The nasal cycle

My sinuses have never been great, I always put it down to tonsillitis as a kid.

I had a virus back in December.  Since then I’ve been perpetually ill.  I went deaf, I had sinusitis, then a chest infection, then conjunctivitis, then sinusitis again.  I’ve had two courses of antibiotics and more sprays than I have orifices to stick them up.

My nose/sinuses still aren’t right.  I’m snoring like a motherlover, I haven’t slept in my own bed in half a year so that my partner can get some sleep.  Severity varies but it all constantly feels partially blocked and I get an odd smell which I can’t quite place, like when you’ve had dental work done (or needed it) perhaps.  If I said “it feels like my eye smells funny” would that make sense to anyone?  Doctor Google suggests polyps, I have corresponding symptoms like postnasal drip, I’m generating so much mucus that I’m occasionally physically sick of a morning and it’s nothing but phlegm.

I saw the doctor this morning, he’s referred me to ENT (finally!) but in the process he’s actually looked at it.  His opening remark was “you have a deviated septum.”

Wait, what?

I asked if that was something I’d had from birth and he said probably.  So back to Doctor Google, and to the reason for this post.  One of the symptoms of a deviated septum [emphasis mine] is:

“Awareness of the nasal cycle. The nose alternates between being obstructed on one side and then changes to being obstructed on the other. This is called the nasal cycle. Being aware of the nasal cycle isn’t typical and can indicate nasal obstruction.”

This hit me like a bus.  I’m fully aware of it, I thought that was just how noses work.  If I’m lying on my side in bed, the contents of my face slosh down so I’m breathing out of the uppermost nostril.  This isn’t overly prominent day-to-day but is highly pronounced when I have a cold.  Suffering from a cold I’ll wake up with the pillowmost nostril blocked solid, turn over and wait for things to equalise so I can relieve the pressure and get enough airflow to blow my nose whilst the other side quietly blocks up.  Even without a cold though, it’s something I’m conscious of.

I thought this was normal.

Is this not normal?

Not aware of my nasal cycle, but a doctor told me my septum was deviated about 15 years ago, and if it affected my sport he’d refer me to get it straightened.

My sport never got to a level that made me think a nose job would be a good idea.

Is this not normal?

No. The nasal cycle is normal, but my nose Just Works™ and unless I test the airflow by blocking one nostril off followed by the other, I would not be aware of it, no!

I thought that was normal…. My right nostril is currently doing all the breathing as I type this

Scratch that. It’s just changed, left is back in business

Totally random suggestion but have you tried a nose buddy type thing? Or in other words a nasal flush?

I got quite into it after a bout of flu, it seemed to help breathing and sleeping.

It sounds horrendous but is actually fine, saline warm water goes in one nostrel and out the other, flushing out the gunk and pollen irritants

I first tried it with an old camelback hose and a funnel, and got madame to pour the water.

It feels fabulous when everything is washed out, I can breathe properly through both nostrils

I never knew about the nasal cycle until fairly recently, was reading about it for some reason. Interesting.

However I think this is different:

Suffering from a cold I’ll wake up with the pillowmost nostril blocked solid, turn over and wait for things to equalise so I can relieve the pressure and get enough airflow to blow my nose whilst the other side quietly blocks up.

I get this too, but surely that’s just gravity? Once aware of this, it’s a good way to clear a blocked nose: lie on one side (gunk side up) until it’s halfway moved across, then blow. Tada, clear nose.

As I understand it the nasal cycle is that the nostril you breathe through alternates naturally throughout the day. You’re actually almost always only using one nostril at a time, but yeah most people (including me) aren’t normally aware of this.

Non vasomotor rhinitus and / or polyps sounds perfectly plausible

Sounds like my normal as well.

have you tried a nose buddy type thing? Or in other words a nasal flush?

Not really the thrust of the thread but yes, I got a “Neil Med” (? I’d have to check) sinus rinse largely to shut up a friend who kept banging on about it.  I was deeply sceptical but when I’ve got a cold it’s astonishingly effective.  But right now, it’s in the wrong place if that makes sense?  Like, the rinse is ‘front’ and the problem is ‘back’.

I’m aware of it …… but only since I watched an episode of QI

It sounds horrendous but is actually fine, saline warm water goes in one nostrel and out the other, flushing out the gunk and pollen irritants

I tried doing this once. The water went into my sinuses and stayed there. Then several hours later I was at work, bent over to pick up a pen, and without any warning, a load of liquid suddenly ran out of my nose. Didn’t do it after that!

I saw the doctor this morning, he’s referred me to ENT

Hopefully they will help, but if not then try Bolt Thrower or Napalm Death ?

That’s my normal OP with regular sinusitis and chronic rhinitis, and a deviated septum I’ve had operated on, but is still considerably deviated. Adenoids and to sils removed as a kid and sinuses flushed a couple of times The recovery from the septum op was no fun. My snoring is quite remarkable, snorelab app showed me just how bad it was!  Luckily my wife could sleep through a nuclear blast.

Anyway, recently diagnosed with severe obstructive sleep apnea and given a CPAP machine. My snoring is now zero, down from 5-6 hours a night with atleast a couple at ‘epic levels’.  The nasal issues make it a bit awkward, but with the pressure and humidity I am breathing better through the night, obviously that’s the point though.

I’ve got a deviated septum, doesn’t bother me much, I just breathe through my mouth more than most and put up with sinus and ear infections fairly often too. Only thought about fixing it after watching Botched and seeing the (staged for TV) relief their patients show.

The first thing that came to mind was blood pressure medicines. A friend had his meds changed and immediately started suffering from soaking wet pillows at night. The doctor changed him back to his previous tablets and the post-nasal drip (as he identified it) stopped.

Any history of asthma? Eosinophilic nasal polyps often come with asthma. Biannual surgery is one common treatment. Covid killed my sinuses.  Very susceptible to sinusitis, normally without infection! Just the pain part.

I helped develop a drug for chronic rhino sinusitis with nasal polyps. The clinical score is called SNOT-22.

  But right now, it’s in the wrong place if that makes sense?  Like, the rinse is ‘front’ and the problem is ‘back’.

ok gotcha. I sympathise though, Ive had a long history of nose issues after i had a septo rhinoplasty after smashing my konk to bits. Had the full strange smells, blockage and sinus infections

@kormoran – how many sessions of the nose flush do you need to do to feel this? I’ve a Neti Pot but still to get round to using it…I’m hoping for some positive result from the first go…I’m assuming I empty the whole pot into a nostril and drain from the other and then do the same on the other side.

Is the nose having erectile tissue inside news to anyone else or just me?

@Dickbarton I had an instant result the first time I used it. It was when I was pretty congested so there was maximum effect I think. Subsequent sessions are always good, but the worse you are, the better the effect.

Trick is to be patient, don’t force it. Water needs to be tepid and saline. I do it over a washing up bowel sat at a table, leaning forward head tilted. Initially its a bit freaky as water can be going across your throat from your nose, so try and relax.

Basically the water goes in and comes out the other side as you keep pouring. It doesn’t feel like getting water up your nose at a pool, which is horrible.

If you are really congested then id probably breath steam over a bowl of hot water with a towel over my head first, just to loosen things up

I had nasal congestion for years. Particularly bad at night. I eventually spoke to a doctor about it and got referred to an ENT specialist.

The specialist shoved a camera up my nose which made my eyes water, and declared I have a deviated septum and mild rhinitis in both nostrils.

I then had allergy tests to determine what was causing the rhinitis and they came back showing I’m allergic to dust mites.

I’ve been given a repeat prescription for mometasone and advised to use a nasal douche daily. Along with extra vacuum cleaning of bedding etc, I’m much improved.  In fact I can’t believe I left it so long to sort out.

I declined surgery for the deviated septum, as it doesn’t affect me too greatly, and it seemed the pain and recovery from the procedure  wouldn’t be worth the slight improvement it might provide me.

Is the nose having erectile tissue inside news to anyone else or just me?

Hence the saying “f*** nose.”

advised to use a nasal douche daily.

Tom Cruise?

Anyway, an update.

I got a text message to attend the surgery to collect a letter.  The letter informs me that they’re going to send me a letter.

The NHS is just a well-oiled machine, isn’t it.

Thanks @kormoran…looks like I’ll be trying to not waterboard myself tonight!

@DickBarton Good luck!