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breathe blog

Breathe In, Breathe Out, Breathe On: How our bodies fight COVID-19, and what we can All do to help!

3/23/2020

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Our bodies are amazing organisms, capable of responding to the slightest stimuli. While that natural internal alarm system is a part of our innate ability to defend against potential sources of infection and disease, it also has the potential to trigger some not-so-great effects.
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Our autonomic nervous system​ can alert every cell in our bodies in times of stress, however ‘sounding the alarm’ can sometimes result in shortness of breath or anxiety and such symptoms. The autonomic nervous system receives information about the body and its external environment, and then responds by stimulating body processes through its two main divisions: the sympathetic and parasympathetic nerve pathways.
The sympathetic nervous system response prepares the body for stressful or emergency situations—fight or flight. Energy and bodily resources are directed to the immediate situation at hand. Adrenaline flows, heart rates elevate, muscles tense, our whole body becomes more alert; 
Functions not critical to immediate survival are diverted to prioritize systems that are most critical to your survival at that moment in time. 
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The parasympathetic nervous system  controls our inner homeostasis or balance and the body's rest-and-digest, conserve-and-restore responses. Resources are directed to restore the body to state of calm, and build tissues for growth, healing, and long-term immune function.
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Balance between the sympathetic and parasympathetic states is vital to overall health and well-being. An imbalance or dominance of one state over the other can divert vital resources away from their most efficient and optimal utilizations.
Imbalance or disruption to a healthy lifestyle, diet and even negative thinking can trigger the sympathetic stress response and prime the body for action through an intimate association with the adrenal glands. This known as the sympathoadrenal system. Within the brain, reception of a stress signal leads increased activity of the sympathoadrenal system. This is done through a complex internal signal cascade that releases a number of neurotransmitters.
A neurotransmitter called acetylcholine causes excitation of the nerves that signal to our skeletal muscles, along with the muscles surrounding certain bodily systems such as the cardiovascular system and respiratory system. This is what can cause increases in strength and speed during times of stress, as well as accelerating our heart rate and breathing.
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Staying physically and mentally healthy in times like these can be challenging, but proper breathing and sufficient sleep can help you maintain your well-being, support your immune system, and mitigate the impacts of stress and lower your risk of becoming sick
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The sympathetic nervous system response is protective on the scale of seconds to minutes to hours, but chronic levels of increased sympathetic stress on the scale of hours to days may actually interfere with the body’s allocation of energy, resources, and immune reserves to sustain an efficient host defense in the long term.
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According to the article "Effects of stress on immune function: the good, the bad, and the beautiful” by Dr. Firdaus S. Dhabhar of Stanford University: long-term sympathetic stress directly impairs both the innate and adaptive immune response in humans.
But it does not stop there; stress disrupts deep sleep by heightening our awareness to external stimuli, which in term suppresses the release of growth hormone and immune modulators. Growth hormone is released during deep stage-3 sleep, and it has been shown that any source of sleep disruption can impair the release of growth hormone, which is important not only for growth and healing, but also for immunoregulation and adaptive immunity.
Moreover, chronic stress may predispose one to mouth breathing (an attempt to keep up with increased respiratory demands) and negatively impact the body’s innate nasal immunity defense mechanism against infectious microbes.
The human immune system has two arms: Innate immunity, and adaptive immunity. Innate immunity is the body’s first line of defense and includes mechanisms that activate immediately or within hours of detecting an unwelcome microbe or antigen in the body.
The adaptive immune response is a secondary response, and is more complex. The microbiological invader first must be processed and recognized. Once the enemy has been recognized, the adaptive immune system creates an army of immune cells specifically designed to attack that antigen specifically.
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Pathogens can rapidly evolve and adapt, and thereby avoid detection and neutralization by the immune system; however, multiple defense mechanisms have also evolved to recognize and neutralize pathogens.
Coronavirus enters the body and infects alveolar epithelial cells of the upper respiratory tract. Once the virus has penetrated the cell it invades the cells’ biology machinery to replicate new viral particles. In that process, the virus constantly evolves to evade the adaptive immune response, until either the virus or the immune system dominates the fight. The viral particles are potent inducers of inflammatory cytokines
The “cytokine storm” or “cytokine cascade” is believed to be the mechanism for organ damage. The virus activates immune cells and induces the secretion of inflammatory cytokines and chemokines into pulmonary vascular endothelial cells.
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The best way to prevent the infection is to limit direct transmission through taking social distancing measures, committing to vigilant and thorough hand-washing, and to avoid touching the mucosal surfaces of the face (eyes, nose, and mouth) as much as possible.
If the virus does somehow find its way into the body, the primary line of defense will be the innate immune response of the sinonasal tract. The innate immunity of the nose is our first line of defense against pathogens, but our immune-system will never get the chance to say “shields up” and fight for us, if those pathogens are invited directly into our lungs through the oral breathing route.
Chronic mouth breathing bypasses the well armed nasal defenses, and as a result our inflammatory and immune pathways must attempt to fight the virus and infection in a much more delicate territory (our lungs). Mouth breathing also drops the temperature in the sinonasal cavity, which further impairs nasal mucociliary function, and can cause the stagnation of mucous, which further impairs nasal breathing and nasal immunity.
So, besides washing our hands what can we do as we temporarily physically distance ourselves from others...
(1) Breathe through the nose
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(2) Get plenty of sleep
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(3) Eat a healthful diet
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(4) Relax and meditate.​​
If you are experiencing a challenge with any one of those four goals, get in touch with us at The Breathe Institute so we can help. We have case managers available for remote telemedicine evaluations to review your case and direct you to the proper resources, as well as Zoom online medical evaluations.
​Our team of doctors and healthcare professionals is available to provide you with individualized medical advice. We look forward to the deep breath of relief we will all experience when we pass though the other side of this interesting time, but for now: keep calm, wash your hands, and Breathe on!
Sincerely,
Your Friends at The Breathe Institute
Dr. Soroush Zaghi, Chad Knutsen, Leyli Norouz-Knutsen

“Tongue up, lips closed, healthy breathing through the nose.”

References:
  1. Pereira VH, Campos I, Sousa N. The role of autonomic nervous system in susceptibility and resilience to stress. Current Opinion in Behavioral Sciences 2017; 14:102-107.
  2. Dhabhar FS. Effects of stress on immune function: the good, the bad, and the beautiful. Immunologic research 2014; 58:193-210.
  3. Tosi MF. Innate immune responses to infection. Journal of Allergy and Clinical Immunology 2005; 116:241-249.
  4. Ooi EH, Wormald P-J, Tan LW. Innate immunity in the paranasal sinuses: a review of nasal host defenses. American journal of rhinology 2008; 22:13-19.
  5. Obal Jr F, Krueger JM. GHRH and sleep. Sleep medicine reviews 2004; 8:367-377.
  6. Vgontzas AN, Mastorakos G, Bixler EO, Kales A, Gold PW, Chrousos GP. Sleep deprivation effects on the activity of the hypothalamic–pituitary–adrenal and growth axes: potential clinical implications. Clinical endocrinology 1999; 51:205-215.
  7. Jiang F, Deng L, Zhang L, Cai Y, Cheung CW, Xia Z. Review of the clinical characteristics of coronavirus disease 2019 (COVID-19). Journal of General Internal Medicine 2020:1-5.
  8. Marusiakova L, Durdik P, Jesenak Met al. Ciliary beat frequency in children with adenoid hypertrophy. Pediatric Pulmonology 2020. 
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  • Home
  • Services
    • Breathe HUB
    • Functional Frenuloplasty
    • Sleep Studies (At Home)
    • Mindful Breathing
    • ENT Services
    • Infant Frenectomy >
      • Commonly Asked Questions by Parents
    • TBI Book Series
    • TBI Surgical Instruments
    • Latera
    • Mindful Meditation
    • Myofunctional Therapy
    • Nutrition
    • Sleep Endoscopy DISE)
    • Sleep Apnea
    • Sleep Hygiene
    • Sleep Quiz
    • Therapy Care Management
    • Practice Management + Support
    • Patient Testimonials
  • TEAM
    • TBI Faculty
    • Breathe Affiliates
    • Breathe Baby Affiliates
    • TBI Ambassadors
    • ENT Collaborators
    • TBI PA CLUB
  • Airway
  • Blog
    • Products We Love
  • Contact
    • Traveling Patients