It doesn't work immediately. You push saline from one nostril through the sinus cavity out the other nostril. It creates some turbulence and helps the mucus flo

It doesn't work immediately. You push saline from one nostril through the sinus cavity out the other nostril. It creates some turbulence and helps the mucus flow. Often water will end up stuck in your sinus and come out when you lean over later. Really, it just seems to help your sinuses clear themselves (did you know about nasal cycle which alternates congestion?). You still tend to just blow out more infected glop. Also, it's easier to tell when something bad is going on, because you'll actually see the blood in your mucus rather than just having dark boogers. That might encourage you to clean more than once.