Be a Sinus Rinse Expert with these Secrets

Get the best, “insider” answers to your sinus rinse questions

Neilmed sinus rinse
Get all your sinus rinse questions answered below! Picture source

I’ve gotten a surprising amount of emails asking questions about sinus rinses.  I knew many of you had strong feelings about sinus rinses, but I didn’t know there were so many questions about it!

To help you with all your sinus rinse questions, I compiled the most common questions along with my best answers, tips and tricks

Please read through this post and hopefully it will answer your sinus rinse questions.  But if not, please let me know and I will take the time to answer your specific questions.


If you don’t want to read through all the sinus rinse questions, jump to the section you want right here:


Frequently Asked Sinus Rinse Questions

Tips and Tricks

Is your questions missing?

Is there benefit to Neti-pot vs sinus bottle

Overall, the biggest difference is comfort.  Between the Neti-pot sinus rinse and the squeezy bottle sinus rinse, they work differently but achieve very similar benefits.

  • The Neti-pot sinus rinse uses gravity to “pour” the saline into your sinuses, which is a little less forceful but rinses a little less deeply although not enough to cause a difference in benefits.
  • The squeezy bottle sinus rinse uses your hands to squeeze the saline into your sinuses, which gives you more control but sometimes has more force. It does seem to penetrate more deeply.  However, not enough to cause a difference in benefits.

So pick whichever one of these two is more comfortable to use


Is there a benefit to the sinus sprays

In general, most sinus sprays have some type of top on them like those old spray cheese bottles (yes, I ate them and I loved them… not so much any more) but the idea is that it is a pressurized can of saline and you just spray the mist into the nose.

Spray cheese
Sinus sprays are better for your nose than spray cheese

There are two major problems that I’ve found with these sinus sprays:

  • They tend to spray a lot into the nostril part of the nose, which does not give you any sinus benefit and can actually dry out your nose and cause nose bleeds!
  • They don’t tend to penetrate deep enough in the sinuses to give significant relief.


I usually only use these for children, where it may be easier for them to tolerate, or if you have a cold/flu and just want some of the goop out of your nose.

In general, I would recommend a true sinus rinse over any of the sinus sprays.


Am I doing something wrong if water comes out of my nose a few hours AFTER using the sinus rinse?

I’ve had quite a few people email different variations of this question.

One person told me a story of how he used the sinus rinse and thought he got all the water out and then 5 hours later he was at the bank and bent over to sign a check and water “poured out of his nose.”  His question:  am I doing something wrong?

The answer:  Nope, you’re not doing anything wrong.  That’s the fun of a sinus rinse!

When you use a sinus rinse, the saline goes into the nose and in the sinuses, gathers all the disgusting dirt, debris, mucous, etc and washes it out.  But think of your sinuses as cups of water:

  • The sinus rinse fills the water cup and you try to pour it all out.
  • Then when you stand back up /over time more saline collects and gathers from the sides, from the nooks and crannies of the sinuses, etc and then starts to fill back up the cup.
  • Then, when you bend over again in the future… surprise!


I have a technique that can help reduce this chance (at the bottom of this post) but overall this is just something you need to be aware of as a fact of using a sinus rinse.


Can I use regular water instead of distilled water?

It is recommended that you use distilled water, commercially bottled water or you can use BOILED tap water (once it cools down to lukewarm or body temperature).  From this perspective, you can use regular water if you boil it first.

But you should NOT use regular tap water straight into the sinus rinse.

The reason for this is that there are case reports of sinus rinsing with regular water causing an infection with naegleria fowleri – the “brain eating” amoeba that causes amebic meningoencephalitis… which pretty much causes certain death (I know I have a flare for the dramatics, but in this case it really is almost certain death).

So please do not use tap water with your sinus rinse.

Do I need to use the sinus rinse packets?

There are a few different versions of this question too so I will try to answer each of them below.

First, you do NOT need to use the sinus rinse packets but there are some great benefits to using the packets:

  • Already prepared, measured, and easy to use
  • Available in most supermarkets and drug stores
  • Are specifically designed not to dry out your sinuses or nasal passages


For these reasons, I often recommend buying sinus packets.  But if you did not want to use the sinus rinse packets, then I would have to answer the question two different ways:


Can I just use water as a sinus rinse?

Do NOT just use water

If you were asking this question because you wanted to only use the water, I recommend against this.  The packets are designed to be more comfortable and to reduce dehydration of the nose and sinus passage.  Water alone would be more uncomfortable and could cause problems with the salt/hydration balance of the nose.


Can I make my own sinus rinse?

You CAN make your own sinus rinse!

If you were asking this question because you wanted an alternative, there you CAN make your own sinus rinse.  There is a great recipe from the American Academy of Allergy and Immunology that does a good job providing the same benefits as the sinus rinse packets:

Saline Rinse Recipe


  1. Pickling or canning salt-containing no iodide, anti-caking agents or preservatives (these can be irritating to the nasal lining)
  2. Baking soda
  3. 8 ounces (1 cup) of lukewarm distilled or boiled water


  • In a clean container, mix 3 heaping teaspoons of iodide-free salt with 1 rounded teaspoon of baking soda and store in a small airtight container.
  • Add 1 teaspoon of the mixture to 8 ounces (1 cup) of lukewarm distilled or boiled water.
  • Use less dry ingredients to make a weaker solution if burning or stinging is experienced.
  • For children, use a half-teaspoon with 4 ounces of water.

Can I use an apple cider vinegar instead of a sinus rinse?

I would not.

I try to support natural remedies when appropriate, using as few medications as possible and not using medications if they are unnecessary.  But this apple cider vinegar thing just confuses me!

A sinus rinse packet or homemade sinus rinse recipe is really just isotonic salt water.  That is pretty damned natural, is not a medication, and does a great job.  To me, that is pretty much as natural as you can go.

I have not found any convincing evidence to recommend apple cider vinegar.  I personally do not recommend it and would not use it on myself or my family.

Note:  If you do want to use it, you certainly can.  I don’t think there are any rules against what you can stick up your nose.  If you do choose this way, I would recommend that you DO NOT use the recipes that add spices, peppers, or honey (placing sugars in a place already prone to bacterial growth seems counterproductive to me) to the rinse.


How often do you need to do the sinus rinse?

Again, there is no right or wrong answer.

If you get a lot of relief out of a sinus rinse then you can do it daily or even a couple times a day if you want.  Again, it’s not a medication!

But most people ask me how often they need to do the sinus rinse because they want to do it as few times as possible and still get relief.  In this case, I recommend that you try to use the sinus rinse about 2-3x/week.  For most people, that is a good balance between maximizing benefit and minimize use.


Best technique for sinus rinse

I recommend sinus rinses for almost all my patients.  But I also know that when I do a large portion will not like them.  As a general rule, I make up this statistic that seems pretty consistent with my observed (not scientific) observation:

Since sinus rinses are such a good, non-medication treatment AND so many people don’t like them, I’ve tried to find the best technique for actually doing sinus rinses.  After many years of listening to people complain about what doesn’t work (and compiling what does) I give to you my current BEST recommendations for sinus rinse:

  1. Aim for using the rinse about 2-3x/week.
  2. Many people hate sinus rinses because what comes out of your nose is gross. And if you’re trying to lean over the sink what happens is that this gross nose gunk goes everywhere (your bathroom will look like mine after Emmett brushes his teeth).  To make this easier, I recommend:
    • Prepare your sinus rinse per instructions BEFORE a shower.
    • When you first get in a shower, the steam will help open up your nasal passages and make the rinse more comfortable.
    • Do the sinus rinse at the start of your shower. Then all the gross nose gunk just goes down the drain.
    • Shower like you normally do.
    • Then, at the end, bend over again (or wash your feet) and try to get that second wave of sinus rinse to drain out at the end of the shower.
  3. If the sinus rinse hurts then it is possible that you are either squeezing too hard or, if you currently have a cold/flu or allergies then there may be congestion in your nose making it hurt more to use the sinus rinse (think high flow through tiny, swollen tubes).
    • You can consider taking pseudoephedrine (Sudafed) to see if it improves the congestion and then trying the sinus rinse.
    • You can also take a few weeks off and use a nasal steroid for a few weeks to try and reduce the swelling and THEN use the sinus rinse


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