Inability to Breathe Through Nose

Exploring Solutions for Nasal Breathing Obstructions

A conversation about the nose needs to be had because of the uptick in mouth breathing.  When one cannot breathe through the nose the only option our brain has left is to mouth breath. Our mouths are primarily meant to speak and eat with but not to breathe with.  Mouth breathing is considered an epidemic in North America.

When a person engages in this activity many things will change.  One of the primary changes we see is orthopedic.  Our brain, which is a survivalist, will position our bodies to receive air in the most efficient way at all costs. In order to breathe through the mouth a passage must be created for the air to enter into the body. This is accomplished by opening the mouth and posturing the tongue down to allow the air to pass over it as it continues first to the throat and then to the lungs. One important concept to appreciate is that our brain will automatically position our head forward to completely clear the tongue so that it will not impede our ability to receive air.  This position places our heads in front of our skeletal frames.  I have coined the phrase “stand-up CPR” to describe this.

Because our heads are positioned forward of our skeletal frame, we tend to develop chronic pain in our backs and necks. The head weighs around 10 pounds which means we are carrying this “backpack” of a head around the whole day in front of our skeletal frame. The more the head is forward, the greater pressure will be placed on our skeletal frames. Every inch forward adds 10 pounds of weight forward of our skeletal frame.  It is not surprising for patients to comment on these issues when they seek treatment.  As we promote proper breathing, many times neck and back pains are resolved.

When evaluating a patient, it is paramount that we address the patency or the opening of the nose to ensure proper breathing. It is not uncommon to enlist the services of an ENT to help in the evaluation and treatment of the nose.

Often, we find our patients have dealt with nose problems since childhood which creates yet another skeletal change. This change occurs as our bodies grow and develop.  The tongue, which is made of muscle, creates much of the internal shape of our mouths as it pushes on the palate from the inside out to help develop the size of our oral cavity as we grow. However, when our tongues are posturing down to allow air to come into our bodies, the size of the oral cavity is compromised.  This is because the tongue is not positioning itself against the palate to counteract the muscles of the cheek.  The palate is the home for the tongue but when it does not fully develop the tongue is then forced to live in the back of the mouth. The remaining shape of the palate is more of a “V” shaped arch rather than a “U” shaped.

Because the internal structure and size of the mouth are not developing as they should the nasal airway is influenced. The palate is the roof of the mouth but also the floor of our nasal passages. When the palate does not develop into a broad shape it impacts our inability to breathe through our nose.  The smaller the nasal passages directly influence the amount of air we can receive through our nose.  From a structural point of view, this decrease in size can cause one to mouth breath. Unfortunately, this tongue positioning can cause a person, including children, to have breathing issues at night.

There are many reasons why we are becoming obligate mouth breathers:

• The most obvious is mentioned above where our tongues are not engaged in the development of the oral cavity which directly correlates to a smaller development of the nasal passage that causes a decrease in the amount of air we receive.
• Previous damage to the nose
• A deviated septum which is a “crookedness” in the wall that divides the interior of the nose can reduce the amount of air entering the body.
• Sinusitis (inflammation of the sinuses)
• Other architecture in the nose that might be abnormal such as nasal valve collapse or swollen turbines