Mouthbreathing & Sleep Disordered Breathing

Humans have evolved to perform optimally when breathing through our noses. Nasal breathing fulfils many roles that breathing through your mouth cannot. The way in which we breathe can have lasting and meaningful effects on our health and wellbeing. So if nasal breathing is so important, why do some of us habitually breathe through our mouths?

Mouth breathing is only a relatively new occurrence in human evolution. With many environmental and social changes over the last few centuries, human facial development has been altered significantly. Facial development relies heavily on factors including prenatal and postnatal nutrition, whether the child is breast or bottle fed, as well as physical factors such as the stress placed on the jaw during mastication in childhood. These help to shape the development of the face to produce a large nasal cavity, a wide, flat palate, and straight teeth. As we have become more industrialised, nutrition at all stages of life has changed drastically, with a greater reliance on soft, processed foods. Average breastfeeding duration has also dropped dramatically, with some children being raised on formula through their infancy. This reduction in nutrition, lack of stress placed on the developing jaw due to soft foods and lowered feeding time where the nipple helps to shape the face of the child, has led to a rapid change in facial structure predominantly in the developed world.

Conversely, breathing through the nose provides a host of health benefits not conferred by mouth breathing:

• Filters, warms and humidifies incoming air.
• Slows the rate of inhalation to improve gas exchange in the lungs.
• Engages the diaphragm to stimulate the parasympathetic (rest and digest) nervous system.
• Produces antiviral and antibacterial gas, nitric oxide.
• Promotes dilation of the blood vessels through enhanced accumulation of nitric oxide and carbon dioxide.
• Reduces stress and anxiety by preventing chronic hyperventilation.

With increasing prevalence of narrow facial features, crowded teeth, impacted nasal cavities and receded jawlines, nasal breathing has become more difficult, and mouth breathing has become more prevalent, particularly during sleep. This has resulted in an increase in the number of people with sleep disordered breathing conditions including obstructive sleep apnoea combined with chronically blocked sinuses and excessive dehydration and dryness of the mouth. Obstructive Sleep Apnoea is a common sleep disorder characterised by snoring, choking and excessive daytime sleepiness. It is a condition caused by the collapse of the upper airways during sleep. When breathing ceases for 10 seconds or more, it is referred to as an apnoea.

While the importance of nasal breathing cannot be overstated, transitioning from habitual mouth breathing to nasal breathing can be difficult and may require practise. Where individuals are capable of prioritising nasal breathing, treatment options for obstructive sleep apnoea may include mandibular advancement splints which reposition the jaw to prevent it from opening during sleep. The use of biological dentistry can also be utilised to gradually remodel the shape of the face to increase the nasal cavity and position the jaw appropriately, however, these treatments are laborious and expensive.

If you are a chronic mouth breather and are currently treating obstructive sleep apnoea with CPAP, most find a full-face CPAP mask most effective. A full-face CPAP mask covers both the nose and the mouth and ensures that regardless of whether you are breathing through your nose or your mouth, positive air pressure is being delivered to your upper airways. A full-face CPAP mask is a great option even for those who are attempting to breathe nasally full-time but are still reverting to mouth breathing during their sleep. By having a mask that covers both the nose and the mouth, you can be sure that your CPAP device is working regardless of how you’re breathing.

Dryness of the nose and mouth are common issues when using CPAP treatment, that’s why it’s important to use a device with humidification. Most CPAP machines will have a humidifier chamber that, when filled with water, will slowly add moisture to the air that’s pumped through your CPAP mask. This humidification reduces dryness in both the mouth and nose and can make treatment of obstructive sleep apnoea much more comfortable.

If you or your bed partner have noticed you snore, choke ad/or feel excessive daytime sleepiness when awake, you may have obstructive sleep apnoea. It is important you speak with your family doctor and/or a sleep specialist. If clinically necessary, they may recommend having a sleep study, where electrodes are attached to your body to monitor your sleep. Sleep studies can determine the presence of a sleep disorder, its severity, and provide guidance regarding treatment options. The most common treatments for obstructive sleep apnoea include CPAP treatment, Mandibular Advancement Splints (MAS), positional sleep devices and weight loss. If left untreated, obstructive sleep apnoea can increase one’s risk of cardiovascular disease, stroke, hypertension and depression.

Sove CPAP Clinic is a leading, independent and comprehensive provider of Respiratory & Sleep Disorder services with a network of clinics nationwide. We have a comprehensive team of Respiratory & Sleep Physicians and CPAP Consultants, and provide eligible patients with access to bulk billed sleep studies, Respiratory/Sleep specialist consultations and sleep apnoea treatment services.* Speak with your doctor or contact Sove CPAP Clinic on 1300 76 29 39 or email info@thecpapclinic.com.au * Medicare criteria apply