Halotherapy for Chronic Respiratory Disorders: From the Cave to the Clinical

Halotherapy (HT) is a form of speleotherapy, a respiratory therapy involving breathing inside a cave, and its therapeutic environment is similar to that of a natural salt cave. Natural crystallized salt is inhaled via aerosols or from the environment directly to enhance breathing and respiratory health-related quality of life (HRQoL). Clinicians need to be aware of its potential benefits, with relatively few or no adverse effects and consider its use an adjuvant therapy for standard care.

The current review intended to compile the existing literature on HT's use in various chronic respiratory diseases. It examines the use of dry salt inhalers; the use of saline nebulizer therapy is already well established in the literature.

The research team performed a literature review to identify all articles published in the English language between January 1980 and December 2018 that used HT or heliotherapy and speleotherapy in the title. Pseudonyms such as salt cave therapy and salt mine therapy were also included. The source of data was the National Library of Medicine's MEDLINE/PubMed.

Literature search took primarily from the main campus of Brookdale University Hospital Medical Center and the Touro College of Osteopathic Medicine.

Literature search and review yielded a total of 13 manuscripts that were completely assessed and incorporated into this review. Overwhelmingly studies comparing various methods of halotherapy showed improvement in various pulmonary function measures including forced expiratory volume in one second, forced vital capacity and peak expiratory flow. Other measures were also seen to improve such as HRQoL as assessed by questionnaires.

HT has been found to have a positive effect on patients suffering from chronic respiratory diseases, improving mucociliary elimination and lung function in common chronic respiratory diseases and also HRQoL. Currently, no official guidelines exist on the use of HT in the form of salt rooms (halo chambers) or dry powder inhalers, but evidence exists for its use as a possible adjuvant therapy. More structured research in the form of randomized clinical trials is required.