Fan therapy for breathlessness - how do you do it and why?

This review summarises high-level evidence for fan therapy and adds a commentary on the relatively-neglected question of how to optimise benefits based on qualitative evidence, clinical experience and broader research and theory.

Recent high-level evidence suggests the fan reduces time to recovery from episodic breathlessness rather than reduces daily levels over a longer period. Lower grade evidence suggests the fan can also help people increase their physical activity. Experimental evidence for physiological mechanisms suggests that airflow reduces inspiratory neural drive and perceived unpleasantness through facial cooling of the trigeminal and olfactory nerves. Faster airflow elicits a stronger effect, with the optimal balance between efficacy and comfort proposed to be 2.85 metres per second. Research on clinician perspectives highlights the need for targeted strategies to drive fan implementation.

Fan therapy contributes to all three domains of the Breathing, Thinking, Functioning model of breathlessness management. Given it is affordable, portable, and has no known harms, the fan should be recommended as first-line therapy for anyone with breathlessness. Future research should evaluate how best to integrate fan therapy as a complex intervention alongside other strategies and supports.