Nasal Strips, Sprays and Devices: Do They Help with Sleep Apnea?

Quick Takeaways

• Nasal aids like strips, dilators and sprays may help open nasal passages and reduce snoring, but they do not treat sleep apnea on their own.²
• These products may improve comfort and airflow for people who use CPAP therapy and have a blocked nose.²
• Expiratory positive airway pressure (EPAP) devices may help some people with mild sleep apnea, but results vary and there may be side effects.⁷
• If you think you might have sleep apnea or continue feeling tired when using nasal aids, talk to your doctor — only a sleep study can confirm a diagnosis.¹⁰

For people with sleep apnea, nasal strips, internal dilators, devices and nasal sprays may seem like tempting alternatives to continuous positive airway pressure (CPAP). But how might they help with a blocked nose or snoring? Learn more about these nasal aids, how they work, and whether they can help people with central sleep apnea (CSA) or obstructive sleep apnea (OSA).

Obstructive sleep apnea (OSA) is a condition where your upper airway becomes blocked repeatedly during sleep, making it harder for air to flow. These blockages can reduce or completely stop the flow of air, causing your breathing to pause throughout the night. ¹

On the other hand, central sleep apnea is a condition in which the brain doesn’t send signals to the muscles that control breathing, causing breathing to pause during sleep.¹

How nasal aids relate to sleep apnea

Nasal aids are not a cure for sleep apnea. ² However, they may help air flow through your nose more easily. In turn, this can help ease snoring and improve comfort during sleep. Before trying any of these aids, it’s a good idea to check with your doctor to make sure a sleep disorder isn’t causing your troubled sleeping.

Nose breathing and sleep apnea 

Breathing through the nose ensures smooth airflow. However, in some people, nose breathing may not be possible depending on the shape and structure of the nasal passages.³

OSA tends to happen when the tongue and soft palate block the airway during sleep.¹ While a stuffy nose doesn’t cause OSA, trouble breathing through your nose can make the symptoms worse. For example, if you have OSA and catch a cold that gives you a blocked nose, symptoms may become more noticeable.

People with OSA often have stuffy noses because of issues such as a deviated septum or inflammation from rhinitis.³

Because these conditions can stop you breathing properly through your nose, it can lead to breathing through the mouth. Some experts think mouth breathing makes sleep apnea worse.³

Research shows that roughly half of your breathing effort comes from your nose.⁴ As a result, a stuffy or blocked nose can make apnea symptoms worse. Improving how you breathe through your nose can make a difference, but it usually isn’t the full answer. ⁴

Because of this, nasal aids aren’t seen as a primary treatment for sleep apnea. While they can help open the nasal airway, they don‘t provide the same support as continuous positive airway pressure (CPAP). ⁴ CPAP is highly effective and is the most used and understood method for treating sleep apnea.⁵ It delivers a continuous flow of air pressure, which opens the airway and helps you breathe normally. While nasal aids may relieve some blockages, they don‘t provide the continuous air pressure needed for treating sleep apnea.

Common nasal aids

There are a number of common aids you can use to improve breathing through the nose. They may be marketed as ways to help prevent snoring, and some are available without a prescription. Options include: ⁴ 

• Nasal strips. These strips attach to the outside of the nose and gently pull the nostrils open. They’re designed to widen the nasal passage and help air pass through more smoothly.

• Internal dilators. Internal dilators are small devices you put in your nose to help keep the nostrils open.

• Nasal sprays. There are several types of nasal sprays, including steroid sprays that help reduce inflammation, saline solutions which helps to relieve nasal dryness and antihistamines that may relieve nasal allergies.⁶Some of these are available over the counter, but prescription-strength options are also available.

• EPAP devices. Expiratory positive airway pressure (EPAP) devices are inserted into the nostrils and create gentle pressure when exhaling.⁷

• “Micro-CPAP” products. “Micro-CPAP” products  may be marketed as alternatives to continuous positive airway pressure (CPAP), but they don’t provide the same continuous airflow system used in CPAP therapy and have limited clinical evidence to support their claims. ⁸ Note that “Micro-CPAP” products are not the same as mini or portable CPAP devices, which are clinically validated.

• If you are thinking about using any of these nasal aids, talk to your doctor first to determine if you have an underlying sleep condition.
  

Snoring vs. sleep apnea

Many people link snoring that keeps a bed partner awake with obstructive sleep apnea (OSA).Snoring can be a sign of sleep apnea, but it’s only one of the possible symptoms. However, people who snore don’t always have OSA. Snoring can happen for a range of reasons, including: ⁹

• Nasal congestion
• Certain mouth or nose shape
• Sleeping position

Only a sleep test can confirm a diagnosis of OSA. A sleep test helps you get answers about what’s happening while you sleep.¹⁰ It can help your doctor understand if you have a condition like sleep apnea. While nasal aids may help with snoring, they don’t provide the continuous air pressure needed to treat sleep apnea that CPAP does.

How well do nasal aids work?

Are nasal aids effective? While they may provide some relief from snoring, these products generally cannot treat sleep apnea on their own. However, for some people, nasal aids may make continuous positive airway pressure (CPAP) therapy feel more comfortable or easier to use. ²

Nasal strips

Nasal strips work by gently pulling the sides of the nose open. Some studies have found that nasal strips may help with snoring, but there’s no evidence they’re an effective treatment for sleep apnea. ² That said, nasal strips may be helpful for individuals with nasal congestion, which could also be experienced by CPAP users.

Nasal sprays

Nasal sprays are often used to help improve breathing:⁶

• Steroid sprays are intended to help decrease swelling.
• Antihistamine sprays are used to ease nasal symptoms in people with allergies and congestion.
• Saline sprays can help keep nasal passages moist.

However, these sprays can have side effects, including irritation and nosebleed, which may occur with overuse. ⁶

Some research suggests that certain steroid sprays may help reduce sleep apnea severity in people with chronic rhinitis,⁹ which is often linked to allergies.

Internal dilators and EPAP devices

Nasal dilators were developed to increase air flow in the nasal valve,² the narrow passage in the nose that regulates airflow. Research shows that internal dilators can improve airflow by as much as 25%,¹¹ but they typically don’t reduce breathing interruptions. While these devices may improve airflow, they do not generate positive pressure. As such, experts don’t consider them a treatment for sleep apnea.²

Other devices, such as expiratory positive airway pressure (EPAP) devices, do create pressure as you breathe out. A study suggests that EPAP may help some people manage their sleep apnea symptoms. Results show that treatment significantly improved sleep for the people with mild to severe OSA who took part.¹²A doctor can help you decide which sleep apnea treatment is best for you.

It’s important to note that ‘Micro-CPAP’ devices aren’t approved by the FDA for the treatment of sleep apnea. ⁸ These products often make claims that have limited clinical support, while continuous positive airway pressure (CPAP) therapy remains the most trusted and widely used method for treating obstructive sleep apnea.⁵ Always talk to your doctor before changing any treatment.

What affects results

The impact of nasal aids may depend on a range of factors. Nose anatomy³ - including a deviated septum, the type of blockage, and even the shape of the nasal passage - can potentially affect how much these devices may help improve nasal airflow or ease snoring.

Tips for using nasal aids with CPAP

If you’re living with sleep apnea and thinking of using a nasal aid alone or with CPAP therapy, talk to your doctor first. Here are some tips for using them together.

Using nasal aids with CPAP

If you have nasal congestion, allergies, inflammation, or a deviated septum, using nasal strips or dilators with your CPAP may improve comfort. These nasal aids can open up the nostrils, which could make breathing through a CPAP mask easier. Sprays can also help ease congestion or inflammation, making CPAP easier to use. This is particularly true for people who can’t always use CPAP therapy because of nasal dryness, inflammation and congestion.

Some studies suggest that combining certain therapies may help people use CPAP more regularly. Research indicates that heated humidification may help relieve nasal dryness in people who use CPAP more than nasal steroids.^13, However, some combinations of nasal sprays may be effective in improving CPAP adherence.¹⁴ In some cases, adjusting humidity or pressure settings may support more consistent CPAP use. ¹⁵

When nasal aids aren’t enough

While nasal aids may help make continuous positive airway pressure (CPAP) therapy feel more comfortable for some people, they are generally not considered a primary treatment for sleep apnea. ² If you are thinking about using a nasal aid to help with snoring, talk to your doctor to rule out an underlying sleep condition first.

By some estimates, there are almost 1 million undiagnosed cases of sleep apnea.¹⁶ In addition to snoring, other red flags that may point to sleep apnea, even among people who use sleep aids, include: ¹

• Excessive daytime sleepiness

• Pauses in breathing during sleep

• Morning headaches

• Dry mouth

• Poor sleep

Other conditions may indicate similar symptoms, including nasal polyps, a deviated septum or chronic sinusitis.³ To learn more about what may be causing your symptoms, talk to your doctor.

Natural support for breathing through the nose

For snoring or other challenges with nose breathing, some natural interventions may help, including:

• Using a humidifier to prevent dryness. Dry nasal passages can lead to inflammation and irritated airways, potentially constricting the nasal passages and making it more difficult to breathe through the nose. A humidifier adds moisture to the air, keeping the lining of the nose and sinuses moist, which can help keep nasal passages comfortable and support easier breathing.¹⁵

• Reducing allergens in the bedroom. If you have allergies, anything in your home or bedroom that causes symptoms can ultimately impact your breathing. Dust mites, pet dander and even mould may agitate your symptoms. Using a vacuum with a high efficiency particulate air (HEPA) filter, investing in a HEPA air filter, and washing your bedclothes every week can help.¹⁷

• Sleeping on your side instead of your back.  Sleeping on your side or stomach can help reduce snoring and ease mild breathing disruptions during sleep. On the other hand, you may experience more breathing pauses while lying on your back. Sleeping on your side or stomach may help keep the airway open, which may be helpful for people with mild obstructive sleep apnea.¹⁸

• Trying saline rinses or irrigation.  Saline rinses and irrigation are often used to gently flush and soothe nasal passages and sinuses. These are not quite the same as a nasal spray, which is administered to the nostrils in a fine mist. Rinses or irrigation use lukewarm saline. They are instilled into one nostril and allowed to drain out of the other. Irrigations and rinses can help remove debris, allergens, bacteria and viruses from the sinuses.¹⁹ They may also help relieve congestion and prevent dryness.⁶

• Maintaining a healthy weight. Maintaining a healthy weight can alleviate some symptoms of obstructive sleep apnea (OSA). ¹⁸

• Avoiding alcohol or sedatives before bed. Research has shown that alcohol consumption is associated with a higher risk of sleep apnea. Drinking alcohol or taking sedatives before bed can relax the muscles in the upper airway, worsening OSA symptoms.¹⁸

• Breathing exercises. Some studies suggest that breathing exercises may help improve breathing patterns in people with mild to moderate sleep apnea. They may improve airway flow, which supports better breathing.²⁰
  
  

Long-term outlook

Nasal aids may help with snoring, but they’re not considered a treatment for sleep apnea.² Whether you use continuous positive airway pressure (CPAP) alone or in combination with a nasal aid, it’s important to have regular checkups to make sure your treatment is effective.

Only a sleep study can diagnose sleep apnea. ¹⁰ CPAP therapy remains the most effective treatment for most people with sleep apnea.⁵ Talk to your doctor about using nasal aids as well as CPAP if you think it might help you get a better night’s rest.

Looking to learn more about your sleep? Take a quick sleep assessment or Book an appointment with us to have a chat with one of our Sleep Coaches*

*Resmed Sleep Coaches are sales and customer service representatives who have received training in sleep health. They can give general information about sleep health, sleep disorders and products that may help improve your sleep. They are not qualified healthcare professionals and cannot provide medical advice. We recommend you continue to consult your GP.