Mouth Breather (Chapter Six)

Ladies and gentlemen, here’s my disease. Give me a standing ovation and your sympathy.
— James, "Johnny Yen"

“Do you breathe through your mouth?”

Mouth breathing is a disease. This simple question, if embraced wholeheartedly, can be the most meaningful question of your life. It can be the game-changer that turns despair into hope, darkness into light. It can catapult you to another level of peace and love. It can change the race and fundamentally alter the course of your existence. It can be the question that leads you to greater happiness.

“No!”

That pretty much sums up nearly every answer. The challenge is almost everyone breathes through the mouth, at least to a degree. Why is there a disconnect between perception and reality?

A good psychiatrist will not point-blank tell you that you are nuts because you will not believe it. Instead, a good psychiatrist will ask a series of questions that make you arrive at the same conclusion seemingly on your own. Similarly, one cannot just ask, “do you breathe through your mask?” You most likely do not think that to be true of yourself. Instead, it’s best to pose a series of questions that collectively guides you to a deeper understanding of yourself, which in turn casts a new light on past setbacks and helps you overcome those same obstacles to cultivate a brighter future.

Ask yourself the checklist questions below to ascertain if you might be a mouth breather. Be careful. Do not be quick to dismiss. Be objective, fair, and most importantly, honest. True healing begins with self-awareness.


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Do you have bad breath?

It hadn’t always been that way. There was a time when your newly born breath was magical, its sweetness irresistible.

But somewhere along the way, you opened your mouth, and it became dry. Bacteria bred under your tongue and in the back of your throat.

And death breath was born.

Are you oblivious to the rank odor radiating and permeating the air around you? Have your co-workers rendered your cubicle a quarantine zone? Does your bedmate duck under the covers to no avail as your breath penetrates like it has homing missile technology? If so, close your mouth.

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Did you get ear infections?

"Can you tell me what's wrong?"

The inflictions of pain came in waves, each lull giving hope of an end to the agony. As the fever rages and the bacteria spread, a final piercing, strangled scream and eardrum bursts. Curling into a fetal position, breathless, trembling, and exuding pus from the skull, you whimper,

"Doctor, my ear hurts."

Mom asks the doctor why you get ear infections. The good doctor peers through his glasses and explains that kids are more prone to ear infections because their eustachian tubes are smaller, shorter, and more horizontal than adults, making it hard to drain fluid out of the ear. He adds that a child's immune system is immature, rendering them more susceptible to infections. Finally, he describes how infected tonsils allow bacteria to spread from the mouth to the middle ear.

Blah. Blah. Blah.

You are a mouth breather, plain and simple. Breathing through your nose infuses and sterilizes air with a remarkable substance called nitric oxide. Immunoglobulins found in nasal secretions also aid in the destruction of bacteria. On the contrary, breathing through the mouth leaves you susceptible to Streptococcus pneumoniae and other pathogens.

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Are your lips dry?

Dear Doctor,

I'm fed up! My lips are ridiculously dry. There isn't a single area where they're not cracked and peeling. Most days, I wake up with them parched as if they could shatter into pieces. It's painful too. The edges are flaky and look terrible. The other day my boss was staring at me, and I could feel something loose. It turned out to be a big piece of skin dangling from my mouth like an icicle! I want kissable lips, not despicable lips.

Patient

Breathing through your mouth is like blow-drying your lips. Even if you do not do it while awake, you most certainly do it while asleep. The difference between having supremely shriveled and satiny smooth lips may be as simple as keeping your mouth closed.

Do you drool?

Deep in the coral reef, gliding amongst the shoals of brightly colored fish, you are at peace. Weightless and carefree, moving as one with the currents, this place, so far from the ordinary world above, is the wonderland of your dreams. Drifting deeper into the watery depths, the glow of the surface becomes dimmer, more distant. The water is cold, colder than you had imagined. The sea envelopes you; the pressure suffocates you. You had never been this deep before. You glance upward at the surface, and your heart races. You struggle to move, but you can't. You want to take a breath, and you do. Drowning, you awaken…in a pool of drool.

You are not drooling as a byproduct of an undersea dream. You are drooling because you are sleeping with your mouth open. It's just gravity.

Do you clear your throat and cough?

"Will…ahem…ummhh…you…arrr…urrr…marry…hem…aha…me?"

Clearing your throat like a cat retching up a hairball can be devastating.

"Y…khjt…khjt…es!"

That is unless you found your soulmate. Then it's the most satisfying feeling ever.

Your nose is more than a decoration. It's an air filtration system that catches tiny particles before they infiltrate the lungs. When you breathe through your nose, air goes through the nostrils, nasal cavity, and sinuses before heading down the windpipe to the lungs. The sinuses' thin layer of sticky mucus traps dust particles, bacteria, and other pollutants. Tiny hairs called cilia sweep mucus from your nasal cavity into the back of your throat, where it is eradicated by acid in your stomach.

Breathing through your mouth instead of your nose bypasses the body's air filtration system, permitting germs, allergens, and pollutants direct access to your lungs to damage delicate tissues. Your only line of defense is to…ahem…ummhh…clear your throat and cough.

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Do you have asthma?

A Cycle of Death and Life

Chest Tightening

Face Whitening

Light Fading

Eyes Opening

Heart Beating

Lungs Breathing

(repeat)

An asthma attack elicits primal fear because nothing is as frightening as not being able to breathe.

Air is the food of the lung, and bread is the food of the stomach. Breathing air through the mouth is akin to feeding bread to the lung. Cold, impure air wreaks havoc on the lung’s small airways. Breathing through the mouth also makes you breathe quickly and deeply. This, in turn, lowers blood carbon dioxide levels until the small airways in your lungs constrict to reduce the loss. The combination of drawing in cold air and its impurities and over-breathing irritates and spasms the lungs' small vessels, worsening asthma.

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Are you waking up with crud in your eyes?

Folklore states the Sandman came every night and gave the village people pleasant dreams by sprinkling magical sand over their eyes. Somehow all you ended up with was eye crud.

The nasolacrimal ducts drain tears from the eyes to the nose. Breathing through the nose keeps the nasal passageways clear and facilitates tear drainage. On the contrary, mouth breathing eliminates air circulation in the nose, worsens nasal congestion, and impairs tear drainage.

Are you waking up with crud or waking up feeling cruddy? It doesn’t matter. In the end, it’s just semantics.

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Do you wake up with a dry mouth?

You sleep on the bed as a fish flops on the sand. Tossing and turning, you awaken as you can no longer bear to breathe the air. Your throat is parched, and your mouth is dry. Your leather tongue runs across cracked lips. Whatever happened last night had taken every ounce of fluid your body could spare and then some you could not.

Every night you are granted 10,000 chances to breathe through the nose or mouth. Each choice, a monumental opportunity. Each decision, a colossal failure.

The nose slows, warms, and humidifies the incoming air, creating an optimal environment for the lungs to extract oxygen. Tissue folds called turbinates inside the nasal cavity slow the air, allowing the blood vessels embedded in the vast surface area of the turbinates to warm and moisturize the air. The nose cools and dehumidifies the outgoing air, maintaining hydration.

You lose a bit of water for every breath you take through the mouth instead of the nose. With that, you lose a bit of yourself. Dehydration robs you of the ability to perform at your best. It depletes you mentally and physically, leaving you confused, weak, and lightheaded. It empties you.

We swam before the dawn of the human story. You carry the memory of that breathable blue past. A memory that fades like a sunset, evaporating with every breath.

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Can you breathe through your nose for 15 minutes?

“Zen master, show me the light. What must I do?”

“Just be, right here and now, and breathe.”

Yet you fade, getting colder by the minute, more dead with every breath.

The reason you breathe through your mouth is simple. It’s easy. Remember Hagen-Poiseuille’s law and the analogy of the overstuffed suitcase? Suppose the bones of the face never developed to their proper dimensions while the soft body parts housed inside not only grew to their full size but became inflamed from allergies and infections. In that case, the high nasal resistance will preclude you from breathing through your nose.

One way to test this is to relax with the lips closed, teeth together, and tongue on the roof of the mouth and breathe through your nose for fifteen minutes. Can you do it? And if so, does it feel uncomfortable and take work? That bit of discomfort and effort signifies your high nasal resistance.

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Do you chew with your mouth open?

"Doctor, it's embarrassing, but when I serve dinner to my husband, it sounds like I'm feeding a steak covered in peanut butter to a German Shepherd. My food is cold by the time I eat because I get nauseous watching him eat. I can't think of a polite way to tell him that he chews so loud that it's like having dinner with a large dog."

"Interesting. Does your husband do a partial or full extension with each mastication?"

Everything is connected, and everything happens for a reason. Your nose is designed for breathing, and your mouth is designed for eating. Chewing with your mouth open equals mouth breathing and a sign you may not be able to breathe through your nose.

Do you have cavities?

When was the last time you saw a lion brush his teeth? Animals in the wild use saliva to keep their mouths clean. There is no swishing with a fluoride rinse and floss, just a wholesome diet and spit.

Saliva coats teeth with minerals to protect against cavities. A natural reduction in the saliva secretion at night coupled with mouth breathing leaves your chops cotton dry. Unfortunately, acid-producing bacteria thrive in the absence of saliva, rotting teeth and boring cavities.

You've been digging a hole, and now that it’s made, you see that black is one hell of a color. Sleeping with your mouth open erodes your teeth and empties your core. Pray your cavity fills with gold.

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Have you lost your sense of smell?

There are different ways to communicate an inability to smell.

"Hey, these tomatoes smell great!"

"What tomato?"

Or you could fake it.

"Honey, don't these flowers smell lovely?"

"Oooh yes, nice," even though you have no clue.

There is also the honest is the best policy method.

"I have something to tell you that I've been keeping a secret. I have anosmia, which means I can't smell things. I love you and feel comfortable telling you now. I brought you some flowers. I hope they smell nice because I sure as hell don't know."

Although no match for a dog, you can detect billions of scents in infinitesimal quantities. With eyes closed, you can identify the subtle aromas in a glass of Zinfandel versus a glass of Cabernet. All thanks to millions of olfactory sensors embedded in the nasal passages. The smells are then transmitted to the brain's emotional center called the limbic system, connecting you with the world around you, conjuring up memories of forgotten times, and eliciting feelings from desire to disgust.

You became a fraction of yourself the moment you took a breath through your mouth. The taste buds on your tongue distinguish four qualities: sweet, sour, bitter, and salt. Everything else, the nuances of flavor, connection to the world, memories, emotions, all of it, is lost.

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Do you have dark rings around your eyes?

The dark circle around your eye is an allergic shiner. Congested sinuses restrict circulation and pool blood in swollen vessels under the skin surface below the eyes. Allergies to wheat, soy, dairy, pollen, mold, grass, dust mites, et cetera darken the ring. Inflamed nasal membranes cause sniffling, sneezing, clogged ears, watery eyes, and runny nose. Mucus-filled sinuses drip behind the nose, making you cough. The collective effect of allergies is to increase nasal resistance, subsequently worsening mouth breathing and allergies.

Round and round the bullseye you go.

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Were your tonsils large when you were a child?

Remember your first kiss?

I do. You were sleepless, fidgety, and inflamed. The anticipation had been mounting for weeks, if not months. Your first kiss stole the breath from your lips at a tender age, but it was nothing like the picture. Your first kiss was your tonsils.

The tonsils, tiny at birth, peak in size at age three to five - at times "kissing" - and shrink from age eight onward.

A ring of tonsils behind the nose and mouth protects the body's vital entrances from foreign pathogens. They swell due to infection, allergies, or acid reflux from the stomach. Though intended to protect, once inflamed, a ring of tonsils becomes a ring of fire. It's impossible to breathe through your nose when tonsils become inflamed to the point that air passing on its journey to the lungs is restricted. In a vicious cycle, mouth breathing makes you susceptible to allergies and infections that enlarge tonsils, promoting mouth breathing.

Chapter Six Conclusion

Anil Rama, MD

Anil Rama, MD serves as Adjunct Clinical Faculty at the Stanford Center for Sleep Sciences and Medicine. He is the former Medical Director of Kaiser Permanente's tertiary sleep medicine laboratory. Dr. Rama is also an editorial board member of the Sleep Science and Practice Journal and has authored several book chapters and seminal peer-reviewed journal articles in sleep medicine. Dr. Rama is a guest lecturer for the Dental Sleep Medicine Mini-Residency at the University of Pacific, Arthur A. Dugoni School of Dentistry. Furthermore, Dr. Rama has been an investigator in clinical trials for drugs or devices designed to improve sleep. Several national newspapers, local news stations, and health newsletters have consulted with him.

https://www.sleepandbrain.com
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The Checklist (Chapter Five)

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Cranial Dystrophy (Chapter Seven)