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Steven Y Park, MD  
Male, 54
New York, NY

Specialties: Sleep-breathing disorders

Interests: Running, Baking, origami
Private Practice
New York, NY
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What You Don't Know About Breathing

Nov 24, 2009 - 25 comments



obstructive sleep apnea


upper airway resistance


Chronic Fatigue

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.

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

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746512 tn?1388807580
by Tammy2009, Nov 24, 2009
Know exactly what you mean, I've had nasal congestion on and off for years with allergies and now congestion most to all of the time with possible nasal polyps.  My sleep is horrible now because I can't breathe through my nose.  

I have never been able to sleep on my back, it's not comfortable and I defintely feel like it is harder to breathe.  

The question is, how do you fix it?  I am going under for jaw surgery next year to bring my lower jaw forward and ENT appointment in december to find out it they are nasal polyps, will that fix the night breathing?

Avatar universal
by Steven Y Park, MDBlank, Nov 24, 2009

I sounds like you're on your way to breathing better. The ENT can help you with your nose and pulling your lower jaw forward should help you breathe better at night since it will pull your tongue forward.

Avatar universal
by choo_choo, Nov 24, 2009
I have allergies and asthma.  I've been off my allergy medication for a week because I'm having allergy testing done.  My asthma controller medication helps my snoring a lot and when I do snore it's not very loud and I use my rescue medication, go back to sleep and I stop snoring.  I feel well-rested when I wake up.  For the past few days, when I snore, I'm told it's very loud and my peak flow readings are lower.  My sleep hasn't been good and I'm tired during the day.  Unfortunatley my rescue medication ran out last night and I spent most of the night snoring (very loudly).  I slept 9 hours and I feel like I slept about 3.  Not only were my lungs obstructed, but so was my nose.  I didn't realize that allergies had this much of an impact on snoring.  I'm sure once I start taking allergy medication again my sleep will improve, but the past few days have really been a bummer.

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by PrettyKitty1, Nov 25, 2009
Wow....I did not know half the information contained in this post. Thank you, Steven, for taking the time to write it. I'll be paying more attention to my breathing from now on. Maybe that's why I always have pressure in my ears. When I start to breathe better it goes away. I may have to see a doctor...

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by Mom2four85, Nov 27, 2009
Thanks for posting this great article, I have a couple of questions you may be able to help me with.

"Not breathing through your nose for whatever reason has potentially detrimental effects on your health"  

I was dx with Moderate OSA after a sleep study.  Would there be any reason why when I had my sleep study I went into a severe vtach episode and passed out after they put the mask on me?   This happened twice, and they said if I didn't get better, they were going to take me to the main hospital and admit me.   When I breathe deeply through my nose and then exhale through my mouth, I get dizzy and pre-syncope symptoms, but the dr I saw said I didn't have any blockages as far as he could tell.  I was thinking it had to do with a nasal blockage or cyst etc.

I had an ablation for frequent pvc's which revealed malignant pvc's and possible arvd, along with NCS and OI from a tilt table test before surgery.  I had to have a pacemaker/icd implanted, along with my successful ablation, my breathing at night seems to be alot better.

I didn't want to do the mask treatment because of the episodes during the test, are there any other treatments or I can try that may help?

Any help or suggestions are appreciated.

Thank you.

Avatar universal
by Jaquta, Nov 29, 2009
You could almost be describing me.  I am frequently tired, anxious and depressed.  I am currently anemic.  My BP is generally low.  I have Raynard's.  I have been having trouble with my breathing due to ?asthma/ allergies.  I sleep with my windows open to try and get sufficient air.  I predominantly breathe through my mouth.  I sleep on my side.  (Sleeping on my back feels extremely unnatural.)

Cause and effect??

Are evolutionary effects the reasons why we are told to place patients on their side in the recovery position?
Why is sleeping on our side or stomach not good enough?  What practical measures can we take to change this?

Will we find a lot of this information in your book?

Sorry for all the questions.  I have a tendency to think aloud.

Avatar universal
by Steven Y Park, MDBlank, Nov 29, 2009

All the answers are in the book. Hope you find it helpful. You may also find my article on upper airway resistance syndrome interesting: http://www.medhelp.org/user_journals/show/42438

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by Lulu54, Nov 29, 2009
Dr. Park,
I have no questions - I just wanted to thank you for the refresher lesson in breathing.  Its all things I learned from you over the past year or so and from your book, but I tend to forget a lot.  

The production of nitric oxide through nose breathing is an important benefit that many of us overlook.  

Thanks again for being a great source of information.

be well,

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by ScottieJonny, Nov 30, 2009
Hello, My name is Scottie and I have a question. I'm 16 years old and my breathing hasn't been normal for about a month. I've been to the ER three times for shortness of breath but they diagnosed me with acid reflux. It kind of feels bad when I exhale. I also been bringing up this Yellowish, greenish and sometimes brown mucus. It always feels like its something that has to come up. Sometimes my breathing isn't bad like when I'm sleeping, eating or drinking. It feels better when I'm outside also. Humidity has bad effects on it when I'm in the shower. I've had a chest xray (clear) blood work (clear) and a test to see if there were any clots in my lungs (clear). Everyone has said "There's nothing life threating wrong with you so just relax". But I can't because I know something is wrong. Do you have a clue what is wrong here?
If you have an answer I would gladly appreciate it. Thank you.

996946 tn?1503249112
by LindaTX, Nov 30, 2009
I know how important correct breathing is.  I have PAF, although currently doing much better off my heart med.  I know I don't have sleep apnea but I do have a weird way of breathing when I sleep.  My tongue is up against the roof of my mouth, I'm sure there's a name for it, and I inhale and exhale through my nose.  Consequently, if my nose is all stuffed up, I'm not really getting a lot of oxygen.  Can this be dangerous and could it have anything to do with bringing on a-fib episodes?

996946 tn?1503249112
by LindaTX, Nov 30, 2009
PS  I just wanted to add, I've had this habit since I was a very, very young child.  Thanks for any advice you can give me.

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by caregiver222, Dec 01, 2009
An excellent and informative post!

Avatar universal
by Steven Y Park, MDBlank, Dec 01, 2009

It sounds like you may have laryngopharyngeal reflux disease, but that may be only a small part of the problem. Irritation of the throat can produce a chronic cough and colored phlegm. Do you sleep on your side, stomach or back. Do you eat later at night? Or drink alcohol close to bedtime? I can't explain my entire sleep-breathing paradigm here, but I do have a number of articles on this site you can start with.


You can have a major sleep-breathing problem and not have sleep apnea. It's hard to guess as to why you breathe this way, but if you have a-fib and PAF, then at least get checked for a sleep-breathing problem.

996946 tn?1503249112
by LindaTX, Dec 01, 2009
Thanks, Dr Park.  I did have a sleep study a few yrs ago but all they told me was that I didn't have sleep apnea.  Maybe I should go for another study?

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by ScottieJonny, Dec 01, 2009
I sleep on every side of my body but predominately on my left and right side. I do have a bad habit of eating right before bed. No I do not drink alcohol. Is that a life threatening disease?

Avatar universal
by Steven Y Park, MDBlank, Dec 01, 2009
LindaTX and ScottieJonny,

It'll take too long to explain in this forum, and I can't answer completely in this format. I recommend you read my book, where I answer all your questions.

996946 tn?1503249112
by LindaTX, Dec 01, 2009
Thanks, Dr Park.   Does your book explain the difference between PAF and a-fib?

Avatar universal
by Steven Y Park, MDBlank, Dec 01, 2009

Not specifically, but I do go into common reasons for heart disease and arrhythmias.

Avatar universal
by legibbo, Dec 03, 2009
I have been breathing through my mouth for a few years now. I didn't really notice I was doing it until recently, and I've been trying to correct it. I am thinner, and I do sleep on my side. And I always wake up tired no matter how much I sleep, and I'm always tired throughout the day. I've definitely also been a little depressed for the past like year or so. I also feel as if my lower jaw is shorter than most people's, and does not look normal. could this be because of breathing through my mouth, and how can I fix this?
This morning I woke up and realized I was breathing through my mouth so I tried to correct it by breathing through my nose and going back to sleep. My only problem is I feel like it's difficult to breathe through my nose at times. How can I improve my ability to breathe through my nose?

Avatar universal
by Steven Y Park, MDBlank, Dec 03, 2009

Having a small jaw means that your tongue to too big for your mouth, and by definition, your nasal cavity will be more narrow than normal, with many other reasons for chronic nasal congestion. I'm hosting a free teleseminar on the nose where I'll answer all your most important questions about the nose. Register here:


Avatar universal
by nancymaclell, Dec 15, 2009
Dr. Park,
My daughter has breathing issues that have been ongoing for many years.  She is currently 11 years old.  She was tested for allergies 4 or 5 years ago with no reactions.  This mystery allergy and a prescription for nasal spray is all my doctor has had to offer.  She does the 'allergy salute', pauses when breathing while awake (holding her breath for 15 - 20 seconds and then exhaling loudly).  She sleeps on her stomach, was a bedwetter until this year and is overweight.  She is a lovely, mannerly girl but is unable to stop two habits: humming loudly (so that I can hear her from the next room) and she chews food with her mouth open.  For someone who otherwise is so proper I can only think that it is because she can't help it. She sometimes gets nosebleeds, not often but occasionally.  Any idea what I can suggest my doctor looks at...lately I have been researching adeniods and have been thinking this should be checked.
Thanks for any help you can give me.

Avatar universal
by Steven Y Park, MDBlank, Dec 16, 2009

Your daughter has the classic signs and symptoms of a sleep-breathing disorder such as obstructive sleep apnea or upper airway resistance syndrome. Mouth breathing, nasal congestion, stomach sleeping, bed-wetting, non-allergic rhinitis.....

You should consider getting her checked by an ENT to get her breathing through her nose first (checking her septum. turbinates, adenoids and tonsils). Then have her evaluated for obstructive sleep apnea.

Avatar universal
by Jordan7, Mar 26, 2010
I am 19 years old and my breathing hasn't been normal for about 2 months now. I am in the ideal weight region(120) for my height(5'2") and my BMI is normal also. I have never drank nor smoked. I generally work out(run and lift weights) about 4 times a week. I have shortness of breath constantly. Sitting, standing, laying down, it doesn't matter what I do, nothing seems to help. I am constantly trying to take deep breaths or yawn to try to catch my breath. It seems like this is all I am ever trying to do. Others have noticed and have asked if I am ok and I continue to dismiss it in hopes that it will go away but it hasn't. Any ideas? Or is this just chronic SOB that I will have to live with?

Avatar universal
by Pcm2, Jul 09, 2012

If you have allergies and they cause your nose to be congested so you can't breath thru them and you start to breath from your mouth can that cause infections in the throat and swollen throat glands. In the past year I have been in antibiotics for swollen glands in my throat 4 times and am about to go on them again. I was wondering if thus swollen gland/ sore throat problem is linked to having to breath thru my mouth when I have allergies?

Avatar universal
by Isa2012, Feb 12, 2013
Hello Dr. Park,

I found this discussion while searching for information on behalf of my husband (and for myself since it can prevent me from getting a full night’s sleep). I haven’t found any information anywhere on this and I’m hoping you can help.

While he sleeps, he inhales normally and then exhales rapidly and loudly. This occurs throughout the night from the moment he falls asleep until he wakes up and doesn’t change if he’s sleeping on his back or side. He does not do this during waking hours. He only very rarely snores when on his back and never when on his side.

If I wake up in the middle of the night or early in the morning the noise from his exhale often prevents me from falling back asleep. I haven’t found any information on this specific issue and don’t know what could be causing this or what we can do to reduce his breathing imbalance during sleep.

Thank you in advance for your input.  

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