454 Karese Laguerre ~ Adventures in Breathing

Transcript

Holly:  Hello adventurers and welcome to the Into the Woods podcast, episode 454. This is your host Holly Worton, and I am back with another exciting guest.

Today we are talking about breathing. I know this is kind of a weird topic but breathing is important and it is something that most of us probably don’t think about. Now, I have got asthma and according to some people I am a weird breather (we will hear more about that in this episode!), so it is definitely something I am aware of but I wanted to learn more and wanted to find a guest, so that is why I brought on today’s guest, Karese Laguerre. What I didn’t know was how simple it can be to fix some breathing difficulties. Karese gives some super simple tips on how we can identify breathing issues and improve our breathing today.

Who is Karese Laguerre? Karese is a registered Dental Hygienist and Myofunctional Therapist. She founded The Myo Spot, a practice aimed at amplifying oral wellness to whole body wellness. Through tele-therapy she helps clients of all ages overcome tongue ties, TMJ disorders, sleep apnea, grinding, anxiety, and various breathing and orofacial dysfunction. Passionate about education and self-help, she published Accomplished: How to Sleep Better, Eliminate Burnout and Execute Goals. When not working with clients globally she spends time with her husband and four kids.

What are you going to learn in this episode? We discuss: the importance of breathing in our outdoor adventures; what we need to know about breathing; the right way and the wrong way to breathe; how improper breathing affects our lives; common causes of improper breathing; how our use of facial muscles affects our breathing; what is myofunctional therapy, and how it helps breathing. Karese’s top tips for better breathing and we also discuss whether or not mouth taping is a good trick to encourage nasal breathing. It might be something you haven’t heard of before but it is something I came across on Instagram a few months ago and it has kind of been in the back of my head ever since.

So, I hope you enjoy this week’s episode.

HOLLY: Hello Karese, how are you today?

KARESE: Good, how are you?

HOLLY: I really look forward to talking to you about this really important but kind of niche topic.

KARESE: Great, I am so excited to be here and I can’t wait to dive in.

HOLLY: So can you start out by telling us a bit about who you are and what you do?

KARESE: So I am a registered Dental Hygienist and a Myofunctional Therapist. Myofunctional therapy is not a household name yet, so I am sure I will have to dive in a little deeper to that. So Myofunctional therapy is essentially working with a personal trainer, so I am a personal trainer but for all the muscles below the eyes but above the shoulders. So I work to help optimise everything that is going on muscularly, to improve breathing and a number of other things that kind of fall into the chain of the surrounding system.

HOLLY: It’s interesting because I think those are muscles that we don’t normally think about and we certainly don’t think about training them.

KARESE: Definitely not and there are hundreds of muscles in this complex, so it is so interesting that people are very focused on the other muscles in the body and not really these important, critical, ones.

HOLLY: So let’s talk about the importance of breathing in our outdoor adventures. So beyond the obvious that of course we need to breathe, what do we need to know about breathing, because this is obviously something we do automatically, we don’t think about it, what do we need to know about breathing that we don’t know?

KARESE: I think what we need to know is that how you breathe matters, there is a right and a wrong way to breathe and you could make it really simple but just saying you need to make sure what you are doing is nasal breathing, but, even deeper than that I think what people don’t think about is that there is a way to artificially stimulate nasal breathing so that we can get it to be optimal. So our tongue actually has a huge role in that, our tongue should be sitting at rest (when you are not speaking, eating, not swallowing, not doing anything else), it should be at rest sitting up against our palette, lightly suctioned up there. Our palette is the roof of our mouth and if you think about it that bone, that one bone, is not just the roof of the mouth it is also the floor of the nose. So by having that tongue up there, lightly suctioned, it is going to stimulate the vagus nerve which regulates our autonomic nervous system, it is going to help to facilitate and really establish a good signal for that nasal respiration to initiate. So you are breathing through your nose, you are able to optimise all the air, you are humidifying it appropriately, you are able to filter it out through the nose and you get an optimal formulation of nitrate oxide, which is going to help that bind oxygen that you are inhaling now, from the great outdoors, you are binding it to those receptors, so that your haemoglobin levels are great.   

HOLLY: So why is nasal breathing preferred to mouth breathing?

KARESE: Nasal breathing is preferred for a lot of the reasons that I stated. We can’t filter any of our air that comes in through our mouth, there is no way to filter it. The only way you may be able to filter it is by going through the tonsils, but our tonsils weren’t really designed for that. If you are filtering through there you are more likely to get more throat infections, you are more likely to to get tonsils infections. Our nose is also where we get a lot of the nitrate oxide, you don’t produce nitrate oxide in your mouth so it is not going to give you optimal oxygen. You won’t be able to bind through those receptors so that can you flow through the body easily by binding on with the blood. So it is really optimal that you are breathing the way that the body was designed for. So there is a saying in our field, ‘where the nose is for breathing and the mouth is for eating’, so if you use them for what they are supposed to be used for, you will be perfect.

HOLLY: So why do people tend to mouth breathe rather than nose breathe?

KARESE: That’s a great question! When we are born, we are born obligate nasal breathers. We are born with everything in place for nothing but nasal breathing but somewhere along the lines, things have come about, or we have evolved in a way, where we are not all developing appropriately. So remember I talked about the palette being the roof of the mouth and the floor of the nose, well a lot of our oral development is going to shape our upper repository system. So if we are having a lot of puréed foods, we are not really eating or chewing appropriately, we are finding that a lot of our skulls are really developing smaller. So we have a lot more people who are winding up in braces, [it makes you think] how come everyone needs braces nowadays, it is not normal at all, a lot of our functional capabilities have impeded how we are able to nasal breathe and therefore it requires us structurally to be mouth breathers so that we can get oxygen, because that’s what the body needs above anything else. We can go for a while without food, we can go for a few days without water, but many of us wouldn’t survive beyond a few minutes without air.

HOLLY: Right. So one person I follow on Instagram shared a picture of herself one day with her mouth taped and it looked kind of violent but it was the way that she was retraining herself to breathe through her nose by taping her mouth shut. But apparently this is a thing, a technique, have you heard of this and what are your thoughts?

KARESE: I have heard of mouth taping. What I can say is, yes, it is good if you are physiologically able to breathe, if you have got clearance from EFT or your physician that says that there is nothing obstructing  and there is no reason why you shouldn’t be then go at it, tape your mouth, it is fine. But, if you don’t have that clearance, just as I referenced before, structurally your body may not be prepared to nasal breathe, you might have a small palette which means that you have less room in your nose for breathing, right? So you don’t have the nostril space, or the nasal capacity, your sinuses aren’t adequately developed, they are not able to really drain appropriately. There may be things that are preventing you from breathing through your nose, so we never want to ignore that. So I love mouth-taping, it is great as long as you have got all of the clearance that you can breathe through your nose and you just, for some reason, haven’t developed that properly.

HOLLY: So if someone definitely has a situation where say her sinuses might not be developed, or some other reason nose breathing is difficult for them, that is something that can be changed? That’s something that can be worked on?

KARESE: Absolutely, definitely. I think we have wonderful ability as humans to be very adaptable. So you can work on things. Once there are physiological things that are ruled out of the equation, be it surgical, be it going through some kind of expansion or appliance therapy, whatever that is, you are able to essentially establish new patterns, because that is really what it would be in facilitating nasal breathing once you haven’t done that for a good amount of time. So it is a wonderful thing how our bodies are able to really rebound after certain events. It does take some training but it is possible.

HOLLY: And I think that’s interesting that in the beginning you described yourself as a personal trainer for these types of muscles and that’s what it is, you have got to completely retrain, as you would your biceps or other major muscles, you are retraining these smaller muscles.

KARESE: Absolutely and I really love that reference because when you think about personal training they are essentially guiding you or holding you accountable. I don’t do all the work for you, I can’t help you nasal breathe by waving a magic wand, it is really about showing you what it is that you can do and then from there you are optimising it and really taking it as your goal, it is a great analogy.

HOLLY: Yeah it is. So how does improper breathing effect people’s lives?

KARESE: Oh, so many ways, so many ways. I think I mentioned it briefly before, we regulate our autonomic nervous system with our tongue up there, so how we breathe matters. People who are in these heightened stages of fight or flight, or they are very over-reactive, they would definitely see a major change by changing the way they breathe. There is a large link between anxiety, depression, and breathing and so mental health and mental health statuses, it is incredibly important to be aware of how you are breathing, because one of the first things that psychologists do, typically with people who have anxiety or panic attacks, or who are depressed, they go over some breathing exercises. It is incredibly important to monitor how you are breathing when it comes to mental health as well. Just cognitively, functionally and with sleep, nothing is more important than breathing. You can do every sleep trick in the book, you can have the most expensive mattress, you can order all of those fancy pillows, you can stop using your cell phone two hours before bed, you can stop eating three hours before bed, you can do everything right, but if you are not breathing well, you won’t cycle through all your sleep stages appropriately and that is going to impact your memory, your brain function, your cognitive abilities and it is definitely going to leave you in a place of brain fog. It kind of leads you in what one ENT has termed a drunken mind, so you are not drunk but you are almost like you are drunk, you are so exhausted, your brain and body is so fatigued from this poor sleep, even though you think you might be getting good sleep, it is poor sleep and it will impede you from being able to function appropriately in the days that follow. So, not breathing well can impact you in many, many ways.    

HOLLY: And I think that is something that a lot of people don’t think about, a lot of people might say, oh I well I get seven or eight hours of sleep a night, but if that is not quality sleep then you are still going to suffer.

KARESE: Exactly, exactly, when we are thinking about our sleep stages, every single one of them is important but the main thing to remember is our brain is doing the most work and we get the most activity from our brain when our body is at rest. And the only time that brain is going to clean out itself, because we have many other systems to clean, we have our kidneys, we have our lymphatic systems, we have to drain everywhere else but the only time our brain will do it is when we are sleeping. So if you miss these critical things it is going to essentially take years off of your life.

HOLLY: Absolutely. So what are some of the causes of improper breathing. I know you have mentioned some things already but what are some things that people might not realise.

KARESE: Some things that I think people are unaware of, or maybe take more lightly than they should, it may be the lip-ties or the tongue-ties, we hear about those types of words and we are typically hearing about them for babies, so like: oh, baby wasn’t able to latch or baby, for whatever reason, had to have these things snipped. Now we are talking a snip but we are talking about physically going in and getting a functional release. So our tongue is important for breathing but if we are doing a release that is less than optimal or it is not releasing enough of the frenum that would be restrictive, then you are still not going to be have enough flexibility to sustain your tongue up against the roof of your mouth when it is at rest. It is going to impede you significantly, it can be at any stage and at any age, that is typically found and it doesn’t have to be just babies. Is it easier with babies to find it, release it and to heal? Absolutely, super easy, but I don’t think enough of us are looking at our tongues and whether our tongue is able to sit up there enough to be able to call that concern to our medical or dental provider so that we can have that reversed.

HOLLY: So since you have started talking about this, I have been aware as I am listening to you about where my tongue is sitting. And it seems to be in the proper position. So if is not in the proper position where would it be? What do people need to look out for?

KARESE: It could be any number of places. So let’s do an activity together, if you are sitting in a chair and listening to this, you can sit, feet flat on the floor and sit up nice and tall, take deep breath in through your nose and then out through your nose and then as you are breathing in I just want you to be very mindful of where exactly your tongue is and then breathe out through your nose. So, if you notice that your tongue is hanging out low, or it is kind of hovering in the middle of your mouth, or it is pressed out against your teeth, or it is anywhere other than sitting nice and secure against the palette (which is the roof of the mouth) with no interference from your teeth, then it is not where it’s supposed to be.

HOLLY: Okay, well I think I am good on that one!

KARESE: Yay, you did it.

HOLLY: However, as I said to you before we hit record, I am a weird breather!

KARESE: What does that mean?

HOLLY: I don’t know, my husband is always mocking the way I breathe, in a good natured way. I am a runner and when I run a lot of times my nose is stuffed up so I tend to breathe through my mouth and it sounds like I am dying but actually I am fine. But even walking around the house, sometimes I will come downstairs and make a cup of tea, and my husband will start imitating my breathing, because apparently it is quite loud. So, I don’t know what I do. For someone who is aware that they have a strange style of breathing, what would you recommend?

KARESE: Well first of all I would say, if your breathing is audible in any way, shape or form, there is a problem. So audible breathing is the sound of air meeting resistance as it is going through your upper respiratory tract. So if you are exhausted, you said you are a runner, you are working your body and your heart rate is up, you might have to have some audible breathing, there is a little bit more exertion that is going on. But if you are just making tea, and you are sitting in the kitchen or the living room, and you can hear yourself breathing, there is an issue. I like to liken it to snoring just like regular daytime snoring essentially, but all of it is a resistance of air going through that upper respiratory tract, so something along that tract is constricted or not allowing enough flow of air for it to be silently passing through. So at that point I would say, it is time to see an airway dentist that has a CBCT (a CT scanner essentially) who is able to scan all of those tissues and he would scope all the of tissues and see where the obstructions is. So you might be breathing properly, in the front or the side boarders, because that is our mouth and our nose, the front and side boarders or our upper respiratory system. They might be fine but some tissues that are too constricted and need to have some sort of revision or myofunctional therapy can help and shape and tone them, in order to get you where you should be, with a nice open respiratory passage.

HOLLY: Sounds good. So how does our use of facial muscles effect our breathing? I know we have talked about that, I think there is so much going on there that we are not aware of.

KARESE: Oh my gosh there is an immense amount that is effecting it. So what we are talking about, I mentioned you might need the myofunctional therapy in order to tone those Oropharyngeal or whatever, up along the respiratory tract, some of those muscles. That can be part of what is going on. In the front portion of the upper respiratory tract, from the oral perspective, when we open up our mouths, we have this little dangly thing, I don’t think many people know what it is called, it is our uvula.

HOLLY: I love that word, I always remember that because it is such a great word!

KARESE: Isn’t it? So our uvula is at the base of our soft palette. Our soft palette can also not be very toned. That uvula and soft palette can be long and droopy and not able to really sit up and facilitate a nice open passageway. So that may be another thing blocking off the respiratory passageway. So I definitely recommend doing exercise. Anybody who sings, I think you find that with certain notes and tones you get a really good lift of that soft palette. The more you lift it and the more that you engage it and the more that you are able to facilitate exercises that are going to tone that tract, the much better you will feel.  

HOLLY: Wow, these are the things that we never think about. What is the purpose of the uvula, now that we are talking about it?

KARESE: The uvula is kind of our awareness, it is like the fire alarm for our oral passageway. So if, say, you are having too much in your mouth and you feel gaggy, it is that uvula saying, hey, all of this is not going to come down the right path, you send it back out, this isn’t going to work! So it is kind of like our fire alarm system. People who are trying to make themselves gag or throw up typically are touching the uvula.

HOLLY: ah interesting! So to pull this all together, what would you say are your top tip for better breathing, how can someone get started in improving their breathing?

KARESE: Best tip ever is to start a nasal hygiene routine. Nobody ever thinks about it but we have got to clean our nose. We have talked about how important breathing is to just overall health, wellness, brain function and everything and we have got to clean our nose if we are going to facilitate a really great breathing space. So having a saline rinse, having a nasal inhaler that helps you decongest and open up the sinus passages, help to open up a lot of what is going on in the pharyngeal passageway, upper respiratory passageway. That is a phenomenal way to just facilitate better breathing, by just taking care of your nose every day, establishing a nasal hygiene routine. Cleanse that nose, decongest that nose, make sure it is nice and open and primed and ready for breathing. If you are having trouble with it and you feel that you just can’t get a good breath after you have cleaned it then consider using something that might help to open it, just holding it open. So from the outside there are those nasal strips, Breathe Right, they make those nasal strips that holds and lifts up those nostrils from the exterior portion, the outside. Or interior you can use a nasal dilater, these little circles that clip on the nasal bridge and then you are able to hold it open from within. Then you are able to make a good start on nasal breathing, make sure it is clean and ready and good to go.

HOLLY: I think that is something that we never think about, we think, oh I blow my nose and that’s enough. I have occasionally used one of those Neti Pots to clean out with the saline, I really hate doing it.

KARESE: Everybody does, I think they are amazing, I love the Neti Pot, they are really, really great.

HOLLY: Maybe I need to take that up as a hobby then, after I brush my teeth, clean my nose!

KARESE: Exactly, yeah, just implement it into your daily routine, it is phenomenal, it is a game changer when it comes to breathing.

HOLLY: Okay, well I am definitely going to add that because as we know I am a weird breather, so we will add that in and see if that improves things! So we have talked a little bit about myofunctional therapy, can you explain to us what is it and how does it help with breathing?

KARESE: So myofunctional therapy just like I touched on before is kind of like personal training for all of the muscles in the oral facial complex and some of the Oropharyngeal complex. So we are working with those muscles below the eyes but above the shoulders and there is a lot of dysfunction that can happen along the chain which is going to impact digestion, breathing, sleep, the way you chew, the way you swallow and so forth. So if those muscles aren’t working correctly they wind up developing their own patterns to make these critical skills still happen, so that you can swallow incorrectly, you can be chewing and chewing only on one side, maybe you feel like another side feels too tight, or something is going on and you are not able to balance out your chewing. Sometimes people pouch food or pouch liquids before they swallow them. Sometimes they have issues where they are swallowing too much air as they are eating, they eat really fast because they can’t use their muscles appropriately or breathe appropriately so they have to just get in whatever they can get in and then finally get to the breathing. So there are a number of things along the chain which can cause dysfunction when you are talking about the complex, from the eyes to the shoulders. So what we do with myofunctional therapy, is (i) we figure out what is the dysfunction on the chain and then (ii) we work to remedy that. So we are working on making new muscular patterns so that we can establish first conscious habits but then get them to habituate into unconscious patterns. So that you are able to facilitate, like a nice long-term solution to that dysfunction.

HOLLY: And so how you determine what are the dysfunctions that a person has? Do you get on a zoom call with them and watch them speak? How does that work?

KARESE: A combination of all those things, yes. I do 100% virtual services, it is definitely something you can do over zoom, in a virtual meeting. You can look at what is going on. I ask people to do all sorts of funny things that they wouldn’t think activates certain muscles, like we are turning to one side, or winking, or pushing our tongue in our cheek, we are doing all sorts of things to see what is going on with different muscles and how they are activating. And, from there, I am able to see, that muscle was moving when it should have been going and that one was going when it should have been going and what’s going on?

HOLLY: And how long do the exercises take? I assume you give some exercises that need to be done every day, how does that work?

KARESE: Yes you picked up on it correctly, it is just like personal training thing. Yes there are exercises that they would have to do daily, that is the only way to get results, just like in personal training, if you sign up at the gym with a personal trainer and you don’t do anything then you don’t lose weight or gain muscle, or whatever your goal is. With the myofunctional therapy we essentially like them to do the exercises at least twice a day and I try to aim for exercises or activities that are going to take no more than ten minutes per exercise session, so we are looking at twenty minutes a day that they would have to be doing active exercising or working on these muscles.

HOLLY: That sounds reasonable and how long does it take for people to see the results, fairly soon or do you have to wait a couple of months?

KARESE: Typically a couple of months. Children are phenomenal to work with because you get changes really fast in kids but when you have habits that have been building for 20, 30, 40, 50 or 60 years, you are having to re-pattern muscles that have been doing the same thing for so long, it is going to take a little bit longer. So depending on the age you can go anywhere from three months up to a year depending. 

HOLLY: And what sort of results do people notice? What are the first things that people see, do they notice that they are breathing better, what kind of results an they expect?

KARESE: So you can definitely i) expect that you will absolutely have a new awareness of muscles that you didn’t even know existed. But ii) you are definitely going to notice improvement in your sleep and your speech, and your ability to really swallow, and eat, and digest significantly better and the cognitive awareness that you get just from getting better sleep is always something I hear about. People say, oh my gosh I feel so much more alive! And that in itself is such a great and wonderful feeling to have.

HOLLY: Absolutely. You wrote a book called, Accomplished: How to Sleep Better, Eliminate Burnout, and Execute Goals, can you tell us about that?

KARESE: I love this book, it is such a work of passion, I am very passionate about this and about breathing and being aware of these muscles and the impact they have on our lives and so I wanted to share that in a way that would reach as many households as possible, be able to impact as many people as possible. I have wonderful tips and tricks in there as to how you can optimise your sleep so that you can get the best performance out of your brain, out of your body, and out of yourself the next day. So we are taking all of these skills that I have in the book in a wonderful process and plan and then you are able to be as effective as possible in executing the goals that you have, be them personal, familial or just a work goal that you have.

HOLLY: So Karese, do you have any tips that I haven’t asked you about, things that we haven’t discussed, anything else that people need to hear about breathing?

KARESE: I think they tip I always have is definitely to always advocate for yourself, if you feel like something is off, or if you have been listening to this and you think, hm, I feel like I might be a weird breather too! It is probably a good sign to just advocate for yourself. Ask! Just like I said you always need some medical clearance that yes you are able to breathe properly. So advocate for yourself, go to your physician and don’t let them ignore you, tell them that such-and-such is going on and continue to advocate for yourself until you feel satisfied that you are reaching your maximum health and wellness goals.

HOLLY: I think that’s a really good point, assuming if you are walking around you are breathing enough to stay alive but fine-tuning that breathing might be something that a doctor might not consider a priority.

KARESE: Exactly. So we have got to continue to advocate for ourselves. It is incredibly important.

HOLLY: Good, well thank you so much for sharing your breathing tips with us today, I know I have learned a lot and I am going to start a new nasal hygiene program!

KARESE: Yay!

HOLLY: Yay! So Karese, where can people find you online and find out more about you?

KARESE: You can find me on most social media platforms or at least all the major ones, Twitter, Facebook and Instagram. I am at:  https://airwaymatters.blog or I am available with free consultations on my website, https://www.themyospot.com.

HOLLY: Thank you so much, I really enjoyed our conversation, I think this is a niche thing that when you fix it, or when you improve in this area, I think it can make a big difference in our adventures and in our physical activities, our sports, or whatever it is that we do and as you said, even sleeping.

KARESE: Absolutely, you can definitely stop your husbands from making fun of you! (Both: laughing)

HOLLY: Thanks again.