Why do I sleep with my mouth open: causes, effects, symptoms, complications and treatment of mouth breathing

Why do I sleep with my mouth open

Some people find breathing through mouth while sleeping very difficult. I was one of the people who could not breath through the nose while sleeping. My family and friends kept on complaining that I always sleep with my mouth open whether I am sleeping on the back or on the side. From their complains, I had to learn how to keep my mouth closed while sleeping. The question “why do I sleep with my mouth open?” then comes to mind.

The body while alive requires oxygen. The oxygen flows through the openings on the face either the nose or the mouth to the lungs for absorption to the blood stream. The body will require oxygen whether one is sleeping or awake. The ventilation rate is regulated by the nervous system.

The body when breathing will require a smooth pathway for the flow of oxygen to the lungs. Breathing or ventilation is necessary for a person to continue living. Blockage of any part of the breathing pathway is catastrophic.

Why do I sleep with my mouth open?

Causes for sleeping with the mouth open vary from individual to individual. It should be noted that the tongue affects both sleeping with the mouth open and snoring. Some of the reasons for sleeping with the mouth open are:

  • To accommodate breathing if the nasal cavity is blocked. When the nasal cavity is blocked, breathing takes place through the mouth and thus the mouth remains open while sleeping. The blockage of the nasal cavity might be because of the tongue is not supporting the nasal cavity for breathing through the nose, infections or abnormalities in the nasal cavity.
  • Having developed a habit of sleeping with the mouth open for some time. This habit might have started at childhood or at a point in time where one had major issues with nasal blockage or not. The habit however can be corrected with training or the use of devices.
  • If a person has sleep apnea. Sleep apnea gives the patient serious concerns with the oxygen flow into the body. For persons with sleep apnea the need to get enough oxygen is mostly accommodated by sleeping with the mouth open.

There are many other unique reasons on why someone sleeps with the mouth open. However, the habit is not good for yourself and others. Sleeping with the mouth open may cause teeth decay, dry mouth and may lead to a higher susceptibility to diseases like high blood pressure, chronic inflammation, poor immunity and chronic pain if done regularly.

Why do I breathe through mouth while sleeping?

There are three major reasons why people breathe through the mouth. These are:

  • Most at times the reason for breathing through the mouth is if the nasal airway is completely or partially blocked.
  • In some people, breathing through the nose is a habit developed over time sometimes starting during childhood. This may be after nasal obstruction or for people suffering from sleep apnea.
  • Some people breathe through the mouth when they have anxiety or stress.

Nasal obstruction while sleeping

The obstruction prevents the air from smoothly passing through the nose to the lungs. When the nasal airway is blocked, since your body still requires oxygen to live, then your body results to the other pathway for provision of oxygen thus breathing through the mouth takes place.

There are several causes of obstruction of the nose or nasal cavity. These include:

  • Collapse of the tongue at the base of the nasal cavity: This is mainly associated with snoring and sleep apnea. The collapsed tongue blocks the nasal cavity, and since breathing must go on, the individual breathes through the mouth.
  • Nasal congestion caused by allergies, a cold or a sinus infection: This is a serious concern for most of the individuals I included. The allergies or colds blocks the nose partially or completely forcing the body to breathe through the mouth.
  • Enlarged adenoids: Adenoids may be enlarged because of an infection or allergies. In both cases they return to the normal size after the problem is resolved. Adenoids are small patched of tissue that are located at the back of the throat. They are tonsils like and are located adjacent to the tonsils just above them. They form part of the immune system but are not very important and thus can be removed if they remain enlarged.
  • Tonsilitis: Tonsils can become enlarged due to infections by several strains of bacteria or viruses. Tonsils might also have tonsillar hypertrophy where they remain enlarged for an elongated period. They are oval-shaped small glands located at the back of the throat like adenoids that form part of the lymphatic system.
  • Deviated septum: The septum is the cartilage that separates one nostril from the other. The septum may be deviated meaning that it severely does not evenly separate the two nostrils. Deviated septum causes blockage of the nostrils and therefore causes difficulty in breathing. The condition may be congenital or caused by injury to the nose. The deviated septum gets worse with age.
  •  Nasal polyps: These are benign (noncancerous) growths of the nasal lining tissues, or mucosa. The polyps may develop with chronic mucosa infections or in conditions like asthma, acute rhinitis, sinus infections, cystic fibrosis, hypersensitivity to NSAIDs and Churg-Strauss syndrome. The nasal polyps may be predisposed by hereditary traits.
  • Enlarged turbinates: Turbinates are long, narrow, bony structures on the sides of the inner nose that are covered with soft tissue. They regulate airflow by warming and moistening the air, and protect the inner anatomy of the nose. Enlargement of the turbinates also referred to as turbinate hypertrophy. It may occur on acute basis or chronically, are caused by deviated septum, chronic sinus inflammation, environmental irritants or seasonal allergies. Family history of allergic rhinitis (Hay fever) predisposes an individual to enlarged turbinates.
  • The shape of the nose
  • The shape and size of the jaw
  • Tumors: These are very rare.
  • Asthma
  • History of finger or thumb-sucking
  •  Birth abnormalities, such as choanal atresia, cleft palate, or Pierre Robin syndrome

Habit of breathing through the mouth while sleeping

For some people, A habit of breathing through the mouth is developed with time.  This habit may have started at childhood, while growing up, during a nasal obstruction episode or due to sleep apnea. Sleeping with the mouth open during obstruction or sleep apnea happens to accommodate the need for oxygen.

However, even after these conditions are resolved the individual continues breathing through the mouth. It is hard to know if a person has this habit unless a partner informs the person.

Stress and anxiety

Having stress and anxiety can cause an individual to breathe through the mouth instead of the nose.

Stress activates the sympathetic nervous system leading to shallow, rapid, and abnormal breathing. Stress and Anxiety can cause the shortness of breaths and tightness of the chest. To mitigate against the anxious moments where one feels that they are not getting enough air and fear for death, people result to breathing through the mouth.

In the third trimester of pregnancy, breathing through the mouth is also quite common.

Effects of breathing through the mouth

Breathing through the mouth has several effects on the health and other features of the individual. Some of these effects are caused by dry mouth. A dry mouth means the saliva does not wash the teeth and the gums. The health effects of breathing through the mouth include:

  • Tooth decay: Due to dry mouth the teeth are not washed by saliva throughout the night to remove food particles and plague. This causes accumulation of acids leading to tooth decay and cavities. Acids originate from digestion of food particles that are fermented by bacteria in our mouth. Dry mouth causes approximately 30 percent of tooth decay cases in adults.
  • Periodontal disease like gingivitis: Gum disease can be caused by having a dry mouth in a similar way to tooth decay. Having a dry mouth also can lead to fungal infection in the mouth thus causing gingivitis.
  • Sore throat: Having a dry mouth can cause dryness of the throat and that may lead to sore throat. Also having a dry mouth caused by breathing through the mouth may be as a result of getting an infection. However, combining the two increases the sore throat severity.
  • Hoarseness: A dry mouth always leads to hoarseness because the vocal cords are not hydrated. This affects speaking where in most instances some people have difficulty in speaking.
  • Difficult in wearing dentures: Sleeping with the mouth open makes braces treatment to take longer. The effects are that the orthodontist will have a bigger challenge in treating teeth malformations. The gaps between the teeth become more difficult to close and teeth alignment and stability after the braces are removed is compromised.
  • Burning sensation in the mouth and dry nasal passages: When the mouth is dry, most people experience a burning sensation and the nasal passages also dry. This in most instances lead to coughing and irritation. This can lead to infections of the throat and ears.
  • Problems with chewing and swallowing food: Having a dry mouth makes chewing of food a taxing affair. This is because there is no saliva to lubricate the food. Dry of the mouth is caused by sleeping with the mouth open making swallowing also hard because the food is dry.
  • Sleep and oxygen: As discussed in the causes of sleeping with the mouth open, breathing with the mouth is a symptom together with blocked pathways of sleep apnea. Sleep apnea is associated with altered levels of oxygen and carbon dioxide in the blood stream. Less oxygen and more of carbon dioxide affect most of the body systems including the brain, the heart and others. This may cause poor learning and reduce the ability to focus in school and work. It is also associated with fatigue, and brain fog. Low oxygen concentration is also associated with high blood pressure and heart failure.
  • Decreased lung function: Dry mouth caused by breathing through the mouth is shown to worsen the symptoms of asthma and decrease the lung function in everyone. This is because the air that flows through the mouth is not warmed and moistened up thus affecting the whole ventilation pathway.

Effects of breathing through the mouth for children

In children, mouth breathing can cause both physical abnormalities and cognitive problems. Some of the mouth breathing effects on children include:

  • Facial growth and development: If a child sleeps with an open mouth regularly, he/she may develop long narrow faces, droopier eyes, less prominent cheek bones, a smaller lower jay or other flatter facial features. These negative growth features may be corrected with ensuring that the child sleeps with the mouth closed.
  • Speech: A child who sleeps with an open mouth is more likely to develop some speech deficiencies. This may be associated with the facial growth and development features or because of the oral myofunctional disorder (tongue thrust swallowing pattern). This affects some of the word’s pronunciation like in the “S” sound which is also known as lisp.
  • Dental malocclusion: In children who mouth breathe, the common defects seen are a large overbite and crowded teeth. This is because the tongue pushes the teeth as we sleep with the mouth open leading to the defects.
  • Poor posture: Children who mouth breathe also have signs of poor posture.
  • Gummy smiles

Mouth breathing in children also makes the children not to sleep well at night. Not sleeping well at night leads to the following:

  • Poor performance in school and in the developmental milestones
  • Poor growth
  • Inability to concentrate
  • Sleeping disorders

Importance of breathing through the nose while sleeping

  1. Increased oxygen absorption as compared to mouth breathers. As discussed above, breathing through the mouth reduces the oxygen absorption. Nose breathing makes the nasal mucosa to produce nitric oxide in small levels which increased the lung oxygen absorption. It should be noted that if one has prolonged oxygen deficiency, the health is compromised as discussed above. Increase in oxygen uptake is also aided by maintaining the lungs’ elasticity by breathing through the nose because it adds resistance to the air stream.
  2. Breathing through the nose cleanses the air from dust, impurities and microbes. This is done by the hairs and mucous produced by the note. The filtered items are then removed from the nose through mucous. If the air passes through the mouth, the filtration is not done hence exposing the respiratory system to infections and allergens.
  3. Warming and moisturizing the air. This helps relieve any asthma and respiratory tract infections. If cold air passes through the respiratory system, it might trigger allergic reactions including asthma attacks.
  4. Reducing incidences of oral diseases. Breathing through the nose ensures that the mouth does not dry up. Drying up of the mouth is associated with several oral health problems discussed above.
  5. Breathing through the nose can relieve one from heavy snoring and sleep apnea.
  6. In children, breathing through the nose helps in the normal formation of facial features. This may sound funny, but it is clinically proven as discussed above.

Mouth breathing diagnosis

Diagnosis of mouth breathing has no single test. As an individual you can check for dryness of the mouth when you wake up as a common symptom.

A doctor will then examine for reasons for persistent nasal congestion and dry mouth. This is done by examining the nostrils physically in addition to asking you questions about sleep, snoring, sinus problems and difficulty in breathing.

A dentist on the other has can check for mouth breathing during a dental exam which are done regularly. The dentist will try to check the reasons for bad breath, teeth cavities or gingivitis. As discussed above mouth breathing comes with the above symptoms.

Further examination by an Ear, nose and throat (ENT) doctor is recommended if the doctor or dentist notices any of the following: swollen tonsils, nasal polyps and other conditions.

How to keep your mouth shut while sleeping

There are several ways that can help to sleep with the mouth closed. The treatment for mouth breathing depends on the cause. The different products or routine will be recommended for different causes. The main ways to keep your mouth shut while sleeping are: training your body to sleep with the mouth closed, use of medication to clear the congestion, surgical removal of the nasal parts that cause obstruction or even use of medical devices.

Devices that can help sleep with the mouth closed

There are some devices that can be used to help you to breath through the nose. These devices help to resolve some of the underlying reasons for mouth breathing. The devices include:

Nasal vents to prevent mouth breathing
  1. Adhesive nasal strips, nose vents or nose dilators: Adhesive nasal strips are strips that are applied to the bridge of the nose to ensure nasal dilation. Nasal dilators or nasal vents being one of the most solid and preferable anti snoring prevention method are small, elastic small tube pieces of non-toxic and non-irritant materials that prevent nostrils collapse while sleeping thus ensuring breathing through the nose. Nasal strips are wing shaped adhesive bandage that has implants of plastic or other splints that is used to prevent breathing through the mouth by opening the airwaves though application on the nose surface and the nostrils side. They ensure deep nasal breaths void of snoring too.
  2. Anti-snore chin strap: These are straps that prevent sleeping with the mouth open. These straps should be used if there is no blockage of the nasal cavity. Sleeping with the mouth wide open is also one of the major causes of snoring because the soft palate and tongue base close the breathing passage. The chin straps are made of soft material and are gentle on closing the mouth hence reducing breathing through the mouth and snoring.
  3. In cases where you have sleep apnea, the most commonly applied device is the continuous positive air pressure (CPAP) machine. The face-mask appliance continuously delivers air to the respiratory tract through a mask. The pressure from the CPAP machine prevents blockage of the nasal cavity as it prevents the airways from collapsing.
  4. In children, appliances to widen the palate are recommended by dentists to open the sinuses and nasal pathway. In addition, braces and other orthodontic treatment to treat the other underlying causes of mouth breathing may be used.

How to use Medication to keep your mouth shut while sleeping

There are medications that can help to reduce nasal congestion or blockage helping the person to breathe through the nose. Some of these medications include:

  • Nasal decongestants: Decongestants constrict the blood vessels in the nasal passages thus relieving congestion. The common decongestants are delivered in pill form or in a nasal spray form. Most of the decongestants contain Phenylephrine and phenylpropanolamine. The decongestant has a disadvantage that they only offer temporary relief from congestion and do not treat the cause of the allergy.
  • Antihistamines: These are medications that are used to decrease the effects of histamine, a chemical produced in the body during an allergic reaction, on the cell receptions in the body. They are broadly classified into first-generation, second-generation and third-generation antihistamines. First generation antihistamines which often sedate the user and have a short half-life include: Benadryl (diphenhydramine) and chlor-trimeton (Chlorpheniramine). The second and third generation antihistamines that can be sold over the counter can target specific receptors thus reducing drowsiness in addition to having a longer half-life in the body. They include cetirizine (Zyrtec), Loratadine (Claritin) and fexofenadine (Allegra).
  • Prescription or over-the-counter steroid nasal sprays: These corticosteroid-based drugs are used to treat swelling and inflammation in allergies including asthma. They can be used in the short term or long term depending on the condition severity. They are used in nasal or oral forms to treat instances of breathing through the mouth.
  • One can also use a saline mist during long flights or cruises.  Saline mist helps to add moisture to the interior of the nose in the process it dissolves and softens the thick and crusty mucus. The mucus may prevent breathing through the nose if the nose is blocked. 

Surgical methods to stop sleeping with the mouth open

These are majorly applied in children where surgical removal of swollen adenoids and tonsils if they are inflamed.  The removal of the two relieves the child from congestion in the long term thus ensuring the child breathes through the nose.

The removal is a minor operation that takes a few days to recover for children.

Training yourself on how to keep the mouth closed during sleeping

There are ways to sleep with your mouth closed without using medications, machines or surgery. In most of these methods conditioning of the body or environment goes a long way in helping a person to breathe through the nose. Some of the methods that are easy to try includes:

1.       Keeping the house clean and free from allergens.

The bedroom and the bed should only be used for sleeping only. If you are allergic to anything like dust, pollen, pet’s fur and molds may be a reason for blocking of the noses thus making a person to breathe through the mouth. The allergens must be eliminated from the bedroom.

It is recommended the pet should not be entertained in the bedroom. This would ensure that there is no animal fur which can cause or aggravate nasal blockage or asthma.

It is also not recommended to have any plants in the bedroom since the moisture they are given, or they produce can entertain the growth of molds. Also, during the night plants consume oxygen thus competing with you as you sleep.

You can also install air filters in your heat and air conditioning (HVAC) systems to prevent the spread of allergens in your house.

2.       Consciously practicing breathing through the nose

The human brain can work miracles given the right conditioning. The brain thus can be used to help a person to stop sleeping with the mouth open. This cane be done by actively practicing breathing with the mouth closed during the day to develop the habit of nose breathing.

To help in doing this a person can set reminders, use sticky notes or use friends to remind whenever the person stays with the mouth open. When you consistently breathe through the nose, a pattern is developed which thus breaks the cycle of breathing through the mouth.

To aid in developing the habit of breathing through the nose, a good posture must be kept at all time. The best posture to enable nose breathing is with the head pressed back a little.

With time the brain is conditioned to always keep the mouth shut except in times where breathing through the nose is impossible. The brain also helps you to keep the right posture to reduce mouth breathing effects.

3.       Sleeping on the back with the head elevated

For mouth breathers who sleep without elevating the head, elevating your head might be the solution to your problem. Other sleeping styles may make the mouth to open but sleeping on the back with the head elevate helps to ensure breathing through the nose is achieved.  

A pillow can help you elevate your body in addition to adjustable mattresses where available. The pillow ensures the head is elevated above the rest of the body.

Elevation of the head helps a person to breathe through the nose because:

  • It prevents acid reflux.
  • It helps clear the air pathways thus helping a person breathe through the nose
  • It also reduces stress on the heart
4.       Exercise and weight loss
Yoga to enable nose breathing

Regular exercise is a good way to prevent a person from breathing through the mouth. Being overweight also works to prevent breathing through the nose. Therefore, regular exercise like cardio, yoga and others go a long way in helping in air circulation and breathing through the nose thus preventing mouth breathing effects.

Exercise also helps in losing the extra weight and thus preventing both mouth breathing and snoring. Exercising helps to keep the body in good shape and spirits.

5.       Practicing nose clearing exercise

As discussed above, one of the main reasons for breathing though the mouth is nasal congestion. A simple nose clearing exercise called Buteyko method or Buteyko Breathing Technique. The technique is used in asthma and other respiratory conditions where blockage of the respiratory system is involved. The complementary or alternative physical therapy was named after its Russian inventor.

The purpose of the technique is to return the breathing volume to normal in asthma or the other respiratory conditions.

The procedure is done in a sitting position with the mouth closed. You are then supposed to breathe through your nose for 2 to 3 minutes. After that you are supposed to breathe in and press to close the nose with your fingers.

While the nose is closed, hold your breath for as long as you can. When you feel you can’t hold the breath any longer, slowly exhale through the nose. The mouth must be closed at all time during the procedure.

Repeat the procedure several times and you can also do the procedure as you do other chores. After the exercises mouth breathing effects will start reducing slowly by slowly.

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