A nasal dilator for snoring widens the nasal valve, the narrowest point of the airway, either from outside (an adhesive strip) or from inside (a small insert in the nostrils). Internal inserts cut partner-rated snoring in two small trials (10 and 17 patients, 10 nights each, device used every second night), and external strips showed mixed results in snorers. Pooled across 14 studies in sleep apnea, dilators improved nasal breathing but not the apnea-hypopnea index, with a slight drop in the apnea index for internal designs only (4.87 events an hour). The best odds are for snorers with a blocked or narrow nose, and the worst for anyone whose snoring comes with pauses and gasping, which needs a doctor.
A nasal dilator for snoring comes in two kinds on the pharmacy shelf. One is the stick-on strip. The other is a small plastic or silicone insert that sits inside each nostril. They are marketed together, and the research treats them separately.
This article is about the device class: what it changes in the nose, what is different about inserts, what trials found for snorers and for people with sleep apnea, and who has the best chance of benefit. The strip-only version of the question is covered in Do nasal strips work for snoring?
Does a nasal dilator for snoring work? What it changes in the nose
A dilator works at the nasal valve, the narrowest part of the airway, just inside the nostril. Its job is to keep the walls of that valve from narrowing as you breathe in.
That effect is measurable. In 112 people, an external dilator enlarged the minimum cross-sectional area of the nasal cavity and lowered nasal resistance significantly in all three groups tested: 33 with mucosal swelling, 28 with septal deviation at the nasal valve, and 51 with healthy noses. It worked best in the septal group. The authors called the external dilator an effective nonsurgical approach for a septal deviation that blocks the valve area. In people with swollen mucosa, the numbers improved but the nose did not feel more open.
Roithmann R, Chapnik J, Cole P, Szalai J, Zamel N. Role of the external nasal dilator in the management of nasal obstruction. Laryngoscope 1998. PMID 9591551
Why this should affect a snore is a hypothesis. The author of the first insert trial proposed that more nasal airflow means less negative pressure in the chest, and therefore fewer chances for the soft palate to vibrate. It is a plausible chain, and the trials below test whether it holds.
Internal and external nasal dilators for snoring: how they differ
Nasal dilators for snoring come in two families, and the evidence for them differs in age, size and design.
| External strip | Internal insert | |
|---|---|---|
| Where it sits | On the skin across the nose, pulls the sides outward | Inside each nostril, pushes the walls outward |
| Studies in snorers | Four small trials, 10 to 35 people, mixed results | Two small trials, 10 and 17 patients, both positive |
| Design | Two open label, two sleep-lab nights, no sham strip | Device on every second night for 10 nights, partners rating |
| Sleep apnea (pooled) | Apnea index +0.64 events an hour | Apnea index -4.87 events an hour, AHI overall unchanged |
| Not covered by the trials cited here | Magnetic clips | Newer silicone inserts |
The 1990 insert trial is the one that started the idea. Ten patients used the Nozovent insert every second night for 10 nights while their sleeping partners judged snoring with a score. Snoring fell significantly, from moderate to slight or from barely tolerable to tolerable, and on about one night in four with the insert the partner noticed no snoring at all. A follow-up with 17 patients on the same schedule found significantly less snoring on insert nights, and the patients themselves reported less mouth dryness because they could avoid mouth breathing.
Petruson B. Snoring can be reduced when the nasal airflow is increased by the nasal dilator Nozovent. Arch Otolaryngol Head Neck Surg 1990. PMID 2317330
Petruson B, Theman K. Clinical evaluation of the nasal dilator Nozovent. The effect on snoring and dryness of the mouth. Rhinology 1992. PMID 1470829
Both trials are small and old, the raters knew when the insert was in, and neither measured snoring with a microphone or a sleep study. They are suggestive and no more. Strip trials on the external side gave a split verdict, with lower partner-rated snoring in open-label studies and no change in a 10-person sleep-lab study, as set out in the strips article above. Nobody has run an insert-versus-strip comparison in snorers, so claims that one design is better are unproven.
One neighbor deserves a mention so it does not get confused with a dilator. Nasal expiratory pressure (EPAP) devices were tested in a sham-controlled trial of 250 people with sleep apnea and reduced the apnea-hypopnea index by 42.7% at 3 months against 10.1% for sham. That result belongs to a different device class and says nothing about dilators.
Berry RB, Kryger MH, Massie CA. A novel nasal expiratory positive airway pressure (EPAP) device for the treatment of obstructive sleep apnea: a randomized controlled trial. Sleep 2011. PMID 21461326
Who benefits: start with the nose
The strongest argument for dilating the nose is epidemiological. In a population sample of 4,927 questionnaires and 911 in-laboratory measurements, people who had nighttime rhinitis symptoms on five or more nights a month were significantly more likely to report habitual snoring, chronic excessive daytime sleepiness or nonrestorative sleep, and those who reported allergy-related congestion were 1.8 times as likely to have moderate to severe sleep-disordered breathing. A later cohort of 4,916 adults found that severe nightly congestion carried 3.0 times the odds of habitual snoring, and that this was not just people with sleep apnea.
Young T, Finn L, Kim H. Nasal obstruction as a risk factor for sleep-disordered breathing. The University of Wisconsin Sleep and Respiratory Research Group. J Allergy Clin Immunol 1997. PMID 9042068
Young T, Finn L, Palta M. Chronic nasal congestion at night is a risk factor for snoring in a population-based cohort study. Arch Intern Med 2001. PMID 11427099
The counter-evidence is just as real. Among 683 people referred for snoring or possible sleep apnea, nasal resistance measured while awake and seated did not differ in snoring or apnea indices between those with normal, unilaterally high and bilaterally high resistance. And in 40 snoring men, surgery that lowered nasal resistance did not change snoring time or intensity on a sleep study. So a narrow nose raises the odds that dilation helps, without guaranteeing it.
Miljeteig H, Hoffstein V, Cole P. The effect of unilateral and bilateral nasal obstruction on snoring and sleep apnea. Laryngoscope 1992. PMID 1405965
If one side of your nose is nearly always blocked, or the walls seem to collapse inward when you breathe in hard, an ENT doctor can look at the nasal valve and the septum. A retrospective review of 37 snoring patients with nasal valve insufficiency who had a cartilage graft reported that snoring stopped completely in 11 (30%) and improved significantly in 13 (35%) after surgery. That is one center and a chart review, and it is evidence for the clinic, not for the pharmacy shelf. More on the septum is in Can a deviated septum cause snoring?
Akcam T, Friedman O, Cook TA. The effect on snoring of structural nasal valve dilatation with a butterfly graft. Arch Otolaryngol Head Neck Surg 2004. PMID 15545588
Sleep apnea: dilators help the nose, not the breathing events
A systematic review of internal (NoZovent) and external (Breathe Right) dilators screened 112 studies and analyzed 14. In 147 patients the apnea-hypopnea index went from 28.7 to 27.4 events an hour (p = 0.64), with no significant change in lowest oxygen saturation or snoring index. A subanalysis showed a slight reduction in the apnea index with internal dilators (4.87 fewer events an hour) and a small increase with external ones (0.64). The authors conclude that dilators improve nasal breathing without improving sleep apnea outcomes, bar a mild effect of internal designs.
Camacho M, Malu OO, Kram YA, Nigam G, Riaz M, Song SA, Tolisano AM, Kushida CA. Nasal Dilators (Breathe Right Strips and NoZovent) for Snoring and OSA: A Systematic Review and Meta-Analysis. Pulm Med 2016. PMID 28070421
A nose device is the wrong first step if the nights include gasping, noticed pauses in breathing, or a headache on waking. Those are reasons to see a doctor, and sleep apnea is one possible explanation.
Comfort, side effects and the other options
Dilators are cheap partly because they are simple, and the trials report few problems. In the 30-person lab study of external strips, 17 participants needed some time to get used to the strip and one felt a short urge to sneeze after the first application, with no other adverse events. In the strip study of 35 snorers, mouth dryness fell alongside snoring, and the 1992 insert trial found the same, which fits the idea that a more open nose lets people stop breathing through the mouth. None of these studies followed anyone for months, so long-term skin or nose irritation is not covered.
Todorova A, Schellenberg R, Hofmann HC, Dimpfel W. Effect of the external nasal dilator Breathe Right on snoring. Eur J Med Res 1998. PMID 9707518
A dilator is also a small part of a larger toolbox. In the 2024 randomized trial that compared a dental device with a combined package, the package contained an external nasal dilator together with a nasal saline rinse with mometasone, mouth taping and side-sleeping therapy, and 58% of partners rated the snoring as much improved. Because the four parts were used together, that trial cannot say how much the dilator contributed. For the dental side, see Does an anti snoring mouthpiece work?
Ioerger P, Afshari A, Hentati F, Strober W, Kallogjeri D, Ju YE, Piccirillo JF. Mandibular Advancement vs Combined Airway and Positional Therapy for Snoring: A Randomized Clinical Trial. JAMA Otolaryngol Head Neck Surg 2024. PMID 38780959
How to test a dilator for three nights each
A trial of this kind fits in a week, and a recording replaces the partner's ear.
- Choose one design first. Follow the maker's size and cleaning instructions.
- Use it for three nights and leave it out for three nights, in alternating order, with a similar routine: no alcohol, no heavy late meal, the same side of the bed.
- Record each night with the phone in the same place. Note how your nose felt at bedtime and at waking.
- Compare snoring on the six nights. If the dilator nights are consistently lighter, you have a signal. If they are mixed, the nose is probably not your bottleneck.
- Stop if the skin or the inside of the nose gets sore, and see a doctor if one nostril stays blocked.
Three nights is short, and snoring varies a lot by itself from night to night, so treat a small difference with suspicion. A large and repeatable one is worth keeping.
Where SleepTrace fits
The test above needs something that listens when you are asleep. SleepTrace uses the phone's microphone, recognizes snoring, talking and coughing and saves short clips of those moments (the free plan plays back 3 clips a month), and marks possible breathing pauses with a timestamp but no clip. You see when the snoring happened and how much of the night it covered, and you can set a dilator night next to a plain night. Sleep phases are estimated from the sound, not measured, and the sleep apnea indicator is a screening estimate that does not diagnose.
Run it on iPhone or Android with the app open and the phone on its charger; the screen goes dim without you touching it. It cannot see whether the dilator stayed in, how open your nose is, or whether you breathed through your mouth. For a wider look at phone tools, see Snore recorder apps.
Frequently asked questions
It holds the nasal valve open, so air passes with less resistance. In 112 people, an external dilator increased the smallest cross-sectional area of the nose and lowered resistance in people with mucosal swelling, a deviated septum and healthy noses alike, with the largest effect in the septum group. Whether less nasal resistance means less snoring is the part the trials split on.
Not shown for snoring. Insert trials from 1990 and 1992 (10 and 17 patients) found less partner-rated snoring and less mouth dryness, and strip trials were mixed, but nobody compared the two head to head. In the pooled sleep apnea data only internal designs showed a slight drop in the apnea index (4.87 events an hour fewer), against an increase of 0.64 for external strips.
Possibly with the nose, less clearly with the snore. In 28 people whose deviated septum narrowed the nasal valve area, an external dilator improved airflow measurements more than in the other groups, and the authors called it an effective non-surgical option for that problem. In 683 patients referred for snoring, nasal resistance on its own was not related to how severe snoring or apnea was.
No. Across 14 studies with 147 patients, the apnea-hypopnea index moved from 28.7 to 27.4 events an hour (p = 0.64). A sham-controlled trial of 250 people used a different device class, nasal expiratory pressure valves, and is not evidence for dilators.
In the trials reported here, side effects were rare: in the 30-person lab study of strips one patient felt a short urge to sneeze after the first application. None of the studies followed people for years. Stop if the skin or the inside of the nose becomes sore, and see a doctor if one side stays blocked.
SleepTrace is a wellness app, not a medical device. This article is general information, not medical advice. If your symptoms are frequent, severe or worrying, please talk to a doctor.
Dilators help when the nose is the narrow point, and the evidence is small. Use one for a few nights, skip it for a few, and compare in SleepTrace: how often you snored, how long, and the clips themselves. It does not see inside your nose, and a dilator is not a treatment for possible breathing pauses, which a doctor should check.
Hear your own night. SleepTrace turns a night of audio into your sleep phases, the sounds you made, and how it all trends. Works without a wearable, better with one. Your phone on the nightstand is enough to start. Get it for iPhone or Android →