Does humming at 130 Hz (approximately a C note) for two minutes effectively clear the sinuses, and are there any studies supporting this?

Humming and Sinus Clearance: Evidence-Based Assessment

Direct Answer

Humming does increase nasal nitric oxide levels 15-fold compared to quiet breathing, but there is insufficient evidence to support the claim that humming at 130 Hz for 2 minutes effectively "clears the sinuses" in any clinically meaningful way. 1, 2

Mechanism of Action

Humming creates oscillating sound waves that enhance gas exchange between the paranasal sinuses and nasal cavity, causing a rapid washout of nitric oxide (NO) that accumulates in the sinuses. 1, 2 The paranasal sinuses are major producers of NO in the upper respiratory tract, and humming at approximately 130 Hz (a low pitch C note) generates pressure fluctuations that facilitate this exchange. 1, 3

What the Evidence Actually Shows

Nitric Oxide Production

• Humming increases nasal NO levels 15- to 20-fold compared to quiet exhalation, measured using chemiluminescence techniques at controlled flow rates. 1, 2
• This effect occurs because oscillating airflow dramatically increases gas exchange between the nasal cavity and sinus compartments. 2

Clinical Evidence Limitations

• Only one case report exists describing a single subject who hummed strongly at ~130 Hz for 1 hour at bedtime, then 60-120 times four times daily for 4 days, reporting resolution of chronic rhinosinusitis symptoms. 3
• This case report is anecdotal evidence (the lowest quality of medical evidence) and has never been replicated in controlled studies. 3
• No randomized controlled trials, cohort studies, or systematic reviews support humming as a treatment for sinus congestion or rhinosinusitis. 1

Diagnostic vs. Therapeutic Use

• The primary validated use of humming is diagnostic, not therapeutic. Combined nasal NO measurement with and without humming helps distinguish between nasal mucosal NO output and sinus NO contribution, particularly useful for screening conditions like primary ciliary dyskinesia. 1
• Repeated humming maneuvers actually decrease nasal NO levels over time because accumulated sinus NO gets washed out, making it useful for standardizing measurements but not for therapeutic benefit. 4

What Guidelines Actually Recommend for Sinus Clearance

Evidence-Based Airway Clearance Techniques

For patients with retained secretions or chronic rhinosinusitis, established guidelines recommend:

• Postural drainage with percussion and coughing for 20-minute sessions performed twice consecutively is the most effective combination for clearing viscous secretions. 5
• Active cycle of breathing techniques (ACBT) combined with postural drainage enhances sputum expectoration compared to sitting positions alone. 6, 5
• Oscillating positive expiratory pressure devices (Acapella, Flutter) improve quality of life, sputum volume, and exercise capacity over 3-month periods. 6

What Doesn't Work

• The American Thoracic Society states that chest physiotherapy for airway clearance cannot be considered standard of care in general pediatric populations without specific indications. 7
• Treatment should be etiologically based once the cause is identified (antibiotics for bacterial infection, steroids for inflammation, etc.), not empiric airway clearance therapy. 7

Critical Pitfalls

The 2-minute timeframe mentioned in your question is completely unsupported. The single case report that exists used 1 hour of continuous humming initially, followed by 60-120 hums four times daily for 4 days—a vastly different protocol. 3

Humming may have diagnostic value for assessing sinus ostial patency and NO production, but this does not translate to therapeutic benefit for congestion. 1, 8

Acoustic vibration devices that combine vibration with oscillating expiratory pressure (like the SinuSonic) have shown some promise in small pilot studies for reducing nasal congestion, but these are mechanical devices, not simple humming. 9

Bottom Line

While humming increases nasal NO production through a well-understood mechanism, there is no credible scientific evidence that humming for 2 minutes (or any duration) effectively clears sinuses as a treatment modality. 1, 2 The single case report suggesting benefit used an intensive 1-hour protocol and represents the weakest form of medical evidence. 3 Patients with chronic rhinosinusitis or nasal congestion should pursue evidence-based treatments including appropriate medical management and, when indicated, established airway clearance techniques. 6, 5