Close Your Mouth! Nasal Breathing is Key to Well-Being

You take 26,000 breaths every day without even giving it a single thought. But we want you to start paying a bit of attention to “how” you breathe. The default mode of breathing for humans is through the nose, and when we do nasal breathing rather than mouth breathing, we tend to feel better and stay healthier.

It’s been said that breathing through your mouth makes about as much sense as trying to eat through your nose. Mouth breathing is generally only necessary when you have nasal congestion from issues like allergies or a cold, or when you are exercising vigorously and need to drastically ramp up oxygen delivery to your muscles.

I’m sure you will agree that a chronically stuffed-up nose can make life miserable, interfering with your ability to sleep well and function at a peak level. Yet, many people mindlessly do way too much mouth breathing, predisposing them to bad breath, gum disease and tooth decay - and that’s just the tip of the iceberg.

Daniel Rome, DDS, is my dentist and he’s also a good friend. I actually look forward to going to see him every six months to get my teeth cleaned. We always have fascinating conversations about the latest breakthroughs in our respective fields.

Who knew dentistry and cardiology would share so much in common? For example, recently Daniel texted me: “At an airway/apnea lecture in Scottsdale right now. Nasal breathing is associated with health; mouth breathing associated with disease. Nitric oxide release from nasal breathing is important for many reasons, and even more so now with the COVID-19 pandemic.”

Nasal Breathing Confers Health, Mouth Breathing Causes Disease

As beautiful as your nose is, it’s more than just a hood ornament. It’s your first line of defense against viruses and bacteria—but only when you breathe through it. Cilia, the tiny hairs lining the inside of your nose, work in combination with mucus to trap pathogens, and decrease the risk of coming down with nasty lung infections like COVID-19, influenza, and pneumonia.

A healthy body continually produces a lot of nitric oxide, which is a natural chemical that’s a potent vasodilator, relaxing blood vessels and keeping them soft and supple, while at the same time improving blood flow to organs.

Simply closing your mouth and breathing deeply through your nose stimulates your blood vessels to produce more nitric oxide. The nitric oxide released from the blood vessels lining the nasal passages has antiviral, antibacterial, antifungal, antiparasitic effects - helping the immune system fight off infections.

Nitric oxide is also a signaling molecule that turns on genes, helping to maintain our youthful well-being. In contrast, a diminished capacity to produce nitric oxide is a fundamental cause of heart disease, diabetes, and erectile dysfunction.

What’s more, the moist nasal passages warm and humidify the air as it flows down into the airways, helping to prevent dryness in the bronchial tubes and lungs. Breathing through your nose also adds airflow resistance to your inhalations and exhalations, slowing down your respirations, and improving the lungs’ ability to extract oxygen from the inhaled fresh air, and unload carbon dioxide from the venous blood into the exhaled air.

Mouth breathing is a vicious cycle - breathing through your mouth makes your nasal passages stuffy, making it harder to breathe through your nose. On the other hand, nasal breathing is a virtuous cycle—breathing through your nose clears your nasal passages, making is easier to keep your mouth closed.

So, nasal breathing is a habit that each of us needs to cultivate. Nasal breathing also will help to maintain normal drainage from the sinuses and middle ear via the eustachian tubes. By breathing through your nose, you can help prevent sinus infections and nasal congestion, as well as middle ear infections.

Nasal Breathing Improves Memory and Sleep

While I was going to college and medical school, I lived with my grandmother Dorothy O’Keefe. Lush hedgerows of lilac trees grew on two sides of her backyard. During May in Grand Forks - home of the University of North Dakota - the lilacs burst into fragrant light-purple blossoms. This is a glorious time of year way up there near the Canadian border when the days get longer and warmer and the earth turns green.

Dorothy would ask me almost every other day to break off a few sprigs of lilac and bring them inside. Then she would put them in a vase that sat on a small kitchen table next to an east-facing window overlooking the backyard. I would eat breakfast and chat with Dorothy while the morning sun streamed in through that window, and the scent of lilacs filled the tiny room.

Even today, decades later, the smell of fresh lilacs evokes fond, vivid memories of Dorothy - who taught me by example the most important lessons of life. Here in Kansas City, years ago I planted a hedge of lilacs in our back yard. It blooms every April. While the lilacs are in bloom, I make a point of keeping several sprigs in a vase on our kitchen table. The fragrance of fresh lilacs never fails to make me smile and remember my dear “Granny O’Keefe.”

For most creatures in the wild, recognizing odors is critical to their survival, to help discern poison from food, friend from foe, danger from security. Thus, via evolutionary adaptations, we are hard-wired with over-riding neural connections linking odors with long-term memory. Studies have shown that when mice sniff, even the flow of odorless air, it triggers brain activity in the olfactory bulb (the part of the brain that recognizes smells), which then stimulates the hippocampus—a key part of the brain that is integral in the creation and storage of memories.

Slow, deep nasal breathing predictably lowers heart rate and blood pressure, improves the elasticity of the lungs, and reduces the flight-or-fight stress hormones in your system. Breathing through your nose calms your thoughts by generating alpha waves and coherence in the brain—a synchronized pattern of slow brain waves characteristic of a meditative, relaxed state of mind.

On the other hand, mouth breathing triggers the brain to produce beta waves - typically associated with a flight-or-fight stress response. Thus, when you breathe through your mouth, your system automatically shifts into stress mode, placing an unnecessary burden on your heart and brain.

Study volunteers show improvements in memory when they are allowed to breathe through their nose, rather than being forced to mouth breath by subtly obstructing their nostrils. Researchers hypothesize that nasal breathing may boost memory consolidation. All this seems to confirm the ancient wisdom that mindful breathing is an effective way to change mental states and improve brain function.

Over 10 years of sleep studies now show that while sleeping, mouth breathers have fewer REM cycles (less dreaming), higher levels of the stress hormone cortisol, and a more stressful sleep pattern.

Mouth breathers are also prone to develop sleep apnea, with a higher apnea-hypopnea index, meaning they stop breathing frequently while sleeping, causing their oxygen levels to plummet. Sleep apnea is a very common and dangerous condition that predisposes to high blood pressure, atrial fibrillation (AFIB), stroke, and dementia.

How to Do More Nasal Breathing

By nature, infants have a strong sucking reflex - babies often suck their thumbs or fingers even before they are born. Sucking tends to have a comforting, calming effect on infants, which is why Joan considered a pacifier an essential parenting tool, and we used a “binky” for each of our four children when they were newborns.

Admittedly, there are pros and cons to pacifiers, though most pediatricians now say they’re OK for a baby, at least for the first several months of life. What I know for sure is that pacifiers soothed our babies when they were fussy, distracted them when they got their shots, settled them down when they were on an airplane, and helped them fall asleep at naptime/bedtime.

I hate to admit it, but I still need a pacifier - it’s called a bite splint. Though I never realized I was doing it, I tend to grind my teeth when I sleep. So, Dr. Rome took an impression of my upper teeth, from which he molded a custom-fit mouthguard to protect my teeth while I sleep. I wear my bite splint every night - it works like a pacifier, allowing me to fall asleep easier and sleep like a baby. A bite splint also helps me to keep my mouth closed while I sleep, encouraging nasal breathing and making snoring less likely.

Your Homework Assignment

Like many of the most important things in life, breathing through your nose is simple - but not easy. Your mind is focused on a million other issues; the last thing you have time to do is pay attention to your breathing. After all, that’s why we have an auto-pilot system - to free up our consciousness to solve life’s problems.

But here’s the thing … you need to stop catastrophizing in a monkey-mind frenzy and pause just for a moment to breathe. Close your eyes, and mindfully notice the cool air streaming into your nostrils, and the warm humid air flowing out your nose while you exhale slowly.

This will settle down your whole system. I have learned to do this frequently during my day, and I find it remarkably calming. One thing each of us can do to help transform this COVID-19 pandemic-induced deadtime into alive-time is simply to work on becoming better at breathing.

In Good Health,

By James H. O’Keefe, MD, with Daniel E. Rome, DDS