Fan on face alleviates exertion-induced dyspnoea

For individuals with chronic respiratory conditions, using a fan across the face while engaging in physical activity can relieve dyspnoea and improve functional capacity, as shown in a small crossover randomized controlled trial.

The level of dyspnoea at the end of a 6-min walking test (6MWT) was significantly lower when using a portable fan worn around the neck than when not (Borg Dyspnea Scale score, 3 vs 4; p<0.001). Similarly, the increase in dyspnoea during the test was smaller with vs without the fan (Borg Dyspnea Scale score, 2 vs 3; p<0.001). [Respir Med 2025;249:108426]

“Given that the minimal clinically important difference (MCID) for dyspnea is –1 point on the Borg scale, these findings suggest a clinically meaningful improvement in breathlessness with fan therapy during the 6MWT,” according to the authors.

Furthermore, “fan therapy not only reduced dyspnoea but also significantly increased the distance covered during the 6MWT,” they continued.

Patients covered a median of 40 m more when using the fan than when not (450 vs 410 m; p<0.001), exceeding the MCID range for the 6MWT of 14–30.5 m. The distance covered when the fan was used significantly increased every 2 min (2 min: 150 vs 140 m; p=0.014; 4-min: 300 vs 280 m; p=0.003).

Finally, pulse oximetry or heart rate did not significantly differ between the tests with and without the fan.

These findings are consistent with observations from other studies in similar populations. [ERJ Open Res 2021;7:00211-2021; Lung 2015;193:725-31]

The clinically significant improvements in dyspnoea and exercise capacity while using a fan across the face hold important implications, given that “exercise-induced breathlessness discourages patients from participating in daily activities and reduces adherence to pulmonary rehabilitation, a key treatment for chronic lung diseases,” the authors pointed out.

Fan therapy is noninvasive and inexpensive, making it an appealing tool for managing breathlessness in rehabilitation and clinical settings, they added.

Cooling effect

The study included 25 adults (mean age 72 years, 56 percent female) with a history of any chronic respiratory disease and were clinically stable for at least 1 month. Of these, 56 percent had chronic obstructive pulmonary disorder, 16 percent had lung cancer, 16 percent had pulmonary fibrosis, 8 percent had chronic dyspnoea, and 4 percent had bronchiectasis. The median score on the modified Medical Research Council breathlessness scale was 2.

The participants performed two 6MWT, either with or without a fan, in a randomized order. The fan used during each test was a portable neck fan consisting of two mini fans positioned on either side of the neck. The device operated at a maximum speed of 1.5 m/s and was positioned 20 cm from the participant’s face

According to the authors, the fan was designed to enhance its cooling effect and ensure activation of the TRPM8 receptors on the trigeminal nerve. The aim was to alter the participants’ breathing pattern by stimulating the somatosensory system, they added. [J Pain Symptom Manage 2022;63:e9-e16; Respir Physiol Neurobiol 2023:311:104035]

When asked to rate their perception of dyspnoea relief and the discomfort caused by the fan, the participants gave a median rating of 4 on a scale of 0–5 for relief, with only three reporting discomfort from the cold sensation produced by the fan.

Fan therapy benefits

Results from a prior study described similar perceived effectiveness with fan therapy during exercise. In another study, some participants also reported a sense of relaxation and enhanced self-management aside from the experienced relief, despite initial scepticism about fan therapy. [ERJ Open Res 2021;7:00211; Sci Rep 2021;doi:10.1038/s41598-021-86326-8]

Evidence have also shown that fan therapy can reduce recovery time from exertion-induced dyspnoea and may be more beneficial than oxygen therapy, which is often overprescribed for chronic dyspnoea, especially in nonhypoxemic patients. [BMJ Support Palliat Care 2019;9:478-481; Palliat Med 2019; 33:618-633; Curr Opin Support Palliat Care 2019:206-211; COPD 2018;15:294-302]

“Additionally, fan therapy has potential psychological benefits, helping to alleviate anxiety and depression, which are prevalent comorbidities in patients with chronic respiratory diseases. By stimulating brain regions involved in respiratory responses, such as the anterior cingulate cortex and insular cortex, fan therapy may contribute to emotional regulation, thereby improving overall well-being,” the authors noted. [Front Physiol 2017;8:617; Maturitas 2013;76:45-50]

“Given its potential benefits on both physical and psychological outcomes, fan therapy warrants further investigation, particularly in long-term studies and real-world applications,” they said.