When clean air turns scarce, cities sort people by what they can inhale. In Hyderabad, summer AQI sits between 90 and 130, in the moderate to poor range
Clean air has shifted from being a given to something that is actively pursued. Across cities, an ecosystem is building itself around breathing. Air purifiers have become standard in certain homes. Oxygen bars and salt rooms promise recovery. Wellness has moved away from aesthetics. It is now about functioning without constant fatigue. Access to that, however, is uneven.
Who is seeking cleaner air Dr Samatha Tulla, Internal Medicine physician and Co-founder/Chief Medical Officer of PMX Health, sees the shift in the people who walk into her clinic. The profiles vary, but the underlying concern is similar. “Today, I see six client types,” she says. “Stressed professionals with high cognitive load and poor sleep. Fitness-focused consumers tracking recovery and performance. Respiratory-sensitive clients dealing with asthma and allergies. Preventive health seekers. Luxury wellness consumers who are not necessarily sick but want clean air and recovery. And parents with children, where cough, wheeze and poor sleep are becoming normalised.”
Different categories, same question. Why does breathing feel harder than it should? “Breathing has moved from unconscious biology to visible lifestyle status,” Dr Tulla explains. “People are asking, is my air clean, is my sleep restorative, why am I tired despite doing everything right.”
Pollution has widened its impact. It is no longer limited to the lungs. It is linked to cardiovascular disease, stroke, asthma, cancer, systemic inflammation and metabolic stress. In India, estimates attribute around 1.6 to 1.7 million deaths annually to air pollution.
Air, shaped by where you live
For Supraja Rao, founder and principal designer, Design House, the divide is visible in how homes are chosen and built. “I think just pure air and water should be a birthright and we should get it free and high quality,” she says. “The problem of pollution is more for people living in denser areas and less for people with privilege. When you have larger houses, larger gardens, homes away from main roads, or you are living in a gated community or a farmhouse, you already have that advantage. With money, you can buy that kind of surrounding space.”
Her work reflects this reality. “Most of my work, I don’t face this as a problem. I’ve not really had to use air purifiers except in one client’s house where a family member was asthmatic and they specifically asked for it. It was not even part of our proposal.” What she sees instead is relocation. “I’ve had clients talk about how polluted and congested certain areas have become. Some have chosen to move further out into gated communities with larger plots. That’s the solution I hear more often.”
What It does to the body
Fatigue, poor sleep and reduced endurance often appear before diagnosis. There is also the way people breathe. “Slow nasal breathing, longer exhalation, diaphragmatic breathing can improve HRV, reduce stress and support sleep,” says Dr Tulla. “But breathwork does not detox pollution. It does not reverse structural lung disease. It is a regulatory tool.”
Younger lungs
Doctors are seeing these effects earlier. “We are seeing a rise in exacerbations of asthma and other chronic respiratory illness due to rise in air pollution,” says Dr Visweswaran Balasubramanian, clinical & interventional pulmonologist, Yashoda Hospitals. “Even in non-smokers, chronic exposure increases the risk of COPD, asthma, recurrent infections and even lung cancer.” Children are part of this shift. “Persistent exposure to pollutants can lead to reduced lung volumes in children.” The warning signs are often ignored. “A cough lasting more than two weeks, unexplained breathlessness, weight loss, fatigue,” he says. “These are early signals people tend to dismiss.”
Wellness shifts to recovery
In studios and gyms, the language has changed. “Indeed, more number of people are showing interest in breathwork,” says yoga expert Ramya Krishna. “Breathing is directly connected to blood supply, cardiovascular function and endurance. Oxygen facilitates smoother flow.” Fitness is no longer only about output. Recovery has become central. “Low endurance, poor sleep quality, being tired by mid day,” she says. “Pollution is affecting younger people as well, reducing stamina and energy levels.”
Hyderabad’s Low-AQI
As of early May 2026, Hyderabad’s air quality shows mixed trends. During peak summer, AQI levels often fluctuate between 90 and 130, falling in the moderate to poor category. However, certain areas consistently record better air quality due to higher green cover and lower traffic density. These pockets are increasingly seen as “low-AQI luxury” zones, where cleaner air is shaped by location, planning and access.
