Breathing is an involuntary act where you take air into your lungs and expel it. You can look at it as a process of ventilating the body. Most people hardly notice how they breathe especially at night. A little observation of this can, however, help you identify important symptoms that can point towards ailments and disorders.

Mouth breathing is a common problem that can cause your throat to dry up and even lead to snoring. If you sleep with your mouth open at night, you are likely to wake up with a dry, irritated mouth and throat.

How to know you sleep with your mouth open

Sleeping with mouth open
Mouth breathing while sleeping can cause a dry mouth and sore throat.

One of the best ways to identify the problem is to look at the symptoms in your mouth when you wake up. Listening to yourself is also a possible way to find out. Mouth breathers may show the following signs and symptoms.

  • A dry mouth and throat.
  • Snoring
  • Sleeping with your mouth open and probably breathing loudly.

If you breathe through your mouth instead of your nose, there are some health problems that you may experience as you will learn below.

When we breathe through the nose, the air we take in is moistened and warmed before it gets to the lungs. If you are always sleeping with your mouth open, you are forced to take in cold, dry air via your mouth.

Causes

According to Dr. Veronique Benhamou, director of periodontology at McGill University in Montreal, some children can make a habit of breathing through their mouths. It is also possible that the jaw positioning is affected and that when they sleep, their lips cannot close.

In general, here are the possible causes of sleeping with an open mouth and breathing through it.

  • Deviated nasal septum
  • Blocked nose
  • Thumb and finger sucking
  • Nasal polyps
  • Enlarged tonsils and adenoids
  • Birth defects such as a cleft palate, choanal atresia, and Robin Syndrome
  • Allergies and asthma
  • Tongue tie

The causes of mouth breathing in children and adults may be different. In adults and especially old people, some medications can cause sleeping with the mouth open. This condition is called xerostomia and is occasioned by a change in the composition of saliva due to certain medications.[1]

The problem is prevalent in the elderly because “mostly because this group tend to take several medications and in persons who breathe through their mouths.”[2]

Birth defects are the most common cause of the symptom because inability to fully close the mouth at night while sleeping (or even during the day) can lead partial breathing through the oral cavity.

Skeletal deformities involving the jaws, mouth and nose are a major cause of oral respiration especially in children although it can occur even in adulthood. A deviated septum, for example, is one such condition that can make it difficult to breathe through the nose due to obstruction.

Some children suffer from abnormally large tonsils and adenoid glands. Illnesses that cause the enlargement, such as adenoiditis usually present mouth breathing as one of the symptoms.

With adenoiditis or swollen adenoids and tonsils, you may find it more comfortable to breathe through the mouth than the nose due to inflammation and pain. As a result, you get a dry or sore throat. Night snoring may also be a symptom of this.[3]

Posture problems may also cause open mouth breathing. According to a research done by Okuro et al, opening the mouth to breathe may be conditioned by the head posture meant to compensate for respiratory difficulties.[4]

The study finds that people who breathe through their mouths rather than the nose have a moderate forward head posture that compensates and helps improve muscle function that helps breathing.

How to stop mouth breathing while sleeping

In order to sleep with your mouth closed and breathe through the nose, you may need treatments as well as behavioral adjustments. Exercises, some anti-snoring aids and devices as well as treatments for allergies can help you stop breathing through the mouth.

1. Manage nasal congestion

Nasal congestion or a blocked nose is one of the reasons for mouth breathing. Early detection is key to decongestion and freeing the airways for proper exchange of oxygen and carbon dioxide.

Nasal congestion is usually a result of various problems such as allergic rhinitis. In order to stop sleeping with your mouth open, you may need to take treatments for allergic rhinitis including the following:

  • Trigger avoidance: Avoid any substances or allergens that cause your noses to block.
  • Using decongestants to relieve the blockage.
  • Corticosteroids and allergy shots.

Some of these treatments provide relief while the treatment continues. The problem with them is that the individual may start to develop the habit of breathing through their mouth that is likely to continue even after the nasal passages have been cleared.

To manage nasal congestion properly, it is important to continue breathing through your nose even as you take the medications and treatments. This can be done along with breathing exercises such as the Buteyko Breathing Method.

2. Try Buteyko Breathing exercise to clear the nose

Since nasal congestion is one of the reasons why you are breathing through the mouth at night, decongestion is a major source of relief. You can unblock it by practicing a simple nose-clearing exercise called the Butyeko.

The nose breathing exercise was developed in the 1950s by Dr. Konstantin Butyeko, a Russian respiratory physiologist in a study that meant to investigate the effectiveness of the exercise in the treatment of chronic rhinitis and asthma.

The exercise uses a control pause or breath hold that eventually unblocks a congested nose. It is believed that reduced breathing in itself helps reset the breathing volume to normal.

How to do the nose clearing exercise

  1. Take in and let out a small silent breath through your nose.
  2. Using your thumb and index fingers, pinch your nose to hold your breath.
  3. Walk or jog a few paces up and down while holding your breath until you feel air shortage. Try not to overdo this.
  4. Resume breathing but only through your nose. Do this calmly.
  5. Repeat this workout after resting for a minute or two.
  6. Repeat the Butyeko breathing exercise six times until your nose is decongested.

Important note

After the hold, you will resume your breathing as if normal. Your first breath will be larger than your usual volume. This is exactly what is likely going to help with decongestion. Try to calm the rate of breathing as fast as you can by suppressing your subsequent breaths. Within two to three breaths, you should have recovered.

Remember to keep your mouth closed throughout this exercise, otherwise, it will not be of any help doing it in the first place.

DO NOT DO THIS EXERCISE IF:

  • You have cardiovascular issues.
  • You are pregnant
  • You suffer from chronic sleep apnea. Sleep apnea often leads to skipped breaths during sleep. Your body is likely to be deprived of enough oxygen already, so avoid holding your breath during the day even if your nose is congested.

This therapy is used to treat various breathing problems including sleeping with the mouth open due to nasal congestion, a cold or rhinitis.

3. Elevate your head when sleeping

Most people focus a lot on the number of hours they sleep. What they forget to do is adjust our sleeping material to improve the quality of sleep and prevent certain disorders in the process.

Sleeping with your head raised can provide relief to multiple disorders including sleep apnea. You can also reduce snoring and mouth breathing with this simple trick.

As we have already pointed out, sinus pressure and congestion are some of the reasons why you breathe through the mouth while sleeping. Sleeping with a raised head helps sinuses to drain with ease. This will allow you to breathe through the nose as normal, thus avoiding complications and risk factors including a sore throat and dry mouth in the morning.

You can adjust your sleeping position at night using a pillow of good quality or simply switching to an adjustable mattress.

Other benefits of elevating your head include:

  • Reducing and preventing dark circles. An elevated head improves the flow of blood throughout your head and face, thus reducing puffiness.
  • Reducing your chances of snoring especially if you are suffering from a sinus infection.
  • Sleeping with your head raised at least 6 inches helps reduce the risk of heart burn.

4. Adhesive nasal strips

For mouth breathers who suffer from nighttime congestion, nasal strips such as the Breathe Right Drug-Free Nasal Strips may be the solution you are looking for to improve your sleep, stop nasal snoring, and stop sleeping with your mouth open.

Nasal strips are usually made of flexible, spring-like bands. When you wear them, they will fit just above the flare of your nostrils. Since their underside is adhesive, they do not fall off.

How do they work?

The tension created means that the bands will attempt to straighten to go back to their original shape. This helps lift the sides of your nose and open up nasal passages. You will breathe better through your nose rather than your mouth.

  • Adhesive nasal strips can provide relief for mouth breathers who are suffering from allergies, colds, and even a deviated septum.
  • The lifting action of the strips helps open swollen and inflamed sinus passages, making it easier to breathe.

A study by Gosepath J et al of the Department of Otolaryngology, University of Mainz School of Medicine, Germany notes in its preliminary remarks that there have been positive effects in patients suffering from obstructive sleep apnea and snoring when Breathe Right nasal strips were used.[5]

In general, nasal dilator strips can help you stop mouth breathing by decreasing airflow resistance to make you breathe with ease through your nose instead of your mouth.

5. CPAP or face masks

Another way to stop sleeping with the mouth open is to wear a face mask for sleeping. Most patients with obstructive sleep apnea and night breathing difficulties may be prescribed a continuous positive air pressure (CPAP) machine or appliance. A CPAP will deliver air to your nose through a mask.

Such a machine is necessary for mouth breathers who suffer from constant collapse and blockage of airways resulting in mouth respiration.

There are different types of these machines in the market today and getting the right one can help solve the problem.

The best (right) CPAP machine for you would be one that incorporates a chin strap to help you keep your mouth closed and also prevent leakage of air during treatment or therapy. An even much more comfortable and effective solution is a CPAP mask that has a secure chin strap as part of its headgear, such as the ResMed Ultra Mirage.

If you are already on a breathing face mask, you may experience air leakage problems that can also cause a dry mouth. The problem is common with CPAP machines for nose breathers. See your doctor for proper advice on the right type of mask you need to buy to stop mouth breathing.

6. Surgical removal of swollen tonsils

Swollen tonsils and adenoids can make breathing through the nose a major difficulty especially in children. Snoring and sleep apnea are some of the possible complications that come with adenoiditis and chronically inflamed tonsils. You may also notice your child speaking with a nasal sound and having difficulty sleeping.

Your doctor may recommend removing them surgically to treat mouth breathing. This option is taken if antibiotics are not able to clear the frequent infections to the sinuses and ears and that breathing problems are becoming severe.

The surgical procedure to remove adenoids is called adenoidectomy. It may be performed together with that of removing tonsils (tonsillectomy). Immediately following the surgery, your child may still experience mouth breathing and snoring. This happens because of the swelling in the throat. However, this should normalize as soon as the swelling goes away about 14 days after the surgical procedure.

In other circumstances, a doctor may recommend that your child wears a device that will help widen the palate to open up the sinuses and aid in better breathing. Braces are the most common orthodontic solution to help remedy the problem.

Surgery may also be performed to widen nasal passages. This will be recommended if the problem is caused by the shape of your airways blocking and causing problems breathing through your nose.

7. Taping the mouth

One of the best hacks for better sleep is taping your mouth at night. It is a sure way it will remain closed throughout the night. But how will you breathe? Well, the normal way to breathe is through your nose.

This method is very simple. As its name suggests, you will keep your mouth closed at night with an adhesive tape. Surgical tape and a little cream are all you need. Applying a little cream or moisturizer before taping your lips will prevent pain when removing it in the morning.

  • Apply a little cream to your lips and the skin above and below them.
  • Apply surgical tape vertically and horizontally on your lips.

That’s it. This tape will keep your lips closed so that you can stop breathing through mouth all night.

You are likely to feel a little bit of discomfort at first but with time you will get used to it. The benefits of taping your mouth will most definitely outweigh the side effects of sleeping with your mouth open.

Taping to prevent mouth breathing is effective but precautions should be taken. You should stop this method if you experience shortness of breath and difficulty sleeping. The best thing to do is see your doctor as soon as possible.

8. Nasal sprays

Taking some medications including anti-inflammatory nasal sprays and decongestants can help relieve nasal congestion and stop mouth breathing. These can be used in conjunction with chin straps and mouth guards to help ease your breathing and keep your mouth closed.

There are three different types of nasal sprays. They include the following:

  • Saline solutions (made with salt and water at home)
  • Steroid nasal sprays
  • Decongestants

You can buy an over-the-counter decongestant if you have a prescription from your ENT. They will help get rid of a stuffy nose fast and stop you from breathing through the mouth especially if the blood vessels in your nose are narrowing.

Steroid sprays can also be bought OTC. They can help relieve symptoms caused by allergy such as a stuffed nose and oral respiration.

If the blockage is not severe yet you find yourself breathing through the mouth, you can treat it with a saline solution applied with a neti pot. It can moisturize your nose, decongest it and make it easier to breathe through your nose again.

Homemade saline solutions loosen up thick mucus to prevent it from crusting over. To make this home remedy:

  • Mix 3 teaspoons of non-iodized salt in 1 quart of distilled water.
  • Add a teaspoon of baking soda.
  • Stir well.
  • Fill a bulb syringe or a neti pot with the solution.
  • Tilt your head to one side and pour the solution into one nostril, letting it go out through the other.

You can repeat this remedy various times a day to help decongest your nose. Most importantly, try it before going to bed if you sleep with your mouth open due to difficulty breathing through your nose.

9. Wear a mouth guard

Mouth guards, like tapes, help keep the mouth shut at night while you sleep. These are devices designed to help you stop breathing through the mouth and help your body gain optimum oxygen and nitric oxide that is made in the nasal lining.

When buying a mouthguard, ensure you get a comfortable fit that will not interfere with the quality and pattern of your sleep. Mouth guards are primarily used by those people who want to stop snoring and heavy breathing through the mouth.

10. Change your sleeping position

While you may not be allergic, some sleeping positions could be the reason why you use your mouth instead of your nose to breathe. In fact, it is believed that sleeping on your back worsens mouth breathing.

Why is it wrong to sleep on your back?

When you sleep on your back, the airways in your throat, nose and lungs become easily blocked. This narrowing can lead to obstructive sleep apnea and struggles when breathing at night.[6] As a result, you open the mouth to help with the breathing and compensating for the inability of your nose to perform its function as usual.

  • You start taking heavier breaths to compensate for the reduced respiratory function.
  • The nose gets blocked and it becomes impossible to channel air in and out through it as usual.
  • The tongue and soft palate collapse back and start to produce vibrating noise (snoring).

What is the best sleeping position to stop mouth breathing?

When you notice that you sleep with your back and experience breathing problems, try to change your sleeping position.

  • Sleep on your side or
  • Try sleeping on your stomach.

Lying down on your stomach can help if you wear sound-proofing devices while sleeping. You will also enjoy other benefits such as a healthier back when you adopt a side sleeper’s position.

Complications and risk factors

Breathing through the mouth all the time can cause various complications. They include:

  • Bad breath
  • Throat infections
  • Periodontal disease

Importance of nasal breathing

Why is nose breathing very important? Your nose has a filtering mechanism that makes sure the air you breathe in is purified before it enters the lungs. When you use your nose to breathe, you will be able to maintain lung volumes.

Other than that, the reason why sleeping with the mouth open and breathing through it is not a good thing is the loss of nitric oxide (NO), an important gas to the functioning and health of body tissues and organs. The gas aids in the regulation of blood pressure and flow. It also enhances platelet function and neurotransmission.

  • Oral respiration reduces the capacity of lungs to absorb oxygen. The nitric oxide gas produced by the nose helps to increase the absorption of oxygen. That is why prolonged mouth breathing can affect your well-being.
  • Mouth breathers experience increased or worsened snoring that can eventually develop into sleep apnea.
  • The nose plays an important role in cleaning the air and removing its impurities.
  • Your nose moistens and warms the air before it goes to the lungs. Mouth breathers suffer from a dry mouth because of inhaling dry air.
  • Nose breathing increases resistance to the air stream passing through it. This increases the absorption of oxygen.

There are times when it is normal and OK to breathe through the mouth. In circumstances where the nose alone cannot suffice, you will find yourself using your mouth to help compensate for the shortage of air.

During strenuous activity, you may find yourself inhaling and exhaling through your mouth. This is normal. However, mouth breathing all the time poses various risk factors as already discussed.

In children, for example, it can cause facial deformities, crooked teeth and even poor growth. In adults, the effects may include gum disease and bad breath. Infants do this as an adaptation to stay healthy and alive.

Mouth breathing in infants

With reference to respiration, infants are sometimes said to be preferential nasal breathers. If you observe them, you may not notice that they part their lips to breathe, but it actually happens a little bit.

In the first few months after birth, most infants will breathe through their mouths when crying. By 6 months, oral and throat developments ensure that the epiglottis and the soft palate separate adequately to allow more mouth breathing to happen.

You should, however, still observe your baby breathing preferably through the nose. If you notice an infant sleeping with the mouth open or preferring to breathe through the mouth, it is likely a sign of upper airway problems.

Choanal atresia is one of the most common abnormality that causes breathing problems in infants. Blockage due to a severe cold or allergies can also cause breathing abnormalities in the early months of infant development.

It is important to see a doctor as soon as an emergency if you notice your baby’s skin turning bluish and struggling to breathe through the mouth all the time. It means there’s a deprivation of oxygen to the tissues.

What you can do at home

While it is important that you consider medical treatments to stop sleeping with your mouth open, you can do something at home to help relieve the side effects of the problem.

Try using a humidifier in your bedroom at night. This will keep the air moist to prevent a dry throat and mouth in the morning.

You can also apply vitamin E oil on your gums to keep them from losing moisture at night. This will keep them moist and also reduce bad breath.

References

[1] The Oral Cancer Foundation: Xerostomia https://oralcancerfoundation.org/complications/xerostomia/

[2] WikiPedia https://en.wikipedia.org/wiki/Xerostomia

[3] Adenoiditis: Causes, Symptoms, Diagnosis and Treatment, St. Louis Children’s Hospital http://www.stlouischildrens.org/diseases-conditions/adenoiditis

[4] Okuro RT, Morcillo AM, Ribeiro MÂ, Sakano E, Conti PB, Ribeiro JD. Mouth breathing and forward head posture: effects on respiratory biomechanics and exercise capacity in children. J Bras Pneumol.2011 Jul-Aug; 37(4):471-9.

[5] Gosepath J, Amedee RG, Romantschuck S, Mann WJ (1999): Breathe Right nasal strips and the respiratory disturbance index in sleep-related breathing disorders. https://www.ncbi.nlm.nih.gov/pubmed/10582117

[6] Obstructive Sleep Apnea – Adults, MedlinePlus https://medlineplus.gov/ency/article/000811.htm

 

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