More Than A Mouth Issue
Joyce Lee-Iannotti, MD, is a neurologist and sleep medicine specialist at Banner Sleep Center in Arizona. She shared a recent study which associates nighttime mouth breathing with serious conditions found throughout the body. Everything in our body is interconnected! Dr. Lee-Iannotti exclaimed.
Long term mouth breathing can lead to a myriad of oral issues including crowded teeth, cracked lips, caries , gum disease and more. But the issues dont stop at the mouth. Mouth breathers are also more likely to experience digestive issues, chronic fatigue, morning headaches and sore throat.
Dry mouth is more than just morning breath, it is a key cause of inflammation. When areas that are normally wet, like the mouth and throat, are dry for hours every night, prolonged inflammation can lead to oral diseases. Bad breath is one symptom of gum disease, but its far from the most dangerous. In fact, evidence shows that inflammation caused by oral disease can increase risk of heart disease. Other conditions related to nighttime mouth breathing, such as sleep apnea, can also put undue stress on your heart.
What Evaluations Should Be Performed On A Child With Suspected Osa
Physical examination:Mouth breathing while awake, dysphagia, midface or mandibular hypoplasia, tonsillar hypertrophy, cleft palate, palatal deformity caused by adenoidal hypertrophy, failure to thrive , or obesity
Lateral airway radiograph: One of the easiest and most direct means of assessing upper airway calibre. Less commonly required are videofluoroscopy of the upper airway, computed tomography, or magnetic resonance imaging.
Flexible nasopharyngoscopy: Useful for dynamic assessment of the nasal cavities, upper airway, and larynx
Detailed nocturnal polysomnography : Until consistent clinical correlates can be found, the gold standard for the definitive diagnosis of OSA
Cardiologic assessment : Used for children with documented OSA and severe or sustained oxygen desaturation
Wetmore RF: Sleep-disordered breathing. In Wetmore RF, editor: Pediatric Otolaryngology: The Requisites, Philadelphia, 2007, Mosby Elsevier, pp 190201.
Dinah Bradley, in, 2002
What Exactly Is Mouth Breathing
When we refer to mouth breathing we are simply referring to when the body is respirating with the mouth open. While the mouth isopen, the bodys natural tendency is to inhale and exhale through themouth. This is what we refer to as mouth breathing. While the mouth isclosed, the bodys natural tendency is to inhale and exhale through thenose. This is what we refer to as nose breathing.
Although the difference between these two methods initially sounds inconsequential, as humans we are actually built to be primarily nose breathers.
Thankfully, mouth breathing is available as a backup option if the nose gets clogged, or during times of intense physical exertion when more oxygen is needed in the body. However, mouth breathing while sleeping can actually be harmful, as well explore below.
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Benefits Of Nasal Breathing
Nasal breathing has significant benefits for patients. Visiting an ENT ear, nose and throat doctor helps patients learn more about their breathing efficiency. Proper technique reduces hypertension and stress, filters the air through the nostrils and sinuses that we breathe, and provides increased oxygen in the body leading to increased energy.
Breathing through the nose protects an individuals oral health. When an individual inhales through their mouth, the gums, tongue, and oral cavity become dried out, resulting in excess acids in the mouth. Extraoral acids cause the gums and teeth to decay faster. A moisturized mouth remains healthier for the long term. Nasal breathing helps the facial muscles and bones develop correctly and helps develop straight teeth. When the mouth is closed, the tongue is in the proper position to help the jaw grow correctly, and teeth emerge in the right places.
Nasal Breathing Helps Prevent Osa
Breathing through the nose lessens the chance of snoring, reduces the chance of sleep apnea by keeping the tongue in the correct place in the mouth, and helps with a good nights sleep. Mouth breathing is linked to three chronic conditions: sleep apnea, diabetes, and heart disease. Breathing through the nose gives the body the correct amount of filtered air that it needs to keep people sleeping peacefully through the night. Oral breathing can also make OSA worse by increasing airway collapse and nasal resistance.
For patients with obstructive sleep apnea, especially those using positive airway pressure devices, nasal breathing is crucial. If there is complete or near-complete nasal obstruction, patients on PAP will be forced to breathe through their mouth. Sleep apnea is important to test in patients to prevent life-threatening comorbidities.
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How Does Mouth Breathing Affect Snoring
Many people snore or sleep with an open mouth without knowing it. Many more arrive at their doctors office or at an overnight sleep study at the instigation of a partner. When we sleep, it is difficult to know how we breathe. But if you frequently wake up with a dry mouth, a sore throat, or still feeling tired, its likely you suffer from sleep disordered breathing, snoring or sleep apnea.
How does mouth breathing affect snoring? We have already looked at the fact that a greater volume of air causes more turbulence. Turbulence and the greater airway collapsibility combine to cause snoring.
Many people who snore have excess weight around the face, or weak jaw muscles. This means that the jaw will hinge open during sleep, causing mouth breathing. How does mouth breathing affect snoring? Mouth breathing narrows the airway. This compresses the throat as the tongue falls back into the airway. The open space behind the tongue and soft palate becomes smaller. With a narrower airway and a greater flow of air, the inhaled air becomes turbulent. Imagine water swirling round pebbles in a fast-running stream. Inhaled air causes the tissues in the back of the throat to vibrate.
What Are The Effects Of Sleep Apnea
If left untreated, sleep apnea can result in a number of health problems including hypertension, stroke, arrhythmias, cardiomyopathy , heart failure, diabetes, obesity and heart attacks.
Its likely that sleep apnea can cause arrhythmias and heart failure because if you have sleep apnea, you tend to have higher blood pressure. In fact, sleep apnea occurs in about 50% of people with heart failure or atrial fibrillation.
This is because sleep apnea can cause:
- Repeated episodes of oxygen lowering .
- Changes in carbon dioxide levels.
- Direct effects on the heart due to pressure changes within the chest.
- Increased levels of markers of inflammation.
With the high prevalence of sleep apnea in cardiac arrhythmias and heart failure , experts recommend that you dont delay in seeking the advice of your physician.
Last reviewed by a Cleveland Clinic medical professional on 03/03/2020.
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Why Do People With Sleep Apnea Have A Greater Danger For Cardiovascular Disease And Stroke
There are lots of risk aspects for heart attack and stroke, but sleep apnea patients have a greater danger.
Sleep apnea is a condition where somebody has stops briefly or stop breathing while they sleep. This takes place when they have an obstructed airway, which causes the persons brain to indicate their body to begin living once again. This can take place hundreds of times each night, making it tough for the person to get relaxing sleep. People who have sleep apnea frequently dont recognize just how much it affects their daily life.
Risks for heart attack and stroke consist of weight gain from lack of workout and diabetes or hypertension when these things are integrated with the effects of not getting quality rest from sleep apnea, the risk of cardiovascular disease and stroke increases substantially.
Is Mouth Breathing Bad
If you look at images of professional athletes, you will notice that most of them breathe through the mouth during competition. Professional athletes are fit, active and at the top of their game. But we see them mouth breathing all the time. Why is mouth breathing bad? And if its so bad, why do many sports professionals breathe badly?
First off, its important to understand that just because someone is fit does not mean that they are healthy12. Many elite athletes experience problems with peak performance, recovery, overtraining and injury that could be addressed simply by learning to breathe through the nose. Asthma is more prevalent in the athlete population than it is among the general public. Respiratory illness is a common problem and the immune system is compromised by intensive exercise13.
For the rest of us, its a common human tendency to emulate others. We see professionals breathing hard through an open mouth while competing, and so the minute we hit the treadmill we start breathing the same way. We exercise, breathing hard, fast and puffing through our open mouths, just like everyone else in the gym. And we believe we are breathing correctly.
Is mouth breathing bad? Yes.
Mouth breathing contributes to problems including:
Scientists have proven repeatedly that mouth breathing adults are at greater risk of sleep-disordered breathing, fatigue, decreased productivity and poorer quality of life14,15,16.
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How Is Mouth Breathing Diagnosed
Theres no single test for mouth breathing. A doctor might diagnose mouth breathing during a physical examination when looking at the nostrils or during a visit to find out whats causing persistent nasal congestion. They may ask questions about sleep, snoring, sinus problems, and difficulty breathing.
A dentist may diagnose mouth breathing during a routine dental examination if you have bad breath, frequent cavities, or gum disease.
If a dentist or doctor notices swollen tonsils, nasal polyps, and other conditions, they may refer you to a specialist, like an ear, nose, and throat doctor for further evaluation.
Mouth breathing is very drying. A dry mouth means that saliva cannot wash bacteria from the mouth. This can lead to:
Mouth breathing may result in low oxygen concentration in the blood. This is associated with high blood pressure and heart failure. Studies show mouth breathing may also , and worsen symptoms and exacerbations in people with asthma.
In children, mouth breathing can lead to physical abnormalities and cognitive challenges. Children who arent treated for mouth breathing can develop:
- prescription or over-the-counter steroid nasal sprays
Adhesive strips applied to the bridge of the nose can also help breathing. A stiff adhesive strip called a nasal dilator applied across the nostrils helps decrease airflow resistance and helps you breathe more easily through your nose.
How To Prevent Mouth Breathing
Chronic mouth breathing caused by the shape of your face or nose cant always be prevented.
If you find that your nose is frequently congested due to allergies or respiratory infections, there are actions you can take to prevent making mouth breathing a habit. Its a good idea to address nasal congestion or dryness right away. Tips for preventing mouth breathing include:
- using a saline mist during long flights or cruises
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How Does Vitalsleep Job
Snoring is generally the result of air passage constricting when throat muscular tissues relax. Sleeping upright can aid, yet mandibular innovation devices like VitalSleep respond to the bodys natural propensity by raising your jaw, so it does not fall back and also tax anything. This also transforms the tongues placement, which lowers the possibility of it falling back.
If you have a hard time with snoring or problem sleeping, some options can help remedy whats going incorrect for you. VitalSleep is one of these kinds of products. Can A Dry Mouth Cause Sleep Apnea
The trademarked Accu-Adjust System enables sleepers to change the positioning of their reduced jaw in millimeters. They can select from one to eight millimeters. The VitalSleep mouthpiece includes a change tool. Turning the screw clockwise steps your lower jaw forward, which benefits snoring. Changes can be made to this tool for individuals with various jaw shapes, attack dimensions, as well as snoring levels.
The low-profile layout suggests the mouthpiece hugs your periodontals pleasantly, and the large opening in the facility allows you breathe via it.
Sleep apnea happens when the air flows to your lungs are tightened or blocked during sleep. The most usual reasons of sleep apnea are overweight people, bigger tonsils or adenoids, and also individuals that snore loudly.
Essential sleep allows you experience a quieter, extra peaceful sleep.
Causes Of Mouth Breathing
Nasal obstruction is a common reason for mouth breathing. You may have a blocked nose from common things such as:
- Enlarged adenoids, which are the patches of tissue in the back of your throat and above your tonsils
- Nasal polyps, which are growths of tissue in the lining of your nose
- Genetic abnormalities that affect your nose
Other conditions like sleep apnea can cause mouth breathing while you sleep. When a sleep apnea episode happens, you stop breathing. This makes your brain panic, which leads to a loud snore as your body suddenly gasps for air. These events can create a habit of mouth breathing so that your body gets enough oxygen.
Who Gets Sleep Apnea
Sleep apnea occurs in about 25% of men and nearly 10% of women. Sleep apnea can affect people of all ages, including babies and children and particularly people over the age of 50 and those who are overweight.
Certain physical traits and clinical features are common in patients with obstructive sleep apnea. These include excessive weight, large neck and structural abnormalities reducing the diameter of the upper airway, such as nasal obstruction, a low-hanging soft palate, enlarged tonsils or a small jaw with an overbite.
What Is Sleep Apnea
Sleep apnea is a very common sleep disorder affecting 25 million American adults, according to the American Academy of Sleep Medicine. It is characterized by repeated breathing interruptions during sleep cycles. Apneas are caused by tissue collapses of the airway related to weak airway muscles, a large tongue, being overweight, or other risk factors. Apneas prevent oxygen from reaching the lungs.
Because sleep apnea disrupts the sleep cycle, this zaps daytime energy and mental performance and affects long-term health.
Untreated sleep apnea can be fatal because it can cause oxygen drops, increased blood pressure, and heart strain.
Common symptoms of sleep apnea include:
- Reduced and absent breathing
- Jaw joints that make clicking or grinding sounds
- Locked jaw
One 2013 study reported in the Journal of Dental Research found people who were more likely to have sleep apnea were also three times more likely to suffer from a TMJ disorder. The study also found people with two or more signs of sleep apnea had a 73% higher risk for a TMJ disorder regardless of their age, race, smoking history, or weight.
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What Are The Treatments For Sleep Apnea
Conservative treatments: In mild cases of obstructive sleep apnea, conservative therapy may be all that is needed.
- Overweight persons can benefit from losing weight. Even a 10% weight loss can reduce the number of apneic events for most patients. However, losing weight can be difficult to do with untreated obstructive sleep apnea due to increased appetite and metabolism changes that can happen with obstructive sleep apnea.
- Individuals with obstructive sleep apnea should avoid the use of alcohol and certain sleeping pills, which make the airway more likely to collapse during sleep and prolong the apneic periods.
- In some patients with mild obstructive sleep apnea, breathing pauses occur only when they sleep on their backs. In such cases, using a wedge pillow or other devices that help them sleep in a side position may help.
- People with sinus problems or nasal congestion should use nasal sprays or breathing strips to reduce snoring and improve airflow for more comfortable nighttime breathing. Avoiding sleep deprivation is important for all patients with sleep disorders.
Hypoglossal nerve stimulator: A stimulator is implanted under the skin on the right side of the chest with electrodes tunneled under the skin to the hypoglossal nerve in the neck and to intercostal muscles in the chest. The device is turned on at bedtime with a remote control. With each breath, the hypoglossal nerve is stimulated, the tongue moves forward out of the airway and the airway is opened.
What Happens In Our Bodies During Mouth Breathing
Even in the absence of oral airflow, mouth breathing, has been shown to increase the propensity for upper airway collapse. The most likely explanation is that jaw opening is associated with a posterior movement of the angle of the jaw, which compromises the oropharynx airway diameter. The oropharynx is the middle part of your throat just beyond your mouth. It also includes your tonsils, the base of your tongue, the sides and walls of your throat and the back part of the roof of your mouth .
This subsequent inferior and posterior movement may shorten the upper airway dilator muscles located between the mandible and the hyoid. The mandible is the largest bone in the human skull, forms the lower jawline and holds your lower teeth in place. The hyoid bone is situated in your necks anterior midline between your thyroid cartilage and your chin. This compromise produces unfavourable length-tension relationships in the associated muscles.
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Who Is At Danger For Developing It
Sleep apnea can be detected in adults when they snore loudly or stop breathing at least as soon as an hour for 10 seconds or longer. Its likewise more typical amongst obese, pregnant ladies, older grownups, people with hypertension and those who smoke.