Sinus Congestion

What they are: There are two over-the-counter medications approved for use as sleep aids to manage occasional insomnia:

• Diphenhydramine. The active ingredient in the antihistamine Benadryl, this medication also is found in brand name sleep aids such as Tylenol PM and Sominex, as well as numerous generic sleep aids.
• Doxylamine. The active ingredient in Unisom, doxylamine also is found in generic sleep aids.

Why to buy: Diphenhydramine and doxylamine effectively induce drowsiness and lead to uninterrupted sleep for many people. These products come in many forms, including soft gels, tablets, caplets, and chewables. Soft gels and chewables are faster acting than tablets.

Things to consider: You should not take diphenhydramine or doxylamine if you are pregnant or breast-feeding, or if you have glaucoma, heart problems, enlarged prostate, or ulcers. Additionally, do not take doxylamine if you have or have had asthma or bronchitis. Some people feel groggy the next day after taking these medications. For very few people, especially children, diphenhydramine and doxylamine may cause agitation and alertness, which will not help insomnia!

What they are: Natural sleep aids include dietary supplements, herbs, and other non-medication substances. Common natural sleep aids include:

• Melatonin. A hormone naturally produced by the body to induce sleep, which can be taken as a dietary supplement as well
• Valerian, chamomile, lemon balm, and passionflower. Herbs believed to have sleep-inducing and relaxation properties
• Kava kava. An herb with relaxation properties, which is no longer recommended by many health care providers due to potential problems with liver toxicity
• Theanine. A substance found in green tea that can promote relaxation and sleep.
• Magnesium. A mineral that the body uses to relax muscles
• Lavender. An aromatherapy herb (smelled, not taken orally) that may promote relaxation and restfulness
• Hops. A plant best known as a flavoring component for beer, which can be used as a dietary supplement to manage insomnia
• L-tryptophan. An amino acid (a building block for protein) that may improve sleep for some people

Why to buy: Some of these herbs and dietary supplements have research to support that they may be helpful for managing insomnia, including melatonin, valerian, chamomile, passionflower, theanine, magnesium, hops, and L-tryptophan. They may be less likely to cause next-day grogginess than over-the-counter sleep medications.

Things to consider: Natural does not always mean safe. All dietary supplements and herbs should be carefully reviewed with your healthcare provider or pharmacist. If you are managing a health condition, this will help to ensure a supplement is safe to combine with medications you are using. Use plant- and herb-based natural sleep aids with caution if you have hay fever or seasonal allergies; some of these products may cause allergic reactions in susceptible individuals. Natural sleep aids may not be safe for people with a history of mental health conditions, such as anxiety or depression. If in doubt, talk to your doctor first. Magnesium can have laxative effects, so start with a low dose to assess your tolerance to this mineral.

What they are: Stop-snoring products are designed to decrease bothersome snoring, either through physically opening breathing passageways, or by changing how the muscles in the mouth and throat are contracting or relaxing. Mouthpieces and nasal clips and strips are used to open breathing passages. Homeopathic, herbal, and other natural substances are taken orally or sprayed into the throat to ease snoring.

Why to buy: Some people find stop-snoring products to be helpful. They are relatively inexpensive and the products designed to physically open breathing passages are safe for nearly everyone.

Things to consider: Snoring can signal a serious health condition, such as sleep apnea. If you’ve developed snoring recently, if your snoring is severe, or if you are groggy most of the time during the day, talk to your doctor before you try to self-treat snoring.

What they are: Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin and the non-aspirin medications ibuprofen and naproxen. NSAIDs block the production of prostaglandins, substances made by the body that cause pain, inflammation, and fever.

Why to buy: NSAIDs relieve muscular and joint pain and may help manage menstrual cramps. Some people find them helpful for treating headaches, especially aspirin (see specialty pain relievers below for more information). NSAIDs may also lessen pain associated with colds, flu, and toothaches.

Things to consider: Non-aspirin NSAIDs (ibuprofen, naproxen) slightly increase the risk of heart attack, while aspirin decreases heart attack risk. If you have existing heart disease, or if you already take daily aspirin to lower heart attack risk, consult your doctor before using ibuprofen, naproxen, or additional aspirin. All NSAIDs may increase the risk of bleeding and may cause ulcers in some people. If you have a sensitive stomach, acetaminophen may be a better option.

Children and teens should not use aspirin or ibuprofen as it can lead to a rare, life-threatening reaction called Reye’s (pronounced “rise”) syndrome in these age groups.

What it is: Acetaminophen is a non-NSAID pain reliever and fever reducer that is believed to work by decreasing the body’s sensitivity to pain (in other words, by raising the pain threshold).

Why to buy: Acetaminophen is a fever reducer that may help manage many of the same pains as NSAIDs, including headaches, toothaches, muscular and joint pain, menstrual cramps, and painful cold and flu symptoms. Acetaminophen often is used instead of NSAIDs, because it is easier on the stomach, and is safe for use in children and teens.

Things to consider: Use as directed. Exceeding the recommended dosage can cause liver disease and even death. Use caution with acetaminophen and alcohol as this combination can harm the liver. Acetaminophen may not be right for people with liver disease or abnormal liver function.If in doubt, always consult your doctor.

What they are: Specialty pain relievers include those that contain NSAIDs or acetaminophen, plus other ingredients to treat a particular issue.

Why to buy: People use specialty pain relievers when they have a cold or flu, to help them sleep when they have pain, or to treat severe headaches such as migraines. The additional ingredients are targeted to the problem. For example, cold and flu products may contain pseudoephedrine, dextromethorphan, or guaifenesin, to manage sinus pain, cough, and congestion, respectively. Migraine formulas often contain aspirin, caffeine, and acetaminophen, a combination especially effective for headaches.

Things to consider: These products contain the same ingredients as regular pain relievers—either NSAIDs or acetaminophen—so apply the same cautions. Additionally, you may need to avoid other ingredients in these products. Consult your doctor if you are unsure.

Some specialty pain relievers are not safe for use in young children and those that contain aspirin always should be avoided. Ask your pediatrician or pharmacist if you need help selecting an appropriate product for your child.

What they are: “Topical” refers to pain relievers that are applied to the skin. They may contain NSAIDs like aspirin or diclofenac, or anaesthetic aromatic compounds like menthol and camphor. These aromatic compounds can be derived from plants but most commercial products contain synthetic versions. Menthol is derived from plants in the mint family and creates a cool sensation; camphor is derived primarily from the camphor laurel tree and may produce either warm or cool sensations. Some topical pain relievers combine menthol with methyl salicylate, an aromatic compound from wintergreen that is chemically similar to aspirin.

Why to buy: If you have pain over a small area, such as a muscle or joint, a topical pain reliever can deliver medicine straight to the area, without having to go through the digestive tract. This may bring faster relief, typically with fewer side effects.

Things to consider: If a topical pain reliever contains the same active ingredient as another medication you are using, such as aspirin, do not take the two products together. Pain relievers applied to the skin are still drugs and should be treated as such.The same cautions apply, such as avoiding topical aspirin if you already take daily aspirin or if you are at risk of bleeding or ulcers. Do not use aspirin-based topical pain relievers on children or teens without first checking with your doctor. If you choose a topical preparation with aromatic compounds, check to see if methyl salicylate or wintergreen oil is on the list of ingredients. Methyl salicylate overdose can occur if it is used over a large area of the body or very often. The risk of overdose is higher for babies and toddlers.

What they are: The best offense is a good defense. Immunity-supporting products are formulated and packaged to support immune function at times when your system is under threat. Most commonly, these products contain vitamin C or zinc, and come in a variety of forms that make it easy to take at the earliest sign of cold symptoms, or other common infections that strike when you’re feeling run down.

Why use them: Studies have shown the positive health and immune benefits of taking vitamin C and zinc, especially at the first signs of sickness, and these types of nutritional products are safe and easy to take. They’re available in a variety of formulas such as chewables, quick-dissolving tablets, nasal sprays (except zinc nasal sprays, which have been associated with loss of smell), lozenges, and effervescent drink powders you add to cold or hot water.

Things to consider: Before adding supplements to your diet, make sure you consult your doctor and do your homework.

What they are: Similar to adult products, but formulated in lower, kid-friendly dosages to best support their kid-size immune systems.

Why use them: A safe and easy way to boost their defenses, children’s immune products are usually available as gummies or chewables in a variety of fun flavors, making it easier to get your little ones to take their vitamins.

Things to consider: Look for supplements formulated for your child’s age range. If your child has never taken supplements before, it is best to talk with their pediatrician first, especially if they’re taking medications.

What they are: To keep your immune system strong, probiotics like acidophilus support healthy digestion and naturally boost your body’s defenses.

Why use them: Research suggests probiotics may help prevent colds and can help to balance the good bacteria in your digestive system to keep it on track.

Things to consider: Not all probiotic formulas have the same effects on the body, and some products contain more “friendly bacteria" than others. Refrigerated probiotic products, including those that are added to yogurts and other foods, are often a good bet, as the colony-forming units are likely to be preserved. However, probiotic powders are also available in capsules and packets.

What they are:These beverages often include a mix of vitamins and minerals for overall vitality, such as B-complex and vitamin C.

Why use them: Vitamin-enhanced waters and drinks have not been well studied, but as long as they are not laden with sugar, they may provide some extra vitamins—and at the very least they can help you stay hydrated.

Things to consider: Pay attention and read labels so you don’t get more than you bargained for, as many may also include sugar and stimulants such as caffeine, guarana, and ginseng. And make note of how many servings are in the container, as calories from enhanced beverages can add up fast—or try one of the low- or no-calorie varieties.

What they are: These products contain gels or other materials that can be used hot or cold. When placed in the freezer before use, they become cold therapy. To use as hot therapy, the product can be heated in hot water or the microwave.

Why to buy: If you aren’t sure whether you need hot or cold therapy, a dual use product will give you both options.

Things to consider: Determine how long it takes the product to become hot or cold enough for use, how long you can expect the pack to stay hot or cold when in use, and whether this fits your needs. Some products can be microwaved for quick heat up, while others have to be placed in hot or boiling water, which takes a little more time and effort.

What they are: These products are designed to supply heat only. They include electric hot pads, heatable gel pads, hot water bottles, and single use “sticky” products that are applied directly to the skin.

Why to buy: If you have a chronic condition that responds well to heat, focus on getting the best heat source for your money.

Things to consider: Electric heating pads stay hot as long as they are plugged in, but you must stay near an outlet. It is not safe to sleep on or with most electric hot pads, so choose another option for nighttime use. Heatable gel pads and sticky pads are more portable, but the heat lasts only for an hour to a few hours.

What they are: These products are designed to supply cold only. They include ice packs and freezable gel packs.

Why to buy: If you know you need cold to treat your condition, keeping one or two of these products in the freezer provides cold therapy right when you want it. If you want cold longer than a single product provides, rotate two packs into and out of the freezer.

Things to consider: Do not use cold therapy for longer than recommended, because long periods of cold exposure can damage skin. Place a towel between the ice pack and your skin if recommended in product instructions.

What they are: Topical products provide a hot or cold sensation over the area to which they are applied. Some products start with a cold sensation and move toward heat over time.

Why to buy: These products are quick and convenient—you rub onto the skin and go. Many are formulated so they don’t stain clothing or have a strong odor. Some products have a pleasant odor, adding aromatherapy to the healing experience.

Things to consider: Some hot and cold therapies are topical, meaning they are applied to the skin. These may contain additional pain-relieving medicines, such as aspirin (products with aspirin should not be given to children). Always compare ingredients to avoid accidentally combining more than one therapy with the same active ingredients. If unsure, check with your doctor or pharmacist about whether these are safe for you. Test any topical product on a small area prior to full application, to ensure it doesn’t cause skin irritation or an allergic reaction.

What they are: Evaporative humidifiers work by drawing dry air into the unit and then over a moistened wick or other material. The moistened air is dispersed back into the room.

Why to buy: This type of machine has the capacity to humidify large areas. Evaporative models are the least expensive type of humidifier to purchase and operate, and they don’t require expensive filters.

Things to consider: Evaporative units tend to be noisier, require more frequent cleaning than other humidifiers, and cannot raise humidity above 40% to 50%. Wicks may need to be replaced periodically, though wicks tend to be less expensive than the filters required in other models.

What they are: Ultrasonic humidifiers use a thin, rapidly vibrating metal plate or diaphragm to create tiny water particles, which generates a mist. The mist is pushed into the room with a fan. Some units have the option of heating the water before it hits the vibrating plate.

Why to buy: Ultrasonic models are quiet and easy to clean, and warm mist can raise humidity faster than cold mist or evaporative humidifiers. A warm mist option may be preferable in cold climates. There is no limit to the amount of humidity that can be added to the air.

Things to consider: These units are more expensive than evaporative humidifiers, and most require replacement filters and demineralization cassettes, which increase operation costs. Ultrasonic models humidify a smaller area than similarly sized evaporative humidifiers, and must be placed several feet off the floor for optimal functioning.

What they are: Over-the-counter decongestant nasal sprays contain oxymetazoline, phenylephrine, xylometazoline, or naphazoline, which are medications that open up nasal passages by constricting blood vessels in the lining of the nose.

Why to buy: These products offer quick relief from nasal and sinus congestion, they are available at any pharmacy, and they are relatively inexpensive.

Things to consider: Decongestant nasal sprays should not be taken for more than five days at a time. Use for more than a few days can lead to a worsening of symptoms, a condition called rebound effect or rhinitis medicamentosa. Do not use these products without consulting your doctor if you have high blood pressure, heart disease or irregular heart beats, thyroid problems, diabetes, glaucoma or increased pressure in the eye, an enlarged prostate or difficulty urinating, liver disease, kidney disease, or are taking a MAOI (monoamine oxidase inhibitor) medication.

What they are: Saline nasal sprays are a mild salt water solution used to flush out the sinuses and rinse away mucus, allergens, and other debris that can irritate the nasal lining and sinuses. Saline rinses using a neti pot or other irrigation systems are another alternative.

Why to buy: These products may be helpful for people with seasonal allergies, dry nasal passages, or thick mucus due to a cold or sinus infection. Rinsing away allergens, bacteria, and other irritants may lessen symptoms.

Things to consider: Saline nasal sprays are available over the counter and are safe and easy to use. If you are trying to limit your use of decongestant nasal sprays to avoid rebound effect, saline sprays may be a good option.

What they are: Natural and homeopathic nasal sprays often use a saline solution as a base and contain added natural ingredients, such as capsaicin to ease pain and inflammation, nettle for allergies, peppermint to clear sinuses, feverfew for headaches, and zinc for colds.

Why to buy: Some of the individual ingredients in natural nasal sprays are research-proven to help specific symptoms when taken orally or applied topically, such as nettle for allergies, feverfew for headaches, and capsaicin for pain. Most are not well studied for use in nasal sprays, but are generally considered safe when used as directed. They may provide more relief than saline spray alone.

Things to consider: Most of the herbs and other ingredients in natural nasal sprays have a good track record of safety, but zinc nasal sprays have caused permanent loss of smell in some people and all of these substances may potentially interact with medications. If in doubt, ask your doctor or pharmacist if these products are safe for you, especially if you regularly use other over-the-counter or prescription medications.

What they are: Antihistamine nasal sprays are available by prescription only and contain medications which lessen nasal and sinus allergy symptoms.

Why to buy: If you have seasonal allergies or hay fever that cause significant discomfort and that are not well managed with other medications or lifestyle changes, an antihistamine nasal spray may be a good option.

Things to consider: These products alleviate nasal and sinus symptoms related to allergies. They will not lessen symptoms of a cold or other non-allergy symptoms. Antihistamine nasal sprays can cause drowsiness, fatigue, and nosebleeds in a small percentage of people who use them.

What they are: Corticosteroid nasal sprays are available by prescription only and contain medications to lessen sinus inflammation and pain due to a variety of causes.

Why to buy: Corticosteroid nasal sprays often are used to manage nasal and sinus symptoms due to allergies, but can reduce inflammation due to other causes as well. If you have chronic sinusitis, these products may be a good option for you.

Things to consider: Symptoms often return when corticosteroid nasal sprays are stopped, so they may be prescribed for years. To date, no studies have identified health risks linked to long-term use. Corticosteroid nasal sprays can cause burning, dryness, irritation and itching in the nose and throat, nosebleeds, runny nose, headaches or upset stomach in some people.

What they are: Most cold and flu remedies use the same active ingredients and are formulated for common symptom combinations: These might include a nasal decongestant, a pain reliever-fever reducer (most use acetaminophen), an antihistamine (to help with sneezing and runny nose), and a cough suppressant. Soothing throat drops often contain a cough suppressant such as menthol, and cough syrups have an expectorant such as guaifenesin to ease chest congestion.

Why to buy: Formulated to provide quick and effective relief, cold and flu products are available in a wide variety of easy-to-take forms, from tablets and capsules to liquids and nasal sprays. Look for variations for night-time or day-time use and long-term release formulas.

Things to consider: Decongestants may lead to wakefulness, antihistamines and alcohol may cause drowsiness. Phenylephrine, a common decongestant, may increase blood pressure so read labels carefully if you have heart concerns. And remember: not all medications play well together so use care if you plan to combine products.

What they are:Similar to adult cold and flu remedies, kid-friendly versions are formulated with ingredients in lower dosage amounts.

Why to buy: When your child is miserable with the cold or flu, many parents are looking for ways to quickly ease symptoms. Children’s products are safe and easy to take—and a spoonful of sugar won’t be needed to get their medicine to go down, as most are available in fun, fruity flavors.

Things to consider: Read labels carefully and don’t exceed recommended dosage amounts. Many children’s formulas contain sugar and flavors to make them taste better, so make certain you store medications out of reach so the kids don’t help themselves. If you have a child under age two, take extra care to make sure you are only using recommended medicines.

What they are: Lozenges and sprays contain soothing and numbing ingredients to ease your pain. Cold products containing aspirin or other pain relievers may also help.

Why to buy: Scratchy, sore, or painful throats deserve quick relief. Choose products enhanced with vitamin C or zinc, known for their immune-supporting power.

Things to consider: Most cough and throat drops are available sugar-free, ideal for people with diabetes or those avoiding sugar (always a good idea when you’re sick). Pay attention to ingredients as some cough and throat syrups contain alcohol which may cause drowsiness.

What they are: Fever and pain reducers are available in a variety of formats, from liquids to tablets, to help prevent the body from overheating and feeling the discomfort of aches and pains. Many fever and pain reducers are nonsteroidal anti-inflamatory drugs (NSAIDs).

Why to buy: Running a fever can be miserable, but several over-the-counter options may help you manage:

• Ibuprofen (NSAID): A proven fever reducer, also good for pain relief and reducing inflammation, ibuprofen is usually less irritating to the stomach than aspirin (although drinking alcohol can increase the chances of stomach issues).
• Aspirin (NSAID): Used to combat fever and pains associated with common cold for decades, aspirin is known to offer sustained fever relief and help alleviate achiness, discomfort, headache, and sore throat pain. Effervescent aspirin has been shown to alleviate pain faster than tablets.
• Naproxen (NSAID): Naproxen can be harder on the stomach, however, it’s a proven pain reliever and fever reducer, known to provide longer relief on a single dose and to offer the smallest overall cardiac risks of all NSAIDs.
• Acetaminophen: A pain reliever and fever reducer used in many cold and flu products, and approved for use in all ages, it’s easy on the stomach, though it may carry some risk of liver issues, especially when combined with alcohol use.

Things to consider: Pay attention when using nonsteroidal anti-inflammatory drugs (NSAIDs), as you should only take one at a time, and they can have a negative impact on heart health (except for aspirin at a low dose). Do not give ibuprofen or aspirin to children or teens with a fever, due to risk of Reye’s Syndrome. As with any medication, read labels carefully and don’t exceed the recommended dosage unless directed by a doctor.

What they are: Nonsteroidal anti-inflammatory drugs (NSAIDs) include aspirin ibuprofen, and naproxen. NSAIDs block the production of prostaglandins, substances made by the body that cause fever.

Why to buy: NSAIDs effectively lower a fever, can lessen muscle aches and pains that accompany a cold or flu, and are available as brand name and generic products. Generics typically cost less. NSAIDs come as tablets, soft gels, or caplets, and ibuprofen comes in a chewable children’s form. Some NSAIDs are available in powdered drink formula, in combination with other ingredients, which are designed to address a variety of cold and flu symptoms in addition to fever.

Things to consider: Non-aspirin NSAIDs (ibuprofen, naproxen) slightly increase the risk of heart attack, while aspirin decreases heart attack risk. If you have existing heart disease, or if you already take daily aspirin to lower heart attack risk, consult your physician before using ibuprofen, naproxen, or additional aspirin. All NSAIDs can increase the risk of bleeding and may cause stomach or duodenal ulcers in some people. Those with sensitive stomachs may want to try acetaminophen instead. Never use aspirin to treat children or teens.

What it is: Acetaminophen is a non-NSAID fever reducer, which also can be used to manage headaches, toothaches, muscular and joint pain, menstrual cramps, and pain due to cold and flu.

Why to buy: Acetaminophen often is used instead of an NSAID, because it does not increase the risk of heart attack or bleeding and it is safe for children and teens. Acetaminophen can be found in tablet, soft gel, caplet, and children’s chewable form. Some powdered drink formulas contain acetaminophen in combination with other ingredients, which are designed to address a variety of cold and flu symptoms in addition to fever.

Things to consider: Use caution with acetaminophen and alcohol; this combination can harm the liver. Acetaminophen may not be right for people with liver disease or abnormal liver function, and excessive doses can damage the liver.

What they are: Specialty fever reducers contain NSAIDs or acetaminophen, plus other ingredients to treat a particular issue.

Why to buy: People use specialty fever reducers when they have a cold or flu and need relief from additional symptoms. Cold and flu products that reduce fever may also contain pseudoephedrine to manage sinus pain, dextromethorphan to quiet a cough, or guaifenesin to loosen congestion.

Things to consider: These products contain the same ingredients as regular fever reducers—either NSAIDs or acetaminophen—so the same cautions with use apply. Additionally, you may need to avoid certain other ingredients in these products. Consult your doctor if you are unsure. Specialty fever reducers that contain aspirin are not safe for children or teens. If you need help selecting an appropriate product for your child, ask your pediatrician.