Optimal Nasal Splints and Appliances for Nasal Congestion
External nasal dilator strips are the most effective retail nasal appliance for improving nasal congestion, with evidence supporting their use for temporary symptomatic relief.
External Nasal Dilators
External nasal dilators (such as Breathe Right® strips) are the most evidence-supported retail option for nasal congestion. These adhesive strips work by:
- Mechanically widening the nasal valve area
- Reducing nasal airway resistance
- Providing immediate relief of nasal congestion symptoms
These devices are particularly helpful for:
- Nasal valve collapse
- Mild to moderate nasal congestion
- Nighttime breathing difficulties
- Snoring related to nasal obstruction
Nasal Decongestant Options
Topical Decongestants
- Provide rapid but temporary relief through vasoconstriction
- Should be limited to 3-5 consecutive days of use to avoid rhinitis medicamentosa 1
- Examples include oxymetazoline and xylometazoline nasal sprays
- Recent research suggests oxymetazoline may be safe for up to 7 days without causing rebound congestion 2
Intranasal Corticosteroids
- More effective than oral antihistamines for nasal congestion 3
- Recommended as first-line therapy for moderate-severe nasal congestion 3
- Take 12 hours to several days for full effect
- Can be used continuously for persistent symptoms
Other Retail Options
Nasal Saline Irrigation
- Buffered hypertonic (3%-5%) saline irrigation shows modest benefit for acute rhinosinusitis 1
- May improve quality of life and decrease symptoms 1
- Available as squeeze bottles, neti pots, or spray bottles
- Safe for long-term use
Nasal Dilator Devices
Internal nasal dilators (inserted into nostrils)
- Less evidence supporting effectiveness
- May cause local irritation with prolonged use
External nasal strips
- More evidence supporting effectiveness
- Non-invasive and generally well-tolerated
Considerations for Special Populations
For Sleep Apnea Patients
- External nasal dilators may provide some benefit but are clearly inferior to CPAP therapy 1
- Should not be considered primary treatment for OSA
- May be used as an adjunct therapy in selected patients with nasal obstruction
For Children
- Hypertonic nasal solutions (like Narlisim™) have shown effectiveness and safety for nasal congestion in children 4
- Avoid decongestant medications in children under 6 years due to safety concerns 1
Limitations and Caveats
- No nasal appliance provides the same level of relief as prescription medications for severe congestion
- Effects are temporary and address symptoms rather than underlying causes
- For persistent nasal congestion, medical evaluation is recommended
- Patients with anatomical nasal obstruction may require surgical evaluation 1
Bottom Line
For over-the-counter relief of nasal congestion, external nasal dilator strips have the best evidence for effectiveness among retail nasal appliances. They are safe, non-invasive, and provide immediate mechanical relief without medication side effects. For more severe or persistent symptoms, consider combining with intranasal corticosteroids for optimal relief.