Breathing Trainers, Masks, and Nasal Dilators: What Works?
From small handheld trainers to full-face resistance masks, a growing category of gadgets promises to strengthen the lungs, simulate altitude, and unlock untapped athletic potential. The science behind these claims ranges from genuinely well-supported to largely fictional. Here is how to tell the difference.
Gadgifyr
December 4, 2025
6 min
Real - World Performance
⚙️IMT devices producing at least 15% of maximum inspiratory pressure for four or more consecutive weeks are the minimum threshold for meaningful respiratory and performance adaptation — casual, low-resistance use will not replicate trial results.
⚙️Blood lactate concentration — a marker of metabolic fatigue — fell significantly from the fourth week of IMT training onward in structured protocols, suggesting a real shift in how efficiently the body handles high-intensity effort.
⚙️Neither external nasal strips nor internal nasal dilators improved 20-kilometre time trial performance in trained cyclists, consistent with the finding that high-intensity exercise naturally shifts breathing to the mouth.
⚙️The elevation training mask was found to reduce time to exhaustion and increase breathing difficulty during acute use — functioning as a breathing impediment during the session rather than a performance enhancer.
⚙️Forced vital capacity (FVC) — the total volume of air a person can exhale forcefully — improved significantly with sustained IMT using threshold resistance devices, one of the few spirometry markers reliably shifted by this training type.
⚙️IMT benefits have been documented across cycling, rowing, swimming, and team sports, suggesting the effect is not sport-specific but reflects a general improvement in the respiratory muscle's capacity to sustain high-output breathing.
Good to Know
🔍IMT does not improve VO2max — the body's maximum oxygen uptake — which is a common marketing-adjacent assumption. Its benefit is specific to respiratory muscle strength and endurance, which become performance-limiting at high exercise intensities.
🔍The minimum effective training load for IMT is at least 15% of a person's maximal inspiratory pressure, maintained for four to six weeks — below this threshold, the evidence suggests little meaningful adaptation occurs.
🔍Elevation training masks do not lower blood oxygen levels in the way altitude actually does. True altitude training requires physical presence at elevation or validated normobaric hypoxic tents — not a mesh face covering.
🔍Nasal dilators may provide a genuine comfort benefit for people with narrow nasal passages during sleep or low-intensity activity — the evidence against them applies specifically to competitive athletic performance, not all use cases.
🔍Wearing an elevation mask during training acutely impairs exercise output — time to exhaustion decreases and perceived breathing difficulty increases. Any respiratory muscle training effect it provides comes at a cost to session quality.
🔍Most IMT clinical trials run for four to twelve weeks, and the long-term maintenance of gains — whether training must be ongoing or whether adaptations persist after stopping — is not well characterized in the current literature.
🔍The performance benefits of IMT appear across multiple sports — cycling, rowing, swimming, and team sports — suggesting the effect is not discipline-specific, making it relevant to a wide range of endurance and mixed-intensity athletes.
The market for breathing performance devices has expanded considerably in recent years, riding the wave of athlete biohacking culture and social media fitness content. Products range from small valve-based inspiratory muscle trainers (IMT) — handheld devices that add controlled resistance to each inhale — to adhesive nasal strips, internal nasal inserts, and the now-ubiquitous elevation training mask, worn over the face during gym sessions.
All are marketed with the promise of better breathing, improved endurance, or enhanced oxygen efficiency. What the research actually shows is a more divided picture: one category has earned its claims through two decades of controlled trials, while others have not.
BY THE NUMBERS
A meta-analysis of 25 randomized controlled trials on inspiratory muscle training found that it significantly improved maximal inspiratory pressure by a mean of approximately 29 cmH₂O and produced a moderate-to-large effect on sports performance (standardised mean difference: 0.64). These are not trivial numbers — they represent consistent, measurable gains across different sports and training populations, not anecdotal reports.
Inspiratory muscle trainers work by adding a threshold resistance to breathing in — the user must generate a set amount of pressure before air flows through the device, progressively strengthening the diaphragm and accessory breathing muscles over weeks of training. This mechanism mirrors how resistance training strengthens skeletal muscles, and the evidence has followed the same logic.
Multiple systematic reviews with meta-analyses — covering more than 20 randomized controlled trials in competitive athletes — confirm that IMT meaningfully improves inspiratory muscle strength and endurance performance, including time trial results, exercise capacity, and repeated sprint ability. Critically, the benefits extend to real-world sports metrics: rowing, cycling, swimming, and team sport performance have all been examined. One important nuance is that IMT does not appear to improve VO2max — the body's maximum oxygen uptake — or broader lung volumes.
The benefit is specific to the strength of the breathing muscles themselves, which under high-intensity exercise conditions become a limiting factor in performance. When those muscles are stronger and more resistant to fatigue, the athlete can maintain pace and breathing efficiency longer. A specific threshold must be met for results: training loads of at least 15% of maximum inspiratory pressure for a minimum of four to six weeks are required for meaningful adaptation. Devices used casually, at low resistance, or for only a few days will not produce the same outcomes as a structured protocol.
Nasal dilators occupy the middle ground of the market — less dramatic in their claims but still widely purchased. External nasal strips (adhesive bands that pull the nostrils open) and internal nasal dilators (small inserts placed inside the nostrils) both aim to reduce nasal airway resistance and improve airflow. At low exercise intensities, some evidence suggests they may reduce perceived effort and heart rate marginally.
However, a randomized crossover trial in trained cyclists — testing both external and internal nasal dilator types head-to-head under competitive conditions — found that neither device improved 20-kilometre time trial performance compared to no device at all. At high exercise intensities, athletes naturally shift to mouth breathing anyway, largely bypassing any nasal airway benefit the devices might otherwise provide. For people with anatomically narrow nasal passages or nasal obstruction, the comfort benefit may be real; the athletic performance claim is not.
THE ALTITUDE MASK MISCONCEPTION
Elevation training masks are widely marketed as altitude simulators — the idea being that restricted airflow mimics the thinner air found at high altitude and triggers the same physiological adaptations. This claim has been directly tested and found to be false. A crossover trial measuring blood oxygen saturation, metabolism, and pulmonary function found that the mask did not alter oxygen saturation or create a hypoxic (low-oxygen) environment in any meaningful way. The masks do add breathing resistance — making them a form of respiratory muscle trainer — but at an uncontrolled and unvalidated load, and at the cost of acutely impairing exercise output during the session in which they are worn.
For athletes or active individuals evaluating the category, the evidence creates a clear hierarchy. IMT devices with a validated threshold mechanism — the type used in clinical trials — have the strongest and most reproducible evidence base. Nasal dilators offer comfort benefits at best and no measurable performance gain at competitive intensities.
Elevation training masks are effective as conversation starters but not as altitude simulators; their resistance-training function is real but unvalidated in terms of dosing and outcomes. Whatever device a person chooses, the science is consistent on one point: the protocol matters as much as the product.
KEY STATISTICS
+29 cmH₂O
IMT effect on inspiratory pressure
The average gain in maximal inspiratory pressure across 25 RCTs — a meaningful increase in the force the breathing muscles can generate, which directly influences endurance capacity under high-intensity exercise.
54%
Inspiratory pressure gain in 4 weeks
The improvement in maximal inspiratory pressure achieved within four weeks when training loads met the minimum threshold of 15% MIP — demonstrating how quickly respiratory muscles respond to structured resistance training.
25
RCTs in largest IMT meta-analysis
The number of randomized controlled trials included in the most comprehensive IMT meta-analysis — an unusually large evidence base for a consumer sports gadget category, lending strong credibility to its performance claims.
Breathing devices represent one of the more scientifically stratified gadget categories reviewed on this platform. The gap between the best-evidenced product and the least-evidenced is unusually wide — and unusually well-documented by independent research.
EVIDENCE-BASED RELIABILITY
70%
Overall Score
7
Sources Used
9
Claim Types
9%
91%
40%
IMT improves inspiratory muscle strength
Elevation mask simulates altitude
Long-term Studies
IMT is backed by multiple systematic reviews and meta-analyses of RCTs, representing unusually strong evidence for a consumer gadget category. Nasal dilator and elevation mask evidence is thin and mostly negative for performance claims. Heterogeneity across IMT trial protocols and unresolved VO2max findings slightly limit the overall score. Long-term outcomes beyond 12 weeks remain understudied across all device types.
IMT — inspiratory muscle strength
Excellent
IMT — endurance performance
Good
Nasal dilators — airflow comfort
Moderate
Elevation mask — altitude simulation
Poor
Elevation mask — resistance training
Variable
IMT — VO2max improvement
Poor
AT A GLANCE - METRIC ACCURACY
The Consumer Takeaway
The breathing device category contains one of the clearest scientific divides in the consumer sports gadget market. Inspiratory muscle trainers have earned their claims through a body of evidence that most gadget categories never accumulate — more than two decades of randomized trials, multiple meta-analyses, and consistent findings across sports disciplines. The mechanism is well-understood, the dose-response relationship is defined, and the performance benefits are real and reproducible at the right training load and duration.
At the other end of the spectrum, elevation training masks have built a large commercial market on a physiological claim — altitude simulation — that has been directly tested and found to be false. They add breathing resistance, not hypoxia. That resistance may incidentally train the respiratory muscles over time, but at an unvalidated dose, and at the cost of compromised training sessions in the meantime. Nasal dilators occupy a more neutral position: not harmful, potentially comfortable, but ineffective as performance tools at competitive exercise intensities.
What this category ultimately teaches is that the mechanism matters more than the marketing. Progressive respiratory muscle training is a real and well-supported intervention; the device chosen to deliver it should be evaluated on whether it provides a controlled, measurable, and adjustable resistance — not on how impressively it looks during a workout.
Romer, L. M., & McConnell, A. K. (2013). Effects of respiratory muscle training on performance in athletes: a systematic review with meta-analyses. Journal of Strength and Conditioning Research, 27(6). https://pubmed.ncbi.nlm.nih.gov/22836606/
Illi, S. K., et al. (2018). The effects of inspiratory muscle training with linear workload devices on sports performance and cardiopulmonary function of athletes. Physical Therapy in Sport, 34. https://pubmed.ncbi.nlm.nih.gov/30261349/
Martínez-González, B., et al. (2021). Inspiratory muscle training program using the PowerBreath®: does it have ergogenic potential? International Journal of Environmental Research and Public Health, 18(13). https://pubmed.ncbi.nlm.nih.gov/34206354/
López-López, J., et al. (2023). Effects on respiratory pressures, spirometry biomarkers, and sports performance after inspiratory muscle training by PowerBreath®. Biology, 12(1). https://pubmed.ncbi.nlm.nih.gov/36671748/
Svensson, M., et al. (2016). Neither internal nor external nasal dilation improves cycling 20-km time trial performance. Journal of Science and Medicine in Sport, 20(3). https://www.sciencedirect.com/science/article/abs/pii/S144024401630161X
Jagim, A. R., et al. (2021). Effects of acute high-intensity exercise with the elevation training mask or hypoxicator on pulmonary function, metabolism, and hormones. Journal of Strength and Conditioning Research, 35(9). https://pubmed.ncbi.nlm.nih.gov/34431483/
Turner, L. A., et al. (2021). Effects of the Elevation Training Mask® 2.0 on dyspnea and respiratory muscle mechanics, electromyography, and fatigue during exhaustive cycling. Respiratory Physiology & Neurobiology, 294. https://pubmed.ncbi.nlm.nih.gov/34538564/
DID YOU GET ANY OF THAT?
Read a summarization of this page's content in question-answer format ▽ (click to open and collapse the content)
How long does it take to see results from an IMT device?
Respiratory adaptations begin around week four at the correct training load, with broader endurance gains typically appearing after six weeks or more. Sporadic or low-resistance use will not replicate the results seen in clinical trials.
Can breathing devices help with conditions like asthma or COPD, not just sport?
IMT has a well-established clinical evidence base in COPD and heart failure. For respiratory conditions, protocols should be supervised by a physiotherapist rather than self-prescribed with a consumer device.
If elevation masks don't simulate altitude, what does real altitude training involve?
True altitude training reduces the oxygen concentration of the air breathed — either at elevation or using a calibrated hypoxic tent. The elevation mask restricts airflow volume but leaves oxygen concentration unchanged, which is why blood oxygen readings show no meaningful difference when wearing one.
Are IMT devices suitable for beginners, or only elite athletes?
Both groups benefit. Trials cover competitive athletes and active non-elite adults, with measurable gains in each. The key variable is adherence to a progressive protocol, not training level.
Is it worth combining IMT with other breath training practices?
Combination protocols have not been rigorously tested at an evidence level that permits confident recommendation. Threshold-resistance IMT alone remains the most evidence-grounded starting point for performance improvement.
Gadgets Connected to These Scientific Insights
The gadgets shown here each rely on the science discussed in this article — sometimes directly, sometimes through a clever variation of the same underlying technology.
For the best experience, we recommend reading the summary first. It gives you a quick, clear understanding of how the technology works and helps you decide whether these gadgets match what you’re looking for.
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