There are a number of reasons why people who are susceptible to sinus infections tend to contact them during air travel. Sharing stale air in close proximity to others is certainly one reason, and oftentimes this air contains more bacteria and viruses than the air in our normal living environments. The low humidity in plane cabins is another contributing factor. The dry air we breathe in airplanes tends to impair the normal mucous-cilia system and make people more prone to bacteria and viruses. Since airplane cabins are pressurized and the pressure is changing during climb and descent, this can also have harmful effects.

Four suggestions to obtain sinus pressure relief in conjunction with air travel include: drinking lots of water before and during long flights; using a saline solution during the flight; doing the Modified Valsalva maneuver; and taking a decongestant before air travel.

Drink Lots of Water

The air intake that occurs at very high altitudes to ventilate plane cabins contains very dry air. Drinking water prior to and during flights can help retain moisture in the body and keep the nasal system as moist as possible. In addition, alcohol and caffeine are often consumed by people on long flights, and these also tend to dehydrate people. Making an effort to drink water regularly on long flights can help avoid dryness of the nasal passages.

Use Saline Solution Often During the Flight

It is wise to bring a small bottle of saline solution along and use it every hour or so to help keep the nose moist. Over the counter saline solutions all contain preservatives, and some people are bothered by these. It is possible to mix a solution yourself without preservatives and avoid this problem. One-half of a teaspoon of salt added to 8 oz. of water is a proper mixture. I personally use a product called Breathe-ease XL® for both nasal irrigation and for making a spray bottle without preservative, and this will be good to use for about a week. These saline sprays offer sinus pressure relief by keeping the nasal membranes irrigated and maintaining proper drainage.

Use the Modified Valsalva Maneuver

Dr. M. Lee Williams describes the maneuver in his book “The Sinusitis Help Book". To do this one clamps the nose between the thumb and forefinger, swallows, and then immediately blows into the nose without letting go. One should not blow forcefully into the nose, a gentle pressure will suffice. Dr. Williams says that this should be done several times per minute during ascent and especially descent as cabin pressure is changing during those times. It should also be done several times per hour while the plane is at altitude. It is important not to forget to swallow just before blowing gently into the nose.

Consider Taking a Decongestant Before the Flight

I generally use flonase spray each night as part of my regular regime to combat sinus problems. I’ll also use it about an hour or two before any flight. On long flights to Europe, I’ll also take 5 mg of prednisone. I find this keeps my nasal passages clear and functioning well, even though flights to Europe from the U.S. are long. Prednisone should be used very sparingly, however, as it can cause damage to the immune system, so this should be taken only in consultation with your doctor.

By realizing that the air in airplane cabins is stale, dry and often polluted, one can obtain sinus pressure relief by drinking lots of water before and during flights, using a saline spray, doing the Modified Valsalva maneuver as described above, and taking a decongestant prior to takeoff, especially on long trips. You should also try to simply avoid air travel if you have a cold and stuffiness prior to a trip. This and many other sinus related topics are discussed at