Upper Airway Dysfunction as a Modifiable Determinant of Physical Function in Aquatic Athletes: Irritant Rhinitis and Decongestant Overuse

Upper airway function has received limited attention as a potentially relevant component of respiratory physiology in aquatic athletes. Repeated exposure to chlorinated indoor environments, combined with high ventilatory demand during training, may contribute to the development of chronic irritant rhinitis characterized by nasal obstruction and mucosal hyperreactivity. Although often perceived as a minor inconvenience, increased nasal resistance may influence breathing comfort, perceived exertion, and recovery stability in swimmers and other aquatic athletes. In addition to environmental exposure, the widespread use of topical nasal decongestants may result in rebound congestion and rhinitis medicamentosa, thereby contributing to a self-reinforcing cycle of airway dysfunction. Performance-related pressure and uncertainty related to anti-doping regulations may further shape medication behavior within athletic environments. This narrative review integrates environmental exposure mechanisms, mucosal pathophysiology, and behavioral medication patterns to provide a unified conceptual framework for understanding upper airway dysfunction in aquatic athletes. Particular emphasis is placed on nasal airflow stability as a potentially relevant factor in breathing comfort, sleep quality, and training consistency. Given that the available evidence is predominantly mechanistic and observational, the proposed relationships should be interpreted as hypothesis-generating and translational rather than as evidence of direct causal effects on athletic performance.