. Those more sensitive to the bitter chemical than those who were not proved to better fight off certain types of respiratory infections. This specific genetic difference correlates to how much one group is able to combat infection following surgery. Thus, the study suggests those more sensitive to certain bitter tastes fight off upper respiratory infections better, and if they do get sick enough to require surgery, they improve more than people with less sensitive systems.
The researchers warn that there is still much research to do because of the diverse functions of taste receptors, but for now, once an easy test kit is produced, ENT specialists will be better able inform and chose a treatment for their patients.
This is welcome news for otolaryngologists who can correlate surgical outcomes to bitter taste tests in order to forecast postoperative complications and results, and thus choose the best sinusitis surgery options.
Other Penn authors are Douglas Farquhar; James N. Palmer, MD; David W. Kennedy, MD; Laurel Doghramji, RN; Shane A. Morris; David Owens; and Robert J. Lee, PhD.
Other authors are Corrine Mansfield, Anna Lysenko; Beverly J. Cowart PhD; and Danielle R. Reed, PhD, all from the Monell Chemical Senses Center in Philadelphia.
A new study offers some surprising answers to offering chronic sinusitis treatment. According to the study, those with this condition may find great relief in quality of life with nasal sprays and other nonsurgical treatments. For those with chronic sinusitis, this is great news because surgery may not be the best way to treat this infection. The general rule is: the less invasive treatment is the best response to most conditions.
Chronic sinusitis treatments can include nasal sprays and antihistamines may be as effective as surgery in helping some patients achieve a better quality of life, the small study found.
The study was funded by the U.S. National Institutes of Health and published online Oct. 29 in the journal JAMA Otolaryngology-Head & Neck Surgery. Dr. Jordan Josephson, a sinus specialist at Lenox Hill Hospital in New York City, said, “Chronic sinusitis is the number one cause for chronic fatigue and is closely associated with snoring and sleep apnea.
Thirty-eight patients with chronic sinus infections were given medical therapy rather than having surgery. “Patients who have relatively minimally reduced productivity at work and minimally reduced quality of life from their underlying chronic sinusitis can avoid getting worse by continuing with medical
therapy,” said lead researcher Dr. Luke Rudmik, a clinical associate professor of endoscopic sinus and skull base surgery at the University of Calgary in Canada.
The decision to choose medical therapy versus surgery for chronic sinusitis should be based on patient preference, and the decision for each treatment should involve an honest conversation between the doctor and patient so that the patient understands the expected outcomes and potential risks.
Surgery, however, can be a good option too for people with severe sinus infections. Surgery is just an aide to the necessary long-term medical plan that is required to improve the quality of these patients’ lives. Surgery can be minimally invasive, performed with local anesthesia. During surgery, the doctor uses probes and a laser to remove tissue and bone and polyps that have developed during the infection and are narrowing the nasal passages.
With newer surgical techniques, these procedures allow most patients to be free of black-and-blue marks, with most going home the same day. After surgery, patients still need their medical treatment because the procedure doesn’t stop the running nose. The best chronic sinusitis treatment is designed for each patient.
The best news here is that traditional treatments, alternative treatments, and surgical techniques that have failed patients in the past have been renewed and improved so that for them new medical and surgical treatments may offer significant improvements for their quality of life.
Anyone with chronic sinus trouble will tell you how it causes problems with breathing and sleep. Anyone can also tell you that much research has been done about improving sinus problems. But what about those with both sleep apnea and sinus problems? In a recent study, published in the JAMA Otolaryngology — Head & Neck Surgery, researchers have found that surgery may help those with chronic sinus problems so that they can breathe easier, better, and even improve the lives of those with the sleep-related condition called obstructive sleep apnea.
In the study, researchers found 15% of people with chronic sinus problems also had the sleep disorder obstructive sleep apnea (OSA). And those who had surgery for clearing the sinuses reported a better quality of life and improved sleep, regardless of whether or not they had a sleep disorder. Of course, this is not surprising for sinusitis treatment. Improved quality of life is the purpose of many surgeries for sinusitis. However, what’s important about this new study is that patients with both sinusitis and OSA have a substantially reduced quality of life, but those with both conditions had dramatic improvements in quality of life following surgery.
OSA is a condition that causes people to stop breathing hundreds of times during sleep throughout the night. For those with OSA, the tongue and other structures might relax too much, blocking the airway and preventing breathing. There are several signs of OSA. Here are the most common ones: Snoring, choking and gasping for air, and daytime fatigue.
Dr. Jordan Josephson, an ENT specialist at Lenox Hill Hospital in New York City, says, “Sinus and nasal problems often are part of the problem leading to snoring and sleep apnea, and are often overlooked and left untreated.” Josephson was not involved in the current study, but was a reviewer of it. He added that patients with sinus problems and nasal breathing problems “should all be evaluated for snoring and sleep apnea.”
For the study, researchers studied 400 patients who underwent surgery for chronic sinus problems. They then checked the outcomes of those with both chronic sinus problems and OSA. Of this group, sixty had OSA, and following surgery these patients had improved psychologically and with their sleep problems.
The link between OSA and chronic sinus problems is still inconclusive, but might much evidence suggests how air passages through the nose and airways and how sleep affects the body’s ability to manage infection have a lot to do with both conditions.
Peter Fotinakes, a neurologist and sleep disorders specialist at St. Joseph Hospital in Orange, Calif., has one theory for the two conditions overlapping, “When we’re asleep, we prefer to breathe through our noses.” He further added, “When we can’t, we open our mouth to breathe, and when you open your mouth, it sets your tongue free.” That freed-up tongue, he said, can fall back into the airway, blocking it.
Does this mean anyone with a chronic stuffy nose and fatigue should go straight for sinus surgery? Of course, not. Patients should try noninvasive measures first, such as medication before surgery. But many patients have experienced tremendous benefits in both disease severity and overall quality of life after sinus surgery. Seeing an board-certified ENT specialist is in your best interest if you’re looking for solutions to your chronic sinusitis and you suspect a sleeping disorder.
No one likes the prospects of surgery, but the good news is that newer surgical techniques can be performed on an outpatient basis without general anesthesia with minimal discomfort and most patients can go back to work the next day. This is welcome news for those suffering from both chronic sinus problems and sleep apnea.
A growing body of research has pointed to some common problems found among western societies: That allergies, asthma and chronic sinus problems are increasing. Although the research is not conclusive, some researchers suspect one main reason for these growing problems is the “hygiene hypothesis,” also called the “cleanliness hypothesis.” This theory states that a lack of early childhood exposure to infectious organisms such as those found in gut flora, probiotics or common parasites increases the chances of allergic diseases because the immune system is naturally suppressed. In other words, the immune system’s tolerance is weakened because it hasn’t been exposed to certain bacteria and parasites that it should have at an earlier age.
Some of the microorganisms that many allergy and asthma suffers have not adapted to are allergens. People who are not routinely exposed to some allergens can develop allergies, particularly as children. When they are later exposed to an allergen, the body misidentifies the foreign substance as dangerous and then reacts with hives or other allergy symptoms.
There are many detractors of this hypothesis. But did you know that allergies and asthma are uncommon in developing or underdeveloped countries yet are increasing in developed countries?
Furthermore on increased allergies, research has shown that severe allergies are connected to chronic sinus problems and asthma. The connection to all these conditions has to do with the inflammation in the airways, which is similar in the nose and sinuses or in the lungs.
What can we do to prevent these conditions from progressing or causing greater severity in the other conditions? There is growing evidence that early management of allergies or sinus inflammation can reduce the risk of developing asthma. Immunotherapy (allergy shots, or now sublingual drops or tablets) in allergic and asthma-prone children has been shown in a couple of studies to reduce developing asthma and reducing asthma attacks.
According to Dr. Michael S. Benninger, “Sinus surgery may also be preventative in some people.” In a recently presented paper at the American Rhinologic Society’s spring meeting, researchers suggested people who underwent sinus surgery had lowered the severity of and even prevented their asthma from occurring.
Other interesting results from the paper include:
- Allergy patients with chronic sinusitis were at a higher risk of developing asthma than those with no allergies.
- Early surgical treatment (less than two years after a sinusitis diagnosis) resulted in less long-term asthma than in those who had surgery later (four to five years after a sinusitis diagnosis).
Sinuses affect the lungs and vice versa. What may cause inflammation in the sinuses may do so also in the lungs, especially for those with allergies. For those with allergies and chronic sinusitis, keeping the sinuses under control helps the lungs, and keeping the lungs under control helps the sinuses. Aggressive treatment, whether with allergy immunotherapy or sinus surgery, may help reduce the risk of developing a worse airway disease, like asthma.
What all this means is that we might be recommending surgery and immunotherapy earlier in order to relieve later symptoms.
One final though before you slather your children’s hands in antimicrobial gel: sometimes a little dirt is good for a little while. Of course, this doesn’t mean they should wash their hands regularly; it means we don’t have to be overly cautious with a little dirt sometimes because it might reduce the development of asthma and severe sinus problems.
Healthy Sinuses: A “How To” Guide
Sinus infections, congestion, and other symptoms can make this time of year miserable. The good news is there are some things you can do to develop and maintain healthy sinuses. Moreover, if you do get sick, the same strategies that keep your sinuses healthy will also help you heal faster.
Drink up. This is important, as drinking plenty of fluids, particularly water, can be one of the best preventative measures for our sinuses. When you stay hydrated, it will help to thin mucus discharge. This, in turn, will help prevent congestion and the miserable symptoms associated with it. Drinking water will also keep your immune system strong. Both of these factors are important in fighting off infection and keeping sinuses clear.
Another way to help keep sinuses well lubricated is to use a humidifier. In drier climates, or when a heating system is used (wood heat in particular), mucus membranes will dry out. This can leave you open to congestion, irritation, or infection. Adding humidity to the air also helps you sleep better at night and also helps to keep your skin from drying out.
Limiting alcohol intake and not smoking are proven to help keep sinus passages clear and healthy. If you do smoke, quitting can be hard. It is worth the effort, however, as the health benefits can be seen almost immediately—and this is especially true when it comes to the sinuses.
Traveling can expose you to a number of things. Developing congestion because you are tired and your immune system is weakened, or being exposed to other people with cold and flu infections, are common features of traveling. By a nasal spray before your trip and keep it on hand. Nasal sprays aid in clearing the sinuses and preventing congestion or blockage. Also, avoiding certain allergy triggers will help ensure your nasal passages are not inflamed. Again, drinking plenty of water before, during, and after your trip will help keep your body strong and your sinuses healthy.
No one enjoys the cold and flu season, but by following a few simple guidelines, you can get it through it with healthy sinuses. ‘An ounce of prevention is worth a pound of cure’, may be a cliché, but that doesn’t mean that it isn’t true. Taking care of some basic health needs, and having the right tools on hand, can go a long way to keeping your sinuses at their best.