I ’m sitting in a hospital room with a family member who had surgery yesterday. It was a septoplasty and turbinate reduction. Yes, a nose job, but not one of those nose jobs. Once the swelling has reduced, the nose won’t look different. However, because of internal realignment of the septum – the divider between our nostrils – and ablation of the lumpy turbinate on one side, they’ll be able to breathe properly for the first time since they were a pre-teen.
As Listener Health columnist Nicky Pellegrino highlighted recently, the nose is the frontline defence against infection in our airways, but there is also increasing evidence the brain is stimulated by nasal breathing. However, not all problems linked to nasal breathing can be fixed with technology such as the wearable nosebuds being trialled at Auckland University of Technology.
I haven’t had the heart to tell my family member that, like chronic congestion from allergies, chronic nasal congestion associated with a deviated septum and malformed turbinate can affect cognitive capacity – the capacity to think.
Specifically, our brains use a lot of the oxygen transported by our blood, so serious, ongoing congestion means reduced oxygen flow to the brain. Anyone who’s had trouble breathing because of a cold, say, also knows it ain’t always easy to sleep with a blocked nose. And, as I’ve written before, quality sleep is important for recharging the brain function battery and to allow the metaphorical cleaners to sweep up the previous day’s detritus.
Research clearly shows nasal congestion predicts more frequent self-reported brain fog and poorer subjective speed of thought, as well as impaired attention and poorer performance on memory tasks.
What about intelligence? As I searched the scholarly literature for research on nasal congestion and IQ, I briefly worried if I should write this column at all. How might my loved one react to being told studies show either no congestion-related differences in IQ, or that the nasally obstructed do show poorer performance than uncongested youth in intelligence tests?
The good news is that, with proper treatment, these effects all appear to be reversible – in this (extreme) case, with surgery. As the specialist said within seconds of the first consultation, “You can’t breathe through that, can you?”
A deviated septum can be congenital (present at birth) or caused by trauma. The process of being born can cause it, but bonking your schnozz on the bottom of a pool during an ill-advised dive can also do it. Turbinates are structures inside the nose that work like a heat pump, filter and humidifier all in one, and they can become enlarged because of chronic allergies or infections, and even by some medications. These problems in tandem often also cause chronic nose-running.
Congestion doesn’t just affect cognition by reducing air flow and compromising sleep. Inflamed sinuses, the membrane-lined tunnels around your nose, also appear to affect brain activity. When we put someone with a blocked sinus in a brain scanner, persistent inflammation triggered by chronic swollenness has been shown to impair brain connections.
Even colds, flus and sinus infections can temporarily affect how we think, because of the viral or bacterial effects on important neurotransmitters involved in things like thinking.
Have I described you? If so, have a word with your doctor. Don’t just tell them your nose runs all the time, but that you can’t breathe. Make them take you seriously.
In the short term, there are things you can do to take a little control. For example – and this is a good idea anyway – work on your sleep “hygiene”: try to sleep at a regular time, avoid stimulants, screens and bright light in the half-hour before going to bed. It’s also a good idea to work on your stress. Easy for me to say, of course.
