Category: Breathing

Snoring, you know….that thing your dad does when he falls asleep in the recliner, or your husband does after a few drinks.  Or maybe you know you do it….but you are in snoring denial.  Snoring never seems to bother the snorer…just those that happen share a room with that person.  Most people consider it normal, but is it??

The quick answer is NO.  But lets look a little more into it.

 

And since I’m all about being real…Yes, this flattering picture is me (taken on a trip with friends in India)….and yes, I snore.  However, I am currently on a mission to fix that…and why I want so badly to share what I am learning.

 

What is snoring exactly?  Snoring is a clinical symptom of something called sleep disordered breathing (SDB).  Sleep disordered breathing encompasses several breathing abnormalities including upper airway resistance syndrome, and sleep apnea.  We will discuss these in more detail in later blog posts.

Snoring results from changes in the upper airway that, in a sense, are due to a decrease in size or collapse of the upper airway (this can be due to an anatomic size abnormality).  Tissues that normally should not touch, end up becoming close or touching creating a vibration known as snoring.  There are many ways that snoring can occur.  Some reasons why snoring can occur are:  A collapse in the airway itself due to lack of tonicity.  Excess weight around the neck (due to being overweight or obese) applying pressure onto the airway.  Inadequate anatomic airway size.  It can also be caused to improper tongue position (sitting down and back), or a longer than normal soft palate.  And if that isn’t enough… to compound the problem, if you are breathing through your mouth and the tissues become dry they because much more likely to stick together because they are no longer hydrated and moist (yep….I just used that word).

Unfortunately, as we grow older we lose muscle tone….which make us more prone to snoring.  We often gain weight as we get older….which applies more weight and stress to the airway.  Double whammy!!  And no….it isn’t just a man thing.  Women, as we go through menopause our hormones change….and as it was said to me oh so nicely by my mentor….”if the airway problems aren’t corrected before menopause, you will become a fat old man”.  Snoring tends to be more of a male issue….until menopause and then it also becomes a female issue.  And with that we also see an increase in cardiovascular disease in women….which can also be linked to sleep disordered breathing.  We’ll talk more about this later.

One thing I do want to say with conviction is….even though snoring is not good in adults….it is NEVER normal in children.

Lets figure out what is causing the snoring…  Is in inability to breathe through the nose? Is it enlarged tonsils?  Is it poor tongue position?  Is it weight?  Is it an anatomic problem?  Lets fix the problem if we can….rather than trying to manage it later in life with something like a cPAP.  We’ll dive more into this when we discuss sleep apnea.

We all know about tonsils….you know…those ball things in the back of the throat that collect all sorts of junk when you are sick.  Or, maybe you are one of those lucky people who gets tonsil stones.  Mmmm…don’t those smell great (not!).

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But what do tonsils actually do?  

Tonsils are a collection of lymphoid tissue.  They are part of the bodies first line of defense toward foreign pathogens.  Humans have several sets of tonsils.  There are the palatine tonsils (these are the obvious ones that sit in the back of your throat…and that you can often see when you are sick with something like strep).  There are also adenoid (pharyngeal) tonsils, and a lingual tonsil (at the base of your tongue in your throat).

Tonsils may become enlarged….but it maybe isn’t just because you’re sick.  The only tonsils that we can typically visualize are the palatine tonsils and we call tell if they are enlarged.  But the other tonsils aren’t easily visualized….and you may not know how enlarged they are.  But regardless if you can see them or not….they can affect you.  Lets talk about reasons why tonsil enlargement might occur.

1.  Tonsillitis. – Inflammation due to being sick.  Tonsillar swelling should subside once you are feeling better.  This one is pretty obvious.
2. Mouth breathing.  Yes, I just listed mouth breathing.  Lets think about this one…. If you review the video I posted previously you’ll notice that if you breathe correctly and you are a nose breather your nose is the first filter for foreign pathogens.  However, if you are a mouth breather your tonsils end up being your front of the line filter as pathogens enter your mouth.  As more foreign pathogens filter through the tonsils they create inflammation of the tissues leading to enlargement of the tonsils.  This enlargement can be a chronic issue, unlike tonsillitis from being sick.
3. Other things that can cause tonsil enlargement are things like a tonsillar abscess, or cancer (but these are rare).

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Lets focus on mouth breathing and chronic enlargement of tonsils.  So what if your tonsils are big???  A lot of people don’t think this is such a big deal….but in my opinion they shouldn’t be so sure.

Enlarged tonsils can affect speech making it more difficult to enunciate correctly and my also make speech hyper nasal.  But the biggest thing is that enlarged tonsils can lead to is an upper airway obstruction….in other words….difficulty breathing!!

Now, I don’t claim to know everything, but I do know that in order for our human bodies to thrive we need to get oxygen to all of our functioning body parts.  So….I’m going to go ahead and make a blanket statement that breathing is pretty darn important.

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So, lets really think about this.  We often see enlarged tonsils in small children.  We also know that tonsil size peaks around age 3 or so.  But tell me this….if a 3-year-old has the same size tonsils as an older individual, but a much smaller airway circumferentially….who do you think that enlarged tonsils are going to affect more?  So, why is it that physicians are so quick to wait and watch tonsils….assuming that a child will “grow into them”.  Hummm….but if that child has an obstructed airway due to the enlarged tonsils??  We have to ask….what is that doing to their growth and development?

A very wise man, and the Godfather to airway (at least to me, and I know many others), Dr. Jeff Rouse once said…“Yes, your child may grow out of enlarged tonsils and adenoids, but are you sure that it is the same kid as the one who [no longer had enlarged tonsils and] breathed better every night for all those years?”

Think about that for a second….if a child is snoring, or mouth breathing, he/she is not breathing properly.  If children aren’t breathing properly their little bodies likely aren’t receiving all of the oxygen they could be.  What is that doing to their growth?  What about their brain development?  We will never know…..

Lets be proactive and help the littles that aren’t getting the oxygen they need so that they can grow to their full potential!

And by the way, if you are an adult with enlarged tonsils, you too can have an airway obstruction….and yes, you deserve to breathe too!

Did you know that the humans are supposed to be nose breathers?  Did you know that mouth breathing can actually be harmful to the body system?  Did you know that the majority of the population does not breathe correctly?

When we nasal breathe our bodies humidify the air and remove toxins and bacteria. Nasal breathing allows the body to increase the amount of oxygen the lungs can transfer into the blood which maintains a good oxygen to carbon dioxide balance and maintains a balanced pH in the blood. When we exhale through our nose, the small size of the nostrils (as compared to the mouth) creates back pressure in the lungs giving the lungs more time to extract oxygen from the air breathed in.  Because this allows for great efficiency in how the body receives oxygen, nasal breathing allows the number of breaths we take per minute to decrease. Proper nasal breathing and decrease hypertension (high blood pressure), stress, asthma, and even allergies.  It also allows for proper tongue position (tongue up and resting against the palate when the mouth is closed) which allows for proper development of the dental arches (in children).

When we breathe through our mouth the body often senses the carbon dioxide is being lost too quickly (because the same back pressure is not created as when we exhale through the nose) which causes the body to constrict blood vessels.  Oxygen that was able to be absorbed into the blood during nasal breathing no longer can be.  This is because of the constriction of blood vessels, but also because there is no back pressure keeping the air in the lungs to allow for longer absorption.  The decrease in oxygen uptake into the blood causes the body to adjust to have to breathe more frequently.  It is very difficult to maintain regular breathing when breathing through the mouth and often causes hyperventilation (over-breathing).  Mouth breathing, as a result of over-breathing elevates blood pressure and heart rate, worsens asthma and allergies, can lead to snoring and sleep apnea, which ultimately deprives your heart, brain, and other organs of optimal oxygenation.  Mouth breathing can also result in narrow dental arches, crowding of the teeth, and improper bites.

Even if breathing through your nose is difficult initially.  If you sit calmly and breathe through your nose, as you do so it will become easier and easier to breathe through your nose.  Be aware of your breathing.  How do you breathe?

The take away from today:  IF YOU BREATHE THROUGH YOUR NOSE, IT IS EASIER TO BREATHE THROUGH YOUR NOSE, SO JUST BREATHE THROUGH YOUR NOSE!