All you need to know about nasal irrigation and how to do it
Nasal irrigation (also known as nasal washing, sinus rinsing, sinus lavage, and sinus irrigation) is a practice in which the nasal cavity is flushed out and cleaned with a warm solution of salt water and sodium bicarbonate. It is usually performed using a device called a neti pot, but several other nasal irrigator systems are on the market now. Ancient yoga practitioners performed a nasal irrigation technique known as jala neti, and today many people around the world do it for its cleansing benefits. In this article we will go into detail about the benefits of nasal irrigation, its possible side effects, and how and when to do it.
Benefits
Airborne allergens (dust and pollen), dirt, pollutants, and bacteria collect in our nasal cavities as we breathe. The body tries to protect itself from these particles by producing mucus, which traps many of them as they travel through the nasal cavity. Too much buildup of these particles can cause problems such as excess mucus, inflammation, and even infection. Nasal irrigation performed daily helps remove these contaminants, allowing the nasal cavity and sinuses to work efficiently and effectively.
Here is a list of benefits from nasal irrigation:
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Freshens breath - Alleviates symptoms of post-nasal drip, which is known to cause halitosis (bad breath).
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Alleviates nasal congestion - Nasal irrigation thins the mucus in a congested nose, making it easier to expel, and it also removes contaminants that may have caused the congestion in the first place. By relieving nasal blockage, it helps you breathe easier.
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Flushes out allergens, pollutants, and bacteria - These are not good for the body, and removing them helps prevent sickness and infection. It also helps with allergies.
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Helps the cilia - The tiny cilia, or hairs, in the nasal passage are able to transport mucus more efficiently.
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Improves sense of smell and taste - Cleaning out the nasal cavity allows the sensory cells to perform effectively.
Side-effects
Multiple studies have been carried out on nasal irrigation. Most of them comment on the benefits the test subjects receive from it, and few report negative side effects. However, there are reports of some negative effects.
Some people report nosebleeds caused by nasal irrigation. A 2009 study reported that frequent nasal irrigation led to higher rates of sinus infections, likely caused by the loss of the protective mucus layer that was constantly being flushed out.
Although there have been reports of side effects, many of these negative experiences arise from improper use, such as not using a proper solution or irrigating the nasal cavity too often. For example, a solution that contains too much salt can dry out the nasal passages and may cause nosebleeds or irritation.
BreathMD’s Advice: Try nasal irrigation. Do it only once per day, and use the proper solution. If you do not like its effects, stop. If you are suffering from acute sinusitis or have frequent nosebleeds, it would be wise to consult a doctor about nasal irrigation before trying it.
Solutions used for nasal irrigation
The membranes in the nose and sinuses are very sensitive. The cells in these membranes have a specific salt concentration, pH level (a measure of the acidity or alkalinity of a fluid), and temperature. When creating a solution for nasal irrigation, it is important to use an isotonic solution (one with the same salt concentration) that has the same pH level and is as close to the body temperature of 98°F / 37°C as possible.
Using a solution that does not match these levels irritates the membranes and sends “pain” messages to the brain. Many people think nasal irrigation would be uncomfortable, but this is mainly because they associate snorting water with pain. That association comes from accidentally getting tap or chlorinated water in the nasal passages — water that does not match the levels of the cell membrane described above — and the irritation and pain that follow. When you snort a solution that is at the correct levels, you will find that it is not uncomfortable and may actually be pleasant.
Salt: Make sure the salt is as pure as possible, non-iodized, and free of additives such as anti-caking agents. Kosher, pickling, and canning salt are pure and acceptable to use. Sea salt, even if it contains no additives, is often discouraged because it may contain algae, though that is debatable. Table salt contains additives, so do not use it. The salt by Himalayan Institute is perfect to use as it was made especially for nasal irrigation.
Water: Pure water is ideal. Use bottled or filtered water. Do not use tap water, as it often contains chlorine, mercury, nitrates, and fluoride, and may even contain carcinogens such as chromium-6. These chemicals can irritate your sinuses and cause problems. Use filtered, bottled, distilled, or mineral water instead. The water should be warm (ideally 98°F) to maximize effectiveness and minimize irritation. If your water is room temperature or colder, you can use an immersion heater to heat it up before use. It usually takes a little over a minute (depending on the quantity) to reach 98°F.
Baking Soda: This is an optional buffering agent that increases the pH level of the solution. Make sure it is pure sodium bicarbonate. Baking powder is not acceptable.
The Proper Proportions
The Normal Saline (NS) solution, also referred to as physiological saline or isotonic saline, is 0.90% w/v (mass/volume) of sodium chloride (salt). This translates to 9 grams of salt per liter of water, or 2.13 grams per cup. Salt granules come in different sizes, so it is important to know how much of the salt you use equals 9 grams. For example, a teaspoon of extra-fine salt will weigh more than a teaspoon of coarse salt.
GENERAL RULE: Using fine salt, a heaping 1/4 teaspoon is needed for every cup of water, and 1 and 1/4 heaping teaspoons for every liter of water.
Salt absorbs moisture, so the higher the salt concentration you use, the more it will relieve swelling; the lower the concentration, the more water the tissues will absorb. Generally, if you are suffering from a congested nose, you may try a hypertonic solution (higher salt concentration) to relieve swelling.
If you add baking soda to your solution, the generally accepted amount is equal to the amount of salt you added. So if you add 1 teaspoon of salt, then add 1 teaspoon of baking soda.
Using these proportions, you will create an effective nasal saline solution.
Methods
There are many different ways to irrigate your nasal passages, and some work better than others. Try various methods and see which one you like most.
NOTE: Remember, whatever method you use, to clean your tools regularly and rinse them out before and after use. For example, rinse your neti pot before using it, or wash your hands before snorting the solution from them.
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Snort solution from cupped hands - This is the cheapest and simplest way to irrigate. You pour the nasal solution into one of your cupped hands and snort it through one nostril while plugging the other. Once the solution is in your nasal cavity, I like to do what I call a nasal gargle: you simply breathe slowly through that nostril, which agitates the water just as gargling does in the back of the throat. After that, expel the solution by blowing your nose while still plugging the other nostril. Switch and do the same through the other nostril, repeating as many times as needed.
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Neti Pot - Using a neti pot is the most common way to irrigate. Below are the steps for irrigating your nasal passages with a neti pot.
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Fill the neti pot with the warm solution.
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Insert the spout into one of your nostrils.
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Bend over a sink with your head face down and tilted to the side so the neti pot is up in the air. The neti pot uses gravity to create positive pressure of the solution in your nose.
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If you are bent over properly and not too congested, the water should soon fill the nasal passage and begin to come out through your bottom nostril. While doing this, keep your mouth open and breathe through it. Let the water run through until you estimate that half of it has been used.
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Plug the nostril that the spout was in and blow the water out from the other nostril.
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Repeat with other nostril.
We like the neti pot by Ancient Secrets the best.
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Bulb Syringe - Irrigating with a bulb syringe is done in essentially the same manner as with a neti pot, except that instead of gravity, pressure applied to the bulb by hand creates the positive solution pressure. Although you can control the pressure more easily with a bulb syringe, it is often harder to clean, and care must be taken to clean it regularly to prevent bacteria and mold from growing inside it.
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Nasal Sprays - Nasal sprays are bottles with a nozzle that you place in each nostril. You squeeze the bottle, and it creates a mist that moistens the nasal passages. While it doesn’t do as thorough a job as other irrigating methods, it is more portable and easier to use for small children and babies. Some good nasal sprays are Simply Saline Adult Nasal Mist and NeilMed Sinus Rinse.
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Nasal Irrigation Machines - Several motorized machines on the market now pump the solution through a tube. Many have adjustable pressure, and some feature a low-rate pulsatile, or pulsating, pumping action designed to match the normal wave rate of healthy nasal cilia. There are many such machines, including the Sanvic Pulsatile Nasal/Sinus Irrigator, Grossan Hydro Pulse System, Nasaline, SinuPulse, and others. There are tips that you may attach to a Waterpik that let you irrigate with it while also using it as an excellent flosser. When buying a system, make sure to read the reviews and do some research so that you get a quality irrigator that meets your specific needs.
When and How Often
How Often - While nasal irrigation is important and beneficial for overall nasal health, doing it too much can have negative effects. When you irrigate, you flush out the protective mucus layer that lines your nasal passages. It is recommended that you irrigate only once or twice daily. Doing it more often than that can cause dryness and irritation in the nasal passages.
When - Some people like to do it before bed, in the morning, or both. Try different times and see what you like most and what gives you the best results.