Sinuses Are a Filtering System for Whole-Body Health

We cleanse our skin regularly to keep it beautiful, not to mention to remove dirt and germs. And, while it may not sound pretty, sinus cleansing or irrigation can be a beautiful thing for the millions of Americans who suffer with chronic nasal and sinus problems. The ancient Ayurvedic technique of flushing the nasal passages with salt water is still one of the most effective, safe and inexpensive ways to provide short-term relief for inflammation of the sinuses (sinusitis) and allergic and non-allergic rhinitis (inflammation of the nasal mucus membrane). When I checked in with Jordan S. Josephson, MD, a New York City sinus specialist at Lenox Hill Hospital and author of Sinus Relief Now (, he said, “People who irrigate on a regular basis feel better, breathe better, sleep better, have fewer sinus and nasal infections, and suffer from fewer allergy problems.”

According to Dr. Josephson, flushing the sinuses is also helpful for other seemingly unrelated health conditions including asthma, snoring, sleep apnea and gastro-esophageal reflux disease (GERD). These can all originate from a condition he calls “Chronic Airway-Digestive Inflammatory Disease” (CAID), which occurs when irritants such as bacteria, viruses, fungi or pollutants are swallowed or inhaled and cause inflammation in the upper respiratory system (the nose and the sinuses), the lower airway (the lungs) and the gastrointestinal (GI) tract. “The membranes that line the nose, sinuses and lungs are so sensitive that inflammation in any of these areas can affect other areas in the body,” said Dr. Josephson.


Using salt water to flush the sinuses cleanses, soothes and moisturizes the sinus passages, removing infection, bacteria, mold, viruses and allergens and pollutants — and therefore reduces inflammation. There are several ways you can do this. Some people use a Neti Pot (e.g. SinuCleanse)… others prefer a squeeze bottle (e.g. NeilMed)… while a third option is a higher-tech, modern version called an irrigation machine (e.g. Hydro Pulse) that provides a gentle, pulsating cleansing, albeit at a much higher price (they start at about $100). Or, you could use a nasal saline spray (e.g. Goldberger’s Saline, AYR, Little Noses), which has the advantage of being portable.

Researchers at the University of Michigan Health System recently conducted a study that compared saline sprays and nasal irrigation treatments. Of the 121 adults who had chronic nasal and sinus symptoms, 60 adults were treated for eight weeks with saline irrigation and compared with the 61 adults who were treated with saline spray. Frequency of symptoms improved in both groups, but more for the irrigation group. At eight weeks, only 40% of the irrigation group versus 61% of the spray group reported they still had symptoms “often or always,” leading researchers to conclude that nasal irrigation treatments are more effective than saline sprays for chronic nasal and sinus symptoms.

However, it doesn’t need to be an “either/or” decision, says Dr. Josephson. He says the best results are achieved using both sprays and irrigation. He suggests irrigating one to two times daily, morning and night, especially for those who suffer from chronic sinus problems, allergies or who have the common cold to whom he also recommends carrying a spray to use as needed. If you live or work in an environment that is dusty or chemical-laden, he advises misting a few times during the day to keep mucus flowing, while also using irrigation at home.


Are you curious about how to do this — perhaps even a little reluctant to try it? Dr. Josephson assured me the process is nowhere near as distasteful or messy as it sounds. “It’s actually very easy — I can irrigate while fully dressed, in a white shirt, tie and suit, and never get anything on me.”

Neti pots, squeeze bottles and irrigation machines are generally available in most pharmacies. Speak to your physician about which is best. Dr. Josephson advises starting off with the low-tech Neti Pot or squeeze bottle first, since they are cheaper and easy. Irrigating systems are a little more aggressive, and they are more expensive, but they may be better for those patients with severe problems. It’s also best if each member of the household has his/her own “tools” to reduce the likelihood of passing germs to one another. Clean your apparatus after each use, as it may harbor bacteria as well.

It’s important to use a sterile saline solution with these devices, such as Breathe-ease XL or Alkalol. Other options are available in pharmacies or you can make your own with boiled distilled water. Bring the water to a boil and add table salt (use one teaspoon of salt to one quart of water). Let the mixture cool to room temperature. Fill the pot (or irrigation apparatus) with the saline solution. Tilt your head to one side and gently insert the spout into the raised upper nostril. Continue to breathe through your mouth, while you slowly pour the saline into your upper nostril. The saline should go into and through the upper nostril and out the lower nostril into the sink. In Dr. Josephson’s book, he recommends various stretching exercises and head positions while blowing your nose and after you irrigate to remove any leftover irritants as well. He also recommends that you tilt your head from side to side while blowing your nose.

In Dr. Josephson’s view, the ancient technique of sinus irrigation is as relevant to maintaining good health today as it ever was. “Daily life is filled with transmission of germs and irrigation helps clear them away,” he said. Given our environmental challenges, Dr. Josephson suggests making sinus irrigation a regular part of daily hygiene, like showering and brushing your teeth and suggests you do it once or twice each day.