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Why Nasal Breathing Is Best

Sleep physicians can identify and correct mouth breathing in their patients.

By Brian D. Robertson, MD

Sometimes we do not think about a disease until it becomes overwhelming. This is especially true when the symptoms are relatively mild, have an unclear origin, or a very gradual onset. Obstructive sleep apnea (OSA) is a good example of this sort of disease; people will often live with OSA symptoms for years before seeking medical attention.

It is important to identify risk factors for diseases like OSA; some will be causal factors, and they may be crucial to effective treatments and even cures. Obesity is probably the most well-known OSA risk factor, but others clearly exist, such as hypertension and smoking.

Less well recognized is how nasal obstruction is a risk factor for OSA. And unlike other contributors to OSA, nasal obstruction is often amenable to treatment. Even when not contributing to OSA, nasal congestion can worsen subjective sleep quality in our patients. What’s more, nasal obstruction can be a major challenge for the treatment of OSA, so it is important to recognize and manage it in all of sleep-disordered breathing patients.

In this article, I will discuss nasal obstruction as a risk factor for OSA, as a barrier to the treatment of OSA, and how sleep medicine specialists can best address it for OSA patients. By treating our patient’s nasal obstruction, we can improve their sleep, adherence to positive airway pressure (PAP) therapy, and improve their quality of life.

Why Nasal Congestion Is Important

The nose performs several functions during breathing. It humidifies and warms the air and filters out large particles—protecting the lower airway. While we are all capable of oral breathing, the oral mucosa is not capable of an adequate amount of humidification. In fact, an easy way to determine if someone is mouth breathing in their sleep is to ask if their mouth is dry in the morning or if they need water at their bedside.

For patients with obstructive sleep apnea, especially those using positive airway pressure devices, nasal breathing is crucial. If there is complete or near-complete

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Our Time to Shine! Behind-the-Scenes of Project Sleep’s Recent Advocacy Initiative

I was scared.

I didn’t know if you’d come with me on this path.

We’d JUST finished the incredible record-breaking Sleep In 2019 campaign, with many of you giving time and spoons to support Project Sleep.

The very next day, I learned that our advocacy moment had arrived — yay!! But with a really quick turnaround deadline — gulp!!

It was our time to shine – our time to show Congress, NIH, & CDC that people with sleep disorders were organized and taking action. I never doubted our community’s fierce passion for the cause, but I worried about the timing, on the heels of the Sleep In and with short turnaround. People are busy and spoons are limited.

Yet, I suppose some opportunities, like adversity, come on their own time, with little regard for our neat little schedules and plans. So we try our best to go with the flow (still hard for me, but working on it).

Here We Go…

As I raced to send out the advocacy action alert on Wednesday 3/13, we effectively had 9 business days to try to get 20 Representatives signed onto an important Congressional Letter. To achieve this, we had to:

reach advocates across the country,
help them reach their Representatives’ offices,
conduct lots of follow up.

So yeah, I was worried. I created a cheesy poster-board to broadcast our progress via Facebook Live and Instagram.

And you showed up.

Even though the process was a bit complicated and some of our important emails went to your SPAM folders (true story). For a while, there was just one Representative listed on the poster (my own), then two…

You kept showing up, you emailed, you called, you shared your stories, and you enlisted friends and family to do the same. Collectively, the project included thousands of emails with nearly 200 patient advocates reaching over 100 congressional offices on Capitol Hill, reaching districts from New Hampshire to California, from Michigan to Alabama!

The day before our deadline, on Monday 3/25, I was doing work at a Starbucks when I learned that we’d …