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Posted on 02/03/2026 4:13:55 PM PST by ConservativeMind
Investigators report that a once-daily intranasal saline spray resolved obstructive sleep-disordered breathing symptoms in nearly one-third of children over six weeks. No added benefit was observed from adding an intranasal steroid for children whose symptoms persisted.
Obstructive breathing during sleep, also called obstructive sleep-disordered breathing (OSDB), is common in childhood and is associated with significant comorbidity. Prevalence in children can reach up to 12%.
Adenotonsillectomy is first-line therapy for pediatric OSDB and a leading reason children undergo surgery, with reported improvements in sleep. Surgery comes at a cost with risk of adverse effects.
In the study, researchers conducted a double-blind, placebo-controlled randomized clinical trial to determine the efficacy of intranasal steroid compared with saline in children with obstructive sleep-disordered breathing.
The trial assessed 139 children aged 3 to 12 years who underwent a six-week saline treatment. Forty-one of those 139 (29.5%) had symptom resolution. Ninety-three children with persistent symptoms at week six were randomized, 47 to intranasal mometasone furoate and 46 continued saline.
Parent views around surgery and specialty care shifted during the initial six-week saline phase. The belief that a child needed surgery was 64.5% at enrollment and 56.3% at week six. Willingness to proceed with surgery if recommended was 91.1% at enrollment and 87.6% at week six.
Randomized results showed similar symptom resolution after the next six weeks of intranasal treatment. Symptom resolution occurred in 16 of 45 children (35.6%) assigned to intranasal steroids and 16 of 44 children (36.4%) assigned to continued saline, yielding a nonsignificant risk difference.
At 12 weeks from the start of the randomized treatment phase, sustained symptom resolution is reported as nine of 45 (20.0%) in the intranasal steroid group vs. 15 of 42 (35.7%) in the saline group.
Investigators concluded that recommending intranasal saline for about three months before reassessing referral needs.
(Excerpt) Read more at medicalxpress.com ...
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Which is why it will never see the light of a doctor’s office.
No money to be made by prescribing saline spray.
It will never be taught in medical school. So, future doctors won’t know about it.
Maybe if you can manage to get your kid treated by a DO he might avoid unnecessary surgery.
Saline can keep nasal passages moist, but it doesn’t help a deviated septum. I was addicted to Afrin Nasal Spray for well over 20 years. I’d been given a bottle by a doctor who had treated me for a bad cold, and continued using it, eventually becoming dependent on it. During one of my surgeries in 2012, I spoke to the hospital doctor about getting off it. He provided me with a script for a non-addictive nasal spray, and told me to follow up with an ear, nose and throat doctor, which I did. He diagnosed me with a deviated septum and Rhinitis. I use the prescribed nasal spray Ipratropium Bromide twice a day to stop my nose from constantly running. At night, I still use Breathe Right Nasal Strips.
I remember taking Afrin, decades ago.
That was the most amazing nasal spray I have ever had.
Thankfully, I don’t have a need for any, but that is the one I would go to, before neti pot-type saline use, now available.
I never liked Afrin.
Too much irritation.
It worked well for me for quite a while, but as time went on, the relief lasted only briefly, and my nasal passages would swell back up. I can still remember panicking if I had forgotten to bring it with me. The ear, nose and throat doctor I went to, told me I was lucky not to have had it cause any damage to my nasal passages, because he had seen people addicted to it with septal perforation – a hole in the nasal septum.
A shot of whiskey or bourbon at bedtime will make the other 2/3rd sleep tight.
It’s addictive. You can’t use it longer than a few days. When you quit, your nose will give you trouble for a while.
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