Dear Alice,

I have had many (over eight) sinus infections in the last three years. The pain and discomfort associated with sinus congestion and infection has been extremely disconcerting. However, I have also found that my sinus congestion prevents me from thinking clearly. My thoughts are actually "cloudy" and incoherent when I'm congested.

I have found that VICKS Sinex 12 Hour Nasal Spray is the only thing that really helps me. Trust me, I have tried almost every prescription or over the counter product that there is. Its active ingredient is oxymetazoline (.05%). Although the warning states that it should only be used for three days, I have been using it regularly for the last two weeks. What are the risks involved? Do the benefits outweigh the risks? I have only been experiencing minor side effects like an itchy and burning nose. These are side effects that I willing to tolerate. But are there any more serious hazards?

— Nasal Spray Junkie

Dear Nasal Spray Junkie,

Long-lasting nasal sprays constrict the smaller blood vessels of the nasal passages, producing a decongestant effect of up to twelve hours and reducing the inflammation of the nasal passages. While the benefits of the spray may seem to outweigh the risks, exceeding the number of recommended dosages or using the spray for more than three days may not be a good idea because of the symptoms that can result. These include burning, stinging, sneezing, or increased nasal discharge (mucus), which sound similar to the symptoms you describe. Also, typically, after five to seven (or more) days of using these sprays, you may even develop a condition called rhinitis medicamentosa in which your congestion comes back or is made worse. The main treatment for rhinitis medicamentosa is to stop using the nasal spray.

Congestion can cause sleep disturbances, which can disrupt thinking and learning and may be contributing to your "cloudy" thinking. Being decongested can improve the quality of your sleep and in doing so allow you to think more clearly. A simple, effective, and time-honored way to alleviate nasal congestion is to inhale the steam from a pot of hot water. This loosens the mucus, which allows you to blow it out through your nose. Saline nasal sprays are another option for thinning the mucus and allowing you to breathe easier. Drinking plenty of non-caffeinated fluids can help to relieve your stuffy nose, too. If this sinusitis problem is persistent, see a health care provider about the possibility of an infection or other problems which may be treated with medication.


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