Letter to the Editor: Why does wearing a mask create anxiety for some?

By: 
Nichole Cauwels
Im sure by now you have heard people tell you that they can’t wear a mask. They sometimes say they can’t breathe with it on or cite they have a medical condition that makes it impossible to breathe through a mask. You may yourself have had that experience. On the other hand, you know that doctors, dentists, painters, autobody workers, grain elevator employees and countless others have been able to breathe and work while wearing a mask. So, what’s going on here? Why do some people adapt to wearing a mask while others just can’t breathe? 
 
I’m going to propose that it’s all in the way you breathe. You see long before any of us had ever heard of COVID-19 the U.S. was already experiencing an epidemic of another kind. Mouth breathing, sleep disordered breathing, allergies, deviated septums, crooked teeth, anxiety, weight gain, fatigue, high blood pressure, strokes, certain cancers and gum disease can all be linked back to the same underlying issue. The size, shape and position of the Maxilla, which is the bone in your face that houses your nasal passages, sinuses, roof of your mouth and houses your upper teeth. The size, shape and position of your Maxilla can either promote or hinder healthy breathing. Normal healthy breathing is quiet and slow, done through the nose with air pulled deep into the lung by the diaphragm. Breathing that is loud, shallow, heavy or causes your shoulders to lift is harmful to your body. 
 
I want to highlight why mouth breathing should be considered as silly as nose eating. Nose eating is done in emergency situations only and typically in a hospital setting through a tube. I want you to consider that mouth breathing should also only be done in emergency situations where nose breathing is not possible. Here’s why: When we breathe through our nose the air we breathe is filtered, humidified, conditioned and infused with small amounts of nitric oxide. The flow of the air is directed, smoothed and slowed in comparison to a mouth breath. Nitric oxide is a big deal, especially during a respiratory disease outbreak. Nitric oxide has several important functions. It acts as your body’s natural anti-inflammatory, it reduces high blood pressure, it aids in getting the oxygen deep in the lungs where better oxygen exchange can take place, it kills germs and it boosts your immune system. If you are already a mouth breather due to allergies or other nasal blockages, it’s even more critical for you to wear a mask. The mask can’t replace all the functions of your nose but at least you would be better filtering, humidifying and flow limiting your breaths. 
 
There are other problems with mouth breathing beyond just missing out on the benefits of nose breathing. This is where I believe we will find the answer to why wearing a mask creates anxiety for some. In order to breathe through your mouth, you have to take your tongue off the roof of your mouth. This will signal to your brain that something is wrong or creating stress and your nervous system will switch into sympathetic or fight or flight mode. In fight or flight mode you either are more edgy and irritated or you want to flee the situation possibly feeling nervous or claustrophobic. When you breathe through your mouth, your breaths are louder, greater in volume, shallower (more in your upper chest) and you exhale much more humidity (fluid) and CO2. This type of breathing pattern also causes the sympathetic nervous system to be triggered. 
 
In true moments of stress like encountering a mountain lion while pheasant hunting this helps saves lives but a chronic condition like this is very hard on your health. Chronically exhaling too much CO2 lowers your tolerance to CO2. So. when you have an increase in CO2 due to exercise or wearing a mask you feel winded, out of shape and like you can’t breathe even though you are breathing just fine. By changing the way you breathe, you can calm yourself during times of stress and anxiety.
 
We’ve all heard the mantra, take a deep breath and stay calm. I just want to point out that a big breath and a deep breath are not the same things. A big breath or even a sigh will lift your shoulders and expand your rib cage stimulating the fight or flight mode, whereas a deep breath, one that takes air down deep into your lungs is done with your nose and diaphragm. So next time you feel like you just can’t breathe or your mask is making you anxious, check and make sure your nose is clear, your tongue is firmly suctioned to the roof of your mouth, your lips are sealed and your breaths are slow, quiet and deep. If you must mouth breathe then it’s critical to wear your mask, it protects you by acting as the filter (nose) that you can’t use and it protects others by keeping all of that humidity you’re exhaling away from them. 
 
Nichole Cauwels
Brandon

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