Chapter One Sinus 411 We’ve all heard the metaphor, “you need that like a hole in the head” to describe something that no one wants or needs. But when it comes to your sinuses, these hollow, air-filled holes in the skull that sit directly behind your face are an integral part of your respiratory system. There are four pairs of the cavities that make up your sinuses. Scientists aren’t exactly sure what purpose the sinuses serve. Some believe they act as air conditioners, filtering, heating, and humidifying the air that comes through the nose. Others think that the sinuses affect the way the voice resonates. Still others speculate that the sinuses are simply there to lighten the weight of the head. Whatever physiological role the sinuses play, healthy sinuses function thanks to mucus—a slimy fluid that is made up of water, proteins, salts, and enzymes. Mucus creates a barrier against bacteria, viruses, and allergens, and adds moisture to the air taken in by the nose. It also lubricates the membranes in the nose. Each set of sinuses is lined with mucous membranes that are covered by a thin blan- ket of this mucus. When you inhale, the mucus traps dirt, chemicals, irritants, dust, allergens, fungi, molds, bacteria, and viruses so they can be flushed from the body before they can do any damage. This occurs thanks to microscopic hairs called cilia that cover the surface of the mucous membrane. The cilia beat back and forth in waves to clear mucus from the sinuses through a narrow opening in the nose and then move the mucus toward the back of the nose to be swallowed. A Conventional Conundrum When we are congested many of us reach for antihistamines or decongestants to try and find relief. But these over-the-counter medications can undermine the body’s natural healing system and create even more problems in those pockets of empty space. Antihistamines block symptoms like itchy, watery eyes, sneezing, or runny nose caused by histamines. While taking an antihistamine can temporarily ease symptoms, their use may actually worsen the problem by interfering with the clear- ing of secretions. If mucus stagnates, it can lead to a full-blown sinus infection. What’s more, anti- histamines can cause drowsiness and dry mouth. Decongestants are often used to relieve con- gestion and sinus pressure by shrinking blood vessels, reducing inflammation in the nasal 4B R E A T H E !passages, and opening mucous membranes. They improve airflow, reduce the need to breathe through the mouth, and decrease pressure in the sinuses and head. But, are the side effects worth it? Decon- gestants can cause nervousness, irritability, insomnia, and dizziness. They can also increase blood pressure and heart rate. Both decongestants and antihistamines can also interact with other medications, espe- cially monoamine oxidase (MAO) inhibitors. It’s important to check with your health care pro- vider before taking either decongestants or antihistamines if you suffer from high blood pressure, heart disease, glaucoma, or benign prostate hyperplasia.