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Steven Y Park, MD  
Male, 42
New York - NY

Specialties: Sleep-breathing disorders

Interests: Running, Baking, origami
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330 West 58th Street, Suite 610
New York - NY
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7 Tips to Breathe Better Through Your Nose

Dec 11, 2008 08:44PM - 25 comments
Tags:

Nasal congestion

,

stuffy nose

,

deviated septum

,

mouth breathing

,

Allergies



Most people take breathing through their nose for granted. But for many chronic mouth breathers, breathing through the nose is a struggle, if not impossible. Not only is their quality of life diminished, but they'll also have a variety of other health-related conditions such as dry mouth, snoring, fatigue, and poor sleep. In my last article I addressed 5 reasons why it's important to breathe through your nose. In this article, I'll talk about 7 ways that you can breathe better through your nose naturally.

Before I discuss the various ways to breathe better, a short anatomy course in in order. The nasal septum is a thin piece of cartilage and bone that splits your nasal cavity right down the middle. No one has a perfectly straight septum; everyone's septum is slightly curved. Sometimes, nasal trauma can shift or move the septum away from its' midline position. The nasal turbinates are wing-like structures that line the sidewalls of your nose. It's covered with a mucous membrane, and normally it helps to smooth, warm and humidify air. The turbinates and sinuses also produce about 2 pints of mucous every day. The turbinates swell and shrink, alternating from side to side every few hours. This is called the nasal cycle.

The front side walls make up your nostrils, which are soft cartilages covered on the inside and outside with skin. The back of your nose is one big cavity (called the nasopharynx), and the passageway turns down 90 degrees into the back of your throat. The nasopharynx is also where your ears connect via the Eustachian tubes.

If any part of the anatomy that I described becomes obstructed partially or completely, you'll feel stuffy in your nose. Usually it's not one thing, but usually due to a combination of different reasons. For example, if you have a mildly deviated septum, suffering from mild allergies will swell up your nasal turbinates, narrowing you nasal passageways. This may not be enough to clog up your nose, but if you have flimsy nostrils or had rhinoplasty in the past that weakened the nostrils, then breathing in with a stuffy nose may trigger your nostrils to collapse.

Starting from the tip of your nose, the first thing you must do is to find out if you have flimsy nostrils. If you have a very narrow nose, or if your nostril openings are very narrow and slit-like, then you may be prone to having flimsy nostrils. Try this experiment: Take both index fingers and press them just besides your nostrils on your cheek. While firmly pressing on your cheeks, lift the cheek skin upwards and sideways, pointing towards the outer corners of your eyes. Take a deep breath in. Can you breathe much better through your nose? Let go and try it again. If this maneuver works for you, you may benefit from using nasal dilator strips at night (one brand is called Breathe-Rite). Sometimes, the adhesives on these devices are not strong enough, or end up irritating the skin. Another way of treating this condition are various internal dilators (such as Nozovent, Breathewitheez, Nasal cones) that you can find over the counter or over the internet.

Second, try using nasal saline sprays. You can use the simple spray bottles that put out a fine mist, to more sophisticated methods such as aerosol cans or even using a Water-pik machine (there's a nasal adaptor that you can buy for this). Another popular variation is something called a Nedi-pot, which uses gravity to pour salt water into your nose and sinuses. You can either use prepared saline packages, or mix your own recipe (one cup of lukewarm water and 1/2 teaspoon of sea salt or Kosher salt with a pinch of baking soda). Whatever method you use, you'll have to do it frequently to get maximum results. Besides cleansing out mucous, pollutants and allergens, saline also acts as a mild decongestant.

Third, try not to eat anything within three hours of going to bed. If you still have food or juices lingering in your stomach when you go to bed, it can leak up passively into your throat and not only prevent a good night's sleep, but these same juices can also leak up into your nose, causing swelling and inflammation. In addition, many people will also stop breathing once in a while, which creates a vacuum effect in the throat which actively suctions up your stomach juices into your throat and nose.

Fourth, try to avoid drinking alcohol close to bedtime. Not only does alcohol irritate the stomach, it also relaxes your throat muscles as you sleep, which aggravates the process described in the previous paragraph.

Fifth, if you have any known allergies, especially if it's something in your bedroom, try to either remove it or or lessen your exposure to it. For example, many people are allergic to dust or molds, and if you have carpeting, or an area rug, it can harbor these allergens. Frequently washing your bed sheets in very hot water also helps. Investing in a quality HEPA filter should help even more. If you have any pets, consider keeping them out of your bedroom. If conservative measure to control allergies is not good enough, consider seeing an allergist for a more formal evaluation.

Sixth, get regular exercise, especially outdoors. Not only are you exercising your heart and your muscles, you're also exercising the nervous system in your nose. Vigorous physical activity activates your sympathetic nervous system, which constricts the blood vessels that supply your nasal turbinates. This allows you to breathe better through your nose, with all the added benefits described in my previous article.

Lastly, slow down and relax. Modern society has removed all the natural built-in breaks throughout the day. Along with all the information overload and constant stimulation, going nonstop all day only adds to the increased stress levels that everyone experiences. In between major activities, take a minute or so to stop what you're doing and stretch, get up and move around, and do some deep-breathing exercises. Stress can tense up the muscles, causing you to breathe shallower, which causes physiologic changes that can ultimately aggravate nasal congestion.

These simple 7 steps won't help everyone, but If you can go down the list and apply all the steps, many if not most of you should feel some improvement in your ability to breathe through your nose. If you've tried all these steps and still can't breathe through your nose, then seek medial help. An otolaryngologist (an ear, nose and throat doctor) is the best doctor to take care of this condition.

If you are a chronic mouth breather, in addition to what I described above, your jaw is probably more narrow than normal, with some degree of dental crowding. Chronic mouth breathers also tend not to sleep well at night due to various degrees of breathing difficulty. I discuss these issues in my other articles (sleep apnea and upper airway resistance syndrome).

____________________________________________
Steven Y. Park, M.D., author of 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 Dr. Christiane Northrup, Dr. Dean Ornish, Dr. Mark Liponis, and Mary Shomon.

www.doctorstevenpark.com

Comments
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by bardcan, Dec 12, 2008 05:33AM
Another great, concise article. Thanks Dr Park.
For me, I was not aware of the effects of physical exercise on turbinate hypertrophy. I will be sure to try it out. B )

by Parafreak, Dec 12, 2008 05:57AM
Dr, when i breathe through my nose, the back of my throat becomes raw. Is this normal? Is there anything i can do to stop this?

Thanks a lot for the post.

by cuzzo614, Dec 13, 2008 01:35PM
help me get healthy i dont want to die

by Steven Y Park, MD, Dec 14, 2008 07:20PM
Parafreak,

If you have any kink of nasal inflammation causing post-nasal drip, the air can irritate the already inflamed throat structures. Do you any nasal allergies? If so, consider taking care of this first.

by allaboutmary, Dec 15, 2008 05:05AM
Thank you so much for these posts. I have been a mouth breather ever since I can remember. I often have inner ear problems and lose my balance. I'm guessing it's because of the mouth breathing ?   Being tired all the time has affected every part of my life. I'm overweight and unhealthy.   I'm also without health insurance.  So frustrating.  It's like a vicious cycle,......too tired to even take care of myself.

Thank you again for these posts.  I can at least try and help myself a little now.  Please keep the information coming.

by PATSINPAIN, Dec 15, 2008 10:21AM
Thank you for your consistent and informative advice.
patsinpain

by Bon-Bon, Dec 15, 2008 05:24PM
Thank you Dr. Park.  I have always wondered why throughout the day, one side of my nose would feel stopped up and the other side would become clear and would switch back and forth every few hours.  

If I understood correctly this is a natural cycle?

Thank you for keeping us informed about all these things.  

I appreciate you and what you are doing.

Have a healthy and stree free day.    

by Steven Y Park, MD, Dec 15, 2008 06:56PM
Bon-Bon,

Yes, it's called the nasal cycle. It alternates every 3-4 hours.

by blivit, Dec 15, 2008 09:04PM
Dr. Park,

I have post nasal drip very often.  I have been using the nedi-pot when I get really bad.  What do you suggest as a preventative aid for this condition

Violet

by Dalubaba, Dec 16, 2008 09:29AM
Neti -pot is usually recommended by yoga teachers.They also include that neti-pot treatment refreshes brain and some other benefits.
Has nasal cycle any other advantages.In Swar yoga it is mentioned that particular work shoud be done when right nostril is operating and so is with other nostrils.
There are many websites on SWARODAYA or SWAR- YOGA.
Your scientific explanation can bread the myth and can keep society free from superstitions.Thanks.

by donna1953, Dec 16, 2008 03:53PM
I have never been able to breathe thru my left nostril so I have always been a mouth breather. I do have very poor sleep as a result of waking up often gasping for air and keep everyone else awake with my snoring. What can I do in order to change and maybe feel better as well?

by drifter0213, Dec 18, 2008 01:34PM
i broke my nose seven times ! -drifter0213

by Steven Y Park, MD, Dec 18, 2008 07:58PM
donna1953,

Can you breathe well through your right nostril? If this is true and you're still waking up gasping for air, you may have a sleep-breathing problem. Your poor quality sleep and lack of every suggests that you're not getting deep, efficient sleep. You may want to consider seeing an ENT for your nasal congestion. Most ENTs can take care of sleep-breathing problems as well. Alternatively, you can see a sleep medicine doctor.

by cheekygirl04, Dec 19, 2008 12:50PM
I can never seem to breathe out of both nostrils passages at the same time.  Its one or the other.  Any suggestions on what can be done in this situation?

by Steven Y Park, MD, Dec 20, 2008 06:24AM
cheekygirl04,

What you describe is a natural process called the nasal cycle, where the nasal turbinates swell, alternating from one side to the other, every few hours. Normally, you won't notice it, but if you're nose is irritated by allergies, colds, or weather changes, since both turbinates swell somewhat, you'll notice the blockage. You can try regular nasal saline rinses. There are various ways to get salt water into your nose: sprays, pumps, aerosols, Water-piks, and Nedi-pots. If you have allergies, you should take care of that first. If the congestion continues to bother you despite these conservative measures, see an ENT doctor.

by bubbles808, May 24, 2009 11:28AM
dear doctor there r these 2 things at the back of my nose making me not breath well what should i do

by Steven Y Park, MD, May 25, 2009 10:06AM
bubbles808, I'm not clear on what you're asking me, but if your nose is stuffy, you may want to have it checked out by an ENT doctor.

by abvt2009, May 27, 2009 09:29PM
I have the same symptoms as Parafreak, but I don't have any allergies.  When I breathe through my nose, it makes my whole throat feel almost raw and I'm not sure what to do about it.  Any suggestions?

by Steven Y Park, MD, May 27, 2009 09:31PM
abtv2009,

If you don't have allergies, there are other reasons for post-nasal drip such as chronic sinusitis and non-allergic rhinitis. Also, acid reflux can also irritate your throat and make it feel raw.

by SE92, Sep 07, 2009 04:50PM
When I go to sleep, I'm breathing through my nose, but when I wake up I'm breathing through my mouth and my mouth feels disgusting. What can I do to remedy this?

by SE92, Sep 07, 2009 05:32PM
Also, is there a comprehensive method with which to change from mouth breathing during the day to breathing through the nose? I realized just now that I breathe through my mouth and nose and when I consciously breathe only through my nose, I sometimes have to take deep breaths to compensate.

by otz, Oct 14, 2009 08:07AM
When I lay down in bed my nose gets all clogged and I can't breathe. I just found that when I lay on my left side it seems to open my nose up and I can breathe again. why is that?

by Gbrown1212, Nov 02, 2009 04:23PM
Dear Doc,

I have seen an ENT about my trouble breathing through my nose. He also stated that I do have a deviate septum. He wanted me to control my allergies before recommeding surgery to fix it. I have done the saline wash twice a day. have been on claritin and singulair and still i feel no different? Is there anything else he can try to do beside having the surgery. I dont have insurance and it cost me 100$ just to see him. I would like to see him again but I kinda wanna just get the deviated septum fixed! i cant take not breathing right anymore. Would correcting the septum cure this??

Greg

by Steven Y Park, MD, Nov 02, 2009 08:04PM
Greg,

A lesser invasive and less expensive procedure that can be done in the office is a radiofrequency procedure of the nasal turbinates. It doesn't work as well as a septoplasty and turbinate procedure in the OR, but it may buy you some time until you get insurance to cover for the septum.

by Tammy2009, Nov 02, 2009 08:23PM
The only thing I have found to work on my nasal congestion is otrivin.  Obviously I can't use it daily but it's the only thing that lets me sleep well at night.  I have been using it twice a week with 1 spray each nostril once before bed.  Is this going to cause rebound congestion?  Can I bump it to 3 times a week without worry?

I have tried flonase, and ava-mys with no luck.  Was using a neil-med nasal rinse but one side is so blocked that I feel pressure in my sinuses and ear when using it so I've stopped using it.  I also get dizzy and a very fast heart rate on the oral decongestants so I can't take them either.  

I do have allergies and on vial 4 in my allergy shot regime, they were working until the fall which makes me think of a particular mold allergy that wasn't tested for.

The problem is I have asthma and the post nasal drip and mouth breathing at night is bugging my lungs and greatly increasing my albuterol use.  I went from not using the albuterol at all in june, once in july to 2-4 puffs 4-5 times a week now, with no change in my preventative medication (800mcg daily of pulmicort).

Is there anything else I can try?  My doctor is hoping the shots will start working better (had almost NO allergy symptoms from may to august) and basically has left it as a wait and see.  Thanks and I appreciate any comments/suggestions you have.

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