By Joy Stephenson-Laws, J.D., Founder

I love to travel, but being on a commercial airplane is not exactly my idea of a good time. Pretty much every time I fly, I get a very bad headache. I thought upping my water intake even more would help, because flying is dehydrating and a very common cause of headache is not being adequately hydrated. Doing this, however, has not seemed to allow me to avoid the dreaded headache when I fly. Determined to get this under control, I decided to do some research and found out that I am not alone. In addition to this, a condition called aerosinusitis seems to be the culprit.

Before we get into exactly what aerosinusitis is, I think it is first important to have a basic understanding of what the sinuses are.

To put it simply, sinuses are air-filled spaces in the skull located behind the forehead, nasal bones, cheeks and eyes. They are interconnected and contain small hairs called cilia which are responsible for moving out particles and mucus. The sinuses are actually lined with a mucous membrane that traps particles such as dirt, and then cilia are like the brooms that sweep out what we don’t want. 

Sinusitis occurs when the tissue of the sinuses become swollen or inflamed. Some causes may include an infection (from a bacteria, virus or fungi), smoking, allergies, already having a weakened immune system, having abnormal sinus structures and changes in altitude (from activities such as flying in airplanes or scuba diving). 

Also called sinus squeeze, aerosinusitis basically occurs due to atmospheric pressure changes while flying.

“Aerosinusitis is an acute or a chronic inflammation caused by trauma to the mucous membrane of a sinus. The trauma is brought about by a difference between the air pressure within the sinus and that of the surrounding atmosphere. This phenomenon occurs commonly during the changes in altitude in airplane flights and is characterized by inflammation of the mucosa lining the sinuses and is accompanied by pain and discomfort. These symptoms may vary with the sinus affected,” according to JAMA Otolaryngology—Head & Neck Surgery.

This condition actually has career-ending potential among military aviators. 

“For some career military aviators, their ability to continue on flight status is limited by the pressure and pain of aerosinusitis, which is present only while in the flying environment. Failure to treat their disease process can mean the end of their flying careers and the loss of valuable assets trained with taxpayer dollars,” according to one study published by Military Medicine.

“Because some medications commonly used in treatment of sinus diseases are not allowed in aviation, this presents a unique problem for their medical management. Surgical treatment must be aimed at treating to symptom relief and not solely disease mitigation.”

Surgery to correct sinus issues is very tailored to the individual, but I’m not ready to resort to surgery yet. But how can I, as well as everyone else who experiences sinus discomfort when flying, be proactive? Here are a few tips:

• Ask your doctor or a competent doctor about taking non-steroidal anti-inflammatory drugs (NSAIDs).
• Nasal lavage (washing out with water or a medicated solution) or taking a topical or oral decongestant may help equalize pressure, according to the NIH.
• Chew gum or sip water during take-off and landing.
• Of course, be as courteous as possible and travel with sanitizer, but blow your nose if it feels congested and/or runny. You want to clear out the sinus passages. 
• Stay hydrated. Water helps thin mucus and get out the bad stuff that may cause swelling and inflammation.
• Avoid caffeine and alcohol. These are both very dehydrating. Keep in mind that alcohol also promotes inflammation which is exactly what you want to avoid.
• Avoid consuming dairy. Although quality dairy products do have good nutrients, dairy is a mucus-promoting food. If you are someone prone to sinus issues (particularly when you fly), I highly recommend avoiding dairy leading up to your trip and while traveling.
• Eat a nutrient-dense, antiinflammatory diet. Again, you want to decrease inflammation as much as possible. Vitamins and minerals, which are micronutrients, provide antiinflammatory properties such as powerful antioxidants including vitamins A and C, zinc, copper and selenium.
• Travel with peppermint or eucalyptus oil. Sniffing these essential oils can help keep sinuses clear and relax you.
• Avoid traveling when sick. Many people power through and travel regardless of being sick, but not only does this potentially expose others to your illness it may also make a sinus infection much worse and trigger very bad aerosinusitis.
• Try to relax. Traveling by plane is stressful, especially post pandemic, but try to relax by mediating or listening to some calming music. As you probably know, stress can cause headaches and to pair that with sinus issues could be a real discomfort.

My last tip is to pack your carry on with a self-care kit that makes you feel pampered and ready for your flight. Mine includes:

• Peppermint oil
• Gum
• A ziplock bag of citrus wedges and anti-inflammatory herbs such as mint. This way I can infuse my water and get added vitamin C which is critical for immune system and sinus health
• An eye mask for relaxation and to block out light
• An NSAID (although I use this as a last resort)
• Ear plugs to cancel out noise. This may also help mitigate exposure to atmospheric pressure changes

I hope these tips make your next flight more enjoyable. And, remember, there is no better way to ensure that you can travel happily for a long time than by making your health a priority. Take care of yourself by managing stress, eating healthily, getting good quality sleep, moving your body, spending time in nature and getting vitamin D from the sun and taking routine nutrient tests in order to determine if you have any nutrient imbalances or deficiencies. If you do, and most people do have imbalances and deficiencies, a competent healthcare professional can guide you regarding necessary dietary changes and recommend quality supplements if necessary.

Enjoy your healthy life!

Disclaimer: This article is not intended to provide medical advice. Please consult with your doctor or another competent healthcare practitioner to get specific medical advice for your situation.  

The pH professional health care team includes recognized experts from a variety of health care and related disciplines, including physicians, attorneys, nutritionists, nurses and certified fitness instructors. This team also includes the members of the pH Medical Advisory Board, which constantly monitors all pH programs, products and services. To learn more about the pH Medical Advisory Board, click here.