Proper breathing is fundamental to good health and vitality. Breathing is the most basic physiologic function that we must do to survive. Improper breathing can lead to illness, disease, and ultimately, death. Ancient Indian cultures recognized this basic principle and developed very sophisticated breathing techniques that we now realize are scientifically sound when it comes to promoting optimal health, energy and life balance. These breathing concepts have spread across various continents to different cultures, but the basic fundamental principles remain the same.

What Most Doctors Already Know

Breathing means spirit in many languages (Hebrew, Latin, Greek, and Sanscrit), but not in English. In Latin, the word for breath and the word for soul are the masculine and feminine roots of the same root. In Greek, the two words are the same.

Breathing is a natural physiologic function which continues, regardless of whether or not you notice it. It's controlled by two parts of the autonomic nervous system: the sympathetic and parasympathetic nervous systems.The sympathetic nervous system is the classic fight-or-flight half that's needed if you're in a fight or running from a tiger. The parasympathetic nervous system is the relaxation half, promoting sleep, digestion and reproduction.

Inhalation is activated by the sympathetic nervous system and exhalation is activated by the parasympathetic part. When you slow down your breathing, your heart rate slows down. If you take a little longer exhaling relative to inhaling, then you're spending more time activating your parasympathetic nervous system. This is the physiologic reason why breathing techniques such as the relaxing breath is literally relaxing. These same concepts also apply to singing, humming or whistling. Notice that when you sing, you're spending up to 10 to 20 times longer exhaling relative to inhaling. By activating your vagus nerve, this is why you feel good when you sing.

What Some Doctors Don't Know

We all take it for granted that the physical air passageways that we breathe through is more than sufficient as conduits for air to travel into and out of our lungs. However, our upper air passageways are dynamically changing all the time, depending on your head position, weather status, allergies, emotions, moods, stress levels and even what you just had for lunch. Your nose is exquisitely sensitive to pressure or humidity changes, swelling or shrinking your internal nasal turbinates to significant degrees. Air passing through the nasal cavity is being filtered, humidified, and warmed before passing into the lungs. Any temporary or permanent blockage to proper breathing in this area can prevent optimal airflow into the lungs.

In addition, the nose and sinus cavities make a gas called nitric oxide, which has two important beneficial properties. The first property is that nitric oxide is antimicrobial, both in the nose as well as in the lungs. This gas, when inhaled even in small amounts into the lungs, can increase oxygen absorption up to 20%. Not breathing through your nose for whatever reason has potentially detrimental effects on your health.

What Most Doctors Don't Know

Everyone in the Western, alternative and complementary fields of healing naturally assume that we are able to breathe properly at night. We now know that there are certain medical conditions such as sleep apnea where you have complete obstruction and repeated bouts of oxygen deprivation. Most practitioners still think that this typically occurs in some people who are overweight, snore, and have big necks. But now we know that even young, thin women who don't snore can have significant obstructive sleep apnea. Even more, many people who don't officially meet the criteria for obstructive sleep apnea still can have significant breathing pauses but wake up too quickly to be classified as an apnea. These are the patients that are commonly diagnosed with idiopathic hypersomnia.

However, the bigger issue is that by definition, all modern humans are susceptible to breathing problems at night for the following reason: Due to jaw narrowing and dental crowding from a radical change in our diets, our tongues take up relatively too much space, and as a result, is more susceptible to obstructing the airway when sleeping supine and in deep sleep due to muscle relaxation. In his classic nutritional text, Nutrition and Physical Degeneration, Dr. Weston Price documented these physical changes. Our ability to talk also positioned our voice boxes below the tongue, which can aggravate this process.

Many modern humans can't sleep on their backs anymore since the tongue and voice box falls back the most in the supine position. As a result, they compensate by sleeping only on their sides of stomachs. The problem is that it's not good enough. A simple cold or an allergy attack, or with even 5 to 10 pounds of weight gain, can cause more frequent obstructions occur, leading to less efficient sleep.

Less efficient sleep leads to a physiologic stress response that can cause or aggravate a number of various medical conditions such as anxiety, depression, insomnia, cold hands, digestive problems, high blood pressure, etc. What I describe in my sleep-breathing paradigm is that all modern humans are on a continuum, where the one extreme end is called obstructive sleep apnea. The rest of us are lower down, but we creep up during various life stages, such as puberty, pregnancy, and menopause. A simple cold, by causing nasal congestion in a young, healthy woman, can cause her to toss and turn at night, due to repeated tongue collapse. Once the cold improves, sleep improves as well.

What We All Must Know

Breathing should never be taken for granted. We must do everything to make sure the proper breathing occurs not only during the day, but also at night. Many younger, thinner patients who complain of being tired all the time will also be found to have hypothyroidism, anemia, cold hands and feet, low blood pressure, anxiety, depression, or other various disorders. Later in life, as they slowly gain weight, they move up the continuum, and eventually will go into obstructive sleep apnea. Almost invariably, one or both parents will snore and have known or unknown cardiovascular disease. If you have a high-arched hard palate, an extra small mouth or a recessed jaw, or scalloping on the side of the tongue, do you prefer to sleep on your side and are tired, no matter how long you sleep? You'll be surprised how often all these features come together to give you powerful tool to help you breathe better and sleep better.

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Steven Y. Park, M.D., Author of the book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. Endorsed by New York Times best-selling authors Christiane Northrup, M.D., Dean Ornish, M.D., Mark Liponis, M.D., Mary Shomon, and many others. http://www.sleepinterrupted.com

When we used to live in a house many years ago, our carbon monoxide alarm would keep going off in the basement. We checked the alarm and all the various possible sources of carbon monoxide leakage, with no obvious leaks. On a routine maintenance call for our furnace, the technician found that whoever installed the unit did it improperly, and it wasn't vented properly. Needless to say, my wife and I were shocked.

Similarly, snoring is your internal alarm telling your spouse or bedpartner that there's a problem. Snoring means that there's partial or total obstruction with your breathing and that it could mean something much more dangerous lurking underneath that can literally kill you in your sleep. I commented in a previous blog how there's no such thing as "benign snoring." If you snore, you have a 35% chance of having obstructive sleep apnea, which increases your chances of having a heart attack or a stroke by 3-5 times. Even if you don't have official sleep apnea, you'll still have a higher chance of suffering from depression, insomnia, or getting into a car accident.

In this country, we routinely screen for dozens of medical conditions that have 1-2% incidence that are much less riskier than having untreated obstructive sleep apnea. With up to 24% of middle-aged men and well over 50% of seniors having this condition, it's a travesty that snoring is not taken too seriously by the medical community. The snorer's health is potentially at risk, but what about the snoree that has to suffer and lose hours of sleep due to his or her snoring bedpartner?

Do you suffer from sleep loss due to a snoring significant other? If you are the snorer, and haven't done anything about it, what are you waiting for?

For many people with obstructive sleep apnea, nasal congestion and chronic sinus infections are a common problem. Nasal irrigation with saline is a natural way of clearing nasal and sinus passageways. The Neti-Pot is a yogic variation of saline irrigation that became much more popular after Oprah's recommendation. Many of my patients that have tried this method report good results, with better breathing and less sinus pressure and headaches.

A recent study showed that contrary to popular belief, irrigating the nose on a daily basis over a long-tern period may actually make things worse. Researchers studied 68 people who used nasal saline irrigation every day for one year. In those that stopped after one year, 62% had a significant drop-off in the number of infections, compared with those that continued irrigating their noses.

The authors of the study proposed that the likely reason for this finding is that frequent irrigation depletes nasal mucous, which contains several important defense mechanisms, including antibodies, lactoferrin, and lysozyme. It's also known that the nose produces nitric oxide, which also has antimicrobial properties.

These results are a bit conflicting with what many of my patients report, but there may be some good reasons to follow their recommendations. Besides the reasons mentioned above, saline acts as a mild decongestant, which is similar to the over-the-counter decongestant, Afrin, but not as strong. This is why you can breathe better after irrigation. One of the reasons why you can't use Afrin for more than 3 days is because of the rebound effect, where after the medicine wears off, your nose gets stuffy again, making you use it more and more frequently. Nasal saline, although not as bad as Afrin, also has a mild rebound effect. This is why some people use it 2 to 4 times every day.

It's also been shown that if the salt concentration is a bit saltier than your nasal membranes' concentration, the cilia that help to move the mucous blanket down into your throat become paralyzed.

If used for short-term periods, such as during an acute sinus infection, it can be useful (just like Afrin), but this study's result shows that long-term use may be more harmful.

My feeling is that if you feel better and you don't get as many infections, keep doing it. After a few weeks or months, you can experiment by stopping the irrigation and see what happens.

Since this study didn't look at cultures or x-rays, there's no proof that these were true bacterial infections. Recent studies also show that the vast majority of what may feel like sinus infections are actually a variation of a migraine headache. Furthermore, it's been shown that nasal saline doesn't really go into your sinus passageways. It works by decongesting your nasal passageways, which indirectly opens the passageways to your sinuses.

Do you irrigate your nose with nasal saline every day? If so, for how long? Are you having less sinus "infections" as a result of irrigating on a regular basis?

Snoring is so common these days that it's synonymous with sleep. In the movies or on TV, a sleeping person is depicted with snoring sounds. Even in the comics, the ZZZZZZZZs that you see coming from the sleeper may signify snoring.

Within the sleep community, we often use the term benign snoring to mean snoring without any sleep apnea. We see it as the least important form of obstructed breathing, without any medical consequences. Every time I see this in our medical journals or in the media, I get mildly annoyed, since there's so much information to show that snoring is never benign.

Snoring itself is usually caused by vibrations from the soft palate. Think of a reed in a wind instrument, or a flag flapping in strong winds making lots of noise. In the human throat, any degree of abnormal narrowing of the throat promotes vibrations of the free edge of the soft palate. The loudest recorded snore was found in a British woman whose sound levels reached 113 dB, which is louder than a low-flying jet. There are other areas in the throat that vibrate and make sounds, but they're probably a secondary effect of the soft palate vibrations.

Here are 5 reasons why snoring is never benign:

1. If you snore, you have a 35% chance of having obstructive sleep apnea, which is a potentially serious medical condition where you stop breathing multiple times every hour, leading to oxygen deprivation, heart disease, heart attack, and stroke. The best way to diagnose sleep apnea is to undergo a formal overnight sleep study. If you stop breathing at least 5 times every hour, with each episode lasting 10 seconds or longer, then you're told you have sleep apnea. But what if you stop breathing 15 times every hour, but you wake up after 1-5 seconds for each episode? Then you're told you don't have sleep apnea, with no clear explanation why you're so tired all the time.

2. It's been shown experimentally in rabbits that artificially applying vibrations to the carotid artery causes thickening of the carotid artery walls, similar to what we see in humans with plaques.

3. Snoring without sleep apnea has been shown to increase your chances of being involved in a car accident.

4. Not only is snoring potentially dangerous for your own health, it also disrupts your bed-partner's sleep quality, health, and relationships. There have been reports of bed-partners becoming deaf in one ear.

5. By not taking snoring seriously, it's likely that you'll delay diagnosing obstructive sleep apnea. Many people try various over-the-counter anti-snore aids with mixed results. Most end up giving up until the problem gets worse.

If you or your loved one snores, take it seriously and get it checked out by a sleep physician or an ear, nose and throat doctor. Even if you're found not to have sleep apnea, treat the snoring. Just because the sleep study doesn't say you have sleep apnea doesn't mean that you don't have a sleep-breathing problem.