Most people do not think about how or how often they are breathing. A person will typically breathe in and out through their nose, allowing the nasal passages to warm and moisten the air they take in. However, some people breathe in and out mostly through their mouth instead. This is known as mouth breathing. Some people breathe through their mouths almost exclusively while others have a medical condition, such as sleep apnea, where they mainly breathe through their mouths at night.
Occasional mouth breathing due to a temporary illness, such as a cold, is not a cause for concern. Chronic mouth breathing, however, can signal that a person needs additional medical intervention or some re-training on how to breathe more easily through their nose.
What causes mouth breathing?
Mouth breathing may have many causes such as chronic colds, sinus polyps, and allergies. Several health conditions and risk factors can lead to mouth breathing. Examples include the following:
Another possible cause is a tongue-tie, where the tongue is tethered in the mouth more than usual. The tongue-tie may cause a person to have difficulty moving the tongue. Mouth breathing can worsen exercise-induced asthma. This happens because the breath does not get as warm or moist, both of which help to reduce airway irritation. Adults who have a history of sleep apnea may find their symptoms worsened by mouth breathing.
Chronic mouth breathing can cause a person with sleep apnea to have their jaw and mouth in a position that does not support breathing. As a result, they may have difficulty in breathing and getting a good night’s sleep. Those with sleep apnea who engage in mouth breathing at night may require a continuous positive airway pressure (CPAP) mask that is larger than a nasal CPAP option.
Symptoms of mouth breathing.
Several research studies have found that children who mouth breathe also experience changes in the development of their jaws. They are more likely to have longer faces and jaws that are not positioned evenly. A child who has experienced mouth breathing for some time will often have an overbite. The technical term for this jaw position is retrognathic.
When mouth breathing is a temporary condition, it is often due to a cold or other illness that has blocked the nasal passages. A person will usually have a stuffy or a runny nose alongside the mouth breathing.
Complications caused by mouth breathing can include:
When to see a doctor.
While mouth breathing is rarely an emergency, a person should see their doctor if they spot any of the symptoms of mouth breathing, especially a dry mouth upon awakening or chronic bad breath. Parents who notice that their child snores or usually breathes through their mouth instead of their nose should make an appointment with a pediatrician.
Diagnosis.
If a doctor suspects that mouth breathing is a problem, they may inspect the mouth, nose, and throat for abnormalities. A doctor will ask questions to obtain a full medical history if they suspect mouth breathing is a problem for someone. They will ask when the person first noticed their symptoms, what makes their symptoms worse, and if anything makes them better. A doctor will often inspect a person’s mouth, throat, and nose to identify any areas of swelling or abnormalities and observe their breathing pattern. They may also order imaging studies to examine the nasal passages and perform lung function tests to see if the lungs are impacted by asthma or other conditions. If a doctor suspects a person may have sleep apnea, they may order a sleep study. This involves the individual going to a sleep center where monitoring equipment can identify if, when, and how often a person stops breathing while they are sleeping. Both children and adults can have sleep apnea.
How is mouth breathing treated?
Treatment of mouth breathing depends upon its underlying cause.
For example, if a person has enlarged tonsils and adenoids, a doctor may refer them to an ear, nose, and throat specialist called an otorhinolaryngologist. This type of specialist doctor can perform a procedure to remove the tonsils and adenoids to help with breathing.
If a person has a problem with the shape of their nasal passages, they may need surgery. A doctor may need to widen a sinus passage or perform other procedures so that the person can physically breathe out of their nose. Taking medication such as anti-inflammatory nasal sprays, antihistamines, and decongestants for a short time period may also help. Additionally, doctors and physical therapists may be able to teach a person techniques that can retrain their breathing to help them focus on breathing through their nose instead of their mouth.
Just as a person performs exercises to strengthen their arm muscles, they can also do exercises that retrain the muscles of the mouth and tongue to help with nasal breathing. Therapists may practice several different methods. Some of the more common ones include the Buteyko Method, the Papworth Method, and pranayama . These exercises regimens should only be performed under the care and guidance of a qualified therapist as they might involve holding one’s breath and controlling the breathing.
Mouth breathing is a highly treatable condition that a person should not hesitate to seek treatment for.
The earlier that a person seeks treatment, the less likely they are to experience any chronic and long-term complications of mouth breathing, including the repositioning of the jaw.
Updated September 25th 2017
Do you find yourself struggling to feel rested? Do you have mood and memory problems? Those issues might be caused by obstructive sleep apnea , a disorder that occurs when you struggle to breathe freely throughout the night and can lead to fragmented sleep. Sleep apnea affects 18 million Americans—and there are certain characteristics that can put you at a higher risk for the disorder. Look out for these five.
Some of these factors—like the size of your neck and the size of your airway—are obviously things that you can't change. But you can try making lifestyle changes, such as getting your weight into a healthy range and reducing or eliminating tobacco and alcohol, to lower your risk for the disorder.
If you do suspect that you may have sleep apnea, don't wait to see a doctor. It's a serious disorder that can be life threatening, so you'll want to treat it as soon as possible—both to protect your health and to get more sleep and feel more energized.
Updated September 24th 2017
Is depression keeping you up at night? Staying awake may be the key to rapidly improving your mood.
Researchers at the Perelman School of Medicine at the University of Pennsylvania looked back at decades’ worth of studies on sleep deprivation and concluded it can temporarily improve symptoms of depression in up to 50 percent of people.
All forms of sleep deprivation, ranging from partial (20 to 21 hours without sleep) to total (up to 36 hours), were an effective anti-depressant for patients across demographics, according to the analysis of 66 English-language studies on the topic from 1974 to 2016. What’s more, patients reported feeling better within as little as 24 hours after treatment.
“These studies in our analysis show that sleep deprivation is effective for many populations,” the study’s lead author, Elaine Boland, a clinical associate and research psychologist at the Cpl. Michael J. Crescenz VA Medical Centre said.
“Regardless of how the response was quantified, how the sleep deprivation was delivered, or the type of depression the subject was experiencing, we found a nearly equivalent response rate,” she said.
The study, first published in the Journal of Clinical Psychiatry, acknowledged that more research needs to be done to determine why lack of sleep eases depression so rapidly.
“More than 30 years since the discovery of the antidepressant effects of sleep deprivation, we still do not have an effective grasp on precisely how effective the treatment is and how to achieve the best clinical results,” study senior author Philip Gehrman, an associate professor of psychiatry and member of the Penn Sleep Center, told Penn Medicine.
One 2015 study found that sleep deprivation affects a receptor in the frontal lobe that is also affected by tricyclic antidepressants and ketamine.
The potential link between sleep deprivation and mood enhancement is nothing new. German psychiatrist Johann Christian August Heinroth noted the connection 200 years ago.
Heinroth, who also coined the term “psychosomatic illness,” found that sleep deprivation had positive effects on patients suffering from depression, or what he called “melancholia.” Since then, doctors have experimented with several types of sleep deprivation on depressed patients.
Wake therapy, first developed in the 1970s, is sometimes administered to patients to jump-start improvement in depressive symptoms. While effective, the benefits are temporary and patients report a return of their symptoms days to a week after treatment.
Another form of sleep deprivation called chronotherapy, which combines forced wakefulness with bright light therapy, may stave off depressive symptoms longer, research suggests.
Although sleep deprivation can alleviate the symptoms of depression, anti-depressant drugs and psychotherapy are considered the most effective treatments.
Updated September 21st 2017
Sleeping soundly and having a good sex life have a greater impact on wellbeing than money.
Strong relationships with family and friends, job security and the good health of loved ones are also much more important than flash cars and exotic holidays claims a new "Living Well Index", which looks at how people cope best with the stresses of modern life.
A poll of 8,250 by experts at Oxford Economics and the National Centre for Social Research found that the average Briton has a Living Well score of 62.2 out of 100.
Those living best are defined as the 20 per cent with top scores between 72 and 92.
Researchers claim that those who regularly get a good night's sleep enjoy an improvement in wellbeing greater than the impact of a four-fold increase in spending money. "Sleep was the strongest indicator of a broader sense of wellbeing," they said.
"The majority of those with the highest Living Well scores reported feeling well rested most of the time, while more than half of those in the bottom 20 per cent of the Index said that they rarely, or never, felt well rested."
Across the population, just over a third (35 per cent) said they were fairly or very satisfied with their sex lives. The study stated: "Once again, these individuals were disproportionately likely to be found at the top of the Living Well Index - with almost two thirds (63 per cent) of those at the top saying that they were satisfied with their sex life, twice the national average."
Researchers revealed job security ranked number three in a measure of wellbeing.
"Among working people, 43 per cent of those with the highest Index scores also experience a very high degree of job security, almost twice the national average," they explained.
The study found most people are more concerned about the health of close relatives, rather than their own ailments. And being part of a community can offer much more comfort than having money in the bank.
Typically, the study funded by Sainsbury's found that people speak to their neighbours once or twice a month. By contrast, those most happy with their lives chat to neighbours at least once or twice a week.
Director of Consulting at Oxford Economics Ian Mulheirn said: "The analysis within the Sainsbury's Living Well Index reveals that, in a world that's never been more connected, the richness of our relationships and support networks remains among the biggest determinants of how well we live..."
Sainsbury's chief Mike Coupe said the index would "help to inform how we run our business and will also help us uncover and engage more boldly on the issues that concern people most in their everyday lives."
Updated September 20th 2017
Preliminary results from a study suggest that short-term sleep extension improves response time and daytime functioning of professional baseball players.
Results show that after five nights of sleep extension, professional baseball players from a Major League Baseball organization demonstrated a 13% improvement on a cognitive processing speed test by reacting 122 ms faster. They also responded 66 ms faster on a test of selective attention when confronted with distractors. According to the authors, a fastball takes approximately 400 ms to travel from the pitcher to the hitter, requiring batters to have optimal visual search strategies to distinguish and react to different types of pitches.
“Our research indicates that short-term sleep extension of one additional hour for 5 days demonstrated benefits on athletes’ visual search abilities to quickly respond when faced with distractors,” says lead author Cheri D. Mah, MS, research fellow at the University of California San Francisco Human Performance Center, in a release.
The research team led by Mah conducted a randomized, controlled trial during a 4-week training camp. Seventeen professional baseball players from an MLB organization completed a two-day baseline of habitual sleep. Athletes then were randomized to either five nights of sleep extension or five nights of habitual sleep. Pre- and post-cognitive tests included the Digit Symbol Substitution Task (DSST) and an adaptive visual search task. Mood and daytime sleepiness were evaluated with the Profile of Mood States (POMS) and Epworth Sleepiness Scale.
In the sleep extension group, the objective, estimated sleep duration measured by actigraphy increased by 0.6 hours per night from 6.3 to 6.9 hours. Assessments of fatigue, tension, and daytime sleepiness all decreased by more than one-third after sleep extension.
“Fatigue over a season can negatively impact performance and possibly pitch recognition,” says Mah. “These findings suggest that short-term sleep loading during periods of high training volumes may be a practical recovery strategy and fatigue countermeasure that has daytime performance benefits.”
Updated September 17th 2017
Do you ever experience night sweats? It’s an uncomfortable feeling, to wake from sleep drenched in sweat, your pajamas and sheets damp and clammy. Sweating at night can be highly disruptive to sleep, keeping you from falling asleep and rousing you out of your sleep repeatedly throughout the night.
Sometimes, of course, we sweat at night because it’s hot outside and in our bedrooms. Summer can bring about plenty of sweaty nights and restless, less-than-refreshing sleep. Warm weather and warm sleep environments are the most common reason for occasional nighttime sweating—and they highlight the importance of controlling temperature during sleep. Sweating is the body’s defense against overheating. A cool bedroom is the best temperature environment for sleep, year round. In the warmer months, that means most of us will need to put some work into keeping bedrooms cool.
How cool? The right temperature really is the temperature at which you can fall asleep comfortably and stay asleep without waking—or sweating. For most people, that’s a temperature in the low to mid-60s Fahrenheit. Fans, air-conditioning, opening the windows at night to let a cooler breeze through the house are all warm-weather practices that can help your sleep. And don’t forget to close curtains or draw blinds in order to keep the sun blocked, and your bedroom cooler, during the day. Wearing light bedclothes—or no clothes at all—can also help keep you cool, and avoid sweating and heat-related discomfort at night. Breathable fabrics like cotton and linen are the best choices for clothing and bedding, when you’re looking to stay cool.
But sweltering temperatures aren’t the only reason people experience night sweats. Sweating during sleep has a wide range of causes. Several different types of medication can lead to night sweats. Anti-depressants, steroids, pain medication, hormones, and medication for diabetes are all types of drugs that have night sweats as a side effect. Often, night sweats are a consequence of another condition or ailment. Here are some of the more common conditions that are linked to nighttime sweating:
Menopause. Night sweats are a frequent symptom for women in menopause, and sometimes for women in perimenopause. Women in menopause and perimenopause often experience sleep troubles, including night sweats, as a result of fluctuating hormone levels. The quality of sleep—and how well you feel during the day—can be deeply affected by night sweats and other menopause-related sleep disruptions. These sleep disruptions last for an average of slightly more than 7 years, according to new research. There are treatment options for women experiencing night sweats, including cognitive-behavior therapy (CBT), which research indicates can help alleviate night sweats and other menopause symptoms.
Other hormonal changes and imbalances. People with several different types of hormonal imbalances may sweat at night during sleep. Hormone dysfunction associated with diabetes and with thyroid disorders both can cause night sweats. The hormonal changes of puberty can also lead to night sweats—as can the hormonal fluctuations of pregnancy.
Obstructive sleep apnea. It’s a lesser-known symptom than snoring and daytime fatigue, but night sweats can be a consequence of OSA.
Obesity. Being overweight and obese can make night sweats more likely. Carrying too much weight can pose an array of other problems for sleep, including increasing risks for sleep disorders such as obstructive sleep apnea.
GERD. Gastroesophogeal reflux disease—most commonly known as acid reflux or heartburn—can bring about uncomfortable night sweats. GERD is problem for sleep in general. People with nighttime heartburn are likely to experience disrupted sleep, including trouble falling asleep and staying asleep.
Anxiety. Stress and mood problems, including anxiety, may cause sweating at night that makes sleep uncomfortable. Anxiety and other mood disorders can be deeply disruptive to sleep, and stress is among the most common causes of sleep trouble.
Night sweats can also be signs of other medical issues, including infection, adrenal dysfunction and cancer. With such a broad range of possible causes for night sweating, it’s important to speak with your physician if you observe any changes to the typical ways your body sweats at night—if you begin to sweat more frequently, or if your sweating increases in intensity.
There are ways other than keeping your bedroom cool and wearing the right clothes that can help diminish nighttime sweating. They also happen to be strategies that are good for sleep in general, including:
Don’t suffer at night because of night sweats. This soggy, uncomfortable experience will interfere with how much sleep you get, and how well you sleep. Make sure you’re sleeping in the right environment—cool but not cold, and not overheating in too much clothing or bedding. And discuss with your physician any questions or concerns you have about nighttime sweating.
Michael J. Breus, PhD
Updated September 16th 2017
Let me describe a very common presentation in children’s dentistry. It happens so much, you could almost consider it normal. I see many, many kids present for a dental exam with sleep apnea symptoms.
When they walk into the surgery, the first thing I see is a thin face. Their lower jaw is set back, and their chin is retruded. They have a skinny mid-face and open mouth at rest, indicating mouth breathing.
They look tired, and their nose is stuffy, they have dark circles or venous pooling under the eyes. Their lips are cracked and dry and they have a slouched forward posture.
It’s common to see teeth grinding too. When we talk about sleeping habits, their parents often say they notice them snoring or bedwetting.
Close to 1 in 3 kids suffer from some level of sleep disorder and up to 70% of these are unnoticed. About 15% of kids snore and many parents are unsure about whether their kids have sleep disorders (snoring or not).
Other sleep apnea symptoms in kids include:
Studies are now showing kids with sleep disorders can harm their brain growth. Areas of the brain that control thinking and problem solving are smaller in kids with sleep apnea.
Sleep disorders often begin with mouth breathing
Your kids should be breathing through their nose. Mouth breathing does not deliver adequate oxygen to their body. Young developing bodies and brains are oxygen hungry, which is why the impact on a child’s health can be severe.
Nasal breathing creates nitrous oxide in the nose, which increases oxygen perfusion. It drives blood flow to the lungs by increasing blood flow, oxygen, and CO2 levels. It also slows the breathing rate and improves overall lung volumes.
Nitric oxide is not produced if kids aren’t nose breathing. Kids who mouth breathe, receive cold, unfiltered air that delivers little oxygen.
One of the most obvious signs of mouth breathing is crooked teeth. Children with high palates have small nasal sinuses. Airflow through the nose is impaired, and mouth breathing can occur, especially during sleep.
Kids brain development and sleep disorders
Kid’s sleep disorders and snoring can directly impact brain development. Sleep is the time where the brain grows and regenerates. During childhood, crucial neural stages occur during sleep.
Sleep disorders are more common in special needs kids, psychiatric disorders or autism.
A lack of oxygen during sleep will starve a child’s brain. Not only does the amount of sleep matter, but the quality of sleep. Oxygen deprivation sends the brain into survival mode, robbing it of proper growth.
Snoring and sleep disorders cause the release of stress hormones. This can be in response to airway closure that increases breathing pressure.
From ages 0-6 the brain is going through remarkable growth. By age six, the brain is at 95% of adult brain weight and peak energy consumption. But up to age twelve, the brain is undergoing critical developmental stages.
Between ages six to twelve, neural connections become more complex and adult-like. From ages 8-11, for example, future IQ will be influenced by learning music.
Negative factors such as bullying and abuse during these years can inhibit brain development.
Behavior and sleep disorders
ADHD is commonly associated with sleep disorders. However, the relationship is complex and bidirectional.
Studies suggest about 5% of all children suffer obstructive sleep apnea (OSA). OSA is the most severe form of sleep disorders, it’s defined by pauses in breathing or ‘apneas’ that expose the brain to lack of oxygen for short periods. The child either wakes up, or the brain opens the airway by teeth grinding.
One study compared brains of kids between 7 and 11 years old with and without sleep disorders. Kids with OSA had decreased gray matter volume measured in the brain. These control cognition and mood. They also showed shrinking in areas involved in thinking and problem solving.
Sleep apnea symptoms in kids can be improved by increasing airway size. Removing tonsils and adenoids may improve children’s school performance in kids with ADHD as well as behavior and sleep-related issues. Evidence in this area is mixed, and experts don’t yet agree on its overall impact on cognition.
The evidence is mounting on the importance of breathing for healthy kids development. Sleep apnea symptoms have close links to a decrease in brain development in kids.
Like adult sleep disorders, diagnosis in kids is difficult. A high number of sleep disorders, don’t test positive for OSA.
The number of kids with upper airway resistance syndrome is not well understood. More research is needed, but experts agree that healthy kids need to sleep better. Many kids show signs of sleep disorders such as snoring or teeth grinding.
If you think your kid has sleep apnea symptoms, consult your GP or Dentist right away.
Dr. Steven Lin.
Updated September 11th 2017
Physiology of Breathing
Normal breathing is done through the nose. Each nostril functions independently and synergistically to filter, warm, moisturize, dehumidify and smell the air.
Babies are born obligate nose breathers, but somewhere along the way nose breathing can change to mouth breathing, with dire consequences. The most obvious adverse effect of mouth breathing is dryness of the oral and pharyngeal tissues, leading to inflamed tonsils, tonsil stones, dry cough, swollen tongue, halitosis, gingivitis and caries.
Normal respiration follows a gentle wave pattern with 10 to 12 breaths per minute. Mouth breathers take too many breaths, with rates from 12 to 20 breaths per minute or more. Breathing delivers oxygen to the cells of the body and removes excess carbon dioxide. Carbon dioxide is produced as a byproduct of exercise and digestion of food. Carbon dioxide plays a significant role in the release of oxygen from hemoglobin. It also triggers breathing, maintains blood pH and prevents smooth muscle spasms. All of these functions are reduced or impaired in mouth breathers.
Surprisingly, oxygen is absorbed on the exhale, not on the inhale. The back pressure created in the lungs with the slower exhale of nose breathing allows more time for the lungs to transfer oxygen to the blood. This exchange requires carbon dioxide. Exhaling through the mouth blows the carbon dioxide out too quickly, resulting in less oxygen being absorbed. The reason nasal breathing results in more oxygen being absorbed is nitric oxide is released in the nasal cavity and inhaled with nose breathing. Nitric oxide increases the efficiency of oxygen exchange by 18 percent. There is no nitric oxide inhaled with mouth breathing, therefore less oxygen is absorbed. The reduced oxygen absorption leads to a cascade of sleep, stamina, energy level and ADHD problems. Children diagnosed with ADHD may in fact be mouth breathers who are simply sleep deprived.
With nasal breathing, the tongue rests against the palate without touching the teeth. In this position, the tongue provides passive pressure that stimulates stem cells located in the palatal suture and within the periodontal ligaments around all the teeth, to direct normal palatal growth. The teeth erupt around the tongue, producing a healthy arch form. The lateral pressures from the tongue counters inward forces from the buccinator muscles
What Goes Wrong with Mouth Breathing.
Several things go wrong with mouth breathing. The low carbon dioxide levels associated with mouth breathing lead to over breathing or hyperventilation. With less oxygen being delivered to the brain, muscles and all the cells of the body, the body functions less than optimally. Sleep is often disturbed and of poor quality, leaving the mouth breather tired in the morning and feeling fatigued mid-afternoon. As the mouth dries out, the pH of saliva drops, leading to increased caries. This dryness and lack of air filtration in mouth breathing causes enlarged and inflamed tonsils and adenoids and increased risk of upper respiratory tract infections. Lower levels of carbon dioxide cause smooth muscle spasms associated with gastric reflux, asthma and bed wetting. Smooth muscle is found throughout the body – in the respiratory system, digestive system and circulatory system.
With mouth breathing, the tongue is down and forward allowing the buccinator muscles to push unopposed, causing the upper arch to collapse. Children who mouth breathe have an underdeveloped, narrow maxilla with a high vaulted palate. They develop a retrognathic mandible and generally have a long face. This is known as long face syndrome.
Some think the long face syndrome associated with mouth breathing is actually dictated by genetics rather than breathing. To see if mouth breathing alone could change jaw development and occlusion, Dr. Egil Harvold and his team tested this idea in monkeys. They artificially switched nose-breathing monkeys to mouth-breathing by surgically blocking their noses with silicone plugs. The monkeys were uncomfortable with the new mouth breathing, but eventually adapted and all developed changes to their jaws and malocclusion.
Mouth breathing related problems of skeletal development will set children up for obstructive sleep apnea later in life. In addition to changes in development of both maxilla and mandible, the airway is constricted, predisposing the child sleep problems.
It may seem logical that mouth breathing occurs because the nose is congested, but that is not always the case. The brain of a mouth breather thinks carbon dioxide is being lost too quickly from the nose and stimulates the goblet cells to produce mucous in the nose to slow the breathing. This creates a vicious circle of mouth breathing triggering mucous formation, nasal passages blocking, leading to more mouth breathing. So in fact, mouth breathing can cause nasal congestion leading to more mouth breathing.
Recognizing Mouth Breathing
Determining if someone is a mouth breather is not always easy. Some people admit they always breathe through their mouth. Others believe they are nose breathers, but if you watch them, their mouth is open most of the time. Sitting still, they may have their mouth closed, but if they get up and walk across the room, their mouth is open. Chewing with the mouth open may be done so the person can breathe while eating. One sign of mouth breathing is an addiction to Chapstick or lip gloss. An open mouth leads to drooling, both awake and asleep, causing chapped lips and a tendency for mouth breathers to lick their lips frequently. Closed-mouth lip seal is efficient at keeping saliva in and air out, but chronic mouth breathers may find it very difficult to hold their lips together.
Mouth breathing at night dries the tissues so the mouth, teeth, tissue and the throat are all dry upon waking. Always having a glass or bottle of water at hand might signal systemic xerostomia, but it is also a sign of mouth breathing. If someone wakes with a dry mouth, they are likely a mouth breather at night, which means they are also more likely to mouth breathe during the day.
Dental hygienists are in the perfect position to recognize mouth breathing. Before asking patients to “open wide,” check first for mouth breathing.
Trisha O'Hehir, RDH, MS
Updated September 7th 2017
Mouth breathing is not as innocent as many people may think. Though it is natural to partially breathe through the mouth during speech or to maximise air intake when the physiological demand is increased (e.g. during strenuous activity or exercise), the mouth is not actually intended to participate in normal respiration. The function of the oral cavity, or mouth, primarily revolves around speaking and eating, and breathing when nasal respiratory function is inadequate.
There are a number of potentially serious health consequences associated with mouth breathing. Breathing through the mouth instead of the nose upsets the normal balance between the structure and intended functions of the oral cavity. When left untreated individuals can develop craniofacial growth abnormalities, dental and orthodontic problems, skeletal and postural changes, sleeping difficulties, exacerbation of asthma and various other physiological and social health issues.
Research shows open mouth breathing can adversely affect the growth and development of the face and jaws by altering the normal positioning of the tongue and lower jaw. When nasal respiratory function is normal, the mouth usually remains closed with the tongue resting in contact with the palate (roof of the mouth). In this position the tongue exerts a lateral force, which assists to shape the jaw. The teeth erupt around the tongue producing the normal healthy arch form.
It is not possible to breathe through the mouth and have the tongue rest in the palate simultaneously. To enable breathing the mouth must be open and the tongue drop to the floor. This is problematic, particularly for growing children, as the tongue can no longer provide the "mould" for the upper jaw and teeth to form around. It is quite characteristic of mouth breathers to have a narrow, high arched palate and small underdeveloped top jaw, and subsequently display a narrow face structure, overcrowding of teeth and jaw misalignment.
During nasal breathing the jaws and mouth tend to naturally remain closed. For chronic mouth breathers though, it is necessary the mouth remains open for extended lengths of time. This causes the downward backward movement of the lower jaw and further contributes to jaw misalignment and long-faced growth patterns.
Not surprisingly, mouth breathing is commonly associated with orthodontic abnormalities. It is quite typical for mouth breathers to tilt their heads backwards to open the airway and maximise air intake. This is because mouth breathing is less efficient than nasal respiration at introducing oxygen into the lungs and bloodstream. Nevertheless, there is no distortion in one part of the body that is not reflected throughout the body. Any head posture where the head is not held level for example, can distort the bones in the skull, including the upper and lower jaws.
Poor head posture and jaw misalignment also affect how the head and spine balance in relation to gravity. When any part of the body is out of alignment with the other parts, there is often a compensating effect throughout the postural chain. In order to maintain the balance of the whole structure, the body must adjust itself. This can involve muscles in the neck, shoulders, back, pelvis, legs and feet. Though often not thought as a health problem, poor posture can place unnecessary wear and tear on joints and over time, be as damaging as an injury.
Dry mouth is a common complaint among chronic mouth breathers. Breathing through the mouth reduces saliva production and increases saliva evaporation. Not only is dry mouth uncomfortable, alterations to salivary patterns can affect an individual's oral hygiene and dental health. Saliva plays an important role in the self-cleaning of the mouth, neutralising acids and washing away bacteria. With reduced saliva flow, chronic mouth breathers are at increased risk for tooth decay, cavities, gum disease and bad breath.
Mouth breathing subsequent to nasal airway obstruction is a primary cause of sleep apnoea (pauses in breathing during sleep. During open mouthed breathing the lower jaw drops and reduces the diameter of the pharyngeal airway (throat). The airway becomes either partially or completely obstructed and causes individuals to either intermittently or repeatedly briefly stop breathing during sleep. Each time airflow is blocked the brain is deprived of oxygen. Lack of oxygen triggers the brain to arouse the individual so they can resume breathing. Sleep can be interrupted many times each night.
Sleep disturbance is common among chronic mouth breathers. Mouth breathing is less efficient than nasal respiration at introducing oxygen into the lungs and bloodstream. This affects sleep because low blood oxygen concentrations cause the brain to remain in a more aroused state. Being more aroused interferes with the normal sleep cycle. Individuals tend to remain in light sleep for longer periods and be deprived of deep, restorative sleep.
Abnormal facial and dental development can also contribute to poor sleep attainment by making breathing more difficult while lying down. Irritation from drying of the oral mucosa and night sweating associated with the increased effort required to breathe and maintain blood oxygen levels, are additional reasons individuals experience sleep disturbance.
The importance of sleep to physical and psychological health cannot be overestimated. Sleep is vital for growth and development. For children, research has shown sleep to be linked to growth, development, academic performance, concentration and behavioral problems.
Nasal airway obstruction and mouth breathing can be very dangerous for individuals with asthma. When breathing through the mouth air is not warmed, humidified or filtered nearly as effectively as when air is breathed in through the nose. Therefore the risk for air, which is cold, dry or which contains irritants, pollutants or allergens, entering the lungs is increased. By allowing cold, dry and/or unfiltered air to enter the lungs more easily, mouth breathing increases the risk individuals (with asthma) will have poor asthma control and experience asthma attacks.
Nasal airway obstruction is far from “just a blocked nose.” Nasal breathing is the only physiologically normal breathing pattern seen in humans. Therefore ensuring adequate nasal respiratory function is maintained is very important to health.
Mouth breathing is not an acceptable substitute for nasal breathing. Mouth breathing is associated with numerous deleterious health consequences for adults and children alike. Being aware of the signs and symptoms of nasal airway obstruction and mouth breathing is necessary to enable early intervention and ensure optimal management.
Re-establishing nasal breathing is particularly relevant for children as left untreated, mouth breathing can significantly impact growth and development.
Some potential signs of mouth breathing:
– Nasal congestion (“blocked” nose)
– Intermittent or constant open mouthed breathing
– Noisy, visible breathing (physiologically normal breathing is through the nose, silent, smooth and almost invisible)
– Snoring
– Frequent night waking
– Dry mouth (often individual’s report needing to keep a glass of water by the bedside)
– Dry, cracked lips
– Night sweating
– Daytime fatigue
– Behavioural issues (in children)
– Long, narrow face
– Dental or orthodontic issues
– Head posture where head it tilted backwards
– Bad breath
– Poor asthma control.
Updated September 6th 2017
Scientists have successfully measured the eye pressure of sleeping patients with obstructive sleep apnea syndrome for the first time, finding an unexpected correlation with glaucoma.
This study shows that the optic nerve could be damaged due to hypoxia without a spike in eye pressure, a finding that could help unravel the details of glaucoma sufferers with normal eye pressure levels.
Scientists at Hokkaido University have successfully measured the eye pressure of sleeping patients with obstructive sleep apnea syndrome for the first time, finding an unexpected correlation with glaucoma.
Glaucoma is thought to be a disease in which the optic nerve sustains damage due to increased eye pressure, resulting in a restricted visual field. In addition to strokes and cardiovascular disease such as heart attacks, people with obstructive sleep apnea syndrome (OSAS) are prone to suffer from glaucoma at a rate about 10 times higher than non-OSAS sufferers.
However, it has been technically difficult to continuously measure eye pressure in sleeping subjects. To address the problem, the team employed a special sensor akin to a contact lens to monitor pressure changes when OSAS patients' breathing repeatedly stopped during sleep.
Normally, intrathoracic pressure is known to rise if people stop breathing (exhaling), resulting in higher eye pressure. The study found unexpectedly that the eye pressure dropped when subjects stopped breathing. The subjects tended to stop inhaling, not exhaling, due to airway closure, which should lead to lower intrathoracic pressure. The subjects also experienced hypoxic effects, as cessations in breathing cause blood oxygen saturation levels to drop, possibly triggering optic nerve damage that can lead to glaucoma.
The study shows that the optic nerve could be damaged due to hypoxia without a spike in eye pressure, a finding that could help unravel the details of glaucoma sufferers with normal eye pressure levels.
Updated August 31 2017
About a third of the persons surveyed in several industrial countries reported too little sleep. If a young adult sleeps less than 8 hours a night, increased attention deficits occur, which can lead to considerable negative consequences. In sleep clinics there is an increasing number of healthy people who are suffering from the negative consequences of insufficient sleep.
Not Enough Sleep Leads to Riskier Decision-making
Researchers at the University of Zurich (UZH) and the University Hospital Zurich have now identified a further critical consequence of a chronic lack of sleep: increased risk-seeking. The sleep and neuroeconomics scientists studied the risk behavior of 14 healthy male students aged from 18 to 28 years.
If the students slept only 5 hours a night for a week, they displayed clearly riskier behavior in comparison with a normal sleep duration of about 8 hours. Twice a day, they had to choose between obtaining a specified amount of money paid out with a given probability or playing it safe with a lower amount of money paid out for sure. The riskier the decision, the higher the possible prize, but also the risk of getting nothing.
Riskier Behavior Remains Unnoticed
While a single sleepless night had no effect on risk-seeking, 11 of 14 of the subjects behaved significantly and increasingly riskier as the week of a reduced sleep duration went on. An additional finding is particularly alarming: The students assess their risk-taking behavior to be the same as under regular sleep conditions. “We therefore do not notice ourselves that we are acting riskier when suffering from a lack of sleep,” says Christian Baumann, professor of neurology and the head of the Clinical Research Priority Programs (CRPP) “Sleep and Health” at UZH, in a release.
According to the authors of the study, we should therefore all strive for sufficient sleep duration—especially political and economic leaders who make wide-reaching decisions daily. “The good news is,” Baumann says, “that, in the high-powered world of managers, getting enough sleep is increasingly being seen as desirable.”
Lack of Recovery in Important Regions of the Brain
For the first time, the researchers have proven that a low depth of sleep in the right prefrontal cortex is directly connected with higher risk-seeking behavior. This part of the cerebral cortex has already been associated with risk-taking behavior in earlier studies. “We assume that behavioral changes occur for anatomical-functional reasons to some extent as a result of the right prefrontal cortex not being able to recover properly due to a chronic lack of sleep,” Baumann concludes.
Updated August 31st 2017
