If you're struggling with poor sleep because of breathing issues, you've probably wondered whether to try our Breathe Right strips or nasal dilators. Both promise better breathing and less snoring, but which one actually works?
After years of testing different breathing aids at SleepSmrt and diving deep into the research, I can tell you the results might surprise you.
Key Takeaways
- Internal nasal dilators are 3.6 times more effective at reducing nasal resistance than external strips
- Nasal dilators provide 110% improvement in airflow compared to 55% for Breathe Right strips
- Internal dilators cost 50% less annually despite higher upfront investment
- External strips may cause skin irritation with long-term use
- Neither device significantly improves sleep apnea, but both help with simple snoring
- Internal dilators work better for deviated septums and anatomical issues
How External Strips and Internal Dilators Work
The main difference between these devices? Where they apply pressure. Strips work from the outside, using sticky bands with spring-like tension to pull your nostrils apart. Think of them as external support for your nose.
These strips have two plastic bands built into the sticky part that create outward pressure on your nasal passages. They target the nasal valve area, which creates 50-60% of your total breathing resistance.
Internal nasal dilators work differently. They go directly into your nostrils where they physically expand the narrowest part of your nasal passages from the inside. This positioning lets them work right at the source of the problem.
The advantage here is significant. External strips have to work against your skin's stretch and the natural resistance of nasal cartilage. Internal dilators work directly against nasal tissues at the exact spot where blockage happens – they need less force to achieve better results.
Clinical Evidence: The Numbers Don't Lie
Research from Wheeling Jesuit University involving 30 people with sleep-disordered breathing showed substantial differences between these devices. Internal nasal dilators (nose cones) increased airflow by 73 L/min – that's a 110% improvement over baseline. Breathe Right strips only managed a 36 L/min increase, or about 55% improvement.
That's twice the difference in actual breathing capacity.
Commercial studies found even more dramatic results. The internal devices achieved 3.6 times greater reduction in nasal resistance compared to external strips. These measurements used rhinomanometry, the gold standard for measuring nasal airflow.
Real-World Effectiveness: What Actually Matters
Research shows these devices work best when your breathing problems come from nasal blockage rather than throat-based issues. A study of 30 snoring individuals found external nasal dilators effective in 73% of participants when nasal blockage was the main cause.
For sleep apnea specifically, neither device shows significant benefit. A review of 14 studies involving 147 sleep apnea patients found minimal impact on apnea events. Internal dilators showed a slight reduction of 4.87 events per hour, while external strips actually increased events by 0.64 per hour.
Athletic applications show more promise. Research involving athletes demonstrated that nasal dilators can reduce fatigue perception during exercise, even when heart and breathing parameters stay the same. The improvement in breathing comfort translated to better perceived performance.
Comfort and Daily Use: The Practical Reality
External strips are simple but come with trade-offs. You just stick them on clean, dry skin. But things like oily skin, sweating, or facial hair can hurt how well they stick. Some users report skin irritation, especially with nightly use over extended periods.
Internal dilators need an adjustment period – most people need about two weeks to get comfortable with having something in their nasal passages. But once you adapt, many users find them almost unnoticeable during sleep.
The big advantage of internal dilators? Stability. They stay in position through mechanical fit rather than adhesive strength, making them less likely to shift during sleep. This is especially important if you're an active sleeper or experience night sweats.
Internal dilators are also completely invisible when properly fitted.
Special Situations: When Each Works Best
For pregnancy-related congestion, both options are considered safe since they're purely mechanical. However, hormonal changes during pregnancy can increase skin sensitivity, potentially making adhesive strips more problematic for some women.
Athletes often prefer internal dilators because they maintain effectiveness despite sweating, rapid breathing, and physical movement. The discreet nature also allows use during competition without appearance concerns.
If you have a deviated septum, internal dilators typically work better. They can be positioned to specifically address the narrowed side of your nasal passage, providing targeted expansion where it's most needed. External strips provide uniform expansion that may not effectively address uneven issues.
For CPAP users, internal dilators may be more compatible since they don't interfere with mask placement or sealing. However, combining any nasal device with CPAP therapy should be discussed with your sleep specialist.
Safety Considerations You Need to Know
The most serious documented safety concern with external strips involves chronic skin damage. An FDA adverse event report documented a case where a user developed skin cancer potentially related to daily strip use over two years. While this represents an isolated incident, it highlights the importance of monitoring skin integrity with long-term adhesive use.
More commonly, users might experience initial insertion discomfort or mild nasal irritation with internal devices. Most people adapt within two weeks, but some individuals may not tolerate foreign objects in their nasal cavity.
Both device types require attention to hygiene, but internal dilators need regular cleaning to prevent bacterial accumulation.
Making Your Decision: Which Option Is Right for You?
Based on the evidence, internal nasal dilators offer superior mechanical performance, better long-term value, and greater convenience for most users. They're particularly worth trying if you have anatomical issues like a deviated septum or need discreet daytime use.
External strips might be better if you're uncomfortable with internal devices, only need occasional use, or want to test nasal breathing aids without initial investment.
Neither device will solve sleep apnea, but both can help with simple snoring when nasal obstruction is the primary cause. The key is having realistic expectations and understanding that these are breathing aids, not cures for complex sleep disorders.
If you're dealing with chronic sleep issues, consider consulting a sleep specialist to identify underlying causes before investing in any over-the-counter solution. For comprehensive sleep improvement, you might also benefit from other sleep optimization tools like blue light blocking glasses or mouth tape for nasal breathing.
The bottom line? For most people seeking better nighttime breathing, internal nasal dilators offer the best combination of effectiveness, comfort, and value. But individual anatomy and preferences matter, so don't hesitate to try both approaches to see what works best for your specific situation. Consider exploring a complete sleep bundle that combines multiple breathing aids for optimal results.
