Rhinitis medicamentosa is a condition that leads many to using bottle after bottle of over-the-counter nasal sprays just to be able to breathe.
I decided that after a year of having to spray my nose two or three times per day just to be able to breathe that I was going to fight my addiction and quit using Afrin, cold turkey.
When I use the term addiction, I’m referring to the condition Rhinitis medicamentosa. This condition is caused by extended use of medicated nasal spray products. If you use these products beyond the two or three day maximum outlined on the packaging, you may find yourself in a cycle of rebound nasal congestion. What I mean by this, is that you may find your nasal symptoms coming back regularly, getting worse, with the only relief being found if you spray your nose again. You may find yourself increasing the dosage and/or the frequency of dosing, which will worsen your condition.
Afrin is not the only nasal spray that can cause this condition. Any nasal spray with oxymetazoline, phenylephrine, xylometazoline, or naphazoline as an active ingredient can cause this condition. Some users continue using nasal spray multiple times daily for years because their rebound nasal congestion is just that bad. To sum up what happens when you use nasal spray: medicated nasal sprays cause the blood vessels of the nose to contract. With the decreased blood flow to the lining of the nose, the tissue becomes less congested and mucous production is slowed. However, the effect is short-lived, and after continued use of these products, you become tolerant of the compounds in them, so you require more frequent and higher doses to prevent the rebound congestion that results when the medicine wears off. In my personal experience, the rebound congestion can last longer and be many times more severe than the initial congestion you were treating with the spray in the first place.
Over the last year, I kept trying to quit using nasal spray. After a few hours of not being able to breathe, I eventually caved every single time and sprayed my nose to resume normal breathing. I noticed a feeling that the roof of my mouth had softened, a sensation I’d never had before. I would notice it whenever I would suck on a piece of hard candy or drink through a straw. It felt like the suction in my mouth was pulling on my sinus cavity. I didn’t know if I was doing permanent damage, but I knew I needed to stop using nasal spray.
When I finally stopped, I didn’t make plans to do so, I just found myself in the right circumstances to give it another try. I fortunately have a three day weekend because of my 4×10 shift. I forgot to spray my nose before going to work on the last day of my week, and also forgot to put my nasal spray in my purse, so I had to go the whole day without Afrin. By the time I got home from work, it had already been 21 hours since my last use, and things seemed to be getting better, which is what inspired me to try to quit again.
That first night was a battle. I kept waking up. I probably snored. I can’t breathe through my mouth when I sleep because I clench my jaw, so not being able to breathe through my nose guarantees my sleep will be disrupted. Trying to sleep seemed impossible that night. My nose stopped up every time I laid down, but cleared when I stood up. I got less than three hours of sleep that night. Thankfully, I didn’t have to work the next day.
The next day I was tired, but I could breathe. The following night, as I got ready for bed, anticipating another rough night, I contemplated just spraying my nose to get a good night’s sleep and trying again another time. I fought the urge and laid down. Surprisingly, I could still breathe. My nose didn’t stop up, and I slept well. I couldn’t believe that I had been using nasal spray religiously for so long, and I could have fought my addiction off in one night. It wasn’t an easy night, by any stretch, but the relief of not having to worry about running out of nasal spray or sneaking off to the bathroom at work to spray my nose is well worth it.
That’s not to say that every nasal spray addict’s experience will be like mine when they quit. I had only been using Afrin two to three times per day for a year. Someone with higher usage or more years of usage may be in for more than one rough night. It may be beneficial for these people to take over the counter decongestants to alleviate some of the symptoms while they are transitioning to not using nasal sprays. In severe cases, oral steroids may be necessary to reduce the inflammation. In rare cases, it’s even possible that surgery may be necessary depending on the severity of their sinus condition. I consider myself lucky that I stopped when I did.