Living with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)
When you have chronic rhinosinusitis with nasal polyps (CRSwNP), it can be frustrating and exhausting. The condition is often unrecognized by others. Many people living with this chronic disease deal with constant nasal congestion, mouth breathing, runny nose, poor sleep, and smell loss for years before receiving a diagnosis. Even after diagnosis, it can take time to understand how much this condition affects daily life.
Common challenges include:
- Difficulty breathing through your nose which can disrupt sleep, drain energy, and affect focus and mood.
- Smell loss, which can take away everyday joys like enjoying food and familiar scents.
- Feeling embarrassed by sounding sick all the time or having bad breath (sinus breath, or a “sour smell to breath)
- Feeling frustrated when others assume it’s just a cold or allergies.
- Poor sleep, which is especially common with CRSwNP. It can lead to daytime fatigue, headaches, trouble concentrating, and worsened mental health.
Over time, these symptoms can interfere with work, relationships, and overall quality of life.
With the right treatment plan, daily routines, and ongoing care, many people learn how to reduce symptoms. They can improve breathing, sleep better, and regain parts of their life that felt lost.
At a Glance: Living with Chronic Rhinosinusitis with Nasal Polyps (CRSwNP)
- 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 CRSwNP
Chronic rhinosinusitis with nasal polyps (CRSwNP) is a long-term (or chronic) condition. It involves swelling in the nose and sinuses that leads to soft, noncancerous, benign growths called nasal polyps (also called nasal polyposis). These can block airflow, reduce your sense of smell, and increase the risk of sinus infections.
It may be easier for you to describe your symptoms as “sinusitis” or a “chronic sinus infection” to family, friends and co-workers. But CRSwNP is the correct name of the disease.
CRSwNP does not usually go away on its own. Treatments can help control inflammation (swelling) and improve symptoms over time.
For a complete description of CRSwNP, including its causes, symptoms, diagnosis and treatment, check out our CRSwNP overview.
What to Expect After Your CRSwNP Diagnosis
After receiving a diagnosis of chronic rhinosinusitis with nasal polyps, you may feel overwhelmed. This is normal. Many people have questions about what comes next. How long will treatment take? What will daily life look like going forward?
This guide on living with CRSwNP focuses on what life looks like after diagnosis. It walks through living with chronic sinus disease day to day, building routines that support long-term control, and working with your healthcare team to manage symptoms over time.
Goal of treatment
The goal of treatment for CRSwNP is to control chronic inflammation (swelling) and improve quality of life. Treatment plans are unique to each person. Creating clear goals with your healthcare team can help guide decisions and track progress over time.
What goals can look like:
- Reduce sinus swelling
- Improve airflow through the nasal cavity
- Restore or improve sense of smell
- Reduce flare-ups and infections
- Lower the need for oral corticosteroids
- Shrink nasal polyps
- Stop polyp recurrence (so they stop coming back)
To support your goals, your doctor may recommend:
- Follow-up visits with an ENT (ear, nose and throat doctor), allergist, or pulmonologist
- Start regular treatments such as saline sinus rinses, intranasal corticosteroids (nasal steroid sprays), intranasal antihistamine sprays, or biologics (advanced therapy given as an injection to reduce inflammation)
- Track symptoms like congestion, smell loss, fatigue, or headaches
Many people notice improvement within a few weeks of consistent treatment, although some symptoms, such as loss of smell, may take longer to improve.
Learn more about CRSwNP treatment options.
Tests you may have already had
Your doctor may conduct tests like nasal endoscopy, sinus CT scans, allergy testing, or blood work to diagnose CRSwNP. These tests can help you and your doctor to figure out the best treatment options.
The tests may be repeated over time to check how well your treatment is working. They can also check whether inflammation or polyps are improving, staying the same, or returning.
Learn more about how CRSwNP is diagnosed.
Who May be at Higher Risk for CRSwNP
Some people are more likely to develop CRSwNP or experience more severe sinus disease. Risk factors include asthma, allergies, family history of nasal polyps, smoking, and frequent sinus infections.
Having risk factors does not mean symptoms will always be severe. Your doctor may recommend closer follow-up or changes to your treatment plan to help keep symptoms under control.
Understanding Inflammation in CRSwNP
CRSwNP is caused by ongoing swelling inside the sinuses. This inflammation makes the sinus lining swell and can lead to nasal polyps that block airflow and trap mucus.
In many people, CRSwNP is linked to Type 2 inflammation. This is a type of immune response (how your body reacts to threats) that becomes overactive. This same type of overactive response is also common in severe asthma, allergies, and eczema.
This inflammation does not typically go away on its own. CRSwNP usually needs ongoing treatment, even when symptoms start to feel better.
Daily Management Strategies for Living with CRSwNP
Managing chronic rhinosinusitis with nasal polyps is a daily process. The goal is to reduce swelling, keep your sinuses clear, and prevent flare-ups before they start. Small daily habits can make a big difference over time.
Setting up a sinus care routine
Daily sinus care is one of the best ways to control CRSwNP. A typical routine may include:
- Saline sinus rinses
- Nasal steroid sprays
- Steroid rinses (if prescribed), especially after surgery
Always use distilled or boiled and cooled water for saline rinses. Clean your rinse bottle or pot after each use to help prevent infection.
Medication consistency is key to severe sinus disease
CRSwNP can come back when treatments are stopped or skipped. Even if you feel better, stopping medications too soon can allow inflammation and nasal polyps to return. Take medications as directed to control swelling, keep your nasal passages open, and reduce flare-ups.
Monitoring symptoms
Pay attention to changes in how you feel from day to day. Tracking symptoms helps your doctor adjust your care plan. Common symptoms to watch include:
- New or worsening smell loss
- Sinus congestion that forces you to breathe through your mouth
- Thick or discolored mucus
- Waking up congested or feeling tired
- More facial pressure or sinus pain
To help track symptoms and disease severity, you can use the SNOT-22 (Sino-Nasal Outcome Test-22) questionnaire tool. This can measure how sinus symptoms affect daily life. It asks about congestion, sleep, fatigue, sense of smell, and focus.
Using the SNOT-22 regularly can help you:
- See changes over time
- Share clear information with your doctor
- Guide treatment decisions
Many people complete the SNOT-22 before appointments or when symptoms get better or worse.
Mistakes that make symptoms worse
Some daily habits can make symptoms worse without people realizing it. You can help prevent flare-ups by avoiding these common mistakes:
- Skipping sinus rinses
- Not using nasal sprays correctly
- Using tap water in nasal rinses
- Stopping medications when symptoms improve
- Not managing triggers
How do I use a nasal spray (usually a corticosteroid medication) correctly?
Proper technique on using a nasal spray is critical to get results you need for relief from symptoms.
- Prime the spray if you haven’t used it in a while.
- Blow your nose gently to clear out mucus before the spray.
- Insert the tip of the nasal spray about a half-inch into your nose.
- Point it away from the center of your nose, outward toward your ear. (This ensures the spray reaches the back of your nose.)
- Lean forward slightly and close the nostril you are not treating.
- Press the spray.
- Breathe in gently through your nose, but not too hard or the medicine will go down your throat.
- Exhale through your mouth.
- Wipe away any liquid that drips.
What does a sample daily routine look like?
Your daily routine may look different based on your needs. Here’s an example of a daily routine that’s simple and easy to follow:
Morning
- Saline rinse
- Nasal steroid spray (use after rinse)
- Smell training, if advised by your doctor
Afternoon
- Check in with your symptoms and note any changes
- Track changes using the SNOT-22 if needed
Night
- Smell training, if advised by your doctor
- Saline rinse
- Use a humidifier if needed
- Follow sleep tips
If your doctor prescribes other medications, add them to your routine as directed.
Understanding Your CRSwNP Control Levels
Doctors usually rate how serious your CRSwNP disease severity is based on how well symptoms are controlled. This helps you and your doctor decide if your current treatment is working or if it needs to change.
| How CRSwNP affects you | Well-controlled | Partly controlled | Uncontrolled |
|---|---|---|---|
| Breathing / congestion | Nose feels open most of the time | Some blockage or pressure | Nose feels blocked most days |
| Sense of smell | Smell is normal or nearly normal | Smell comes and goes | Smell is mostly or fully gone |
| Sleep | Sleeping well | Sleep sometimes disturbed | Poor sleep most nights |
| Daily life | Symptoms do not limit daily activities | Some impact on energy or focus | Symptoms affect work, school, or daily life |
| Flare-ups / infections | Rare flare-ups | Occasional flare-ups | Frequent flare-ups or infections |
If your symptoms are partly controlled or uncontrolled, it does not mean you have failed treatment. It usually means your inflammation is not fully controlled, and your care plan may need to be adjusted.
How healthcare professionals decide your control level
Your doctor looks at more than just how you feel. During visits, they often consider:
- How your nose looks inside, using a small camera to check swelling or polyps
- How severe your symptoms feel overall
- How often you have needed oral corticosteroids or antibiotics for flare-ups
Even if you feel okay, ongoing swelling or frequent flare-ups can signal that CRSwNP is not fully controlled.
Knowing your control level helps guide next steps. If symptoms stay partly controlled or uncontrolled despite daily sprays and rinses, your doctor may talk with you about other options, such as advanced medications called biologics or surgery, to better control inflammation.
Long-Term Nasal Polyp Treatment Options
CRSwNP often requires long-term management. Treatments may change as symptoms improve or worsen. The goal is to control inflammation, reduce flare-ups, and help you feel well in daily life. Your ENT or allergist will guide decisions as your symptoms change.
For full details on treatments, visit our CRSwNP guide.
Medical treatments
Most people start with daily treatments such as nasal sprays and sinus rinses to relieve symptoms, reduce swelling, and keep the sinuses open. Short courses of oral steroids may be used during flare-ups, but they are not meant to be a long-term solution. Antibiotics may be used when sinus infections occur.
Biologics for CRSwNP
Biologics are advanced medications that target the inflammation that causes nasal polyps. By treating the root cause of inflammation, biologics have helped many people with CRSwNP breathe better, smell again, and have fewer flare-ups.
A biologic may be considered if standard treatments or surgery have not worked well. They may also be an option if you have ongoing smell loss, asthma, or AERD.
Surgery for nasal polyps
Surgery, such as functional endoscopic sinus surgery (FESS), may be recommended if medications are not enough or if the polyps are very large. Surgery can improve breathing and help medications work better afterward. Surgery helps many people, but nasal polyps can return without ongoing care.
Post-surgery care
Even after symptoms improve or polyps are removed, inflammation and polyps can return if they are not controlled. Ongoing routines, medications, and follow-up care remain important after surgery.
Why CRSwNP Symptoms or Nasal Polyps Can Return
Nasal polyps can come back because CRSwNP is caused by ongoing inflammation (swelling), not just the polyps themselves. Even after surgery or treatment, inflammation can still be present in the sinuses.
Polyps may return because:
- Inflammation (usually Type 2-related) is still active in the sinuses
- Asthma or AERD is also present
- Daily treatments, like nasal sprays or rinses, are stopped
- Small areas of inflammation remain after surgery
Setting doable routines, taking medications as prescribed, and attending regular follow-up visits are important, even when symptoms improve.
Managing Flare-Ups and Worsening Symptoms
CRSwNP symptoms can worsen at times, even when you are following your treatment plan. These periods are often called flare-ups. Learning to recognize early signs and knowing what to do can help limit how severe a flare becomes.
Below are some signs that your CRSwNP is getting worse or you’re about to have a flare-up. You may notice:
- Increased sinus congestion that forces constant mouth breathing
- More facial pressure or fullness
- Thick mucus
- New or worsening smell loss
What to do during a CRSwNP flare
If symptoms begin to worsen, take these steps:
- Increase your sinus rinses to help clear mucus.
- Use nasal sprays or rinses to improve sinus drainage.
- Avoid triggers like smoke, strong scents, and chemical fumes.
- Call your doctor if symptoms do not improve after a few days.
Early treatment can help prevent flare-ups from becoming more severe.
How to prevent flare-ups
Daily habits play a big role in flare-up prevention. Helpful steps include:
- Following your sinus care routine every day, even if things are feeling fine
- Avoiding known triggers
- Managing allergies and asthma
- Keeping humidity levels around 30-50% in the home and using a humidifier when air is dry
Seasonal Considerations to Avoid Flare-ups
Seasonal changes can trigger flare-ups for many people with CRSwNP. Being aware of seasonal triggers can help you prepare and adjust your routine.
Winter triggers
Cold air and dry indoor heat during winter can dry out the sinuses and worsen congestion. Using a humidifier, staying hydrated, and keeping up with sinus rinses can help reduce winter flare-ups.
Spring and summer triggers
Spring and summer pollen seasons can increase sinus inflammation. Exposure to environmental allergens may lead to more congestion, pressure, and smell loss. Checking pollen counts, showering after being outdoors, and managing allergies can help reduce flare-ups.
Other seasonal triggers may include wildfire smoke, air pollution, and sudden temperature changes. Adjusting your routine during these times can help keep symptoms under control.
Lifestyle Habits that Make Living with CRSwNP Easier
Managing CRSwNP is not only about medications. Your daily habits and environment also play an important role in how you feel.
Small changes to your routine can help reduce symptoms, support your treatment, and make day-to-day life easier.
It is not about being perfect. It is about finding habits that help you stay consistent.
Improving indoor air quality
Indoor air quality can strongly affect CRSwNP symptoms. Cleaner air can help reduce irritation and inflammation in the sinuses. Some quick ways to help air quality in your home:
- Reducing dust
- Keeping pets out of your bedroom
- Checking for mold
- Using an air purifier
- Keeping humidity between 30–50% (higher levels encourage dust mite growth and mold)
Avoiding common triggers
A trigger is anything that can make CRSwNP symptoms worse or cause a flare-up. Triggers do not cause CRSwNP, but they can increase swelling and irritation in the sinuses. Some common triggers include:
- Cigarette smoke or vaping
- Strong perfumes, cleaning products, or scented candles
- Chemical fumes
- NSAIDs (if you have AERD)
Healthy habits for living with chronic rhinosinusitis with nasal polyps
Taking care of your overall health can make CRSwNP easier to manage. Small daily habits can support your body and help reduce flare-ups.
- Sleep: Aim for 7–9 hours of sleep each night. Try to go to bed and wake up at the same time every day to help your body rest and recover.
- Hydration: Drink enough water to keep mucus thin and easier to clear. A simple goal is about 8 cups of water a day. Drink more if the air is dry or you are active.
- Movement: Gentle activity helps your body work better and gives you more energy. If exercise feels hard, start with a short daily walk and build up slowly.
- Stress management: Try simple, low-cost options like deep breathing, stretching, limiting screen time before bed, or spending time on a relaxing hobby.
- Balanced eating: Focus on regular meals with fruits, vegetables, whole grains, fiber, and healthy fats. No specific diet treats CRSwNP, but good nutrition supports your immune system and overall well-being.
These habits work best when paired with your sinus care routine and medical treatment plan.
Working, Exercising, and Daily Life with CRSwNP
Living with CRSwNP can affect work, exercise, and everyday activities. Small adjustments can help you stay comfortable and reduce symptoms.
At work:
- If your job has a lot of dust, strong smells, or chemicals, take breaks to get fresh air. Wear a mask if it helps.
- If your office air is very dry, a small desk humidifier can help. Just remember to clean it to prevent mold growth.
Exercise:
- Regular exercise is good for your body. However, if you feel a lot of pressure or pain in your face while jumping or running, stop and take a break.
- Be careful with swimming in pools. The chlorine used to clean the water can irritate your nose and cause swelling. If you swim, try using a nose clip or rinse your nose right after you get out.
Daily tips when you can’t smell
If you cannot smell well, you need to use your eyes and technology to keep yourself safe. Let close friends or coworkers know if you have smell loss so they can help with safety.
Hygiene:
- Many people worry about body odor because they can’t smell themselves. A strict daily shower and deodorant routine can help you feel confident.
- If you care for babies or young children, regular routines matter even more. Since you may not notice smells that usually signal it is time to act, set reminders for diaper changes, bath time, and laundry.
In the kitchen:
- Do not “sniff” food to see if it is bad. Always look at the “Use By” or “Expiration” date.
- When you put food in the fridge, write the date on it. A rule of thumb is if it has been there for more than 3 days, throw it away.
- If you can, use an electric stove instead of gas. If you have a gas stove, always double-check that the knobs are turned all the way to “Off.”
Home safety sensors:
- Make sure you have smoke alarms on every floor of your house. Test them once a month to make sure they work.
- Install a natural gas detector in your kitchen. It will make a loud noise if it finds a leak.
How CRSwNP can affect your eating habits and nutrition
Chronic rhinosinusitis with nasal polyps can have a significant impact on nutrition and overall health. One of the most common challenges is the loss of smell and taste. When food loses its flavor and aroma, some people may experience a reduced appetite. This can lead to:
- poor nutrition
- unintended weight loss
- difficulty getting important vitamins and nutrients
- seeking our stronger flavors by adding extra salt, sugar or spicy seasonings
Changes in taste and smell can also affect your long-term health. For example, someone who cannot fully taste salt may consume higher amounts of sodium without realizing it. This could increase the risk of high blood pressure or worsen heart disease. Reduced enjoyment of food may also contribute to emotional stress, social withdrawal, or unhealthy eating habits.
Managing nutrition is an important part of living well with CRSwNP. It can help to focus on foods with varied textures, temperatures, and colors to make meals more appealing even when taste and smell are reduced. Using herbs, citrus, vinegar, and salt-free seasoning blends instead of excess salt or sugar may improve flavor.
Eating a balanced diet rich in fruits, vegetables, lean proteins, healthy fats, and anti-inflammatory foods can help support respiratory and sinus health.
Mental and Emotional Well-Being
Living with a long-term condition like CRSwNP can affect how you feel emotionally, not just physically. Many people feel frustrated, tired, or discouraged after repeated flare-ups, sleep problems, or ongoing smell loss.
These feelings are common and valid. Managing symptoms day after day can be hard, especially when others cannot see what you are dealing with.
It is normal to feel:
- Annoyed because symptoms keep coming back
- Sad because you miss smelling flowers or tasting your favorite foods
- Very tired because your body is working hard to fight swelling, plus you can’t sleep because of nasal symptoms
- Misunderstood because others may not take your symptoms seriously
Some people with CRSwNP also experience anosmia grief, which is the sadness that comes with losing your sense of smell. This is a real type of sensory loss, similar to losing some hearing or vision. It is normal to experience feelings such as denial, anger, or sadness when smell is lost.
Poor sleep plays a big role in emotional health. Ongoing sleep loss can make people feel low, irritable, or “fuzzy.” Improving sleep is often an important step in feeling better emotionally. If you feel extra tired, it is okay to rest. Managing CRSwNP takes energy, and your body is working hard behind the scenes.
If you notice that you are avoiding meals, social events, or activities because you cannot smell, it may help to talk with a mental health professional who understands chronic illness.
You are not alone
Having CRSwNP can feel lonely, but you do not have to handle it by yourself. Many people need support beyond medications.
Helpful ways to get support include:
- Connecting with others who live with CRSwNP or chronic sinus disease
- Talking openly with family or friends about how symptoms affect you
- Letting your doctor know if stress, low mood, or frustration is building
Managing inflammation and symptoms often helps emotional well-being, but support matters too. CRSwNP is easier to manage when you have a care team and people around you who understand.
Sleep Tips for CRSwNP
Many people with nasal polyps find it hard to sleep. You may feel like you cannot breathe through your nose because of nasal congestion, or you may feel mucus dripping down your throat, called postnasal drip. These simple steps can help you rest better.
Pre-sleep routine
- Wash your nose: Use a saline (saltwater) rinse about 30 minutes before bed. This helps clear thick mucus so you can breathe more easily.
- Use your medicine: If you use a steroid nasal spray, use it after your nose rinse. This helps the medicine coat the inside of your nose. Stay upright for about 20 minutes after using your spray so it does not drip down your throat. You can sit and read, watch TV, or do another quiet activity.
Bedroom setup
- Bedroom humidity: Keep bedroom humidity between 30%-50%. If you use a humidifier, clean it regularly to prevent mold, which can make symptoms worse.
- Keep it scent-free: Avoid candles, perfumes, or strong cleaning products in the bedroom. Strong smells can irritate your nose and increase swelling.
Sleeping position
Prop up your head: Use an extra pillow to keep your head higher than your heart. This helps mucus drain and reduces stuffiness.
Sleep on your side: Sleeping on your side often helps breathing more than sleeping on your back.
Try the “flip” trick: If one side of your nose feels very blocked, turn to the other side. Gravity can help the upper side open and drain.
Smell Loss and Training
Smell loss is one of the most frustrating symptoms of CRSwNP. Not being able to smell can affect how food tastes, reduce the enjoyment of daily life, impact memory, and create safety concerns at home.
Why smell loss happens
How do you develop a sense of smell? Tiny nerves inside your nose carry messages back and forth between your brain and your nose. But with CRSwNP, swelling can cause nasal obstruction in the smell nerves in the nose. Ongoing inflammation can also affect how well these nerves work. Even after your swelling improves, the nerves may need time to recover. This is why smell does not always return right away.
In CRSwNP, swelling can cause nasal obstruction in the smell nerves in the nose. Ongoing inflammation can also affect how well these nerves work. Even after swelling improves, the nerves may need time to recover, which is why smell does not always return right away.
As smell nerves begin to heal, some people notice distorted smells. This is called parosmia. For example, coffee may smell burnt or unpleasant. While this can be upsetting, it is often a good sign. It means the smell nerves are starting to reconnect and recover.
What is smell training?
Smell training (olfactory training) is a gentle exercise that may help some people improve their sense of smell over time. It works by regularly stimulating the smell nerves. Smell training is safe, low-risk, and recommended by many ENT specialists. Improvement is often gradual, so patience and consistency are important.
Smell training using The Hummel Method:
- Pick four smells in each category: Flowery (rose), Fruity (lemon), Spicy (clove), and Fresh (eucalyptus).
- Sniff slowly: Smell each one for 20 seconds.
- Picture it: While you sniff, try to imagine what that thing looks and smells like.
- Be consistent: Do this two times a day for at least 3 to 6 months.
Safety considerations with smell loss
If you have reduced or no sense of smell, you may miss important smells like fire, gas or spoiled food. Take these extra safety steps:
- Use smoke detectors and carbon monoxide detectors in your home
- Check food expiration dates carefully
- Label leftovers with dates
- Ask others to help check for spoiled food, smoke, or gas odors
Traveling with CRSwNP
Planning a vacation that requires a long trip? Keep in mind that air travel and new environments can trigger symptoms if you are not well prepared.
Air travel and nasal polyps
Airplane air can get very dry, and changes in air pressure can cause discomfort. Your nose and ears are connected by a small tube. If you have nasal obstruction, your ears may feel painful, stuck, or pop during takeoff and landing.
To reduce discomfort:
- Use a saline rinse before and after flying to clear out mucus.
- Apply a saline gel to keep the nose from drying out.
- Drink plenty of water during the flight.
- Ask your doctor if using a decongestant spray only on travel days is safe for you.
New environments and triggers
Travel can mean new climates and new triggers. Moving between humid and dry areas can cause swelling or extra mucus. New pollen exposures, dust, or mold may also trigger inflammation. Hotel rooms may expose you to strong cleaning scents, scented laundry detergent, or dust from carpets.
What can help:
- Keep using your nasal rinses and sprays every day while traveling.
- Shower and change clothes after being outdoors to remove allergens.
- Ask for scent-free rooms when possible.
- Open windows or use air conditioning to improve airflow if the room feels stuffy.
Medication Safety Reminders
People often ask, “Is it safe to use a nasal spray every day?” or “How much saline rinsing is too much?” Your doctor can help you understand what is safe for you. Keep these safety tips in mind:
Do not stop your medications without talking to your doctor
- When you start feeling better, it can be tempting to stop your daily nasal corticosteroid spray or biologic treatment. Before doing this, talk with your doctor.
- Remember that nasal polyps are caused by ongoing inflammation. Your medicine helps keep that inflammation under control. If you stop treatment, swelling can return quickly, and polyps may grow back before you notice symptoms.
Decongestant nasal sprays
- These are sprays like Afrin or similar brands that promise fast relief. They can help for a short time, but using them too often can make congestion worse.
- If you use these sprays too much and then stop, your nose may swell more than before. This can make it even harder to breathe.
- Decongestant sprays should only be used for a few days unless your doctor tells you otherwise.
Corticosteroid nasal sprays
- Steroid sprays are safe for daily use when used the right way.
- If your nose bleeds, you may be spraying the middle wall of your nose. Try pointing the spray slightly outward, toward your ear on that side. This helps the medicine reach the swollen tissue and keeps it away from delicate blood vessels.
Saline rinses
You may need to adjust your routine if you notice dryness, itching, stinging, burning, redness, soreness, or a “plugged” feeling in the ears.
Never use tap water for sinus rinses. Only use distilled water from the store or boiled water that has cooled. Tap water is safe to drink but can contain germs that are harmful in your nose.
Regular saline rinsing is safe and helpful for most people. It washes out mucus, allergens, and irritants.
Living with Both CRSwNP and Asthma
CRSwNP and asthma often occur together because they share the same type of inflammation. Swelling in the sinuses can make asthma harder to control, and asthma flare-ups can worsen sinus symptoms.
This is why treating both asthma and CRSwNP together is important. When sinus inflammation is better controlled, many people notice improvements in their breathing and asthma symptoms as well.
Learn more about the connection between CRSwNP and asthma.
Other health conditions that may occur with CRSwNP
Some people with CRSwNP also have other related conditions, including:
- Seasonal or environmental allergies affecting the nose
- AERD (aspirin sensitivity)
- Atopic dermatitis (eczema)
- Chronic infections
- Sleep apnea
Knowing about these related conditions can help you and your care team create a more complete treatment plan and improve long-term symptom control.
CRSwNP and Allergy Management
Allergies can make sinus swelling worse and cause more symptoms. When you breathe in an allergen, the lining of your nose can swell even more. Managing these triggers can help reduce flare-ups.
Helpful steps include:
- Use air filters or air purifiers at home.
- Vacuum with a HEPA filter to reduce dust and allergens.
- Check daily pollen counts and limit outdoor time when levels are high.
- Do not wear outdoor shoes inside your home.
- Shower and change clothes after being outdoors to remove pollen.
- Keep home and car windows and doors closed on windy or high-pollen days
Managing allergies alongside your sinus care routine can help keep inflammation under better control.
When to See Your Doctor
Do not wait until your nose feels totally blocked to see a doctor. Work with your care team early to help prevent symptoms from getting worse. Develop a treatment plan that fits your life.
Make an appointment if you notice:
- Ongoing or worsening smell loss
- Frequent sinus infections
- Taking antibiotics for sinus infections does not help you feel better
- You need oral corticosteroids often
- Symptoms that are not improving
- Asthma flare-ups or breathing problems
- Possible signs of AERD, such as reactions to aspirin or NSAIDs
Shared decision-making with your healthcare professionals
Shared decision-making means you and your healthcare team work together to choose the best plan for you. Your goals, symptoms, and daily life all matter when decisions are made.
Talk to your team about:
- Your goals: Tell them what matters most to you. Is it sleeping better? Getting your smell back? Having fewer flare-ups?
- Your control level: Ask, “Is my CRSwNP well controlled, partly controlled, or uncontrolled?” This helps you understand if your current treatment is working.
- Medication: Ask if your treatment should be adjusted if symptoms are not improving.
- Biologic monitoring: If you are using a biologic, ask when and how your doctor will check if it is working to treat underlying inflammation and treat nasal polyps.
- Future plans: What should I do if symptoms return or worsen?
Working with your care team
Managing CRSwNP often involves more than one provider. Because nasal polyps are linked to asthma and allergies, your team may include an ENT, allergist and pulmonologist. Working together helps keep care consistent.
Topics to review with your care team include:
- How care is shared between your providers
- How often follow-up visits are needed
- When biologic treatment should be reviewed or changed
Tracking your symptoms: what to record
After your diagnosis, keeping track of symptoms can help you and your health care team see what is working and when changes may be needed. Writing things down makes it easier to notice patterns over time.
You may find it helpful to track:
- Congestion (stuffiness), using a 0 to 5 scale
- Sense of smell, using a 0 to 5 scale
- Headaches or facial pressure
- Sleep quality
- Number of flare-ups
- Asthma symptoms, if you have asthma
- Triggers you notice, such as allergies, illness, or smoke
Bringing this information to appointments can help your doctor adjust your care plan and improve symptom control.
The SNOT-22 questionnaire tool can help you track how sinus symptoms affect your daily life and support conversations with your care team.
When Symptoms Are an Emergency
Most CRSwNP symptoms can be managed with medical therapy and routine care. However, some symptoms may signal a serious problem like an infection that needs urgent medical attention.
Because the sinuses are close to the eyes and brain, certain symptoms are red flags that an infection could be spreading.
Seek medical care right away if you have:
- A fever that does not go away with medicine
- Swelling, redness, or bulging around the eyes or eyelids
- Vision changes, such as blurry vision, double vision, or trouble seeing
- A severe or sudden headache
- Stiff neck
- Confusion or trouble staying awake
- Trouble breathing, especially if you have asthma
If you are unsure, contact your doctor or the emergency department right away.
Long-Term Outlook for People Living with CRSwNP
Most people with CRSwNP live healthy, active lives. Even though CRSwNP is a long-term condition, it does not have to stop you from doing the things you enjoy.
With daily sinus care, regular checkups, and the right treatment plan, many people are able to:
- Breathe more easily
- Sleep better
- Have fewer flare-ups
- Improve or regain their sense of smell
With good management and ongoing care, CRSwNP does not have to control your life.
Questions & Answers (Q&A) About Living withCRSwNP
Here are some frequently asked questions about living with chronic rhinosinusitis with nasal polyps. If you have a question you’d like to see covered 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).
