Free Diving Breathing Training in Allergic Rhinitis

This study aims to investigate the effects of diver-style breathing training in patients with allergic rhinitis. A total of 30 patients aged 18-35 years were recruited from students and staff of Chulalongkorn University, as well as patients attending the Chulalongkorn University Health Service Center and King Chulalongkorn Memorial Hospital. Participants were randomly assigned into two groups: an experimental group (n = 15) that received diver-style breathing training and a control group (n = 15) that continued their usual daily activities without any exercise intervention.

The independent variable was diver-style breathing training. The dependent variables included rhinitis symptom outcomes (symptom scores, Peak Nasal Inspiratory Flow, nasal blood flow, and Fractional Exhaled Nitric Oxide), pulmonary function parameters (FVC, FEV1, FEV1/FVC, FEF25-75%, MVV, and breath-holding time), and respiratory muscle strength (MIP and MEP).

Inclusion criteria

• Patients diagnosed with persistent allergic rhinitis (allergen of any type), both male and female, presenting with nasal congestion, sneezing, nasal itching, and rhinorrhea occurring more than 4 days per week, with an average symptom score greater than 7. Eligibility was determined using the Rhinitis Symptoms Score (0, 1, 2, and ≥3 scale) assessed over the previous week and on the day of testing. Participants must not have any complications such as sinusitis, Eustachian tube dysfunction, or asthma.
• No history of other respiratory diseases, including bronchitis, pertussis, pneumonia, pneumonitis, pulmonary aspergilloma, tuberculosis, asthma, lung cancer, emphysema, or other related conditions.
• No regular exercise training exceeding 20 minutes per session, 3 days per week or more, during the 6 months prior to participation.
• No regular consumption of vitamin supplements or herbal products at least 3 days per week during the 6 months prior to participation.
• Ability to discontinue the following medications before and during the study period: Antihistamines for at least 3 days, Oral steroids and nasal steroids for at least 2 weeks, Leukotriene receptor antagonists for at least 1 week
• Participants were permitted to use decongestants (pseudoephedrine) if necessary. All participants were advised to consult their primary physician before discontinuing any medication and to ensure that their physical condition was appropriate for participation in the breathing training program.
• Willingness to participate voluntarily and provide written informed consent.

Exclusion criteria

• Inability to continue participation due to unforeseen circumstances, such as injury or illness.
• Absence from more than 8 training sessions out of a total of 40 sessions.
• Withdrawal of consent or unwillingness to continue participation.
• Inability to discontinue medications according to the specified criteria.
• Exacerbation of allergic rhinitis symptoms that prevents continued participation, such as persistent rhinorrhea or severe nasal congestion causing difficulty breathing.