Can humming help alleviate symptoms of sinus congestion or sinusitis in patients?

Humming for Sinus Symptoms

Humming is not recommended as a treatment for sinus congestion or sinusitis based on current clinical practice guidelines, which instead prioritize saline nasal irrigation, intranasal corticosteroids, and analgesics for symptomatic relief. 1, 2

Why Humming Is Not Guideline-Recommended

Major clinical practice guidelines from the American Academy of Otolaryngology-Head and Neck Surgery make no mention of humming as a therapeutic intervention for acute or chronic rhinosinusitis. 1 The evidence-based treatment algorithm consistently recommends:

• Saline nasal irrigation as first-line adjunctive therapy, particularly buffered hypertonic (3-5%) saline, which provides mechanical clearance and modest anti-inflammatory effects 1, 2
• Intranasal corticosteroids for reducing inflammation and mucosal edema in both acute bacterial rhinosinusitis (ABRS) and chronic rhinosinusitis (CRS) 1, 2
• Analgesics (NSAIDs or acetaminophen) for symptomatic relief of facial pain and fever 1, 2

The Limited Research on Humming

While humming has been studied in research settings, the evidence consists only of small observational studies and case reports—not the randomized controlled trials that inform clinical guidelines:

• Humming increases nasal nitric oxide (NO) levels 15-20 fold compared to quiet exhalation, theoretically improving sinus ventilation 3, 4
• One case report described resolution of chronic rhinosinusitis symptoms after 1 hour of humming daily for 4 days, hypothesizing that increased NO production had antifungal effects 3
• Humming-induced NO release has been proposed as a diagnostic test for sinus ostial obstruction in allergic rhinitis patients, but not as a treatment 5

Critical limitation: These are hypothesis-generating studies from 2002-2006 with no subsequent validation in controlled trials or incorporation into any major clinical practice guidelines. 3, 5, 4

Evidence-Based Treatment Algorithm for Sinus Symptoms

For Viral Rhinosinusitis (VRS) - Symptoms <10 days:

• Analgesics for pain/fever relief 1
• Saline nasal irrigation for mechanical clearance 1
• Intranasal corticosteroids may provide modest benefit (number needed to treat ~14) 1

For Acute Bacterial Rhinosinusitis (ABRS) - Symptoms >10 days or severe:

• Watchful waiting (observation without antibiotics for 7 days) is appropriate for uncomplicated cases with assured follow-up 1
• Antibiotic therapy (amoxicillin-clavulanate) for severe symptoms or failure to improve after 7 days 2
• Saline irrigation and intranasal corticosteroids as adjunctive therapy 1, 2

For Chronic Rhinosinusitis (CRS) - Symptoms ≥12 weeks:

• Intranasal corticosteroids are most effective for controlling major symptoms 2, 6
• Regular saline nasal irrigation (not just spray—irrigation is more effective) 2
• Short-course oral corticosteroids (5-7 days) for severe cases with marked mucosal edema or nasal polyps 2, 6

Common Pitfalls to Avoid

• Do not use topical decongestants beyond 3-5 days due to risk of rhinitis medicamentosa (rebound congestion) 1, 2, 6
• Do not prescribe antihistamines for non-allergic sinusitis as they may worsen congestion by drying nasal mucosa 1, 2, 6
• Do not use saline spray when irrigation is indicated—irrigation provides superior mechanical clearance 2
• Do not delay antibiotics in severe ABRS with high fever (>39°C) and purulent discharge lasting >3-4 days 2

When to Refer

Patients with recurrent sinusitis (4+ episodes per year) or symptoms refractory to medical management require otolaryngology evaluation for possible anatomic obstruction, nasal polyps, or other complications. 1, 2