Quick Fixes for Sinus Trouble

It’s estimated that up to 30 percent of adults experience a stuffy or runny nose due to allergies to substances such as tree, grass, or weed pollen, as well as mold, pets, dust mites, and cockroaches, says allergist Zachary Rubin, MD, a spokesperson for the American College of Allergy, Asthma & Immunology. And older adults tend to have less robust immune systems, which makes them more prone to colds and flu, says Hiten Patel, MD, a family medicine specialist at the Ohio State University Wexner Medical Center in Columbus. Both can cause sinus trouble.

Nonallergic rhinitis—caused by irritants such as cigarette or fireplace smoke, traffic fumes, strong odors, and weather changes—can also cause sinus trouble. “It’s due to a dysregulation of the nerves in your nose that make mucus,” Hur says.

Stuffiness that’s accompanied by a dry, crusty nose, or even nosebleeds, may signal what’s called atrophic rhinitis. “As you age, your nasal tissue thins and atrophies, due to decreased blood flow to the nasal cavity,” says Peter Manes, MD, an ear, nose, and throat specialist at Yale University School of Medicine in New Haven, Conn. “Cartilage weakens, too, which can change the shape of your nose.”

What to do: If you suspect that you may have nonallergic rhinitis, avoid potential triggers and use saline nasal spray several times a day to flush out mucus and irritants. Need more help? The prescription nasal spray ipratropium (Atrovent), which reduces the amount of mucus you produce, is useful for a primarily runny nose, Manes says. For a stuffy nose, antihistamine nasal sprays are often quite effective. “It’s most likely because they have some sort of anti-inflammatory effect, and they may also calm down nerve endings in the nose,” Manes says. Treatment for atrophic rhinitis usually involves spritzing your nose frequently with saline nasal spray.

If you don’t feel a lot better within a few weeks after trying some of the treatments above, it may help to have an ear, nose, and throat specialist examine your nose with an endoscope. “This allows us to look for mucus that could indicate infection, as well as swelling or even nasal polyps, benign growths on the lining of your nasal passages,” says Gregory Levitin, MD, an otolaryngologist at New York Eye and Ear Infirmary of Mount Sinai in New York City. Sometimes, the solution is simple. For nasal polyps, for instance, the injectable prescription drug dupilumab (Dupixent) may help shrink them.

But if the cause of persistent nasal symptoms isn’t straightforward, you may need a CT scan of your sinuses. “Sometimes, years of untreated inflammation has damaged sinus tissue,” Levitin says. “This can lead to chronic inflammation and swelling.” A small amount of such tissue can be removed in your doctor’s office, but more extensive sinus disease may require surgery done under general anesthesia. This is considered relatively safe for older adults: In a study published in the American Journal of Rhinology & Allergy in 2022, the rate of surgical complications was 3.9 percent for adults ages 70 and older, but it was higher—8 percent—for younger patients.

• A steamy shower: The warm, moist air will help mucus drain, Manes says. You can also drape a towel over your head and breathe in steam from a bowl of hot water.
• Staying hydrated: Both hot and room temperature drinks help ease nasal symptoms, found an older study in the journal Rhinology. But people reported more relief from sipping a hot drink than a room temperature one. Another older study found that chicken soup and hot water relieved cold symptoms like nasal congestion more than cold water did.
• Chili peppers: These are rich in capsaicin, which may help relieve nasal congestion, according to a 2015 Cochrane review.
• A humidifier: Dry air can irritate and inflame the nasal lining. A humidifier (opt for cool mist) set at 30 to 50 percent humidity will increase moisture in your home appropriately, Manes says. (See our humidifier ratings here, and one of our top-rated humidifiers below.)

• Chronic heartburn: In gastroesophageal reflux disease, stomach acid regularly backs up into your esophagus and mouth, damaging the esophageal lining. The most common tip-off is a persistent sore throat or cough, Hur says. But in a study published in BMC Pulmonary Medicine in 2021, GERD was also associated with a fourfold increase in nonallergic rhinitis. “We tend to see this in patients with severe GERD” who may not realize the condition is also affecting their sinuses, Hur says. A gastroenterologist can help.
• Obstructive sleep apnea: People with this condition (where breathing stops briefly numerous times during slumber) who also reported nighttime nasal congestion were more likely to have severe OSA, according to a 2022 study. They were also more likely to have high or uncontrolled blood pressure. Dealing with issues that may get in the way of OSA treatment—like a deviated septum or other structural obstructions in the nose—can help your sinuses too, Hur says.
• Medication side effects: Beta-blockers, antidepressants, and erectile dysfunction drugs may worsen nasal congestion. If you suspect this, talk to your doctor. You may be able to switch to a different class of medications.