The Dragontree

I was wandering around in a hardware store the other day, feeling rather hot and stuffy in my mask – and also a little anxious – when I realized my mouth was wide open. I shut my mouth, which required me to deepen my breathing through my nose, and soon my mask felt less stuffy and the anxiety was gone. It occurred to me that I mouth-breathe a lot when I have a mask on, and I’ve resolved to stop.

A few years after moving to Colorado I realized that I had been mouth breathing while asleep and increasingly while awake, too. During the same period of time, I noticed my sleep had been worse, I felt more anxious, I had a harder time concentrating, my energy was lower, and my gums had receded significantly. It might sound like a stretch to attribute all of that to breathing through my mouth rather than my nose, but I’m convinced that mouth breathing was a contributing factor. 

Mouth breathing begets more mouth breathing. When we breathe through our mouth over years, the facial structure can change – especially in children. The face may become longer and narrower. The palate narrows too, which causes a higher arch, infringing on the airways above. Teeth become crowded and crooked. The tongue drops to the floor of the mouth all day instead of resting against the upper palate, and this can contribute to sleep apnea and snoring. 

Mouth breathing tends to be more rapid than nose breathing, which may promote a feeling of anxiousness and may be misdiagnosed as Attention Deficit Disorder. Breathing through the mouth is less efficient at oxygenating the body than nasal breathing. Mouth breathing can raise our blood pressure. It causes dryness of the mouth, bad breath, and increased susceptibility to tooth decay and gum disease. 

When we breathe through the nose, we inhale more of a gas called nitric oxide (not “laughing gas” which is nitrous oxide) that is produced in the paranasal sinuses. Nitric oxide kills bacteria. The nose also warms and filters incoming air. For all these reasons, nasal breathing reduces our chances of getting sick via airborne germs. In terms of spreading sickness to others, we exhale many fewer “respiratory droplets” through the nose than through the mouth. Some doctors propose that nasal breathing is an easy intervention to reduce your risk of contracting COVID-19. If wearing a mask causes you to mouth breathing, this may partly or significantly negate the protective value of the mask. I recommend trying to remember to breathe through your nose especially in public spaces and when wearing a mask. 

Nose breathing carries the nitric oxide from the nasal airways down into the lungs, where it decreases blood pressure and increases oxygenation of our tissues. When we mouth breathe we don’t get these benefits. Interestingly, studies have shown that humming increases nasal nitric oxide production, so your homework assignment is to hum throughout the day. 

For most mouth breathers, switching to nasal breathing is mainly just a matter of remembering to do it. But there are three times when it can be more tricky: while sleeping, while congested, and while exercising. 

If you keep your mouth closed while sleeping, chances are you’ll sleep better, snore less, wake up with sweeter breath, and without a sore throat. Some scientists have also proposed that mouth breathing during sleep increases the need to urinate during the night, so switching to your nose may reduce your trips to the bathroom. 

I’ve found that blowing my nose before bed and simply intending to keep my mouth closed while asleep works fairly well. If that doesn’t work for you, consider taping your mouth closed. I know it sounds weird and perhaps unpleasant, but it’s not bad. Just use a small piece of medical tape (about an inch) vertically over the center of your lips. 3M paper tape is a good choice. If this makes you psychologically uncomfortable, try taping your mouth half an hour before going to sleep so you can get used to it. Or try taping just one side of your mouth. (Don’t tape your mouth if you’re drunk or have a health issue that may necessitate an urgent need to open your mouth or an obstruction of your nose. It’s also a good idea to leave at least a corner of your mouth not taped.) Having a bedroom that’s cool, airy, and clean will help. 

It’s totally normal to breathe through your mouth while engaged in intense exercise. Just watch people jogging down the street and note how many have an open mouth. It takes practice and effort to break yourself of this habit, and it may feel at first like you simply can’t get enough air in through your nose. But you’ll find that your nasal breaths are longer and deeper. Your breathing rate will slow down considerably and so will your heart rate. Plus, you’ll get more oxygen into your body and at the end of your workout you’ll feel invigorated.

If you have a hard time breathing through your nose because you’re congested, there are a few options. Obviously if you’re sick you may just have to wait for it to pass, and if you have allergies you’ll have to do your best to avoid allergens and treat your allergy symptoms with whatever works (some natural options include quercetin, nettle extract, liposomal vitamin C, n-acetyl cysteine, and a supplement called Antronex made by the company Standard Process [I have no relationship with them]). 

But simply breathing through your nose anyway can often encourage it to clear. At the beginning you may have to enlist your mouth to assist, but if you continue to breathe exclusively through your mouth your nose will be less apt to clear. Just try to breathe through your nose and notice its ability to clear itself. 

Finally, there are some specific breathing techniques for unblocking your nose, one of which is simply to hold your breath for as long as you can while nodding your head up and down or swaying your torso from side to side, then releasing the breath through the nose. Within five breaths this usually works. Here’s a video of it. You may also benefit from nasal rinsing (AKA “neti”) followed by nasal lubrication. We make a Nasal Oil for this purpose which I formulated. 

I would love to hear about your experience with mouth breathing and nose breathing. Share with us in the comments section. 

Be well,

Dr. Peter Borten