How Chronic Rhinosinusitis with Nasal Polyps and Asthma are Connected
Both asthma and CRSwNP are long-lasting diseases that involve Type 2 inflammation. They often occur together. Type 2 is a kind of inflammation (swelling) in the airways caused by an overactive immune response.
CRSwNP happens when the nose and sinus passages stay swollen for many weeks. Small, soft, benign (noncancerous) growths called nasal polyps (also called nasal polyposis) develop in the nasal passages.
- CRSwNP affects about 1 to 4 out of 100 adults, according to a large review of sinus disease research.
- About 25–50 out of 100 people with severe CRSwNP have asthma, which means these two conditions often occur together.
This patient guide explains how CRSwNP and asthma are connected. It addresses how treating both conditions together can help you breathe well and feel better.
At a Glance: Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)
The polyps may be painless, but they can make daily life harder.
- Common symptoms include a stuffy nose, loss of smell, pressure in your face, fatigue, chronic mouth breathing, and trouble breathing through your nose.
- Many people with CRSwNP also have asthma or allergies.
- Treatments include nasal sprays, medicines, biologics (shots), and sometimes surgery. Nose rinses with salt water are also effective.
- CRSwNP is a long-term condition, but with the right care, many people feel much better and can do the things they want to do.
What is Chronic Rhinosinusitis with Nasal Polyps?
Your sinuses are hollow spaces in the bones of your face, and your nasal cavity is the open space inside your nose. Together, they help you breathe, warm the air, and drain mucus.
- The word “rhino” means nose, and “-itis” means inflammation. So rhinosinusitis is swelling in both the nasal cavity and sinuses.
- When the nasal cavity and sinuses stay swollen and blocked for 12 weeks or longer, it is called chronic.
Chronic rhinosinusitis (CRS) can cause a stuffy nose, facial pressure, trouble smelling, and thick mucus that drips down your throat. When sinuses are flaring up, it can cause difficulty breathing. It can also force you to constantly breathe through your mouth.
Up to 30 out of 100 people with CRS also develop nasal polyps. Nasal polyps are soft, painless, benign growths. They can form in the nose or sinuses when the tissue stays swollen for a long time. The polyps can block airflow and make it harder to breathe through your nose.
When someone has both chronic sinus swelling and nasal polyps, it is CRSwNP.
How Are Chronic Rhinosinusitis and Asthma Connected?
Asthma is a condition in which the airways (the tubes that carry air to your lungs) become inflamed and the muscles around them tighten. This makes the airways smaller, so it is harder to breathe.
People with asthma are also more likely to have chronic rhinosinusitis and/or nasal polyps. These conditions all involve inflammation, or swelling and irritation inside your airways.
When swelling happens in the nose or sinuses, it can affect the lungs, too. This is because the nose, sinuses and lungs work together as one “united airway.” Inflammation in one part of the airway can spread or trigger symptoms in another part.
CRSwNP and asthma often happen together because they are caused by Type 2 inflammation. This chronic inflammation is a kind of long-lasting immune response that can become overactive. As a result, people with both CRSwNP and asthma often have a hard time controlling symptoms and may feel the conditions affect their daily life more.
If nasal polyps block your nose, they can make asthma symptoms worse. This can lead to:
- More coughing, wheezing or chest tightness
- More asthma flare-ups
- Harder time breathing through the nose and lungs
Keeping both conditions treated can help improve breathing, sleep, and daily comfort. This is why treating your sinus symptoms can also help your asthma feel better.
The Science Behind the Connection: Type 2 Inflammation
The nose, sinuses, and lungs are all part of a single airway system. When one part becomes swollen, the rest can be affected too. This is why people with chronic rhinosinusitis with nasal polyps (CRSwNP) often also have asthma.
What is Type 2 inflammation?
Your immune system is your body’s defense system. It protects you from germs and helps you heal when you are sick or hurt. In Type 2 inflammation, your immune system becomes overactive. It keeps sending signals that cause chronic inflammation, even when there’s no germs to fight off.
Type 2 inflammation happens when certain immune cells become too active:
- Th2 cells start the inflammation. These cells send out chemical signals called interleukins (IL-4, IL-5, IL-13). These signals activate (turn on) other immune cells like eosinophils and mast cells.
- Immunoglobulin E (IgE) antibodies are an important part of this process. IL-4 and IL-13 signal cells to produce IgE, the antibody most closely linked to allergic reactions. IgE attaches to mast cells and basophils. When the body encounters an allergen, IgE triggers these cells to release histamine and other chemicals that cause swelling, itching, mucus and airway tightening.
- Eosinophils are white blood cells that normally fight germs. When they are activated by Th2 signals, you get too many of them. This causes swelling in your nose, sinuses, and lungs.
- Mast cells are involved in allergic reactions. When activated by Th2 signals, they release chemicals that make your airways swell. They also trigger your body to make extra mucus.
This long-lasting swelling often affects the nose, sinuses, lungs and skin. Many conditions, like asthma, chronic rhinosinusitis with nasal polyps (CRSwNP) and allergies, are caused by this type of inflammation.
The ‘Unified Airways’ concept
Your nose, sinuses and lungs work as one connected airway system. Doctors call this the “Unified Airways” or “United Airways” concept.
This means swelling in one area can affect other areas.
- When the nose or sinuses become inflamed, it can trigger inflammation throughout your airways. The upper airways include your nose, sinuses, and throat. The lower airways include your lungs and the tubes that carry air to them.
- Asthma symptoms like coughing, wheezing, or chest tightness may worsen.
- Sinus blockage can also make it harder to breathe and may worsen asthma control.
This connection is supported by research showing that CRSwNP and asthma share the same Type 2 inflammation. Because the upper and lower airways are connected, you may work with both an ENT (who treats the nose and sinuses) and an allergist or pulmonologist (who treats asthma and lung issues).
How CRSwNP develops
The exact cause of CRSwNP is not fully understood, but several factors contribute to its development.
The inside of the nose and sinuses is covered by a mucosal barrier. This barrier helps block germs, dust, and irritants. In people with CRSwNP, the barrier becomes weaker. When irritants get through, the body reacts with chronic inflammation.
Over time, this constant swelling can change the sinus tissue and lead to nasal polyps. Patients with CRSwNP and asthma may also have higher levels of:
- IgE. This is the protein your immune system makes. It is involved in allergic reactions. High IgE levels can increase swelling.
- Eosinophils. These are white blood cells that normally help fight infections. When you have too many, they cause eosinophilic inflammation in the airways.
CRSwNP and asthma symptoms affect three areas of the body: the nose, sinuses and lungs. As a result, people with both conditions have a hard time controlling symptoms.
Symptoms of CRSwNP and Asthma
Your symptoms may vary depending on whether inflammation is affecting your nose, your lungs, or both. Because your airways are connected, symptoms can overlap and feel similar. This can make it difficult to tell which condition is causing your symptoms.
“Smell and taste loss are common in CRSwNP and are often one of the symptoms patients find most disruptive.”
| Symptom | CRSwNP | Asthma |
|---|---|---|
| Reduced or lost sense of smell | x | |
| Loss of taste | x | |
| Stuffy or blocked nose | x | |
| Trouble breathing through the nose | x | |
| Facial pain, pressure or fullness | x | |
| Thick nasal discharge | x | |
| Postnasal drip | x | |
| Wheezing (whistling sound when breathing) | x | |
| Chest tightness | x | |
| Shortness of breath | x | |
| Feeling out of breath during exercise | x | |
| Trouble breathing during allergies, colds, or infections | x | |
| Coughing | x | x |
| Sleep problems from congestion or breathing trouble | x | x |
| Difficulty breathing comfortably | x | x |
| Swelling that causes congestion | x | x |
Swelling in the nose and sinuses can make asthma worse, and poorly controlled asthma can make sinus symptoms worse. This is why treating both conditions together often leads to better symptom control.
Who is Most at Risk for CRSwNP and Asthma?
Some people are more likely to develop chronic rhinosinusitis with nasal polyps (CRSwNP) along with asthma. Research shows that between 20 to 60 out of 100 people with CRSwNP also have asthma, and many severe asthma patients have nasal polyps. Knowing your risk can help you understand your symptoms earlier and get the right treatment sooner.
Allergic rhinitis (sometimes called hay fever)
People with allergies (especially to pollen, dust mites, or pet dander) are more likely to develop long-lasting sinus swelling. Ongoing allergies can keep the nose inflamed. Long-term swelling increases the chance that nasal polyps develop. This can make asthma symptoms harder to control.
AERD (Aspirin-Exacerbated Respiratory Disease)
This medical condition involves asthma, nasal polyps, and sensitivity to aspirin or NSAIDs (medicines like ibuprofen or naproxen). People with AERD often have more severe symptoms and may notice fast-growing polyps.
Family history
If close family members have asthma, allergies, or nasal polyps, your chances of developing these conditions may be higher. This may run in families because of genetics, or because family members are often exposed to the same things at home and in their neighborhood (like mold, dust, pets, or air pollution).
Smoking or secondhand smoke
Breathing in cigarette smoke (either your own or someone else’s) can irritate your airways and increase inflammation in both the lungs and nose.
Certain jobs or environmental exposure
People who work around dust, strong smells, chemicals or fumes may be at higher risk. These irritants can inflame the sinuses and lungs. Examples include cleaning, construction, manufacturing, and salon work.
Older age
CRSwNP is more common in adults, especially those over age 40. Symptoms can also become more noticeable with age as inflammation builds up over the years.
History of chronic infections
Frequent sinus infections or upper-airway infections can weaken the sinus lining and make long-term inflammation more likely. This increases the chance of forming nasal polyps.
How Does CRSwNP and Asthma Impact Daily Life?
When you have both chronic rhinosinusitis with nasal polyps (CRSwNP) and asthma, it can make getting through the day and everyday tasks harder. These conditions can affect how you breathe, sleep, smell, and feel throughout the day. Many people say these symptoms affect their quality of life in multiple ways.
You might:
- Have trouble breathing through your nose. A blocked or swollen nose makes it hard to breathe comfortably. Many people can breathe only through their mouths. Mouth breathing can cause a dry mouth, bad breath, sore throat, and trouble sleeping.
- Have more asthma flare-ups. Blocked sinuses can make asthma symptoms worse. You may notice more coughing, wheezing, chest tightness, or trouble exercising.
- Lose your sense of smell (and taste). Smell loss is one of the most frustrating symptoms of CRSwNP. It can affect taste, enjoyment of food, safety (like not smelling smoke or gas), and emotional well-being. Many people say it makes them feel disconnected from daily life.
- Feel tired during the day. Poor sleep from congestion, coughing, wheezing, or trouble breathing can leave you feeling exhausted. This can make it harder to focus at work, school, or even during conversations.
- Need more medications. People with both conditions often need several treatments to keep symptoms controlled. These treatments include asthma inhalers, nasal sprays, rinses, or biologics. Managing all of these can feel overwhelming.
- Miss work or school. Frequent sinus infections, asthma flares, or medical appointments may lead to more missed days.
- Avoid certain activities. You may skip exercise, outdoor events, or social gatherings if symptoms are bad or if strong smells, allergies, or cold air trigger your breathing issues.
- Feel self-conscious or frustrated. Symptoms like constant congestion, mouth breathing, coughing, always sounding sick, or blowing your nose can feel embarrassing.
- Worry about triggers. Strong smells, pollen, dust, cold air, or even cleaning products may make symptoms worse. This can make everyday places like work, school, or stores feel stressful.
Diagnosis of CRSwNP When Asthma is Present
Getting an accurate diagnosis is important because CRSwNP and asthma often happen together. Your doctor will start by asking about your symptoms, your medical history, and how long you have been feeling this way.
The doctor will also do a physical exam. This may include looking inside your nose, checking for sinus pressure, testing your sense of smell, and listening to your breathing to check for wheezing or other signs of asthma.
Tests used to diagnose CRSwNP and asthma
- Lung function tests (spirometry): These tests measure how well your lungs work. They help diagnose asthma and show how severe it is.
- Blood tests: Blood tests can check levels of IgE and eosinophils, which are signs of Type 2 inflammation seen in both asthma and CRSwNP.
- Nasal endoscopy: A thin, flexible camera is placed gently inside your nose. This allows the doctor to look for polyps and see how open or blocked your nasal passages are.
- Sinus CT scan: A CT scan takes detailed pictures of your sinuses. It helps your doctor see swelling, blocked passages, or nasal polyps.
- Allergy tests: These tests help find out if allergies (like pollen, dust mites, mold, or pets) are causing or worsening your symptoms. They are also used to diagnose allergic asthma.
Finding triggers
As part of the diagnosis, your doctor will also ask about things that make your symptoms worse. These are called triggers. Learning what your triggers are can help your doctor understand whether allergies, irritants, or other factors are playing a role in your CRSwNP or asthma.
Common CRSwNP and asthma triggers include:
- Allergens such as pollen, mold, dust mites, or pets
- Irritants like tobacco smoke, cleaning chemicals, or strong odors
- Outdoor air pollution
- Respiratory viruses
- Cold or dry air
Why early diagnosis matters when you have asthma
Getting diagnosed early is important because it can help slow down or reduce the swelling in your nose and sinuses before it becomes severe. When CRSwNP is caught early, medicines or biologics may work better, which can delay or even prevent the need for sinus surgery. Early care also helps you avoid long-term problems like smell loss, constant congestion, and repeated sinus infections.
Treatment Options for Chronic Rhinosinusitis with Nasal Polyps and Asthma
CRSwNP and asthma each have their own treatments. You can treat each disease or, in some cases, treat both with the same medication. Working together with your doctor to manage both conditions gives you the best chance for relief and better breathing.
Asthma treatments
Keeping your asthma under control is key to living healthy and safe. Along with avoiding known triggers, asthma can be treated with:
- Quick-relief inhalers. These provide quick relief during asthma attacks or sudden symptoms.
- Long-acting bronchodilators. These relax the airway muscles to make breathing easier for a longer period of time.
- Inhaled corticosteroids (daily “controller” medicines). These reduce swelling in the lungs and keep airways open.
- Oral corticosteroids. These pills are only prescribed on a short-term basis to treat severe asthma symptoms or an asthma attack. They reduce swelling to open up airways. These pills should not be used as controllers because there are risks of severe side effects, especially with long-term use.
- Leukotriene modifiers. These help reduce inflammation and improve both asthma and sinus symptoms in some people.
- Biologics. These are used for moderate to severe asthma, especially when you also have other conditions like CRSwNP.
CRSwNP treatments
CRSwNP treatment focuses on reducing swelling in the nose and shrinking nasal polyps. Treatment options include:
- nasal corticosteroid sprays
- saline rinses
- oral corticosteroids for severe CRSwNP and flare-ups
- medical and surgical treatments
For complete information on CRSwNP treatments, visit our CRSwNP Treatment Guide.
Biologic medications for CRSwNP and asthma
Asthma and CRSwNP share Type 2 inflammation, so certain treatments can help both conditions at the same time. Biologic medications are injections given every 2-4 weeks. They target the inflammation causing both asthma and CRSwNP.
Biologics are often a good choice for people with moderate to severe symptoms who haven’t found relief with other treatments. They can reduce the number of medicines you need and help control symptoms in your whole airway system.
Some biologics are specifically approved for people with high IgE and/or eosinophil levels. This can help patients maintain control of both asthma and CRSwNP.
Biologic treatment work on the cell level and target the underlying inflammation, not just the symptoms. They work to:
- Shrink nasal polyps
- Improve breathing
- Reduce sinus swelling
- Prevent asthma flare-ups
- Provide lung function improvement
- Reduce the need for oral corticosteroids
Biologics used for asthma and/or CRSwNP conditions include:
- Dupilumab (Dupixent®)
- Omalizumab (Xolair®)
- Mepolizumab (Nucala®)
- Tezepelumab (Tezspire®)
- Benralizumab (Fasenra®) – asthma only
In addition to the medication, healthcare providers may recommend lifestyle changes, such as avoiding triggers. This can also help reduce asthma and CRSwNP symptoms and help you feel better.
Surgery for CRSwNP
If medications don’t give enough relief, your doctor may recommend surgery to remove nasal polyps and open the sinus passages. The most common surgical intervention is Functional Endoscopic Sinus Surgery (FESS). This surgery uses a small camera to gently remove polyps and improve drainage. This can remove the nasal obstruction and allow air and medicine to reach the sinuses better.
Polyp regrowth after sinus surgery
Surgery removes polyps but doesn’t cure CRSwNP. It also does not stop new polyps from growing. About 30 out of 100 patients have polyps return within 5 years. This is why ongoing treatment after surgery, including saline rinses, steroid irrigations, biologics and regular check-ups, is important.
Learn more about surgery for nasal polyps.
Post-surgery care to manage CRSwNP
After surgery, ongoing care helps prevent polyps from returning. This may include saline rinses, steroid irrigations, biologic therapy, and regular check-ups.
Why Professional Treatment Matters
Getting symptoms treated is very important when you have CRSwNP and asthma. These conditions can get worse over time if the inflammation is not controlled. Your doctor can help you find the right treatment plan and prevent long-term problems.
You should seek medical care if you notice:
- Frequent sinus infections
- Chronic cough
- Severe asthma flares
- Worsening smell loss
- Poor sleep and daytime fatigue
Red flags to watch for:
These signs mean it is time to see a specialist, such as an ENT or allergist:
- Needing several rounds of antibiotics for sinus infections that keep coming back or never fully improve
- Using over-the-counter nasal sprays for weeks with little or no long-term relief
- Symptoms that return quickly after short-term improvement
- Constant mouth breathing because your nose always feels blocked
- Nasal congestion lasting more than 12 weeks
- Loss of smell that lasts for weeks or months
- Asthma that becomes harder to control while sinus symptoms worsen
Seeing a specialist early can help you feel better sooner and reduce the chances of symptoms getting worse.
Tips for Managing Symptoms at Home
Managing CRSwNP and asthma requires more than just medicine. Your home environment and daily habits are also risk factors. They can play a big role in how you feel.
These steps can support your treatment plan and help you avoid a sinus flare-up. They should be used alongside your prescribed medications and regular doctor visits.
Improve your indoor air quality
Indoor air quality is something many people overlook, even though we spend most of our time inside. The air in your home or workplace can affect swelling in both your nose and your lungs. What to consider about your indoor air quality:
- Dust, pet dander, smoke, and mold can make indoor air quality worse and trigger your symptoms.
- Keeping your space clean and reducing irritating particles can help lower inflammation.
- Air purifiers and regular cleaning may help remove irritants.
- A humidifier can help keep air moist, especially in drier months. A temperature and humidity monitor can help you track conditions in your home.
Avoid triggers
Work with your doctor to learn what triggers your symptoms. Common triggers include cigarette smoke, strong scents like perfumes or cleaning products, and workplace irritants such as dust or chemical fumes.
Tips to avoid triggers include:
- At home: Switching to fragrance-free cleaning products, laundry detergent, and personal care items can reduce exposure.
- At work: Consider asking for accommodations if you’re exposed to dust, fumes, or chemicals. Taking breaks in fresh air or wearing a mask may help.
- Outdoors/Pollen: Check pollen counts before going outside. On high-pollen days, keep windows closed and use air conditioning. Showering and changing clothes after being outdoors can help remove pollen.
- High-trigger places: Hair salons, nail salons, perfume stores, candle shops, and home improvement stores often have strong chemical smells. If you must visit these places, try scheduling appointments when they’re less busy or asking for better ventilation.
- Keep a symptom journal: Writing down when your symptoms get worse. List what you were exposed to at the time. This can help you and your doctor identify your specific triggers.
Build daily self-care habits
Simple daily habits can support your treatment plan. These can include:
- Saline rinses can help clear mucus and soothe your nose.
- Taking your medications exactly as prescribed helps keep inflammation under control.
- Getting enough sleep, staying hydrated, regular physical activity, healthy eating, and stress management can all help you feel better.
Check out more tips on living with CRSwNP.
Here are some simple steps you can take to feel better:
- Use a saline rinse. Rinse your nose with a saline solution to clear mucus and reduce swelling.
- Avoid triggers. Stay away from cigarette smoke, strong perfumes, and other irritants.
- Keep the air moist. Use a humidifier to prevent your nasal passages from drying out.
- Control allergies. Take allergy medications if allergies make your symptoms worse.
- Take your medications. Follow your doctor’s instructions for asthma and sinus treatments.
These steps support your treatment plan but do not replace medical care.
Special considerations: AERD / Samter’s Triad
Aspirin-Exacerbated Respiratory Disease (AERD) is a condition where you have asthma, nasal polyps, and react to NSAIDs (such as aspirin, ibuprofen, or naproxen). This group of symptoms is also called Samter’s Triad.
People with AERD have breathing symptoms soon after taking aspirin or NSAIDs. Reactions can include a blocked or runny nose, coughing, wheezing, chest tightness, trouble breathing, facial flushing, or sinus pressure. AERD symptoms occur because the medicine causes a sudden increase in airway inflammation.
AERD affects about 7 out of 100 adult asthma patients, but symptoms are usually more severe than in people with asthma alone. The condition is strongly linked to nasal polyps, and many people with AERD have polyps that grow back quickly even after surgery.
Why AERD matters for CRSwNP treatment
- Asthma and sinus symptoms are often harder to control, as disease severity is often worse.
- Inflammation is stronger, polyps grow faster, and sinus infections and asthma flares happen more often.
- Polyps often return quickly after surgery without ongoing treatment.
- Special treatments such as aspirin desensitization and biologic medications can help control both nasal polyps and asthma.
Living with CRSwNP and Asthma
Living with both CRSwNP and asthma means working with your healthcare team over time to keep symptoms under control. These conditions are long-lasting. It is normal to need regular check-ups, ongoing treatment, and adjustments to your care plan
Long-term management and monitoring
Both CRSwNP and asthma can flare up again even after treatment, so long-term monitoring is essential. You may need ongoing medicines like inhalers, nasal sprays, rinses, or biologics to keep persistent inflammation down. Regular follow-up visits help your doctor see what’s working and what needs to change.
A team approach
Many people see more than one specialist to manage both conditions:
- An ENT (ear, nose and throat) doctor can help with the nose and sinuses
- An Allergist can help manage inflammation and triggers
- A pulmonologist can help with asthma and lung function improvement.
Working with a team makes it easier to control symptoms in your airways.
A maintenance mindset
Because CRSwNP and asthma can come back or flare up, having a “maintenance mindset” helps. This means taking care of your condition every day, not just when symptoms are bad.
A maintenance mindset includes:
- Taking your medications as prescribed, even when you feel good
- Using nasal rinses or sprays regularly
- Watching for changes in symptoms
- Managing triggers and home air quality
- Keeping scheduled follow-up visits
Staying on top of your care can help you breathe better, prevent setbacks, and keep symptoms from interfering with daily life.
When to See Your Doctor
If you notice the following warning signs of CRSwNP and asthma symptoms, schedule an appointment with your doctor.
Warning signs:
- Smell loss that doesn’t go away
- Frequent sinus infections
- Asthma flares
- Needing oral corticosteroids or antibiotics often
- Symptoms not improving with medication
- Possible AERD signs
Even if your symptoms seem mild, regular check-ins can help keep symptoms from worsening or coming back.
CRSwNP and asthma often occur together because they share the same underlying inflammatory pathways. When both are treated as a unified condition, many people see major improvements in breathing, sleep, and quality of life.
If symptoms continue or return, or you have more frequent exacerbations, talk to your doctor about more advanced medications like biologics.
Questions & Answers (Q&A) about CRSwNP and Asthma
Management of CRSwNP and asthma works best with a multidisciplinary approach. This means working with a team of specialists, including allergists, ENT doctors and pulmonologists. If you have any more questions you’d like to see answered here, please email our editor.
June 2026
Reviewed by:
Bradley Chipps, MD, FACAAI, is a board-certified allergist and pediatric pulmonologist with Capital Allergy and Respiratory Disease Center in Sacramento, California. He earned his medical degree from University of Texas Medical Branch in Galveston in 1972. He is Past President of the American College of Allergy, Asthma and Immunology (ACAAI).
