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Nasal Spray or Somnoplasty for Congestion Relief?

Updated on October 31, 2013

If you suffer from nasal congestion, and have been using nasal sprays for weeks or months with no improvement, you may be a candidate for an outpatient surgical procedure called somnoplasty.

Many people have somnoplasty to relieve snoring. But I had the procedure to relieve chronic nasal obstruction. My ENT recommended the procedure because I was experiencing severe nasal swelling at night that would last until mid-morning. (Oddly enough, though, I never snored.)

If you have trouble breathing through your nose at night, if you often wake up congested in the morning, or if you've been using nasal spray for your congestion for weeks or months (instead of days, as recommended), talk to your doctor about somnoplasty. Here's more about it and my experience ditching the nasal spray and getting the somnoplasty procedure.

Nasal spray
Nasal spray

What's Wrong with Nasal Spray?

There's nothing wrong with an over-the-counter nasal spray if you need an occasional decongestant. The problem is when you find yourself needing nasal sprays for long term use. Nasal sprays can actually stop working. They become less effective when used over time, and you need to use more of it to get the same results you were getting before -- a phenomenon known as "nasal spray addiction." Prescription steroid nasal sprays can cause side effects, not to mention being an expensive ongoing treatment method to maintain.

Although I got temporary relief from my nasal spray, my congestion was returning every single night. And that's an important point: I noticed that it was only happening at night, so I knew there had to be a physical or medical reason why it was happening, and I knew it wasn't going to be solved with nasal spray.

What Is Somnoplasty?

I'm no doctor, so the best I can do is explain somnoplasty in layman's terms from a patient's point of view.

In a nutshell, the doctor numbs your turbinates (the pink mounds of tissue you see when if you look up your nostrils) and then zaps them with a radio wave that shrinks the tissue inside of them. The zapped turbinate tissue dissolves (internally) over the next few weeks, and when everything heals, the turbinates will be smaller. And voila, easy breathing is restored.

It's a really quick procedure that my insurance company fully covered with the proper pre-notification. It's outpatient, so you'll be able to drive, go to work, or whatever afterward, although you may want to spend the day at home just to handle the drippage and what not. (Read about my experience with somnoplasty below, and I'll explain.)

Why I Chose Somnoplasty

Every morning, it was the same thing. The inside of my nose (turbinates) would swell up enormously during the night when I went to bed, making it impossible for me to breathe normally. Some nights it was so bad that I had trouble getting to sleep in the first place. By 11 am or so, I'd be back to normal. Then it would all start again at bedtime.

After suffering for a couple years with this chronic nasal congestion every morning, I finally went to an Ear Nose and Throat doctor and asked what could be done. He explained that the turbinates naturally swell during the night when we lay our heads on our pillows and the blood flows toward the head. But he saw that mine were more swollen than normal, and that the swelling lasted well into the day. I explained that I was looking for a permanent solution, because although Afrin and nasal sprays worked, I didn't want to be dependent upon them and I knew they had diminishing effectiveness over time. He told me I was a candidate for somnoplasty, which could permanently shrink my turbinates after one or two treatments.

My doctor put me on a steroid nasal spray for a few weeks, just to confirm that the turbinates would respond to treatment. Steroid nasal sprays don't cause "nasal spray addiction" the way over the counter sprays do, so theoretically, you could get a prescription and keep using the spray as long as you want, and it would work. But I didn't want to bear the cost of an ongoing prescription, nor did I want to be dependent on a spray in order to breathe. So I chose to have the somnoplasty. It was quick and virtually painless.

What to Expect after Somnoplasty

The hardest part is right after the somnoplasty procedure. Your nose will run uncontrollably, but you can't blow it for the first day or so. All you can do is wipe and dab. Also, you have to use a saline nasal spray every couple of hours for the first day. You might also have some nasal bleeding as well (though I never did). So like I said earlier, you might want to take the day off just to deal with all the mucous and the spraying and the dabbing and the wiping.

You might also experience slight pain (I had a little bit of a burning sensation from the radio thingy, but nothing that required pain reliever).

The doctor will warn you of the possible risks and side effects. The most serious one that I remember being mentioned was potential loss of smell.

It takes about a month and half after to really gauge the results. I had to pay for the nasal insert they used on me out of pocket, but they stored it on site for a year so they it would be available for additional rounds of somnoplasty (which I ended up needing).

The first round of somnoplasty offered some relief, but I found I still needed a nasal spray daily, which is the very thing I wanted to get away from.

I experienced a HUGE improvement after the second round of somnoplasty. I still reach for my prescription steroid nasal spray every once in a while if I feel the swelling coming on at night, but overall, somnoplasty gave me the relief I needed, and now I can breathe easy.

Would You Choose Somnoplasty or Nasal Spray for Relief?

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