Causes of impairment of nasal breathing

Nasal BreathingFor both people with or without an existing respiratory disorder, a greater pressure on the upper respiratory system airways when you lie down horizontally creates a restriction in the flow of air to the lungs. Scientific studies have shown that the recumbent position you would be in to get off to sleep relates to an increase in airflow resistance. This causes a marked decline in the volume of air that enters the lungs.

In addition to this, the relaxation of oral and pharyngeal tissue during sleep puts a greater demand on the nasal air passages as the main supply of oxygen to the lungs while sleeping, so it is important to ensure an optimal airflow through the nose to ensure a good night’s sleep. The combination of this phenomenon and other factors of nasal obstruction can greatly affect our quality of sleep.

There are various additional aggravating factors that may impair nasal breathing. Examples of factors which decrease airflow and ease of breathing include:

  • Pharyngeal narrowing, due to recumbency (lying in a comfortable position to sleep) and sleep induced (relaxation causing narrowing of air passages)
  • Structural nasal diseases, such as nasal polyps, collapsed valve, deviated septum, hereditary, accidental, or surgical malformations
  • Swelling and secretions of nasal mucosal tissue, due to inflammatory causes, such as allergies, sensitivities, rhintitis, sinusitus, viral infections – colds, flu, etc.
  • Congestion of one nasal cavity when lying on one side, due to pressure on tissues and nasal drainage
  • Drug induced, such as rebound congestion due to overuse of topical nasal decongestants, or as side effect of various other medications
  • The nasal cycle – a normal pattern alternating congestion and decongestion of nasal passages
  • Sleep apnoea

See more in our sleep deprivation article

Fiona Morris MA BSc Hons MNIMH is a Medical Herbalist with a special interest in sleep and the respiratory system. She runs consultations for individuals with a wide range of respiratory and breathing conditions, offering herbal prescriptions, alongside lifestyle and nutritional advice. She is the formulator of Breathing Solutions’ Sinus Balm and Sleep Balm. For more information visit


Duggan C.J., Watson R.A. & Pride N.B. (2004) Postural changes in nasal and pulmonary resistance in subjects with asthma Journal of Asthma Oct 41(7):701-7

Gotlib T., Samoliński B. & Arcimowicz M. (2002) Spontaneous changes of nasal patency, the nasal cycle, classification, frequency, and clinical significance Otolaryngologia polska. The Polish Otolaryngology 56(4):421-5

Hanif J., Jawad S.S. & Eccles R. (2000) The nasal cycle in health and disease Clinical Otolaryngology & Allied Sciences Dec 25(6):461-7

Naclerio R.M., Bachert C. & Baraniuk J.N. (2010) Pathophysiology of nasal congestion International Journal of Generl Medicine Apr 8(3):47-57

Ng B.A. (2000) Nasal congestion: A review of its etiology, evaluation, and treatment Ear, Nose and Throat Journal Sept 79(9):690-3, 696, 698

Pervernagie D.A., De Meyer M.M. & Claeyys S. (2005) Sleep, Breathing and the Nose Sleep Medicine Reviews Dec 9(6):437-51

Sung Y.W., Lee M.H., Kim I.J., Lim D.W., Rha K.S. & Park C.L. (2000) Nasal cycle in patients with septal deviation: evaluation by acoustic rhinometry American Journal of Rhinology May-June 14(3):171-4

Young T., Finn L. & Kim H. The University of Wisconsin Sleep and Respiratory Research Group (1997) Nasal obstruction as a risk factor for sleep-disordered breathing Journal of Allergy and Clinical Immunology Feb 99(2):757-62

Article by: Fiona Morris,  medical herbalist MA Bsc(hon)MNIMH