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Nasal Breathing and Tongue Position: What Research Shows, and a 3-Minute Exercise | Alter Physio & Acupuncture Amsterdam

Nasal Breathing and Tongue Position: What Research Shows, and a 3-Minute Exercise

You breathe roughly 20,000 times a day, mostly without noticing. Whether that air goes in through your nose or your mouth, and where your tongue rests while it does, are small details. In our treatment rooms at Alter Physio & Acupuncture in Amsterdam Zuid, we often notice that they are linked to how tense the jaw, neck and chest feel.

This article separates two things clearly: what published research actually shows, and what we observe in the clinic and treat as working hypotheses. Then we share a simple 3-minute exercise you can try at home.

What research shows about nasal breathing

Nasal breathing and heart rate variability (Watso et al., 2023)

In a randomised crossover study of 20 healthy young adults, Watso and colleagues (2023) compared five minutes of nasal-only breathing with five minutes of mouth-only breathing. During nasal breathing, diastolic blood pressure was lower and the high-frequency component of heart rate variability (HRV), a marker associated with parasympathetic (“rest and digest”) activity, made up a larger share.

What this does not show: heart rate itself did not differ, the sessions were short, and the participants were young and healthy. It is a promising signal, not proof that mouth breathing puts you in a stressed state all day.

Mouth breathing and the diaphragm (Trevisan et al., 2015)

A cross-sectional study by Trevisan and colleagues (2015) measured diaphragm movement with ultrasound and found that adults who habitually breathe through the mouth had a smaller diaphragmatic excursion than nasal breathers.

Interestingly, the same study did not find that mouth breathers used their neck “accessory” breathing muscles more; during rapid inhalation, activity in the sternocleidomastoid was actually lower. So the popular claim that “mouth breathing = chest breathing with neck muscles” is not directly supported here. And because it is cross-sectional, it cannot tell us which came first.

Slow breathing and the vagus nerve

Reviews by Russo et al. (2017) and Zaccaro et al. (2018) found that slow breathing (around six breaths per minute) is consistently associated with increased HRV and other markers of parasympathetic activity. Note that the key ingredient in these studies is breathing slowly, not specifically breathing through the nose.

Exhaling and your deep abdominal muscles (De Troyer 1990, Hodges 1997)

The transversus abdominis is the deepest layer of the abdominal wall. De Troyer et al. (1990) showed that this muscle is active during expiration in humans, and is recruited more readily during breathing than the more superficial rectus abdominis. Hodges, Gandevia and Richardson (1997) found that transversus abdominis activity during postural tasks is modulated by the breathing cycle and by respiratory manoeuvres, showing that this muscle serves both breathing and trunk control. An ultrasound study by Ishida and Watanabe (2013) also found the lateral abdominal muscles thicken during maximal expiration.

What we could not find: any study directly comparing nasal versus mouth exhalation in terms of which abdominal muscles work. That part is our hypothesis (below).

Tongue position and jaw muscles: mixed evidence

Research on tongue posture and jaw muscles is small and inconsistent. Takahashi et al. (2005) reported that tongue position changes chewing-muscle activity, while Carlson et al. (1997) found that pressing the tongue to the front of the palate actually increased activity in some jaw muscles (temporalis and suprahyoid) and did not change the masseter. So “tongue up = relaxed jaw” is not established by research.

Our clinical observations (hypotheses, not proven)

Clinical observation / hypothesis. The points in this section come from hands-on practice at Alter Physio & Acupuncture. They have not been tested in controlled studies, and we treat them as ideas to explore with each patient, not facts.

Tongue position, jaw tension and feeling settled

When patients rest the whole tongue lightly against the palate, the lips close and breathing tends to move through the nose. Many describe their jaw softening, and with it a sense that the head and then the rest of the body relax. When the tongue drops to the floor of the mouth, mouth breathing becomes easier and some people find it harder to switch off. Our hypothesis is that this chain (tongue → closed lips → nasal breathing → softer jaw → calmer state) contributes to how relaxed someone feels. There is no direct research yet on tongue position and the autonomic nervous system, and gentle resting is very different from the firm pressing tested by Carlson et al.

A long nasal exhale and the deep core

When we exhale slowly through the nose, the narrow airway adds gentle resistance. Patients often report feeling the deep, side-of-waist muscles (transversus abdominis and obliques) engage, whereas a forceful mouth exhale tends to be felt more in the front “six-pack” muscle. This fits the known physiology of transversus abdominis as an expiratory muscle, but the nose-versus-mouth difference itself is our clinical hypothesis.

We use these ideas as one part of breathing physiotherapy in Amsterdam, alongside assessment of posture, neck and jaw, and exercise. For background, see our posts on diaphragmatic breathing and core stability and nasal vs mouth breathing.

A 3-minute at-home exercise: tongue up, long nasal exhale

Sit or lie comfortably. Set a timer for three minutes.

  1. Lips and teeth. Close your lips gently. Let your back teeth come slightly apart, with no clenching.
  2. Tongue. Rest the whole tongue softly against the roof of your mouth, with the tip just behind the upper front teeth. Don’t press.
  3. Inhale through the nose. Breathe in quietly for about 4 seconds. Notice your belly, sides and lower back widening.
  4. Long exhale through the nose. Breathe out slowly and smoothly for about 6–8 seconds, longer than the inhale. Notice whether your lower belly and sides draw gently inwards.
  5. Repeat for three minutes, a few times a day: for example, at your desk, before sleep, or after a long call.

If 4/6 feels too long, shorten both. It should feel easy, never like holding your breath.

Safety note

  • Stop and breathe normally if you feel dizzy, light-headed, short of breath or anxious.
  • If your nose is often blocked, you snore heavily, or you suspect sleep apnoea, see your GP or an ENT specialist; don’t force nasal breathing.
  • If you have a heart or lung condition, are pregnant, or have significant jaw pain or clicking, check with a healthcare professional first.

This exercise supports wellbeing. It is not a treatment for any medical condition.

When to see a physiotherapist

If jaw tension, neck stiffness or tension headaches keep coming back, an assessment can look at the whole picture: breathing pattern, posture, jaw, neck and workload. Related reading:

At Alter Physio & Acupuncture, physiotherapy is led by Hide, a physiotherapist, and may include manual therapy, exercise, breathing work and, where appropriate, dry needling within physiotherapy. Acupuncture at our clinic is rooted in East Asian tradition and offered as a complement to evidence-based care. Sessions: 25 min €68, 55 min €126. International insurance accepted.

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FAQ

Is nasal breathing better than mouth breathing?

For everyday, relaxed breathing, small studies suggest nasal breathing is linked with lower diastolic blood pressure and more parasympathetic HRV (Watso et al., 2023). During hard exercise, mouth breathing is normal. Evidence is still limited.

Where should my tongue rest?

Many clinicians suggest resting the tongue lightly on the palate with lips closed and teeth apart. Research on its effect on jaw muscles is mixed, so treat it as something to try, not a rule.

Can breathing exercises help jaw tension?

Some people find that slow nasal breathing with a relaxed tongue position eases a sense of jaw tension. That is a clinical observation, not proven. Persistent jaw pain deserves an assessment.

Do you offer breathing physiotherapy in Amsterdam?

Yes. Breathing assessment and retraining can be part of a physiotherapy session at Alter Physio & Acupuncture in Amsterdam Zuid. Contact us to book.

References

  1. Watso JC, et al. Am J Physiol Regul Integr Comp Physiol. 2023;325(6):R797-R808. PMID 37867476
  2. Trevisan ME, et al. J Electromyogr Kinesiol. 2015;25(3):463-8. PMID 25900327
  3. Russo MA, Santarelli DM, O’Rourke D. Breathe. 2017;13(4):298-309. PMID 29209423
  4. Zaccaro A, et al. Front Hum Neurosci. 2018;12:353. PMID 30245619
  5. De Troyer A, et al. J Appl Physiol. 1990;68(3):1010-6. PMID 2140344
  6. Hodges PW, Gandevia SC, Richardson CA. J Appl Physiol. 1997;83(3):753-60. PMID 9292460
  7. Ishida H, Watanabe S. J Bodyw Mov Ther. 2013;17(2):254-8. PMID 23561875
  8. Takahashi S, et al. Angle Orthod. 2005;75(1):35-9. PMID 15747813
  9. Carlson CR, et al. J Orofac Pain. 1997;11(4):291-7. PMID 9656904