Complementary treatment of asthma with salt therapy

What is asthma?

Asthma – formally asthma bronchiale – is a chronic inflammatory disease of the airways. The essence is that the bronchial walls are persistently inflamed and hypersensitive: they overreact to certain triggers – allergens, cold air, physical exertion, infections. In such cases the bronchial muscles contract, the mucosa swells, and thick secretions are produced. All this narrows the airways, causing the characteristic symptoms.

It is important to understand: asthmatic airways are inflamed even when you have no symptoms. That is why maintenance therapy is needed regularly even during symptom-free periods. Asthma cannot be cured, but it can be controlled – and with well-controlled asthma you can live essentially a normal life.

The types of asthma

There are several forms of asthma, and the type may influence how helpful salt therapy can be for you.

Allergic (atopic) asthma is the most common form, especially in children. Symptoms are triggered by allergens: pollen, house dust mite, animal dander, mold. If you have allergic asthma you likely also have allergic rhinitis – the two conditions often coexist. Salt therapy is particularly promising for this type because it can help wash allergens out of the airways.

Non-allergic (intrinsic) asthma is more common in adults and is triggered not by allergens but by other factors: infections, cold air, stress, physical exertion, air pollution. Salt therapy can also help here by reducing airway inflammation and aiding mucolysis.

Exercise-induced asthma (EIA) causes symptoms during or after physical activity. Inhaling cold, dry air is a particularly provoking factor. Interestingly, research suggests that salt therapy can reduce bronchial hyperreactivity.

Asthma symptoms

Asthma symptoms are characteristic, although their severity varies between individuals. Shortness of breath is the most typical – the feeling that you cannot get enough air, as if someone is sitting on your chest. Wheezing is the sound of air passing through narrowed airways, especially audible on exhalation. The cough is often dry and irritating, and worse at night or early morning. The sensation of chest tightness feels like something is compressing your chest.

Symptoms typically occur in attacks – called asthma attacks or exacerbations. During an attack symptoms suddenly worsen and require immediate action. Between attacks you may be completely symptom-free or have mild, persistent complaints.

Warning signs that asthma is worsening: you need to use your reliever inhaler more often, you wake at night because of symptoms, your daily activities become limited.

How is asthma treated?

The goal of asthma treatment is to control symptoms, prevent attacks and ensure normal daily life. Treatment rests on two pillars.

The first is maintenance (preventive) therapy, which must be used every day even if you have no symptoms. Its basis is the inhaled corticosteroid (ICS), which reduces chronic airway inflammation. This is your most important medication – never stop it without your doctor’s knowledge! In more severe cases it is combined with a long-acting bronchodilator (LABA).

The second is the rescue treatment, used only as needed when symptoms occur. This is usually a short-acting bronchodilator inhaler (SABA), which quickly opens the airways and relieves symptoms. If you need the rescue inhaler several times a week, it means your asthma is not well controlled – speak with your doctor!

A modern approach to asthma management also emphasizes avoidance of triggers: minimizing exposure to allergens, avoiding tobacco smoke, and ensuring a suitable living environment.

And here comes the fourth element: complementary therapies, including salt therapy.

What is salt therapy and how does it work in asthma?

Salt therapy – or halotherapy – is a natural method based on inhaling salt particles. Several mechanisms are relevant for asthma.

The first and perhaps most important is the reduction of bronchial hyperreactivity. Asthmatic bronchi characteristically overreact to various stimuli. A 2017 Israeli randomized study – described in detail below – showed that halotherapy reduced bronchial hyperreactivity in children with asthma.¹ This means the bronchi respond less to triggers.

The second effect is the reduction of airway inflammation. Asthmatic airways are chronically inflamed, and the degree of inflammation can be measured by fractional exhaled nitric oxide (FeNO). The Israeli study also found that halotherapy reduced FeNO levels, indicating inflammation decreased.¹

The third effect is mucolysis and improved mucociliary clearance. In asthmatic bronchi thick, sticky secretions are produced, which further narrow the airways. Salt particles, through their osmotic action, dilute these secretions and stimulate the airway cilia that sweep mucus outward.² Think of flushing a clogged pipe: fluid flows more freely afterward. Salt therapy similarly “flushes” the airways.

The fourth effect is reduction of IgE. IgE antibodies play a key role in allergic asthma. Some research suggests salt therapy can lower IgE levels, which may reduce allergic reactions.³

If you want to learn more about salt therapy, read this article: Salt therapy and halotherapy guide

What do scientific studies say?

The relationship between salt therapy and asthma has been analyzed in numerous studies. I summarize the most important findings.

The 2017 Israeli randomized, double-blind, controlled trial is one of the highest-quality studies in this field.¹ Bar-Yoseph and colleagues studied 5–13-year-old children with mild asthma who were not on anti-inflammatory treatment. The children were randomly assigned to two groups: one received treatment in a salt room with a halogenerator, while the control group stayed in a salt room without an active halogenerator. Treatment lasted 7 weeks with two 45-minute sessions per week.

The results were promising: the halotherapy group had a significant reduction in bronchial hyperreactivity (improved methacholine provocation test), decreased exhaled nitric oxide (indicating reduced airway inflammation), and improved asthma-related quality of life on questionnaires. No significant adverse effects occurred.

A comprehensive 2021 literature review analyzed 18 original publications on halotherapy in asthma.⁴ The authors concluded that the studies overall support beneficial effects of halotherapy as a complementary therapy for asthmatic patients, without adverse effects. The review highlights that halotherapy may be useful in diagnosing, treating and preventing asthma.

A 2008 Brazilian study specifically examined nocturnal asthma symptoms.⁵ The researchers found that inhalation of hypertonic saline had a protective effect against nocturnal asthma attacks. This is important because nighttime symptoms are one of the most disturbing aspects of asthma.

A 2020 review summarized 13 studies on halotherapy for chronic airway diseases including asthma.⁶ The majority of studies showed improvements in lung function parameters including FEV1 (forced expiratory volume in one second), FVC (forced vital capacity) and PEF (peak expiratory flow). Quality of life also improved based on questionnaires.

A 2017 Iranian randomized crossover trial followed 6–14-year-old children with mild to moderate asthma.⁷ After salt room treatment (three times weekly for three weeks) cough, wheeze and dyspnea frequency decreased, as did the need for rescue medication.

A 2012 Russian study examined the preventive effect of halotherapy in schoolchildren.⁸ Follow-ups at 1, 3, 5 and 12 months confirmed that salt therapy had lasting preventive and therapeutic effects – i.e., benefits persisted after treatment ended.

The effect of salt therapy on asthma symptoms

In practice, people with asthma report the following effects from salt therapy.

Easier breathing is one of the most commonly reported changes. Reduced bronchial hyperreactivity and inflammation combined with dilution of secretions together make breathing freer. Many report being able to take deeper breaths.

Reduction of nighttime symptoms is particularly important for quality of life. If you don’t wake up coughing or short of breath, you feel more rested and your day starts better. The Brazilian study specifically confirmed this effect.⁵

Less frequent use of the rescue inhaler is a good sign – it indicates better asthma control. Several studies found that salt therapy users required fewer rescue medications.

Improved exercise tolerance is also commonly reported. If your airways are less sensitive and contain less mucus, you cope better with physical activity.

Different salt therapy methods in asthma

Several salt therapy methods can be considered for asthma, and it’s important to know the differences.

Natural salt caves (speleotherapy) are the oldest form. The microclimate of salt mines and natural caves – stable temperature, high humidity, salt-enriched air free of allergens and pollutants – has been used for healing for centuries. Salt mines in Transylvania are most accessible from Hungary. The advantage of speleotherapy is its complex effect; the drawback is you need to spend weeks there.

Artificial salt rooms (halotherapy) use a halogenerator to produce salt particles (where only a salt wall is present, the therapeutic effect is much less compared to halogenerator-equipped chambers). Most scientific studies were conducted in artificial salt rooms.

Home salt therapy devices, like the SaltDome, make regular daily use possible. This is particularly practical for asthma because treatment regularity is crucial – and not everyone can attend a salt room multiple times a week.

Home salt therapy with the SaltDome device in asthma

The SaltDome ultrasonic salt therapy device is specifically designed for home use. The device nebulizes a salt solution ultrasonically and releases salt particles sized 2–5 microns into the air. According to Semmelweis University, particles between 0.5 and 5 microns reach the lower airways down to the bronchi⁹ – which is exactly where asthma causes problems.

It is advisable to place the device in the bedroom and set it for nighttime use. While you sleep the device continuously generates saline air that passes through your airways. Regular nightly use – based on studies – can produce meaningful improvement after 2–4 weeks.

The SaltDome’s advantage over dry salt therapy tools is that it works with wet nebulization. This is important because dry air itself can be an asthma trigger – wet salt therapy does not cause this kind of irritation.

My advice: If you have asthma and start home salt therapy, continue your maintenance medication unchanged! Salt therapy is an adjunct, not a replacement. If you experience improvement, talk to your doctor – they may decide to reduce medication, but never do this on your own.

The place of salt therapy in asthma treatment

It is very important to understand: salt therapy is a complementary treatment, not a substitute for asthma medications. The fundamental treatment of asthma is based on inhaled corticosteroids and, if needed, bronchodilators – do not stop these because of salt therapy.

The 2021 comprehensive review also emphasizes that halotherapy "can be a reliable therapeutic complement to allopathic treatment."⁴ So the keyword is: alongside, not instead of.

Think of asthma treatment like a multi-legged stool. The first leg is maintenance medication (inhaled corticosteroid). The second leg is the rescue inhaler as needed. The third leg is avoidance of triggers. The fourth leg is complementary therapies, including salt therapy. Each leg is important – if one is missing, the stool wobbles.

Salt therapy can be especially useful for those who want to optimize asthma control, reduce medication dose (under medical supervision), seek natural adjuncts to maintenance treatment, or frequently suffer from nighttime symptoms.

Before you start treatment

Salt therapy is generally safe, but there are special considerations for asthma.

Consult your pulmonologist or allergist before starting salt therapy. Although studies have not found significant adverse effects, your doctor knows your individual situation and can judge whether this complementary treatment is appropriate for you.

Do not use salt therapy during an asthma attack! During an attack you need your rescue inhaler. Salt therapy is useful during stable, controlled periods – for prevention and improving baseline status.

Caution is required in severe, uncontrolled asthma. If your asthma is not stable (frequent attacks, regular nighttime symptoms, daily rescue inhaler use), first stabilize your condition with medication, and only then begin salt therapy.

In case of respiratory infection, wait until recovery. If you have a cold, fever, or another respiratory infection, do not use the salt therapy device until you have recovered.

Possible side effects

Side effects of salt therapy in people with asthma are generally mild and transient. The most common is throat irritation or mild cough at the first session. This is a normal reaction and usually subsides after a few sessions.

Important note: inhalation of hypertonic (stronger) saline can itself be an asthma trigger in very sensitive airways – this is even used diagnostically (bronchoprovocation test). Therefore, asthmatics should start with low intensity and gradually increase treatment.

If you experience wheezing, chest tightness or shortness of breath during salt therapy, stop immediately and use your rescue inhaler. If symptoms do not resolve, seek medical attention.

Experts at Semmelweis University state that professionally conducted halotherapy has no significant adverse effects.⁹

Practical tips for people with asthma

If you start home salt therapy with asthma, here are some practical tips.

Start with low intensity. During the first week use the device for shorter periods or at lower power. If you tolerate it well, gradually increase the duration.

Keep your rescue inhaler at hand. Although side effects of salt therapy are rare and mild, it’s safer to have your inhaler within reach.

Keep an asthma diary. Note your symptoms, rescue inhaler use and PEF (peak expiratory flow) values. This helps you and your doctor evaluate the effect of salt therapy.

Combine with breathing exercises. Diaphragmatic breathing and chest-mobilizing exercises work synergistically with salt therapy. Do a few breathing exercises in the morning after nighttime salt therapy.

Do not stop your medications. I cannot stress this enough: salt therapy is an adjunct. If you notice improvement, discuss it with your doctor – they may decide on medication adjustments.

Watch your triggers! Salt therapy does not make you immune to asthma triggers. If you have allergic asthma, continue to avoid allergens; if cold air triggers your symptoms, continue to take precautions.

Summary – Quick overview

What is this article? A comprehensive guide to the relationship between asthma (asthma bronchiale) and salt therapy (halotherapy), presenting the scientific background, clinical trial results and the possibilities for home use.

Who is it for? Adults and children with asthma, their parents and relatives, and healthcare professionals seeking complementary therapeutic options.

Main message: Salt therapy (halotherapy) is a scientifically studied complementary method in asthma that can help reduce bronchial hyperreactivity, airway inflammation and nighttime symptoms. It does not replace inhaled corticosteroids and bronchodilators, but when used alongside them it can improve asthma control and quality of life.

Key terms and definitions:

Mechanism of action in asthma:

Salt therapy acts in asthma via four main mechanisms. First, reduction of bronchial hyperreactivity: the Israeli study showed halotherapy reduces bronchial hyperreactivity. Second, reduction of airway inflammation: decreased FeNO indicates reduced inflammation. Third, mucolysis: salt particles dilute thick secretions and stimulate mucociliary clearance. Fourth, IgE reduction: in allergic asthma it may reduce the intensity of allergic reactions.

Level of scientific evidence: Moderate-strong. The 2021 comprehensive review pooled 18 studies that overall support beneficial effects of halotherapy in asthma.

Contraindications:

Salt therapy is not recommended during an asthma attack, for severe uncontrolled asthma, or during an active respiratory infection. In severe asthma, prior medical consultation is required.

Frequently asked questions:

Can salt therapy replace asthma medications? No. Salt therapy is a complementary method that can be used alongside inhaled corticosteroids and bronchodilators. Never stop maintenance treatment because of salt therapy.

Can I use it during an asthma attack? No. In an attack you must use your rescue inhaler. Salt therapy is useful in stable periods for prevention and maintenance.

How long until results are expected? Most studies showed meaningful improvement after 4–7 weeks of regular treatment. The Israeli study found significant changes after 14 sessions (7 weeks).

Is salt therapy safe for children? Yes. Most high-quality studies (including the Israeli RCT) were conducted in children and found it safe.

How should I combine it with medications? Continue your maintenance treatment unchanged. Use salt therapy at night while sleeping. If you experience sustained improvement, consult your doctor – they may decide on medication reduction.

In which type of asthma is it most effective? Most studies were in mild–moderate allergic asthma. Evidence is strongest for this type.

Detailed guides by condition

If a specific disease or condition interests you, read our detailed guides, where we present the possibilities of salt therapy backed by scientific research:

• Sinusitis and salt therapy – Get rid of sinusitis
• Cystic fibrosis and salt therapy – Mucolysis and respiratory support
• COPD and salt therapy – Easier breathing, better quality of life
• Common cold and salt therapy – Faster recovery
• Hay fever and salt therapy – Alleviating allergic symptoms
• Recovery after pneumonia – Salt therapy as a complementary treatment
• Snoring and salt therapy – How it can help freer breathing
• Dermatological issues and salt therapy – Complementing eczema and psoriasis treatment

References

1. Bar-Yoseph R, et al. (2017). Halotherapy as asthma treatment in children: A randomized, controlled, prospective pilot study. Pediatric Pulmonology, 52(5):580-587. PubMed: 27723955
2. Bennett WD, et al. (2021). Acute and durable effect of inhaled hypertonic saline on mucociliary clearance in adult asthma. ERJ Open Research, 7(1):00062-2021. PMC article
3. Szabó K, et al. (2021). Salt Therapy as a Complementary Method for the Treatment of Respiratory Tract Diseases. Alternative Therapies in Health and Medicine. PubMed: 34726628
4. Crisan-Dabija R, et al. (2021). Halotherapy—An Ancient Natural Ally in the Management of Asthma: A Comprehensive Review. Healthcare, 9(11):1604. PubMed: 34828649
5. Borges MC, et al. (2008). Protective effect of bronchial challenge with hypertonic saline on nocturnal asthma. Brazilian Journal of Medical and Biological Research, 41(3):209-214.
6. Barber D, et al. (2020). Halotherapy for Chronic Respiratory Disorders: From the Cave to the Clinical. Alternative Therapies in Health and Medicine, 28(3):52-56. PubMed: 32827399
7. Hedman J, et al. (2017). The Effect of Salt Space on Clinical Findings and Peak Expiratory Flow in Children with Mild to Moderate Asthma: A Randomized Crossover Trial. Iranian Journal of Pediatrics. PubMed: 28732433
8. Khan MA, et al. (2012). The use of halotherapy for the health improvement in children at institutions of general education. Voprosy Kurortologii, Fizioterapii i Lechebnoi Fizicheskoi Kultury, 89(5):31-35. PubMed: 22908472
9. Semmelweis University, Department of Otorhinolaryngology and Head-Neck Surgery. The effects of salt therapy. semmelweis.hu
10. Chervinskaya AV, Zilber NA. (1995). Halotherapy for treatment of respiratory diseases. Journal of Aerosol Medicine, 8(3):221-232. PubMed: 10161255

The information in this article is for guidance only. Salt therapy serves as a complement to asthma medications and does not replace them. Never stop inhaled corticosteroid maintenance therapy without medical consultation. In an asthma attack use your rescue inhaler and seek help if needed. If symptoms are persistent or worsening, consult your treating physician.