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Flu Shots, Hutterites, and Sleep Apnea

It seems that even in very closed communities, flu vaccinations can help to lower the rate of influenza infections. A recent NY Times article described a study that revealed that widespread flu vaccinations in Hutterite schoolchildren resulted in lower rates of infection throughout the community, including adults. The population that received the vaccine had about a 5% rate of infection, whereas the placebo group had a 10% rate of infection. 

 

Regardless of the implications of this study, what caught my eye were the pictures. In the article, the two children and woman's faces were nice and wide. I went on to google other pictures of Hutterites, and by a wide margin, most of the adults and children have very wide jaws and facial structures. This is in contrast to regular urban people (especially younger adults and children) with more narrow faces and small jaws. Small jaws means less room to breathe at night due to narrowing of the space behind the tongue.

 

This makes sense since secluded communities like the Hutterites tend to eat off the land and breastfeed for extended periods of time. It's expected that they'll have proper dental development, and as a result, will be more immune to the effects of any viral infection, even the influenza virus. 

 

Any degree of inflammation in the upper airways can aggravate further narrowing, leading to more frequent pauses in breathing, leading to aspiration of stomach juices into the lungs and nose, aggravating a vicious cycle into more obstructions. This is why people with sleep-breathing problems suffer more complications such as pneumonia, sinus and ear infections.

 

We know that some people who catch the flu experience it just like a common cold, whereas for others, it can be deadly. It's one thing to show that giving immunizations can prevent infections, but what's the rate of complications in Hutterites that do contract the flu? I'm willing to bet it's much lower than normal. With this in mind, it it even worth vaccinating this particular population?

 

What's your opinion about my theory? 

When Your Cold Is Not A Cold

Every time you get a cold, notice how it usually starts in the throat with a tickle, a scratch, or a slight cough. It then progresses into chest congestion or travels up into the ears and the sinuses. You’ll have a low grade fever, mild chills, and a runny nose. Even if you start out with a runny nose, eventually, you’ll have throat symptoms later on. Sounds like a classic cold, right? When you see your doctor, throat redness and irritation and swollen glands are noted, confirming even further that you’re in the middle of a standard upper respiratory infection, or the common cold. Typically, it’ll last anywhere from 3-5 days. A small minority will progress into one of the classic complications of a common cold, such as a bronchitis or sinusitis.

 

Any time I see patients in the office that come in with any of these classic symptoms or one of the more severe complications such as sinusitis, I always ask about the few days or weeks prior to the onset of the throat symptoms. With few exceptions, most of you will have either increased stress (out of the ordinary), a history of eating later than normal, or drinking alcohol later in the evening. Sudden weather fluctuations such as pressure or humidity changes is another common trigger.

 

If you’re susceptible to sleep-breathing problems at all (most modern humans are to some degree), any degree of inflammation in the throat will cause further swelling, starting up a vicious cycle that brings up more stomach juices into the throat, which causes more obstructed breathing and stomach juice reflux. It’s important to realize that whatever comes up from your stomach includes not only acid, but also bile, digestive enzymes, and bacteria. Even microscopic amounts will cause irritation to your delicate voice box, giving you a scratchy throat, cough or hoarseness. This is why these symptoms are most obvious when you first wake up in the morning.

 

It’s also been shown that these same stomach juices can then travel down into the lungs or up into the ears of the sinuses. Pepsin, a digestive enzyme, and H. pylori, a common stomach bacteria, have been found in lung and sinus washings. This is also why the ears are usually affected before the sinuses—it’s a direct line from your throat to the eustachian tubes, whereas you have to take right angled turn to reach the sinus passageways in the nose.

 

You may now be asking, "but what about the fever and the chills?" Any sudden, or abrupt change in your sleep-breathing status can cause an autonomic nervous system imbalance that can bring about these same fevers, hot flashes, chills and sweating.

 

How does your typical cold start? Please enter your experiences below in the comments box.

The Gingivitis–Heart Disease–Sleep Apnea Connection

There have been numerous studies on your increased risk of heart disease if you have gum disease or cavities. The most common explanation is based on the antiquated germ-theory that Louis Pasteur developed over 100 years ago—that bacteria or other pathogens in the gums and the teeth can travel into the bloodstream and lodge in the heart, causing heart disease. The explanations that were given during medical school were never too satisfying. To this day, I still wonder how bacteria in your mouth can spread and reach your heart. We have hundreds, if not thousands of stains of bacteria living naturally in our bodies. Why do some preferentially reach the heart, whereas others can’t?

 

If you look at this connection through the perspective of my sleep-breathing paradigm, there’s a much better explanation. Studies have shown that acid reflux is linked to gingivitis and cavities. What’s acid reflux linked to? Right! Obstructive sleep apnea. I also mentioned in a past post that these same juices also contain bile, digestive enzymes, as well as bacteria. Imagine bathing your gums and teeth in acid, bile, digestive enzymes and bacteria all night. What do you get? Gingivitis and cavities.

 

In his book Nutrition and Physical Degeneration, Dr. Weston Price showed that in certain cultures with wide and spacious jaws, the presence of cavities was almost nonexistent. However, in cultures with narrow jaws dental crowding, cavities were rampant.

 

There are also  tons of studies strongly linking obstructive sleep apnea with heart disease, hypertension, diabetes, stroke, and heart attack. 

 

So is obstructive sleep apnea the common link? What’s you opinion on this theory? Please enter your comments in the text box below.

5 Quick And Easy Ways To Get Better Sleep Fast

 

In our over-stressed, over-weight, sleep-deprived society, there’s a tendency for experts to offer you the latest, greatest, high-tech, and usually expensive advice when you want to get better sleep. From the new Zeo (which measures your brain waves while you sleep), to $3,000 mattresses with reclining features and NASA engineered memory foam, there’s an unlimited number of gadgets and devices that promise to give you a better nights’ sleep.

But before you consider these expensive options, try the following 5 quick and easy tips to help you sleep better for free, or at a relatively low cost.

Tip #1: Avoid Acid Reflux

Acid reflux is a major cause of poor sleep, especially if you eat just before going to bed. If you have a sleep-breathing problem, this condition becomes even worse, since stomach juices are actively being suctioned up into your throat every time you stop breathing. In sleep apnea patients, vacuum forces are created in the throat with each obstruction, which forces normal stomach juices into the throat.

Two of the most common ways of treating this condition is to either take acid reflux medications, or sleep inclined, with your upper body angled up. Before you invest in an expensive adjustable bed that can incline your body upwards, just stop eating close to bedtime. Make sure you stop eating at least 3-4 hours before you go to bed. This way, even if you do stop breathing, you won’t have as much stomach juices that can come up into your throat (which also includes bile, digestive enzymes, and bacteria).

Take Power Naps

There are tons of research studies that tout the benefits of taking short naps in the mid to late afternoon. Our bodies naturally have sleepy tendencies during this time, so why not take advantage of it? It’s been shown that not only will you have more energy for the remainder of the day, but your chances of heart disease and dying early can be lowered if you nap regularly.

If you have a sleep-breathing problem, like obstructive sleep apnea, make sure you don’t sleep longer than 30 to 45 minutes. Sleep-deprived people tend to go into REM sleep earlier than the 90 to 120 minutes it normally takes to reach REM sleep. This is when your muscles relax the most and you’ll be more likely to have obstructive events.

Take Breathing Lessons

Deep breathing exercises have been shown scientifically to calm your nervous system. Thy is why people who engage in yoga, tai chi, or any other discipline that teaches proper breathing techniques feel so much more relaxed.

If you don’t have time or the funds to take classes on a regular basis, make it a point to take 4-5 slow deep breaths every 1-2 hours, especially when you’re transitioning from one activity to another, or if you’re feeling stressed. You can also make it a habit to meditate on your deep breathing anytime you’re waiting on the phone, standing inline, walking somewhere.

Take A Media Vacation

Modern humans are inundated with too much information. Too much news coming from too many sources can lead to information overload, not to mention anxiety-provoking states that keep your mind racing before you go to sleep at night. Turn off the TV, don’t read the paper, check email only once a day, and limit surfing the internet. Think of it as a cleansing that empties your mind of needless clutter. The world will go on without you if you don’t know what’s going on.

Undergo Natural Phototherapy

Rather than investing in bright light boxes or suntan sessions, expose yourself to more sunlight. Early morning sunlight is the best time since it’s not as intense, and exposing your eyes to light at this time helps to strengthen your sleep clock. This is also the best time to exercise outdoors, if you have the time.

If you’re already supplementing with vitamin D and calcium, exposing yourself to more natural sunlight can help to optimize theses supplements’ beneficial effects. Don’t worry too much about skin cancer, since sleeping better can help to fight off cancer.

These 5 tips are some of the many free or inexpensive ways that you can get better sleep. Without laying the foundations for these fundamental sleep habits, sleeping pills, beds, pillows, and gadgets won’t ultimately help you sleep better in the long run.

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Click here to find out the secrets of using ancient Chinese herbal medicine to get better sleep quickly and easily from , Dr. Maoshing Ni (AKA: “Dr. Wow” from Sex and the City).

I Confess—I Broke My Own Rule

I admit it—I broke my own rule. I had apple pie just before going to bed Sunday night. My 6 year old son and I made apple pie from scratch. We made two pies—one for the family and one for our friends that were coming over that evening. We waited patiently as it cooled after taking it out of the oven. My two boys were salivating and eying it all evening. When it was eventually served, it was a hit. But I literally didn’t have time to taste my own pie, since I was too busy making arrangements for our guests. Later that evening, after our guests had left and we finished cleaning up, I just had to have a slice of my pie. I knew that I was going to turn in to go to sleep within 30 minutes, but I still had to eat it. The next day, I paid the price.

 

One of the most common pieces of advice that I give is that you should try not to eat within 3-4 hours of bedtime. There are lots of explanations for why this can lead to weight gain and poor sleep. One such explanation is that having food in your stomach diverts energy and blood to the stomach, depriving the rest of the body the energy needed to rest and regenerate. Another is that it slows down your metabolism. What most people (and doctors) don’t realize is that the more juices you have in your stomach when you go to sleep, the more likely it’ll come up into your throat, leading to poor sleep. 

 

As mentioned in my sleep-breathing paradigm (in my book, Sleep, Interrupted), all modern humans stop breathing once in a while when sleeping, due to our unique upper airway anatomy and our ability to talk. Muscle relaxation during deep sleep leads to these partial to total obstructions. If these episodes happen very often, for longer periods, then this is what we describe in medicine as obstructive sleep apnea. But obstructive sleep apnea is not something you develop suddenly in your 50s or 60s. All of us have minor variations of it at certain times in our lives (during colds, when we gain weight, or during pregnancy for women). All of us are on a continuum.

 

Once you stop breathing (but before you wake up and turn over), a vacuum effect is created in your throat, which can literally suction up your normal stomach juices into your throat. This not only causes you to wake up from deep to light sleep, but also causes the all-too-common symptoms of post-nasal drip, throat clearing, chronic cough and hoarseness, usually worse in the morning.

 

When I woke up in the morning the night after I ate my apple pie, my throat was a little sore, but what really got my attention was the fact that I felt like I only slept for 5 hours, rather than the 7 that I got that night. I was also more tired than usual all day long.

 

It’s not too surprising that sleep length, sleep efficiency, energy, appetite, and weight loss are all directly or indirectly connected. Yesterday, I saw a child in the office who stated that his sleep quality improved dramatically once he stopped eating ice cream before bedtime.

 

If any of you eat close to bedtime, and don’t sleep well are tired during the day, I challenge you to make it a regular habit to eat earlier for the next 4 weeks. Then let me know on this blog when you feel better. I’m confident that you’ll sleep better and feel better. 

 

By the way, if you want the recipe for my apple pie, just let me know. It’s from a Mrs. Fields recipe book.

The Truth About Acid Reflux Medications

 

When Your Cold is Not a Cold

 

In our current age of economic recession and flu epidemics, experiencing hoarseness or a sore throat can conjure up worst-case scenarios. What I’ve noticed in more recent months is that more and more people with these two symptoms are coming in concerned about throat or lung cancer. If you feel a lump in your throat, the word lump itself can cause feelings of stress or anxiety. If you’re a smoker or a past smoker, the situation is even worse. 

The other day a man came in complaining of an itchy, scratchy throat 4 days prior, with loss of his voice the next day. He didn’t have any other viral symptoms such as fever, chills, or muscle aches. Upon further questioning, he normally eats dinner early, but the night before all this happened, he went out to eat dinner late and also had some drinks. 

 

Here’s the explanation to the sequence: Because of his upper airway anatomy, he was predisposed to acid reflux at night due to occasional obstructions and arousals. I talk about who may be predisposed and why this occurs in my book, Sleep, Interrupted. During an obstruction, vacuum forces can suction up small amounts of stomach juices into the throat, leading to various throat symptoms such as scratchiness, pain, hoarseness, post-nasal drip, lump sensation, and chronic cough. More often than not, doctors will give oral antibiotics in this situation, "just in case."

 

Many typical "colds" start of  with a scratchy or sore throat, with no other viral symptoms. Later, it can "travel" up into the nose and sinuses, leading to nasal congestion and sinusitis. What’s happening here is that there was an initial episode of acid reflux, which first irritates the throat, leading to more swelling and congestion, aggravating the vicious cycle. It’s also been shown that your normal stomach contents (acid, bile, digestive enzymes, bacteria) can travel up into your nose and ears. Chronic inflammation can predispose any part of the body to true viral or bacterial infections. 

 

The typical fevers, chills and sweats that are seen in this situation may suggest a viral infection, but you can also have all these symptoms from an involuntary nervous system reaction, which is called vasomotor symptoms. This happens when your involuntary nervous system becomes imbalanced due to a sudden change in your sleep-breathing status. 

 

Even if you start off with allergies or a runny nose from a cold, eventually, the tongue will collapse more and perpetuate this vicious cycle.

 

So the next time you have a sore throat and are convinced that you have an infection, think again. In many cases, you’ll find that either you must have eaten late or drank alcohol the previous night. If not, then you may have a true cold. But since it’s been shown that having colored nasal mucous of throat phlegm does not necessarily mean you have a bacterial infection, things are not always what it seems.

 

How do your typical "colds" begin? I’d like to know.

 

When Your Cold Is Not A Cold

It’s cold and flu season again, and for many of you, drinking lots of liquids, getting enough sleep and eating chicken soup will be enough to bring you back to health. But for some others, you’ll have persistent or lingering problems that may make you wonder, could it be something else?

Whether it’s a chronic cough, a lump in your throat, headaches, or post-nasal drip, there are a variety of symptoms that can mimic routine colds or flu symptoms. The challenge is in determining what exactly is causing your problem so that you can address it properly.

Cold Versus A Flu: What’s the Difference?

Most routine colds are self-limited, and go away within 4-7 days. Common symptoms of colds are a low-grade fever, a runny or stuffy nose, mild cough, and a mild sore throat.

A flu infection, however, is caused by a different virus, and tends to be more severe, with higher fevers, chills, muscle aches, worse headaches, slightly longer course, and increased generalized fatigue. If you’re otherwise healthy and you follow the typical precautions (rest, fluids, sleep, etc.), both the common cold and the flu will eventually go away. But if you have an underlying medical problem, are more stressed than usual, or run yourself ragged despite your infection, then either the infection may not go away, or slowly turn into something else, or be left with one major symptom that just won’t go away for weeks to months. This is when the real problem begins.

When Colds Never End

There are a number of different conditions that can aggravate your cold and flu symptoms. For example, if you have any degree of underlying allergies, this can make your symptoms even worse, with continued nasal congestion, post-nasal drip or ear and sinus congestions and fullness. If you have a history of allergies, either removing yourself from whatever you’re allergic to or taking an over-the-counter allergy medication may help.

One of the more common situations that cause chronic or persistent symptoms is if you have sinusitis. Persistent nasal congestion can back up your very narrow sinus passageways (or the Eustachian tube for the ears) and after an initial negative pressure sensation, fluid can build up and get infected with normal bacteria that live inside your nose.

However, it’s been shown in recent studies that what most people describe as a "sinus infection" is not truly a bacterial infection, but mostly due to pressure or clear fluid. In this case, opening up the sinuses or ears, starting with conservative methods such as vigorous nasal saline irrigation may help. More aggressive decongestants such as over-the-counter (OTC) decongestant pills or sprays (only for a few days at most) are other options. Antibiotics are rarely needed, since most cases are not really due to bacterial infections. If you can open up your sinuses, your body is able to do the rest.  Click here for a FREE brochure on which OTC medications are best for your cold symptoms.

Another interesting fact about sinus pain and headaches is that the pain itself in most cases is not caused by an infection, but by a migraine attack of the nerve endings in your sinuses. In contrast to your classic migraine headache (pounding one sided headaches with sensitivity to bright lights and noised, nausea and vomiting), irritation and inflammation of the nerves in your sinuses can cause pain, pressure, post-nasal drip, and sometimes nausea. In some cases these sinus "headaches" may respond to anti-migraine medications, such as Excedrin Migraine or Imitrex. In this situation, avoidance of certain foods that can trigger migraines is also recommended (such as caffeine, alcohol, MSG, aged cheeses, red wine).

Colds and Acids Don’t Mix

Acid reflux can’t cause colds or flus, but colds and flus can definitely cause acid reflux. For some people, the inflammation from the infection causes narrowing in the nose and throat, leading to stronger than usual vacuum forces in the throat via the following mechanism:

Due to modern human’s unique oral cavity anatomy, our tongues can easily fall back, especially if on our backs (due to gravity) and when in deep sleep (due to muscle relaxation). Many people with this condition naturally like to sleep on their sides or stomachs, but any degree of even mild narrowing due to inflammation can trigger a vicious cycle, where the tongue falls back, leading to partial or total obstruction. (I talk about the reasons why some people are more susceptible to this in my newly released book, Sleep, Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. For more information or to download sample chapters click here.  

Once the tongue falls back and obstructs, as you try to take in a few breaths, tremendous vacuum forces are created in the throat, literally sucking up normal stomach juices into your throat. Your stomach juices include not only acid, but bile, digestive enzymes, and bacteria. Even small amounts of these substances can irritate not only your throat but studies have shown that these can even go into your ears, sinuses and lungs. This causes more inflammation, which narrows the airway even more, causing more tongue collapse. If your nose is stuffier, then vacuum forces are created downstream and the tongue falls back easier. Notice the multiple vicious cycles.

Acid irritation in the throat will produce the classic throat acid reflux symptoms, such as chronic throat clearing, lump sensation, difficulty swallowing, hoarseness, chronic cough, post-nasal drip, and tightness in the throat. This condition frequently coexists with a variety of other upper respiratory conditions.

Not too surprisingly, sinus headaches, post-nasal drip, and throat acid reflux frequently go hand in hand. It’s also been shown that people who are prone to these issues also have what’s called chronic rhinitis or non-allergic rhinitis. This is where your nose’s nervous system is hypersensitive to weather changes such as temperature, humidity, and pressure changes, and other irritants such as chemicals, fumes, scents or odors. This is thought to be due to an imbalance in the involuntary nervous system of your nose.

Sometimes, a patient will come in extremely stressed and concerned about the possibility of cancer, as they’ve smoked in the past, or a parent died of throat or lung cancer. In almost all cases, after a thorough history and  examination of the throat structures, patients are reassured that their symptoms are most likely due to the conditions that’s causing inflammation, such as acid reflux, or allergies.

Why Antibiotics Aren’t The Cure

So now that you know what may be causing your chronic problems, what can you do about it? In most cases oral antibiotics are not the answer (although this is too often prescribed by most doctors). In certain cases patients swear that within a day or two of being given a certain class of antibiotics (macrolides, which include azithromycin or clarithromycin), they felt significantly better, which proves that it was a bacterial infection. One possible explanation is that the macrolide antibiotics have a unique property where it stimulates the smooth muscles of the stomach, causing more contractions and thereby pushes the stomach juices and contents down faster into the intestines. So the less acid is lingering in the stomach, the less it can come up into the throat to cause problems. This is probably why many patients feel better after being given a Z-Pak for throat pain. General surgeons use these medications intravenously to stimulate bowel function after major abdominal surgery.

So now that you know the improper way to treat a cold or flu, what should you do to feel better? The first thing to address is to make sure you are able to breathe well through your nose. Try nasal saline sprays or any of the other various ways of getting saline into your nose. Saline acts as a mild natural decongestant, helping to open up nasal passageways and sinuses. The only downside is that it has to be repeated frequently. If you have any allergies, try to find out what you’re allergic to and get it under control. You can start with over-the-counter allergy medications and if that doesn’t work, you may need to see your doctor about your allergies. Worst case scenario, you may need to see an allergist. If your nose is still stuffy, you may want to consider seeing an ear, nose, throat specialist to figure out if you have an internal structural problem that needs to be addressed.

Some people have naturally flimsy nostrils. Sometimes, this occurs years after rhinoplasty, since narrowing the tip of the nose also weakens the sidewall cartilages that support the nostrils. In this case, Breathe-rite nasal dilator strips may help. If this is not strong enough, or if it won’t stay on, there are various internal nasal springs or clips that can be used (Nozovent, Breathewitheez). Having a stuffy nose internally can also aggravate this nostril collapse problem.

One of the most important habits to avoid is eating close to bedtime. If you have stomach juices lingering from a recent meal and you lay down to sleep, if you have even mild partial to total obstructions, you’ll vacuum up these juices into your throat, which can then go into your nose. This causes more inflammation and more obstruction with arousals. You should try to avoid eating about 3-4 hours before you go to bed.

Alcohol is another substance that should be avoided close to bedtime. It may make you drowsy and fall asleep better, but because it relaxes your muscles, you’ll stop breathing and wake up more often. Again, use the same 3-4 hour rule. What this means is that you can still have a glass or wine or beer with an early dinner.

Many of you will naturally want to sleep on your side or stomach, but if you normally like to sleep on your back, try sleeping on your side or stomach, whichever is more comfortable. This will lessen the degree of tongue collapse due to gravity.

I alluded to sinus pain and pressure being like migraine. Even if you’ve never had a migraine, try to avoid certain foods that can trigger migraines (already mentioned above).

Lastly, it’s not too surprising how often people push themselves while sick. It’s just common sense that you should rest, take it easy, and care of yourself. This involves regular exercise, eating healthy, and taking part in activities that is calming and relaxing. If all these conservative options don’t help, then it’s time to see your doctor.

7 Tips to Breathe Better Through Your Nose

Most people take breathing through their nose for granted. But for many chronic mouth breathers, breathing through the nose is a struggle, if not impossible. Not only is their quality of life diminished, but they’ll also have a variety of other health-related conditions such as dry mouth, snoring, fatigue, and poor sleep. In my last article I addressed 5 reasons why it’s important to breathe through your nose. In this article, I’ll talk about 7 ways that you can breathe better through your nose naturally. 

Before I discuss the various ways to breathe better, a short anatomy course in in order. The nasal septum is a thin piece of cartilage and bone that splits your nasal cavity right down the middle. No one has a perfectly straight septum; everyone’s septum is slightly curved. Sometimes, nasal trauma can shift or move the septum away from its’ midline position. The nasal turbinates are wing-like structures that line the sidewalls of your nose. It’s covered with a mucous membrane, and normally it helps to smooth, warm and humidify air. The turbinates and sinuses also produce about 2 pints of mucous every day. The turbinates swell and shrink, alternating from side to side every few hours. This is called the nasal cycle. 

The front side walls make up your nostrils, which are soft cartilages covered on the inside and outside with skin. The back of your nose is one big cavity (called the nasopharynx), and the passageway turns down 90 degrees into the back of your throat. The nasopharynx is also where your ears connect via the Eustachian tubes. 

If any part of the anatomy that I described becomes obstructed partially or completely, you’ll feel stuffy in your nose. Usually it’s not one thing, but usually due to a combination of different reasons. For example, if you have a mildly deviated septum, suffering from mild allergies will swell up your nasal turbinates, narrowing you nasal passageways. This may not be enough to clog up your nose, but if you have flimsy nostrils or had rhinoplasty in the past that weakened the nostrils, then breathing in with a stuffy nose may trigger your nostrils to collapse. 

Starting from the tip of your nose, the first thing you must do is to find out if you have flimsy nostrils. If you have a very narrow nose, or if your nostril openings are very narrow and slit-like, then you may be prone to having flimsy nostrils. Try this experiment: Take both index fingers and press them just besides your nostrils on your cheek. While firmly pressing on your cheeks, lift the cheek skin upwards and sideways, pointing towards the outer corners of your eyes. Take a deep breath in. Can you breathe much better through your nose? Let go and try it again. If this maneuver works for you, you may benefit from using nasal dilator strips at night (one brand is called Breathe-Rite). Sometimes, the adhesives on these devices are not strong enough, or end up irritating the skin. Another way of treating this condition are various internal dilators (such as Nozovent, Breathewitheez, Nasal cones) that you can find over the counter or over the internet. 

Second, try using nasal saline sprays. You can use the simple spray bottles that put out a fine mist, to more sophisticated methods such as aerosol cans or even using a Water-pik machine (there’s a nasal adaptor that you can buy for this). Another popular variation is something called a Nedi-pot, which uses gravity to pour salt water into your nose and sinuses. You can either use prepared saline packages, or mix your own recipe (one cup of lukewarm water and 1/2 teaspoon of sea salt or Kosher salt with a pinch of baking soda). Whatever method you use, you’ll have to do it frequently to get maximum results. Besides cleansing out mucous, pollutants and allergens, saline also acts as a mild decongestant. 

Third, try not to eat anything within three hours of going to bed. If you still have food or juices lingering in your stomach when you go to bed, it can leak up passively into your throat and not only prevent a good night’s sleep, but these same juices can also leak up into your nose, causing swelling and inflammation. In addition, many people will also stop breathing once in a while, which creates a vacuum effect in the throat which actively suctions up your stomach juices into your throat and nose. 

Fourth, try to avoid drinking alcohol close to bedtime. Not only does alcohol irritate the stomach, it also relaxes your throat muscles as you sleep, which aggravates the process described in the previous paragraph. 

Fifth, if you have any known allergies, especially if it’s something in your bedroom, try to either remove it or or lessen your exposure to it. For example, many people are allergic to dust or molds, and if you have carpeting, or an area rug, it can harbor these allergens. Frequently washing your bed sheets in very hot water also helps. Investing in a quality HEPA filter should help even more. If you have any pets, consider keeping them out of your bedroom. If conservative measure to control allergies is not good enough, consider seeing an allergist for a more formal evaluation. 

Sixth, get regular exercise, especially outdoors. Not only are you exercising your heart and your muscles, you’re also exercising the nervous system in your nose. Vigorous physical activity activates your sympathetic nervous system, which constricts the blood vessels that supply your nasal turbinates. This allows you to breathe better through your nose, with all the added benefits described in my previous article. 

Lastly, slow down and relax. Modern society has removed all the natural built-in breaks throughout the day. Along with all the information overload and constant stimulation, going nonstop all day only adds to the increased stress levels that everyone experiences. In between major activities, take a minute or so to stop what you’re doing and stretch, get up and move around, and do some deep-breathing exercises. Stress can tense up the muscles, causing you to breathe shallower, which causes physiologic changes that can ultimately aggravate nasal congestion. 

These simple 7 steps won’t help everyone, but If you can go down the list and apply all the steps, many if not most of you should feel some improvement in your ability to breathe through your nose. If you’ve tried all these steps and still can’t breathe through your nose, then seek medial help. An otolaryngologist (an ear, nose and throat doctor) is the best doctor to take care of this condition. 

If you are a chronic mouth breather, in addition to what I described above, your jaw is probably more narrow than normal, with some degree of dental crowding. Chronic mouth breathers also tend not to sleep well at night due to various degrees of breathing difficulty. I discuss these issues in my other articles (sleep apnea and upper airway resistance syndrome). 

 

Q: Why do I lose my voice all the time?

A: There are many reasons for losing your voice, but one of the most common reasons for chronic voice problems is due to acid reflux. This is not your typical gastro-esophageal reflux (GRED) in that you don’t have to have any heartburn or indigestion. The only thing you may feel is hoarseness, but more often than not, you’ll also have chronic post-nasal drip, throat clearing, cough, a lump sensation, difficulty swallowing, or pain. This is called laryngo-pharyngeal reflux disease, or LPRD.

Initially, try eating dinner much earlier, and avoid alcohol close to bedtime. There are various over-the-counter medications for acid reflux, but they are not designed for this type of reflux. If your problem persists for more than a few weeks, or keeps coming back, it’s probably prudent to see an ear, nose and throat specialist for a proper evaluation.

 

 

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