Treatments for Sinus Congestion and Drip

Sinus congestion and postnasal drip have significant implications for pulmonary and sleep medicine. Postnasal drip is the most common cause of cough. Sinus congestion causes snoring and can interfere with PAP use while you are sleeping. Treatments for sinus congestion and postnasal drip are similar. There are very effective over-the-counter therapies and some prescription therapies as well.

Over-the-counter treatments

Large volume saline nasal rinse such as Neil Med Sinus Rinse. The job of the nose is to filter out particles. If the particles cause allergy or irritation, they can cause swelling of the nasal mucous and drip. Removing these particles improves symptoms.

Topical nasal steroids such as fluticasone propionate. Both allergies and irritants can cause inflammation. Nasal steroids are anti-inflammatory and have been shown to improve snoring and mild sleep apnea. Since this is preventive medicine, it should be used every day.

Topical Antihistamines. Astepro is an over the counter topical antihistamine that is used in addition to nasal saline and fluticasone to treat nasal allergies. Topical antihgistamines are more effective than oral antihistamines for nasal symptoms without side effects.

Oral Antihistamines. Histamine is a chemical involved in the allergy cascade. An antihistamine such as diphenhydramine (Benadryl) or cetirizine (Zyrtec) is very effective in treating allergy symptoms. Histamine is also a wake-promoting neurotransmitter in the brain. Antihistamines are also anti-wake, so they will make you sleepy. Most over-the-counter sleep medications have an antihistamine.

Decongestants. Decongestants constrict blood vessels and reduce swelling. Sudafed is an oral antihistamine. Afrin is a topical antihistamine. Since decongestants work by constricting blood vessels, people with heart disease or high blood pressure should be careful using them.

Prescription treatments

Montelukast. Montelukast is an allergy treatment that prevents the formation of leukotrienes. Leukotrienes are part of the allergy cascade. Fewer leukotrienes mean less of an allergic reaction. This medicine prevents symptoms, so it must be used daily.