Because of the many advertisements for sinus pills, we have come to assume that most headaches are associated with sinus problems. This is not the case. Sinus headaches usually begin after a person is up and about in the morning, and usually subside by evening. Headaches occurring at night, especially those that awaken the victim, are rarely, if ever, due to sinus infection. Changes in atmospheric pressure and temperature, however, may bring on sinus inflammation with a headache. For example, sinus headaches often begin after people experience pressure changes on airplane flights. Some individuals report that their sinus headaches begin when the weather changes, for example, before a storm when the humidity is high. My patient Stanley is usually more accurate than the local weatherman at predicting a severe thunderstorm; he calls my office for a renewal of the antibiotic he takes for his sinus headaches, which start when the air humidity is high.

Headaches or facial pressure associated with sinusitis are often accompanied by some degree of nasal congestion or blockage. If you can relieve sinus pressure by spraying your nose with an over-the-counter decongestant spray (Neo-Synephrine, Afrin) or by taking a decongestant tablet (Sudafed), that suggests that the pressure or headache is sinus in origin. If your headache is stress related, or if it is a migraine, then the decongestants (spray or tablets) will have little effect. Remember that the use of nonprescription decongestant sprays should be limited to three to five days only. Decongestant tablets should not be taken with any regularity by people with high blood pressure or men with prostate problems.