By George Eby
revision date: June 16, 2010

"Blow your nose!" Your mommy taught you that when you were a pre-schooler. For nearly all of us, that is the main lesson that we receive from our parents or physicians on how to clear our noses. The classical technique that we all know so well to treat nasal congestion works well for us most of the time. But what about the person whose nose remains constantly "congested", perhaps from allergy or some kind of deformity?

Did you know that a congested nose can lead to serious events like sleep apnea? How about death? Can it kill a person? Yes. When sleeping soundly with a congested nose, blood oxygen can be driven dangerously low, and a person could have a stroke or die from it, perhaps from a heart attack. After all, one of the most important functions of the heart is to circulate and deliver oxygen to the cells, especially to the heart itself.

Why risk death and misery? What does one do? Normally, a person would just use a "nasal decongestant" like Afrin or Neo-Synephrine. These products (and many similar ones) have been in use since before 1960. They are not supposed to be used for more than 3 to 5 days, or one risks "rebound congestion" caused by overuse. For some people, a vicious cycle of overuse and dependence that feels like an addiction occurs. These drugs are not for people with heart problems or some other conditions since they can worsen those conditions. For example a person with a stable atrial heart rate of about 80 can easily be driven to 330 simply by using these drugs on a regular or even infrequent basis. This is another way that nasal congestion can kill a person. Whoops! That is a "side effect" allowed by the FDA. There are many other side effects of these types of drugs as shown in this page. The treatment can be much worse than nasal congestion! Again, why risk death and misery?

The cure, air pressure, is free and nearly harmless, unless you have a nasal infection - maybe. Don't try my technique if you have a cold or some other kind of nasal infection. Even in a nasal infection, air pressure may be more helpful than harmful, I just don't know for certain, so you are on your own in that case.

When your mommy taught you to "blow your nose" when you were a small child, she didn't tell you to also hold your nose at the same time. What? That sounds ridiculous! Right? Hold the nose? Ridiculous! How can "holding the nose" help a decongested nose?

I will explain. The nasal turbinates inside the nose are the tissues that are swollen, or even swollen shut during "nasal congestion". The turbinates are boney structures with tissues around them that are loaded with tiny blood vessels. In fact, if one removed all of the non-blood vessel tissue in the nasal turbinates, the remaining tissue (blood vessels) would look like a bowl of spaghetti. Do you see in your mind's eye how extensive the blood vessels are in the turbinates? They are nearly solid with blood vessels! Nasal decongestants like Afrin (Oxymetazoline hydrochloride), are effective in reducing their diameter, thus "de-congesting" the nose. In actuality, these nasal tissues are "erectile tissues" (yes, just like the penis) that enlarge when engorged by blood.

Interestingly, the blood vessels of the nose are also susceptible to control by pressure. If you want to decongest your nose instantly and have it remain decongested for one to eight hours, you must also hold the nose shut for 15 to 30 seconds while blowing hard. Yes, I said shut! As in no air flow at all. Simply hold your fingers on the nasal nares closing off any air flow, and from the diaphragm and lungs blow pressure into the nose. At first you may feel you are blowing your head off. You may hear clicking in your ears. Don't blow so hard that you injure your ears.

When you have held your nose shut and blown hard for about 20 seconds, slowly (over a second or two) release the pressure in your nose. Don't immediately take the pressure off since there will be a rush of air coming out that can be a bit alarming.

If you are like most people using my technique, you will notice that your nose is much clearer immediately upon taking your first breath. You will be startled at how well you can breath. This technique can be used as often as desired and at any time it is needed. In my case, I need to use it about 3 times a night to keep my nose open due to my 75 documented allergies.

What if it doesn't work? What if a nostril still remains congested? Well, just repeat the technique. My nose was so congested once that this technique did not work as I expected. In that case, I held the less congested side closed, and forced air through the totally congested opening. It was difficult and slow going for a while and it took a lot of pressure, but after a few attempts, air-flow increased enough for me to be able to breathe a bit out of that nostril. Then, I closed both nasal nares with my fingers and blew pressure into my entire nose. The point here is that the passages must be open enough for air to get to them for pressure to work. I also kept the pressure up for 30 seconds. That worked, and I suspect that it will work for you too.

I know this technique sounds overly simplistic, too simple for it to be true. But, we are a consumer society trained mainly by advertising. Know anyone willing to spend marketing money on this discovery?

If you had tried this when you first figured out what I was writing about, your now would likely have a crystal clear nose by now. It usually works much faster than Afrin.

If you have chronic rhinosinusitis, or also want to open your sinus passages (sinus ostia), try humming. It turns out that loud, low-note humming generates nasal nitric oxide, which kills the Candida albicans fungus that cause this disorder. See my medical journal article on this matter here.

For some people, we also need physical force to hold open our nares while sleeping, and that is the magic of products like Breath Right nasal strips. They are attached to the outside of the nose and have a spring-like effet that holds the nostrils open.

For the medically minded, this "air pressure" technique is called the Valsalva maneuver. For those of you with cardiovascular issues, please read this section of the Wickipedia article. It has long been used to clear the ears of pressure due to flying, but to my knowledge this is the first report for using it to decongest the nose.

Another very useful technique to prevent nasal congestion while sleeping is to elevate one's torso, neck and head using pillows. Just lay on a pillow long-ways from the lower back to head, and another pillow under the upper back, neck and head. By elevating the head, gravity helps prevent excessive accumulation of mucus in the nose. Or, just use this special "wedge pillow".