Bridging the Gap - Health Equity for all

Shut Up and Go to Sleep…It’s Better for You

Published on:

01 Nov 2023, 12:00 pm

It sounds like a great way to end up with “death by misadventure” on your medical certificate, but it’s one of the biggest wellness trends of the year. Mouth taping is the act of literally taping up your mouth at night before you go to sleep so that you exclusively breathe in and out of your nose. TikTok influencers and other wellness gurus praise it for quieting snoring and preventing dry mouth. They say it deepens your sleep, making you feel more rested, decreases anxiety, boosts your immunity, and lowers blood pressure. The hashtag #mouthtaping has over 51 million views on TikTok so far. How could taping your mouth possibly be useful? And is it safe? All reasonable questions, and ones that health experts are keeping an eye on too. <h2>Triumph of the trumpet</h2> The basic idea is that mouth breathing sucks, while the nose reigns supreme. That pointy organ on your face filters the air you breathe via the cilia (tiny hairs in nostrils), removing allergens and other nasty bits that pollute your oxygen intake. It is also thought to be more efficient at absorbing oxygen than the mouth is, as it pressurizes the air, allowing the lungs to draw more oxygen out. The nasal passages release nitric oxide (a neurotransmitter involved in gas transport) and moisturize and warm the air that you inhale, making it closer to body temperature. This kind of air is easier for your lungs to use. What’s key, however, is that nasal breathing activates your body’s calming, stress-reducing parasympathetic nervous system. The sympathetic branch of the nervous system is responsible for the “fight or flight” response — which can be triggered during anxious or panicked states — whereas the parasympathetic branch triggers rest and relaxation. In other words, the former fires your body up while the latter chills your body out. The claims against excessive mouth breathing are numerous. In children, it’s connected to facial deformities, crooked teeth, and poor growth, while in adults, it may worsen chronic diseases as well as promote gum disease by drying out the gums and the tissues that line the mouth. Digestive issues, chronic fatigue, headaches, and a sore throat are all on the charge list too. Perhaps most critically, mouth breathers are more likely to develop sleep disorders like sleep apnea, in which breathing stops or becomes shallow during sleep, and snoring is a key sign (though not a conclusive one). This can escalate into obstructive sleep apnea, in which the throat muscles relax and block the airway, interrupting sleep. Uncontrolled sleep apnea may trigger dangerous complications like type 2 diabetes, strokes, heart attacks, and possibly a shortened lifespan. <figure><img alt="" height="442" src="https://cdn.storymd.com/optimized/RdaXa2TXol/original.jpg" width="662" /> <figcaption>Obstructive sleep apnea - Breathing, Interrupted Source: TheVisualMD</figcaption> </figure> Many of us unconsciously turn to mouth breathing as our primary way to breathe as a backup because there is some kind of obstruction in our nose. Blockages can be caused by various conditions like congestion due to allergies or sinus infections, a deviated septum (the cartilage wall that divides the separate nasal chambers deviating from the midline), or enlarged adenoids or tonsils. Mouth taping, as you could guess at this point, seals your mouth up so that your body retrains its breathing process to focus on the nose instead. Doing this while you’re asleep and out of conscious control is an efficient way to convert over to the nose. The practice involves placing a piece of porous tape across your lips at bedtime, thereby discouraging mouth breathing and the snoring that may follow. <h2>James Nestor, the author of Breathe</h2> Mouth taping has actually been around for a few years now, but the biggest catalyst for its soaring popularity is the writer and journalist James Nestor, whose book Breathe spent 18 weeks on the New York Times bestseller list. As part of his research for the book, Nestor delved deep into the physiology of breathing and forced himself to breathe through his mouth (by sealing up his nose) for a period to demonstrate just how bad mouth breathing is. He recounts how his sleep deteriorated, his blood pressure went up, and snoring through the night became chronic in no time. "I still have a little PTSD about it all," Nestor said to CBC. Nestor’s book explores the history of breathing techniques and ancient knowledge on the matter. He writes about the declining quality of breathing in recent centuries, and on the recommendation of biological anthropologists, he traveled to the Catacombs in Paris to examine human skulls that demonstrate this decline. The skeletal records he reviewed featured wide faces, big jaws and nasal apertures, and straight teeth. Today, we endemically suffer from narrowed mouths and airways in which people's teeth no longer fit. The inspiration to write a book about it all came out of his work with Dr Jayakar Nayak, chief of rhinology research at Stanford's Otolaryngology Head and Neck Surgery Center. In his conversation with Nayak, Nestor learned how mouth breathing apparently has a huge impact on skeletal structure. "Nobody knew how quickly that damage came on because nobody had tested it," said Nestor. What’s more, Nestor says that we can overbreathe as well: “You can absolutely breathe too much. You hear people breathe like that all the time. We think that we're getting more oxygen when we're breathing this way. We're actually doing the opposite," he explained. "You can feel this for yourself by taking 10 or 20 big, deep breaths. You're going to feel some tingling in your head or maybe your fingertips will get cool. That's from a lack of circulation to those areas." The good news is that anyone, no matter how far down the rabbit hole of shrunken airways or whatever, can start breathing properly, according to Nestor. Retraining yourself to breathe with the nose as exclusively as possible, and also breathing slower and more deeply, will reap bountiful rewards. On top of taping and nose breathing, there are all sorts of breathing techniques out there used to help with insomnia, stress, anxiety, focus, and more, many of which are detailed in Nestor’s book. A simple place to get started with breathwork for better health and wellness is box breathing, which can aid with anxiety and stress. Also known as “4+4+4+4”, box breathing works as follows: <ol> <li>Breathe in for four </li> <li>Hold for four</li> <li>Breathe out for four </li> <li>Hold for four </li> <li>Repeat</li> </ol> With sufficient repetition, this should help to take things down a notch. <h2>Mouth taping: the evidence</h2> Back to the tape. It sounds impressive, but most of the evidence we have is purely anecdotal. The limited amount of research we have so far has been inconclusive on the matter, so the jury is still out on whether mouth taping is truly beneficial. A small study in 2015 showed that 30 participants benefitted from less snoring after mouth taping, and another study in 2022 of 20 mouth-breathers with mild sleep apnea found that 13 snored less intensely with the tape versus going without. A separate 2022 study in the journal Sleep and Breathing observed 18 people with sleep apnea who wore mouth tape overnight in the lab. The researchers found that the participants “mouth-puffed”, meaning that they began inhaling through the mouth in spite of the tape obstacle. This is apparently a response after an apnea episode to restore normal breathing. Dr Ann Kearney, a speech and swallowing disorders specialist in the department of otolaryngology at Stanford University in California, is researching mouth taping to see if it can elicit proven benefits. She’s planning on researching the practice in larger groups, including people who snore but don’t have sleep apnea, to see if it can improve sleep. “Currently, we lack clinical trials to demonstrate the effectiveness of mouth tape,” she said to Everyday Health. “Consequently, this simple, low-cost method with potentially a significant impact to a high percentage of the population has not been utilized.” Kearney warned that not everyone is a suitable candidate to experiment with the tape. For those who struggle to breathe through their nose or can hear themselves when they do so during the day, mouth taping should be parked, and you should get evaluated by an ENT (ears, nose, and throat) specialist instead. We also do not have any studies evaluating the safety of the practice. Some have raised concerns about blocking airflow during sleep, potential skin irritation from an allergic reaction to the tape material, and aspiration — if you vomit or have acid reflux while the mouth is taped, those contents go into the lungs, which could be extremely dangerous. The bottom line for those with existing snoring issues is that those concerns should be raised with your doctor first before you go around taping your mouth up. Mouth taping isn’t recommended as a practice yet, but if you’re going to try, a conversation with your doctor may be worthwhile first. Also, make sure not to use duct tape as it may elicit an allergic reaction; gentler alternatives like surgical tape are recommended instead. <h2>More on the Respiratory System</h2><ul><li><a href="https://soulivity.storymd.com/journal/m9ab7a4igj-respiratory-system" target="_blank">The Respiratory System: Anatomy and Function</a></li><li><a href="https://soulivity.storymd.com/journal/vj6kkd20zm-sleep-apnea" target="_blank">Sleep Apnea: Causes, Symptoms, Treatments</a></li><li><a href="https://soulivity.storymd.com/journal/7m7aod2hpm-breathing-problems" target="_blank">Breathing Problems and Shortness of Breath</a></li></ul>

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