Nasal or Sinus Saline Rinse Uses and Recipe

Nasal saline irrigation has been shown to be a beneficial therapy in the treatment and prevention of sinus infections and allergic rhinitis. This non-pharmacologic therapy involves rinsing the nasal passages with a salt-water solution, helping to rid the nose of allergens and thin out mucus.

Saline rinses help to prevent the crusting of secretions in the nasal passages, which may otherwise block the sinuses from draining. If the sinus drainage sites become blocked, which could also occur with swelling from allergies or irritants, a sinus infection may develop. Saline rinses also serve to reduce tissue swelling in the nasal passages and improve the clearance of mucus.

The two most common ways to perform nasal saline rinses are with a gravity-driven device, such as a Neti Pot, or with a pressure-driven device, such as a squeeze bottle. A nasal bulb syringe can also be used.

Various nasal saline rinse kits are available commercially, including the Sinus Rinse brand, which contains pre-mixed salt packages.

Alternatively, a home-made salt-water mixture can be made and used in a Neti pot, squeeze bottle, or nasal bulb syringe.

Here is a saline sinus rinse recipe from the American Academy of Allergy, Asthma, and Immunology (revised for a single use):

To make your own saline, mix the following in a clean container:

• 1/2 to 1 teaspoon non-iodized salt, such as pickling or canning salt (ionized salt can irritate the nasal passages)
• Pinch baking soda (added to prevent burning; you can increase the amount as needed)
• 1 cup warm water (distilled or previously boiled water)

Then, place the above mixture in a clean Neti pot or sinus rinse squeeze bottle, or draw up into a nasal bulb syringe. The most convenient way to perform a sinus rinse is in the shower, but may also be performed over a sink.

The head should be tilted down, with the rinse bottle, bulb syringe, or Neti pot spout placed into one nostril. With your mouth open, the bottle or syringe is squeezed with moderate force (or the Neti pot is poured) so that the water can go through the nasal passages and out through the mouth. If this makes you gag or hurts your ears, squeeze or pour more gently and have the water come back out through the nose.

You may notice that mucus comes out of the nose with the water. Keep rinsing one side of the nose until the water comes out clear. Repeat the same process for the other nostril.

Saline irrigation may need to be performed on a daily (or multiple times per day) basis for people with severe symptoms, or less often, as symptoms improve.

After rinsing, it is recommended to wait 30 to 60 minutes prior to placing any prescription nasal sprays into the nose. Using nasal sprays prior to this time may make them ineffective, as the saline will continue to drain for a period of time after the rinses are performed.

It is also not recommended to perform sinus rinses within at least 60 minutes prior to going to bed, as the saline will drain down the back of the throat, and could cause a cough.

Finally, while neti pots are typically considered safe, there were two deaths in the United States related to brain infection with the amoeba Naegleria fowleri from people who used tap water in Neti pots for nasal irrigation. This is why it's critical to only use distilled or boiled water when performing nasal irrigation. Cleaning the device properly is also key to preventing contamination.

Talk with your doctor before starting nasal sinus rinses and of course, stop doing it if you experience any problems like pain or nosebleeds. Sometimes, adjusting the rinse mixture can be helpful if you find it irritating. It's important too to ensure proper hygiene—be sure to clean your device thoroughly and use only boiled or distilled water. For children, only perform a nasal sinus rinse under the guidance of his or her pediatrician.