Synergistic Effects of Intra-Nasal Low-Level Laser Therapy and Bhramari Pranayama on Sino-nasal Symptoms and Sleep Quality in Chronic Rhinosinusitis: A Randomized Controlled Trial

Background: Chronic rhinosinusitis (CRS) is a persistent, often debilitating inflammatory disorder of the sinonasal mucosa that not only impairs nasal function but also significantly disrupts sleep quality. Until now, non-pharmacological interventions have remained underexplored.
Objective: This study aimed to evaluate the efficacy of intra-nasal low-level laser therapy (LLLT) combined with Bhramari Pranayama breathing exercises on sino-nasal symptoms and sleep quality in CRS patients.
Methods: 54patients with chronic rhinosinusitis without nasal polyps (CRSsNP) were randomly allocated into two equal groups (n = 27 each). Group A received intra-nasal LLLT (650 nm, 288J/cm², 3×/week) combined with a daily Bhramari Pranayama breathing exercise regimen for four weeks. Group B practiced the daily Bhramari Pranayama breathing exercise and received sham laser for the same duration. SNOT-22 scores for sino-nasal symptom severity and PSQI scores for sleep quality were assessed both at baseline and post-intervention.
Results: After the intervention, group A experienced a greater reduction in SNOT-22 scores compared to group B (29% vs. 9%, p = 0.001). Both groups showed improvement in PSQI scores (group A: 36%, group B: 20%, p = 0.001), with no significant difference between groups post-treatment (p = 0.125). Group A’s intervention resulted in a significant reduction in sinonasal symptoms and a greater improvement in sleep quality compared to breathing exercises alone.
Conclusion: This study indicated that intra-nasal LLLT, as a non-invasive and low-risk intervention, may offer additional therapeutic benefits by enhancing patient-reported outcomes in CRS.