Nasal Strips vs Internal Nasal Dilators: Which One Should You Use?

The bottleneck both devices target

Around two-thirds of the total resistance your lungs fight on every breath comes from your nose, and most of that resistance is concentrated in a 1–2 mm slit called the external nasal valve — the narrowest point of the entire airway, sitting just inside the nostril opening where the soft cartilage of the side wall meets the septum.

When that valve narrows, partially collapses on inhale, or gets congested by allergies or alcohol, breathing effort rises, mouth-breathing kicks in, and snoring follows. Both nasal strips and internal dilators exist for exactly one reason: to physically hold that valve open while you breathe.

They just do it from opposite sides. An external nasal strip is an adhesive band with one or two sprung plastic ribs that pull the side walls of the nose outward from the bridge. An internal dilator is a small silicone or polymer device — usually shaped like a stent, ring or Y — that you insert into each nostril and which pushes the valve walls open from inside.

What the airflow research actually shows

This is the part most comparison articles skip. Both products have been measured in peer-reviewed rhinomanometry and acoustic-rhinometry studies, and the numbers are closer than the marketing on either side suggests.

External strips have been shown to increase the cross-sectional area at the nasal valve by roughly 18–25% and reduce nasal airway resistance in the 20–30% range in healthy adults. Internal dilators of the stent or ring style sit in a similar 22–35% resistance-reduction range, with a small edge in cases of severe valve collapse where the strip alone can't generate enough outward pull.

Translated into real life: for the average snorer, allergy sufferer or athlete, the difference in raw airflow between a good external strip and a good internal dilator is usually small enough that comfort, consistency and habit matter more than the device itself. The best device is the one you'll actually wear every night.

Comfort, sleep quality and learning curve

• External strip — zero learning curve. Peel, place across the bridge, press for 10 seconds, sleep. Most users feel the difference on the first breath.
• Internal dilator — 3 to 7 nights of adjustment. The foreign-body sensation triggers reflex sneezing and watery eyes in roughly 1 in 4 first-time users.
• External strip — no impact on side-sleeping; the adhesive holds against pillow friction. Best worn on clean, oil-free skin.
• Internal dilator — fine on your back and side; some users report the device shifting or being partly ejected by morning, especially if they breathe forcefully through the mouth during deep sleep.
• External strip — leaves a faint pressure mark on the nose for around 30–60 minutes after removal. No mark inside the nose.
• Internal dilator — invisible from the outside, but can cause mild nostril-rim soreness if the size is wrong, and a small percentage of users report nosebleeds during the adjustment period.

Who each one actually suits

Pick an external strip first if any of these describe you: you snore from mild congestion, allergies, alcohol or a cold; you want a no-fuss nightly habit; you wear a CPAP mask; you train or race and need breathing support during exercise; you've never tried either category before; or you share a bed and don't want to handle a silicone insert at the bedside.

Consider an internal dilator if: a strip has genuinely failed you after a fair 2–3 week trial; a specialist has diagnosed severe internal valve collapse rather than external valve narrowing; you have very oily skin or facial hair that prevents the adhesive from sealing; or you specifically want a device that's invisible in photos (wedding nights, video calls, on-camera sport).

For the small subset of users with severe deviation or surgically altered anatomy, some clinicians suggest wearing both simultaneously. For everyone else this stacks discomfort without much extra airflow.

Cost per night, lifespan and hygiene

• External strips — single-use, no cleaning, around $0.50–$1.00 per night in Australia depending on pack size. A 30-pack of RhinoGear works out to roughly $0.83 per night.
• Internal dilators — $30–$70 upfront, manufacturer-recommended lifespan of 4–12 weeks per device. Per-night cost lands around $0.25–$0.80 once you average the upfront price across actual nights worn.
• Hygiene gap most people overlook: internal dilators sit inside a warm, moist airway every night and need to be rinsed and air-dried daily, then sterilised weekly. A device that gets skipped on cleaning becomes a bacterial reservoir within a fortnight. Strips are tossed in the bin each morning, so the hygiene question never comes up.
• Real-world value rule: strips win if you wear them inconsistently; dilators win on pure dollars only if you wear them nightly for the full lifespan and clean them properly.

CPAP, sport and travel

For CPAP users, external strips are the clear choice. They sit on the bridge of the nose, well clear of nasal-pillow or full-face mask seals, and many sleep clinics specifically recommend them to reduce the pressure setting needed for an open airway. Internal dilators can disrupt nasal-pillow seals and cause mask leaks.

For athletes, the conversation is split. Endurance runners, cyclists and combat-sport athletes overwhelmingly choose external strips because they're cheap enough to use per session, don't fall out under heavy exertion, and don't interfere with mouthguards. Internal dilators have a small following in shooting and motorsport where invisibility on camera matters.

For travel, strips beat dilators on practicality. Airline air is roughly 10–20% humidity — drier than most deserts — which is why nasal congestion spikes in flight. A flat sleeve of strips slides into any pocket; a silicone dilator needs a case and a place to rinse it.

Side effects and who should avoid each

• External strips — main risk is skin irritation from the adhesive, mostly in users with very sensitive skin or active eczema on the nose. Avoid on broken skin or sunburn. Always remove gently after warming with water.
• Internal dilators — main risks are nosebleeds (small percentage during the adjustment period), reflex sneezing, and aspiration risk if the device dislodges. Not recommended for children, people with severe deviated septum without medical advice, or anyone with recurrent epistaxis.
• Neither device treats obstructive sleep apnoea. If you stop breathing in your sleep, gasp awake, or your partner reports apnoeic pauses, see a sleep physician — not the chemist aisle.

How to choose in 30 seconds

Start with an external nasal strip. It's the lower-risk, lower-cost, faster-to-habit option, and it resolves the underlying breathing complaint for the large majority of people who try it. Give it a fair two-week trial — every night, applied to clean skin, sized to your nose.

If after that honest trial you're still waking congested, escalate: try an internal dilator, or stack both for a few nights to see whether extra force at the valve makes a real difference for your specific anatomy. If neither helps, the bottleneck isn't your nasal valve — it's likely your soft palate, tongue base or jaw position, and the right next step is a GP or sleep specialist rather than another device.