How to Support Nasal Breathing

When trying to establish and maintain nasal patency for optimal nasal breathing, we need to consider that there are multiple factors that can impact nasal breathing. Each patient will be different, so here are some of the contributing triggers to mouth breathing and how we can reduce and/or resolve this condition and support proper nasal breathing.

Preliminarily, it is advisable that all patients be evaluated by a provider who has advanced training in airway and breathing for a comprehensive evaluation and to ensure no anatomical defects that may be interfering with nasal breathing. This can be accomplished through a clinical exam, and in some cases, the doctor may recommend imaging (ie. CBCT) to evaluate the upper airway structure. Pending those findings, there are adjunctive therapeutics that can be implemented at home to improve this condition.

Understand the problem better...

Many patients have increased success when they understand the "why" behind the things we are trying to treat. While ideally Dr. Beth and her team explained these concepts to you during your exam, further evidence and explanation can be found in James Nestor's book Breathe. We highly recommend giving it a listen or a read during this part of your health journey.

Cleaning out the nose by decreasing/preventing nasal inflammation:

Over-the-counter nasal spray: One of the fastest and easiest things we can do to begin to decrease nasal tissue inflammation is to introduce use of a saline spray. My preference is the Xlear spray, which can be found in most drugstores and online. The patient can use 2x/d until nasal breathing is stable.

Nasal lavage: there are 3 main options I recommend for this, but it is entirely dependent on patient tolerance and preference. There is the squeeze bottle, the syringe, and the teapot neti pot. It is recommended that the parent also try one of the mechanisms as well to model how it is done and also to better understand how their child will feel while undergoing to nasal lavage. It is important to use filtered water with the salt packets included with the kits, and you want to run the water until it runs clear on both sides. If a child is really inflamed, then it may be advisable to do this 1x/d for a week or more until the water easily passes through. It is not recommended to start this protocol prior to flying in an airplane to ensure no ear canal or sinus complications.

Reinforce Nasal Breathing:

Hot showers & warm compress: It can be helpful to take a hot shower prior to bed and/or to apply a warm compress on the sinuses to open up the nasal passage.

Practice breathing: This may seem silly, but patients who have deficient nasal breathing capabilities benefit from performing exercises where they engage in deep breathing (HeadSpace Meditation app). This can be completed during a meditative practice or one can follow one of the various breathing techniques available online (WimHof Method).

Open the nose at night: Some patients benefit from use of BreatheRight Strips to provide a few extra millimeters of opening at night. Pending the severity of your mouth breathing habit, it can be helpful to wear a strip during the day while doing breathing exercises, and then also again at night while you're sleeping. Once nasal breathing is established, then you can experiment with sleeping without the strip to see if you have sufficient patency to support full night nasal breathing.

Close the mouth: If unfamiliar with this practice, use of mouth tape may seem strange, but there is data to support that gentle medical grade tape that reinforces the soft tissue to be closed at night can be sufficient to correct the mildest forms of this habit. It is recommended to try for 10 nights in a row, and then remove and try without to see if the habit has been broken.

Support a healthy body and a healthy environment:

Evaluate environment & adjust as needed: Depending on environmental variables, some patients require use of an air purifier, humidifier, or dehumidifier to provider conditions that support nasal breathing. Additionally, if there is a history of mold problems in your house or if there are pets or other triggers that may be in the environment, then this may be something that warrants additional testing.

Anti-inflammatory nutritional support: Experimenting with a modified diet for a temporary period of time can be helpful in identifying any triggers. A good start can be switching to a diet rich in fruits and vegetables, foods containing omega-3 fatty acids, whole grains, lean protein, healthful fats, and spices; and then limiting the consumption of processed foods, sugary foods and beverages, red meats, and alcohol. Some patients benefit from temporarily removing gluten and dairy from their diet for a period of 6 weeks and then reintroducing after the body is in a non-inflammatory state, one at a time to confirm the reaction is not induced again. It is recommended to discuss in detail with your healthcare provider (primary care physician/ internal medicine doc, pediatrician, nutritionist, etc) prior to implementing a more restricted diet for yourself or your child to confirm all nutritional needs are met and there is no harm done during this time period.

Supplements: Chronic inflammation is best addressed as a symptom that is caused by multiple factors: genetics, environment, diet, habits, etc. Having this approach can help prepare a patient to understand that we want to attack whatever might be contributing to the problem while also bolstering those natural systems in your body that combat inflammation and allow for optimal health. In this case, support of the natural immune system can occur through the foods we choose to eat as well as supplements such as Vit C, D, probiotics and prebiotics, and gut-friendly supplements like L-glutamine, licorice and marshmallow extract, and aloe.

If unresolved, intervene with minimally invasive oral appliance therapy:

Oral appliance therapy: In some patients, despite all other variables being optimized, mouth breathing still occurs especially at night. In children, this can be due to a poor habit that the body needs to "unlearn", and for adults, it can oftentimes be indicative of an anatomical complication (relaxing of the muscles that hold the mandible in place, weight gain in the neck region, compromised orthodontics from childhood, etc). In these cases, use of an oral appliance can help retrain the body NOT to breathe through the mouth and instead reinforce nasal breathing. In some cases, this can be a temporary treatment, and in others, this can be an ongoing solution. It is recommended to schedule for a comprehensive exam with Dr. Beth for a diagnostic and therapeutic evaluation.

Further evaluation: If we do not see significant improvement in nasal breathing using the more easily accessible methods listed above, then some patients will require additional testing and diagnostics to reveal the root cause to their deficient nasal breathing. This can include but is not limited CBCT 3d imaging and evaluation and treatment by an ENT with medication and/or surgery.

The purpose of this is not to overwhelm a patient or a patient's parent, but rather to provide multiple avenues to help improve this condition. Breathing through the nose is so vitally important for oral and whole body health, it is a priority to address this for any patients to support vibrant health and longevity.