Sunday 18 March 2018

Ask the GP: Liquid may improve your airways but not your sleep

Netti pot
Netti pot

Nina Byrnes

Our GP advises on sinus pain and the consequences of consuming alcohol before sleeping.

Question: My nose is blocked all the time. My pharmacist suggested that I try using a rinse daily to keep them clear. Will this work and are these safe?

Dr Nina replies: Sinus pain and congestion are really common and often caused by an allergic response to pollens, weeds, moulds or house dust mites. Antihistamines and steroid nasal sprays are prescribed and can help. Nasal rinses are also often recommended.

Nasal rinsing involves flushing a solution of salt, bicarbonate of soda and sterile water into the nasal passages. This rinsing can flush out debris, allergens and irritants, easing congestion and discomfort. It can also help thin out thick problematic mucus.

Nasal rinsing is not new. It actually originates from an Indian Yogi practice of flushing a salt solution into the nose. There are a number of containers or solutions you can purchase.

One of the originals is called a 'Neti pot'. Neti is Sanskrit for nasal rinsing. The containers, in general, can flush or squeeze fluid into the nasal cavity. The solutions are either a pre-made saline solution or sachets of powder which you add to water.

It is easy to make up the solution yourself. Mix three teaspoons of salt (un-ionised and without anti-caking or preservative agent) with one teaspoon of bicarbonate soda. Take one teaspoon of this mix and mix it with 220mls (8oz) of cool boiled water, then use this as a rinse. It is essential that the water is sterile. Use either cool (lukewarm) boiled water or gently warmed distilled or sterile water. Tap water is not safe as it can contain bacteria which may then flourish in the nasal cavity.

The technique in performing the rinse is also important. Lean your head sideways over a sink. Gently flush about 100mls of the prepared solution into the top nostril allowing it to flow out the bottom one. Remember to breath through your mouth at all times. Gently blow your nose to remove any residual rinse, then repeat the process on the opposite side. Rinse the bottle and allow it to air dry fully each time. You can do this daily initially, but as your sinuses clear, you can reduce the frequency to a few times a week.

Take a break after a few months and replace the bottle every few months too.

Nasal rinsing is not for everyone. If you have an obstruction in your nasal cavity or if you experience nose bleeds, pain or headaches using the solution, talk to your doctor before any further rinsing.

Question: I have found that if I have a few drinks, I fall asleep no problem.In fact, I often have trouble sleeping without them. I have been told that alcohol doesn’t improve sleep and actually makes it worse. Is this true?

Dr Nina replies: For many years, people believed that a drink at night helps you sleep better. The truth is that alcohol does not help sleep and can, in fact, disrupt it.

There is a lot of evidence to show that a good night’s sleep is essential to our health and wellbeing. Simply falling asleep is not enough. We need to pass through all the phases of sleep in order to wake up feeling rested and refreshed.

Slow wave sleep is the deep restorative sleep. REM sleep is a lighter phase where we dream, but appears to be very important for health.

If you consume alcohol in the hours immediately before bed, it is likely you will fall into a deep sleep quickly. This sleep lasts the first part of the night. As the alcohol wears off, you move back into a lighter REM sleep. Sleep in the second part of the night is restless, leading to tossing and turning and frequent waking. The normal passage through the sleep phases is disrupted.

 If you drink late at night, you are likely to wake needing to pass urine, leading to disrupted sleep. Drinking late at night is often combined with eating heavy foods. This can lead to stomach upset and heartburn which will further disrupt sleep.

Alcohol before bed increases the chance that you will snore. The airway becomes more floppy increasing the chance of episodes of apnoea. Obstructive sleep apnoea is associated with an increased risk of stroke and heart attack. Your snoring can also disturb the sleep of those around you, making you less than popular to family or housemates.

Ultimately, consuming alcohol at night leads to broken poor-quality sleep. You wake unrefreshed, unrested and may have difficulty focusing on tasks.

Alcohol is not a sleep aid.

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