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Can I Dive with a Cold?
Whether it is a stuffy nose, nagging cough or overall fatigue, upper respiratory symptoms are incredibly common. Unfortunately, they always seem to strike just as you are preparing for your dive. The challenge is knowing when it is safe to get in the water and when it is smarter to sit a dive out. Like many things in diving, the answer depends on your circumstances including symptoms, severity and personal risk tolerance.
Why Diving with a Cold Is Risky
The primary challenge when diving with a cold involves managing pressure within the air spaces in your body, such as the sinuses and middle ear. As you descend underwater, the water pressure around you increases and the pressure in the internal air spaces needs to match the increased ambient pressure to avoid pain and injury. Luckily, your sinuses connect directly to your nasal passages while the middle ear is also connected, via channels called Eustachian tubes. The Eustachian tubes allow air to flow freely in and out and equalization can occur passively or with the assistance of a gentle equalization maneuver such as the Valsalva.
Related Reading: 6 Methods to Equalize Your Ears
However, a cold or congestion can interfere with your ability to equalize. Increased inflammation and mucus production from a cold can block the Eustachian tubes and sinus passages thus preventing the flow of air. Diving while unable to equalize causes a buildup of pressure and can damage the delicate tissues, leading to barotrauma.
- Barotrauma on descent: If you can’t equalize on descent, water pressure pushes in against the ears and sinuses. Attempting to forcefully equalize and clear a block may also cause damage.
- Reverse block on ascent: Equalization is not just important on the descent. Air can also be trapped behind the eardrums causing what is known as a “reverse block.” These can be even more dangerous as they are often more difficult to clear and may prevent you from returning to the surface.
These are not just theoretical concerns. Ignoring an inability to equalize can lead to ruptured eardrums with associated vertigo and hearing loss.
Related Reading: Lessons for Life: Save your eardrum
Red Flag Symptoms
Certain symptoms should immediately take diving off the table. These are widely agreed upon in diving medicine and safety literature and include:
- Shortness of breath or difficulty breathing
- Fever or chills
- Chest congestion or productive cough
- Significant sinus blockage or congestion
- Fatigue or reduced physical capacity
Nasal and sinus congestion can occur intermittently and be difficult to gauge. It is good practice to wait at least a day until you can consistently equalize on land before diving. If you find that you can’t equalize on the surface, trying to force equalization at depth will only worsen the problem!
As a rule of thumb: if your symptoms affect breathing, awareness or equalization, don’t dive!
The Grey Zone
Suppose you just have a runny nose or mild allergies—is it safe to dive?
There is no clear right or wrong answer, and your decision comes down to a judgment call and personal risk tolerance. Some divers may be able to dive safely with very mild symptoms, but only if strict conditions are met:
- You can breathe easily through both nostrils
- You can equalize your ears effortlessly on land
- You have no coughing or chest involvement
- You feel otherwise fit for physical activity
- Symptoms are improving, not worsening
Even if all these criteria are met, caution is still advised. Those with pre-existing health conditions such as heart disease, asthma or other significant medical history should err on the side of caution. For those divers who decide to proceed, make sure to equalize early and abort the dive immediately if equalization becomes difficult. Clear communication with your buddy is essential to avoid separation and allows both divers to descend in a slow and controlled manner.
If you are on the fence, consider reaching out to DAN for personalized recommendations from the experts. In case of a medical emergency, call the 24/7 hotline at +1-919-684-9111. Other inquiries can be made through the Ask a Medic Form or at +1-919-684-2948.
Pushing Through with Decongestants
If you are on an expensive or once-in-a-lifetime trip, it is understandable to be tempted by medications that promise to alleviate your symptoms. However, trying to force a dive today may cost you the rest of the trip.
Decongestants can be effective and reduce sinus pressure on the surface. Unfortunately, they may wear off during a dive, leaving you with a stubborn reverse block at depth. In addition, long-term usage of certain medications can also lead to rebound symptoms when discontinued. Even if medications temporarily alleviate symptoms and allow you to push through some dives, repeated dives with incomplete equalization can cause minor barotrauma. The inflammation can be cumulative and lead to increasing difficulty on subsequent dives. That is why you may notice difficulty equalizing at the end of a long dive trip, even when you weren’t sick at the start.
If you do decide to try medications, be sure to only take medications that you have taken before and know are well tolerated. The day of your dive is not the time to try something new.
The Bottom Line
Diving with a cold is a dilemma all divers are likely to encounter at some point. Understanding the risks can help you make an informed decision on how to best proceed.
The safest approach is not to dive if you are feeling unwell, unable to equalize or have reservations about jumping into the water. Missing a dive is disappointing, but damaging your ears or lungs can end your trip—or your diving season entirely.
In diving, good judgment is one of your most important skills. Knowing when not to dive is just as big a part of being a safe, experienced diver as looking good in the water.
