Nasal strips vs CPAP: can nasal strips help sleep apnea?

Nasal strips are not an alternative to CPAP, and they don't treat sleep apnea. Several studies and two meta-analyses have found that strips don't meaningfully change the breathing pauses that define the condition. CPAP is the standard treatment. Strips are a useful tool for a stuffy nose and for snoring in people without sleep apnea, which is a different job.

Are nasal strips an alternative to CPAP?

Nasal strips are not an alternative to CPAP. CPAP treats obstructive sleep apnea by keeping the airway open with air pressure, while a strip only widens the front of the nose. The research consistently finds that strips leave sleep apnea measures largely unchanged, so swapping CPAP for strips would mean going without treatment.

Even strip makers say this. One major strip maker states that its nasal strips are not intended to treat sleep apnea, and advises seeing a doctor if you suspect your snoring is a symptom of a serious condition like sleep apnea.

If CPAP is uncomfortable or hard to stick with, that's a common and fixable problem, and it's worth raising with your sleep doctor rather than quietly stopping. Our guide to sleep apnea treatment options covers what else a doctor may offer.

What does the research say about nasal strips for sleep apnea?

The research says nasal strips don't treat sleep apnea. This is one of the clearer findings in the nasal strip literature, because several controlled trials and two meta-analyses point the same way.

A 2016 systematic review and meta-analysis in Pulmonary Medicine pooled 14 studies of internal and external nasal dilators. In the 147 people with sleep apnea whose apnea-hypopnea index (AHI, the number of breathing pauses and shallow breaths per hour) was reported, it went from an average of 28.7 to 27.4 events an hour, which wasn't a significant change. Lowest oxygen levels and snoring index in people with sleep apnea didn't change significantly either. The authors concluded that dilators should not be thought of as curative for sleep apnea.

A larger 2026 meta-analysis in Cureus pooled 17 studies with 496 people. It found no significant differences in AHI, apnea index, hypopnea index, snoring index, sleep time, sleep architecture or oxygen saturation between people using nasal dilators and controls. Its conclusion was that nasal dilators can't be recommended as a standalone treatment for sleep-disordered breathing.

How do nasal strips compare with CPAP head to head?

Nasal strips have been compared directly with CPAP in randomized trials, and CPAP comes out well ahead. In fact, strips perform so much like a placebo that researchers now use them as one.

In a 2017 randomized crossover trial in the Journal of Clinical Sleep Medicine, 26 people with severe sleep apnea used both nasal strips and nasal CPAP, in random order with a washout in between. Strips had no significant effect on any sleep study measure, although people did feel less sleepy with them. CPAP scored significantly higher on satisfaction. The authors concluded that strips make an attractive placebo for trials of CPAP.

A 2012 crossover trial in Clinics found the same in 12 people with acromegaly and moderate to severe sleep apnea, each treated for three months with CPAP and three months with strips. AHI fell significantly with CPAP and didn't change with strips. Symptoms improved with both, but much more with CPAP, and the authors said the improvement with strips was compatible with a placebo effect.

Why do strips help snoring but not sleep apnea?

Strips can help snoring but not sleep apnea because the two problems often happen in different parts of the airway. A strip lifts the sides of the nose and widens the nasal passage at the front. That can make breathing through the nose easier and snoring quieter when the nose is part of the problem. Our guide to how nasal strips work explains the mechanics.

In a 1998 sleep lab study of 30 habitual snorers, strips reduced peak snoring intensity, and the researchers found snorers without sleep apnea were the ones most likely to benefit. In people with sleep apnea, the 2016 meta-analysis found no significant change in snoring index or breathing pauses. Opening the nose doesn't stop the airway collapsing farther back.

That's also why strips can be a trap for someone with undiagnosed sleep apnea. Quieter snoring can make it seem like the problem is solved when the breathing pauses are still happening. Our article on snoring vs sleep apnea goes through the differences.

Why do some people with sleep apnea feel better with strips?

Some people with sleep apnea feel better with strips because the feeling of doing something can improve how you rate your sleep, even when your breathing hasn't changed. In the 2017 trial, people with severe sleep apnea reported less sleepiness while using strips, although their sleep study results didn't improve. In the 2012 trial, every symptom the researchers measured improved with strips as well as with CPAP, but the gains were much larger with CPAP, and the authors called the strip effect compatible with placebo.

Placebo effects show up in strip research generally. In two 2019 randomized trials of people with chronic nighttime congestion, sleep scores improved in both the real strip and placebo strip groups, and the authors suggested a strong placebo effect may explain why the real strip didn't beat the placebo.

That doesn't mean feeling better is imaginary or unimportant. It means a better-feeling night isn't proof that the breathing pauses have stopped. With sleep apnea, only a sleep study can tell you that, which is why treatment decisions belong with a doctor.

What does CPAP do?

CPAP is a machine that delivers constant air pressure through a mask to keep your airway open while you sleep. The National Heart, Lung, and Blood Institute says a PAP machine is the most common treatment for sleep apnea.

The American Academy of Sleep Medicine's 2019 guideline strongly recommends that clinicians use PAP therapy to treat sleep apnea in adults with excessive sleepiness. It also says PAP treatment should be based on a diagnosis made with objective sleep apnea testing, and that people starting PAP should get education and follow-up. NHLBI lists possible side effects including congestion, dry eyes or mouth, nosebleeds and a runny nose, and points people with problems back to their care team.

Can you use nasal strips with CPAP?

Whether you can use nasal strips with CPAP is a question for your sleep doctor or CPAP provider, because the evidence is thin. The authors of the 2016 meta-analysis wrote that nasal dilators may reduce the pressure CPAP needs and that dilator use may possibly improve CPAP use. They presented both as possibilities, not established findings.

We didn't find a trial testing external nasal strips as an add-on to CPAP, so no study has shown whether they help. The 2026 meta-analysis said dilators may be helpful as an add-on in some people with mild symptoms or nasal congestion, but that's a general statement, not a CPAP-specific finding.

If your nose feels blocked or dry on CPAP, tell your provider. NHLBI lists congestion as a known CPAP side effect, and there are several ways a care team can address it. Our article on how to sleep with a stuffy nose covers general congestion tips.

Do nasal strips help mild sleep apnea?

Nasal strips haven't been shown to treat mild sleep apnea either. The 2026 meta-analysis found no significant improvement in AHI across the studies it pooled. Its authors left room for dilators as an extra in people with mild symptoms or nasal congestion, but only alongside proper care, not instead of it.

If you've been told you have mild sleep apnea, ask your doctor what they recommend. Our guide to positional sleep apnea covers one pattern that's common in milder cases.

When should you see a doctor?

You should see a doctor if your snoring comes with choking, gasping or pauses in breathing. The American Academy of Sleep Medicine says that combination is a reliable sign of sleep apnea. It also lists daytime sleepiness, unrefreshing sleep, morning headaches, high blood pressure and trouble staying awake while driving as warning signs, and recommends talking to a medical provider about testing.

A home sleep apnea test is one way your doctor may check. Our list of sleep apnea warning signs can help you decide whether to book an appointment.

Where do nasal strips still fit?

Nasal strips still fit well for people whose problem is in the nose. Controlled studies support them for nasal congestion and for snoring in people without sleep apnea, and they're drug-free and simple to use. Once sleep apnea has been ruled out, or alongside treatment if your doctor agrees, they can be part of a good night's routine. Our nasal strip research roundup covers what they do well.

Read next

• Snoring vs sleep apnea: how to tell the difference
• Sleep apnea treatment options
• Why nasal strips don't work for some people

* This content is for informational and educational purposes only and is not medical advice. It is not intended to diagnose, treat, cure or prevent any disease or health condition. Talk to a qualified healthcare provider about your health.