Hi @altius1300. I too have a hiatal hernia. I've noticed that many people who have this SOB/air hunger also have GI issues. Not sure of the relationship, but there could be something there. My breathing has improved a bit through daily breathing Buteyko exercises (minimal) and moderate weight lifting and a daily walk. Definitely not 100%, and I do struggle with it at times, also due to constant sinus inflammation, but it is quite a bit better over the last couple of years. Still trying to get it better, but it seems to be stagnant at this point; manageable but still there.