Stuffy nose? Your understanding of nasal congestion may be wrong...

Leviathan Press:

I guess many people who have been breathing through one nostril for many years have a trick to change nostrils when sleeping. My experience is that if you want to breathe through the right nostril, you just need to turn slightly to the left. However, I know the reason but not the reason. But after learning about the erectile tissue in the nasal cavity, many people should have a new understanding of their nasal congestion.

I've had a cold every month since my kids started daycare. Lately I've been spending a lot of time dealing with a stuffy nose. I blow my nose all the time. I've also tried a neti pot, and various nasal clearers. During sleepless nights I've spent hours tossing and turning trying to clear one nostril, then the other.

What I learned from this is that a stuffy nose is a lot weirder than I thought.

First of all, what we often call a nose is actually two noses, which work in an alternating cycle and are somehow connected to our armpits.

© Wikipedia

The first argument I was told that humans have two noses was made by Ronald Eccles, a nasal specialist at the Cold Research Centre at Cardiff University in Wales until his retirement a few years ago. I know it sounds ridiculous, but think about your nose, or what your two noses look like on the inside: Each nostril opens into its own nasal cavity and does not connect directly to the other nostril. They are two separate organs, just like your two eyes or two ears.

Far from being a passive passage, the nose hides an ever-changing internal structure. As Eccles puts it, the nose contains venous erectile tissue, which is structured “similar to the erectile tissue of the penis,” and it can become engorged with blood. Infections or allergies can increase swelling to the point where the nasal passages can become completely blocked.

The main cause of nasal congestion is swelling , not mucus, which is why clearing your nose may not completely solve it.

© Theraflu

"You can keep blowing your nose, but you're not going to get the swollen tissue out," says Timothy Smith, an otolaryngologist at the Oregon Health & Science University Sinus Center. Gently blowing your nose is effective for any mucus that may be aggravating a blocked nose, he tells me. But nasal decongestants containing pseudoephedrine and oxymetazoline constrict the blood vessels in the nose, temporarily opening it up for brief relief.

In a healthy nose, the swelling and deswelling of nasal tissue usually follows a predictable pattern called the "nasal cycle." Every few hours, one side of the nose will partially become congested while the other side opens up. Then they alternate, back and forth.

The exact pattern and duration vary from person to person, but we rarely notice these changes inside our noses.

Normally, people don't notice that breathing is more labored through one nostril than the other; they often notice it when they have a cold, when their nose becomes more blocked than usual. © Wikipedia

“When I tell people about the nasal cycle, most people have no idea about it,” says Guilherme Garcia, a biomedical engineer at the Medical College of Wisconsin.

I certainly didn’t know that either, having breathed through my nose my entire life, but once I consciously thought about the idea, it made sense: When I’m sick, the extra swelling can turn a partial congestion into a full one, and I do tend to feel more blocked on one side than the other.

Once you understand the nasal cycle, you can control it to some extent.

In fact, on my sleepless nights, when I rolled from side to side, I unknowingly activated receptors under my armpits, which opened the other side of my nose.[1] This may be an ancient survival reflex: when we lie on our right side, the left nostril is farther from the ground and may be less likely to become blocked.

© Etsy

Yogis have learned to take advantage of this by using a small cane, called a yoga danda, under the armpit to direct the breath from one nostril to the other.[2] One online remedy for nasal congestion suggests squeezing a bottle under the opposite arm—but the results aren’t immediate.[3] When I tried this recently, my arm got tired before my nose cleared. When I tried it again, using an old cane I had from a knee injury, it took several minutes to work, by which time I’d already reached for a tissue out of impatience.

No one knows exactly why humans have the nasal cycle, but cats, pigs, rabbits, dogs and mice also have it, Eccles said. One hypothesis is that the cycle helps protect against pathogens. When the venous erectile tissue contracts, antibody-rich plasma is squeezed to the lining of the nose. Each cycle replenishes the nose's defenses.

Eccles also notes that upper respiratory viruses seem to prefer temperatures slightly below body temperature; when one side of the nose is partially congested, it may warm up enough to ward off the virus. Or, the cycle may allow one half of the nose to rest.

© NHPR

Unlike our eyes, ears, and mouths, our noses have to work 24 hours a day, constantly filtering and warming air for our delicate lung tissue. The nose's job may not sound that hard, but consider what it has to do: The air we breathe might be 70 degrees Fahrenheit (about 21 degrees Celsius) with 35 percent humidity, "and by the time that air enters my nose and returns to my nasopharynx (about three to four inches), it has reached 98.7 degrees Fahrenheit (about 37 degrees Celsius) with 100 percent humidity." The nose is a very powerful little HVAC system.

But it’s also flawed. Our noses don’t measure air flow directly; instead, they rely on cold receptors that activate when cool air passes through. These cold receptors can be tricked by substances like menthol[4].

Eccles found that people who took menthol lozenges could hold their breath longer, probably because the cooling sensation of the mint tricked them into thinking they were still breathing air. This is also why Vicks VapoRub may make a blockage feel better, even though it has no active effect on clearing the nasal passages.

The opposite may occur in a confusing condition known as “empty nose syndrome”[5], in which a very small percentage of patients who undergo nasal unblocking surgery experience eventual complete blockage, perhaps due to damage to cold receptors and other changes in sensation. The lack of airflow sensation can be so disturbing that these patients feel as if they are suffocating, even though their noses are completely open.

To some extent, we are all unreliable narrators of our own stuffy noses. When a patient goes in for a checkup, the doctor might see that one side of their nose is noticeably more swollen than the other, but that’s not necessarily the side that the patient feels more blocked. “It’s still baffling to clinicians,” Smith told me. Other factors, like temperature, may also play a role. The internal structure of the nose is complex and mysterious. I’ll be thinking about all of these things the next time I’m sick and feel blocked again.

References:

[1]www.tandfonline.com/doi/abs/10.3109/00016488509119158

[2]www.researchgate.net/publication/299215358_Nasal_cycle_and_its_therapeutic_applications_a_yogic_perspective

[3]technology.inquirer.net/69129/plastic-bottle-under-armpit-can-clear-stuffy-nose-suggests-japanese-lifehack

[4]academic.oup.com/jpp/article-abstract/42/9/652/6163948

[5]www.abc.net.au/news/health/2016-07-22/empty-nose-syndrome-when-routine-nasal-surgery-goes-wrong/7652696

By Sarah Zhang

Translated by tamiya2

Proofreading/tim

Original article/www.theatlantic.com/health/archive/2023/10/humans-have-two-noses-really/675823/

This article is based on the Creative Commons License (BY-NC) and is published by tamiya2 on Leviathan

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