Can mouth-breathing contribute to heart attack deaths?
March 28, 2018 10:20 AM Subscribe
Can anyone point me toward any research/literature on mouth breathing and heart attacks deaths? My hypothesis is that it does. I will ask my doctor, but I’d like to do some research before my appointment in a month or so.
My father died at age 47 of a heart attack. He was in relatively good shape and there was no prior warnings other than stress. He was a mouth breather. I am a mouth breather.
Not that I don’t inhale through my nose at all, just probably a lot less than ideal. When I see a movie with a hostage with their mouth taped shut, it makes my skin crawl worse than any depiction of violence because I can picture myself slowly dying from not getting enough air.
I am 39 and am a runner in relatively good shape. Better than my dad was when he died. I am intentional about minimizing stress. I go to the doctor every couple years about practically begging them to tell me something about my lifestyle I could change to improve my heat health. But ever test they run comes back saying I’m fine. In fact, better than fine.
I do a high intensity interval training class, and the instructor always talks about inhaling through your nose and exhaling through your mouth. They say this helps your heart rate recover better/faster.
I find myself taking having a few moments of uncomfortable recovery inhaling and exhaling through my mouth after a particularly intense session.
This lead me to my hypothesis that mouth breathing could increase death rate from heart attack as you’re unable to breath in enough oxygen through your mouth during so an intense event.
If that’s the case, I would like to inquire on surgical procedures that could improve my ability to breath through my nose.
My father died at age 47 of a heart attack. He was in relatively good shape and there was no prior warnings other than stress. He was a mouth breather. I am a mouth breather.
Not that I don’t inhale through my nose at all, just probably a lot less than ideal. When I see a movie with a hostage with their mouth taped shut, it makes my skin crawl worse than any depiction of violence because I can picture myself slowly dying from not getting enough air.
I am 39 and am a runner in relatively good shape. Better than my dad was when he died. I am intentional about minimizing stress. I go to the doctor every couple years about practically begging them to tell me something about my lifestyle I could change to improve my heat health. But ever test they run comes back saying I’m fine. In fact, better than fine.
I do a high intensity interval training class, and the instructor always talks about inhaling through your nose and exhaling through your mouth. They say this helps your heart rate recover better/faster.
I find myself taking having a few moments of uncomfortable recovery inhaling and exhaling through my mouth after a particularly intense session.
This lead me to my hypothesis that mouth breathing could increase death rate from heart attack as you’re unable to breath in enough oxygen through your mouth during so an intense event.
If that’s the case, I would like to inquire on surgical procedures that could improve my ability to breath through my nose.
If you are having trouble getting enough air breathing through your nose have you have been checked by an ENT? Mouth breathing for some reasons might be associated with sleep apnea - which is a risk factor for heart attack. Did your father snore? Do you? Those might be things to investigate for peace of mind if nothing else.
posted by leslies at 10:40 AM on March 28, 2018 [8 favorites]
posted by leslies at 10:40 AM on March 28, 2018 [8 favorites]
Q: Should I Breathe Through My Nose or My Mouth?
A: “Breathe freely! ... It doesn’t matter whether you’re breathing out of your nose or your mouth while you exercise.” "...once you exceed four to six times your resting breathing rate—taking in 20 to 35 liters of air per minute—everyone in the world is a mouth breather."
posted by Mr.Know-it-some at 10:45 AM on March 28, 2018 [5 favorites]
A: “Breathe freely! ... It doesn’t matter whether you’re breathing out of your nose or your mouth while you exercise.” "...once you exceed four to six times your resting breathing rate—taking in 20 to 35 liters of air per minute—everyone in the world is a mouth breather."
posted by Mr.Know-it-some at 10:45 AM on March 28, 2018 [5 favorites]
What you eat is going to have a way higher effect on whether or not you have a heart attack.
posted by tooloudinhere at 11:03 AM on March 28, 2018 [1 favorite]
posted by tooloudinhere at 11:03 AM on March 28, 2018 [1 favorite]
I don't know the answer but I know how you could set your mind at ease about oxygen. Presumably in all the tests you've had, they've measured your blood oxygenation (it's the little think they put on your finger). You're concerned about oxygen after activity, why not buy a simple oximeter and check. You'll obviously want to do a little reading to find out if oxygen is supposed to dip and how much, but you can find out if your oxygen is really dipping and if it's dipping more than normal.
posted by If only I had a penguin... at 11:04 AM on March 28, 2018
posted by If only I had a penguin... at 11:04 AM on March 28, 2018
Mouth breathers often have sleep apnea (or rather, people with sleep apnea are often mouth breathers) and apnea is related to many heart problems.
source: am mouth breather, have untreated apnea, have heart failure and docs who won't shut up about the apnea
posted by misanthropicsarah at 11:11 AM on March 28, 2018 [8 favorites]
source: am mouth breather, have untreated apnea, have heart failure and docs who won't shut up about the apnea
posted by misanthropicsarah at 11:11 AM on March 28, 2018 [8 favorites]
IANAD but this information might set your mind at ease a little:
"Mouth-to-mouth breathing isn’t necessary if you are doing CPR on someone you saw go into cardiac arrest. That’s because the individual’s blood has enough stored oxygen to keep him or her going for a while."
Source: Harvard Health Blog
posted by donut_princess at 11:17 AM on March 28, 2018
"Mouth-to-mouth breathing isn’t necessary if you are doing CPR on someone you saw go into cardiac arrest. That’s because the individual’s blood has enough stored oxygen to keep him or her going for a while."
Source: Harvard Health Blog
posted by donut_princess at 11:17 AM on March 28, 2018
Remember that correlation does not guarantee causation!
posted by Dr. Wu at 11:22 AM on March 28, 2018 [7 favorites]
posted by Dr. Wu at 11:22 AM on March 28, 2018 [7 favorites]
Your heart beats slower while you're inhaling (heart rate variability). However, if you're at a 160 HR after a strong long effort, inhaling alone won't drop your HR to 120. But part of why the instructor is probably saying to inhale through the nose is due to the limited air volume this will require one to inhale longer to get the amount of air one needs, and the body will likely exhale a bit faster to try to get the air exchange rate up to the recovery value it desires. I would imagine the theory is that the increased ration of inhale to exhale would lend more strength to the body's parasympathetic systems.
The important parts of an interval workout are balancing the length and intensity of the effort against the amount of recovery one is allowing. The body will naturally lower the heart rate as is detects the blood oxygen levels rising. I would not argue that attempting to artificially lower the HR while at the same time limiting air exchange is optimal for the body's recovery. I could easily imagine that if one wanted to get the body's HR down faster one would get much better results by stimulating the dive reflex by dunking one's face/head in a bucket of cold water as part of recovery. I've never seen that recommended by serious training regimes, and thus imagine that allowing one's body to naturally recover as it sees fit is probably optimal.
On the question of heart health/mortality, it's easy to imagine a physiological response of poor heart health / low blood oxygen levels triggering the desire to mouth breath. Assuming good blood oxygen levels and heart health, I have trouble thinking of a phyiological way that mouth breathing could be bad for the heart. However I'm not a exercise physiologist.
I agree with the others, it might be worth investigating if there's a reason that nose breathing is so troubling for you. But if your heart and blood oxygen levels look fine, I personally would not be concerned.
Regarding your actual hypothesis of mouth breathing could lead one to not being able to draw in enough breath during a heart attack, I'd suggest that more practiced mouth breathing would allow one to sufficiently draw in breath. And I'll note that what most people mean by a heart attack, the heart doesn't get enough oxygen, not because the blood is insufficiently oxygenated, but because of blood flow (either a blockage or decreased flow through specific veins/arteries).
posted by nobeagle at 11:36 AM on March 28, 2018 [1 favorite]
The important parts of an interval workout are balancing the length and intensity of the effort against the amount of recovery one is allowing. The body will naturally lower the heart rate as is detects the blood oxygen levels rising. I would not argue that attempting to artificially lower the HR while at the same time limiting air exchange is optimal for the body's recovery. I could easily imagine that if one wanted to get the body's HR down faster one would get much better results by stimulating the dive reflex by dunking one's face/head in a bucket of cold water as part of recovery. I've never seen that recommended by serious training regimes, and thus imagine that allowing one's body to naturally recover as it sees fit is probably optimal.
On the question of heart health/mortality, it's easy to imagine a physiological response of poor heart health / low blood oxygen levels triggering the desire to mouth breath. Assuming good blood oxygen levels and heart health, I have trouble thinking of a phyiological way that mouth breathing could be bad for the heart. However I'm not a exercise physiologist.
I agree with the others, it might be worth investigating if there's a reason that nose breathing is so troubling for you. But if your heart and blood oxygen levels look fine, I personally would not be concerned.
Regarding your actual hypothesis of mouth breathing could lead one to not being able to draw in enough breath during a heart attack, I'd suggest that more practiced mouth breathing would allow one to sufficiently draw in breath. And I'll note that what most people mean by a heart attack, the heart doesn't get enough oxygen, not because the blood is insufficiently oxygenated, but because of blood flow (either a blockage or decreased flow through specific veins/arteries).
posted by nobeagle at 11:36 AM on March 28, 2018 [1 favorite]
the instructor always talks about inhaling through your nose and exhaling through your mouth. They say this helps your heart rate recover better/faster.
This sounds suspiciously like the Buteyko Breathing Technique
This sounds suspiciously like the Buteyko Breathing Technique
This method is based on the assumption that numerous medical conditions, including asthma, are caused by chronically increased respiratory rate or deeper breathing (hyperventilation). However, this theory is not widely supported in the medical community due to the lack of evidence supporting either the theory behind the method or that it works in practice.posted by zinon at 12:15 PM on March 28, 2018 [1 favorite]
Your heart beats slower while you're inhaling
The heart beats slower during exhalation, and faster during inhalation. (Source)
posted by crookedneighbor at 12:40 PM on March 28, 2018 [1 favorite]
The heart beats slower during exhalation, and faster during inhalation. (Source)
posted by crookedneighbor at 12:40 PM on March 28, 2018 [1 favorite]
Opps, crookedneighbor is definitely right, I misremembered which was which. That kind of makes the rest of that paragraph's guessing about what your instructor might have been intending. I'll note that for most (all?) running books I've read, the advice has always been to breath however feels comfortable.
I still think that if your test results are good that mouth breathing is unlikely to be something to worry about. I missed it on preview, but donut_princess 's comment (with cite) really helps drive home the point that mouth breathing really would seem unlikely to be related to heart attacks.
posted by nobeagle at 1:18 PM on March 28, 2018
I still think that if your test results are good that mouth breathing is unlikely to be something to worry about. I missed it on preview, but donut_princess 's comment (with cite) really helps drive home the point that mouth breathing really would seem unlikely to be related to heart attacks.
posted by nobeagle at 1:18 PM on March 28, 2018
Mouth breathing can dry out your mouth, which is bad for dental health and poor dental health can lead to heart disease?
posted by elsietheeel at 2:18 PM on March 28, 2018 [1 favorite]
posted by elsietheeel at 2:18 PM on March 28, 2018 [1 favorite]
Hey so I considered putting this in a MeMail but figured it might help other mouth breathers. I'm a medical librarian and a mouthbreather so I have two kinds of answers.
Can I find out if mouthbreathing is related to heart attacks? Head yourself on over to pubmed.gov to see abstracts of scientific articles. Try putting "Mouth Breathing"[MAJR] (include the quotes and brackets) to find abstracts where mouth breathing is the major topic (most important thing about the article). Also try "Mouth Breathing"[MeSH] to get abstracts about this as a topic in the article. You can AND these with other words to make your search more narrow/specific:
"Mouth Breathing"[MeSH] AND heart
"Mouth Breathing"[MeSH] AND cardiovascular
"Mouth Breathing"[MeSH] AND mortality
"Mouth Breathing"[MeSH] AND effects (this one might be too big but will get abstracts that use the word effects which might narrow it down a bit)
etc.
You could also do the most reasonable and write "Mouth Breathing"[MeSH] AND heart attack but I'll save you the clicks-- there's nothing.
In skimming these it seems that for adults, the topics most discussed relating to mouth breathing are sleep issues and dry mouth. In kids, it seems like doctors aggressively treat kids who mouth breathe because there is a perception that this can mess up facial bone and tooth development.
This doesn't rule out that someone out there is doing this kind of research and trying to answer this question. It could mean:
- most research is done by people who have training in physiology. If physiologically there is a reason that your heart and breathing method aren't connected, they would never pick this question to investigate. (I know nothing about physiology so cannot test this.)
- someone tested it and found no association and wasn't able to get this paper published because publication bias
- it happens so infrequently that no one has put the pieces together yet
- many other possibilities too.
So, ask your doctor. It is OK to wonder about your health and ask the expert. Especially if you haven't ever talked to a doctor about this. It seems like some mouthbreathing can be due to physical problems like enlarged adenoids or deviated septum, and there can be surgeries to reduce these if you have them.
Now my personal answer: I was aggressively treated for mouthbreathing as a kid (not at the same time, but adenoid removal; orthodontics to push my tongue; breathing therapy ) but it didn't really take. During these therapies I was monitored with an oximeter and I can tell you, I get close enough to the same amount of oxygen no matter if I use my nose or mouth, even if it feels like the volume is different. I'm 37 now and breathe through my nose about 30% of the time, usually when I'm not paying attention at all. I am 100% familiar with the "OMG they taped that guy's mouth shut so he'll be dead soon" movie-watching thought. I found this article and Metafilter thread on Empty Nose Syndrome to be very interesting for reframing how I think/feel about the sensation of air in my nose, and the relationship between perceived air volume and required air volume per breath.
It sounds like you are pretty stressed about this and god knows everyone makes fun of mouthbreathers reflexively so I know it's hard to talk about. Best of luck and I hope you get a satisfactory answer.
posted by holyrood at 2:23 PM on March 28, 2018 [4 favorites]
Can I find out if mouthbreathing is related to heart attacks? Head yourself on over to pubmed.gov to see abstracts of scientific articles. Try putting "Mouth Breathing"[MAJR] (include the quotes and brackets) to find abstracts where mouth breathing is the major topic (most important thing about the article). Also try "Mouth Breathing"[MeSH] to get abstracts about this as a topic in the article. You can AND these with other words to make your search more narrow/specific:
"Mouth Breathing"[MeSH] AND heart
"Mouth Breathing"[MeSH] AND cardiovascular
"Mouth Breathing"[MeSH] AND mortality
"Mouth Breathing"[MeSH] AND effects (this one might be too big but will get abstracts that use the word effects which might narrow it down a bit)
etc.
You could also do the most reasonable and write "Mouth Breathing"[MeSH] AND heart attack but I'll save you the clicks-- there's nothing.
In skimming these it seems that for adults, the topics most discussed relating to mouth breathing are sleep issues and dry mouth. In kids, it seems like doctors aggressively treat kids who mouth breathe because there is a perception that this can mess up facial bone and tooth development.
This doesn't rule out that someone out there is doing this kind of research and trying to answer this question. It could mean:
- most research is done by people who have training in physiology. If physiologically there is a reason that your heart and breathing method aren't connected, they would never pick this question to investigate. (I know nothing about physiology so cannot test this.)
- someone tested it and found no association and wasn't able to get this paper published because publication bias
- it happens so infrequently that no one has put the pieces together yet
- many other possibilities too.
So, ask your doctor. It is OK to wonder about your health and ask the expert. Especially if you haven't ever talked to a doctor about this. It seems like some mouthbreathing can be due to physical problems like enlarged adenoids or deviated septum, and there can be surgeries to reduce these if you have them.
Now my personal answer: I was aggressively treated for mouthbreathing as a kid (not at the same time, but adenoid removal; orthodontics to push my tongue; breathing therapy ) but it didn't really take. During these therapies I was monitored with an oximeter and I can tell you, I get close enough to the same amount of oxygen no matter if I use my nose or mouth, even if it feels like the volume is different. I'm 37 now and breathe through my nose about 30% of the time, usually when I'm not paying attention at all. I am 100% familiar with the "OMG they taped that guy's mouth shut so he'll be dead soon" movie-watching thought. I found this article and Metafilter thread on Empty Nose Syndrome to be very interesting for reframing how I think/feel about the sensation of air in my nose, and the relationship between perceived air volume and required air volume per breath.
It sounds like you are pretty stressed about this and god knows everyone makes fun of mouthbreathers reflexively so I know it's hard to talk about. Best of luck and I hope you get a satisfactory answer.
posted by holyrood at 2:23 PM on March 28, 2018 [4 favorites]
I think (but check with your dentist!) that mouth breathing can raise your risk of gingivitis, if you truly breathe through your mouth most of the time. And dental health problems are correlated with heart health problems. I second the suggestion to make sure you don't have apnea. IANAD, IANYD.
It sounds like you are taking good care of yourself. Keep doing that! I'm sorry you lost your dad so young. If your doctor and dentist say you are in good health, and thoughts like these keep bothering you, it might be worth talking to a therapist about it. But consult your doctor and your dentist first!
posted by purple_bird at 3:01 PM on March 28, 2018
It sounds like you are taking good care of yourself. Keep doing that! I'm sorry you lost your dad so young. If your doctor and dentist say you are in good health, and thoughts like these keep bothering you, it might be worth talking to a therapist about it. But consult your doctor and your dentist first!
posted by purple_bird at 3:01 PM on March 28, 2018
Using a neti pot might help you gain some more use of your nose, if that's of interest.
Some people suggest distilled water & dedicated salt; I use lukewarm tap water and a big pinch of sea salt meant for cooking, just eyeballing the amounts and swirling it around the pot to mix it.
posted by pseudostrabismus at 5:01 PM on March 28, 2018
Some people suggest distilled water & dedicated salt; I use lukewarm tap water and a big pinch of sea salt meant for cooking, just eyeballing the amounts and swirling it around the pot to mix it.
posted by pseudostrabismus at 5:01 PM on March 28, 2018
I used to be a mouthbreather because of untreated sinus problems. I can't speak to the link to heart problems (never had any myself so I guess that doesn't help your hypothesis), but I do feel compelled to encourage you to get your sinuses looked at. Good gracious, life changing. My teeth are in better shape, I get fewer throat infections (next to none these days). Best bit is, you might not even need surgery. I had to spray three different drugs up my nose for going on six months but did it EVER do the trick. I am a sinus-fix evangelical.
posted by greenish at 3:37 AM on March 29, 2018 [2 favorites]
posted by greenish at 3:37 AM on March 29, 2018 [2 favorites]
Response by poster: Thanks, all, for the responses! Gave me a lot to think about...
posted by glenngulia at 5:29 AM on March 29, 2018
posted by glenngulia at 5:29 AM on March 29, 2018
You've gotten good advice here overall. Just need to respond to say please do NOT use tap water with a Neti pot. There have only been a few deaths that I know of but as a rule tap water is not treated/tested/purified with an aim toward being inside your sinus cavities and that close to your brain, so there are some known infections you can get (that would never be an issue for drinking). Boil it well first or use distilled.
posted by Lady Li at 5:41 AM on March 30, 2018
posted by Lady Li at 5:41 AM on March 30, 2018
This thread is closed to new comments.
I hope one of the answers will explain this concept and then debunk it to put the OP's mind at ease, along the lines of this article.
posted by JimN2TAW at 10:28 AM on March 28, 2018