My husband's grandmother, who lived a very active life until she died in 1971 at 99, claimed her good health was due to having a short nap after lunch every day throughout her adult life except the 10 years until her oldest turned ten and could look after the younger ones for 20 minutes.
Hard to argue with that vignette, and that short nap after lunch sounds delightful, especially with multiple children. The brain certainly needs a rest with even taking care of one! Thanks for sharing, Merry.
Ryan, how timely--I found myself looking at your previous insomnia posts (stress insomnia is an issue for me.) CBT-i hasn't been helpful for me. So, the issue of napping is relevant.
I'm not a habitual napper, but I can see the appeal. My husband is a habitual napper and I sent this to him. He's always done a short nap after lunch.
Could you revisit or repost the insomnia post? -so helpful and reassuring. Prior to the craziness of current events, you advised stepping back from the news. Great advice.
Hi Jan! Can I also confess that CBT-i has not been helpful for the (rare) patient who actually commits to it!? I know we follow the evidence in medicine, but there are many times when the evidence does not line up with the experience.
I think the insomnia post you are referring to is this one:
And I don't want to jinx it, but I am in the late stages working with an editor to have a new version of this idea published in a big time media source! Keep you posted...
Hi Patti :) Glad to help with the sleep-inducing and curiosity-stimulating post... that's a tightrope and I'm guessing a few time I wobbled into too much jargon. Hope the nap was restorative ;) Take care!
At the tender age of 78, I rarely nap, and my brain function is better than it was 30 years ago. That's because I finally figured out how lifestyle affects brain function. The book "Invincible Brain" by Majid Fotuhi outlines these issues in detail. You also need to avoid getting CARB syndrome: https://carbsyndrome.com/
Hi William. I honestly don't have time right now to read that book, as I have 12 more waiting for me to crack the covers! But I did ask Claude about the ideas you mentioned here, and this is what it synthesized. Seems reasonable?:
What is "CARB Syndrome"? (Dr. Bill Wilson, not Fotuhi)
Dr. Bill Wilson defines CARB Syndrome — Carbohydrate Associated Reversible Brain Syndrome — as a form of brain dysfunction triggered by the long-term consumption of ultra-processed food, foods loaded with excess sugar, high-glycemic carbohydrates, and omega-6 fatty acids from vegetable oils. Carbsyndrome
A central claim is that the symptoms of CARB syndrome overlap with many traditional medical and psychiatric disorders, and that physicians end up labeling patients with major depression, bipolar II, ADHD, IBS, anxiety disorders, OCD, PTSD, and other conditions, when patients "really only have one disease — CARB syndrome." Carbsyndrome
Wilson argues that the condition drains the brain of monoamine neurotransmitters such as dopamine, epinephrine, serotonin, and norepinephrine, and that without these chemicals, the brain starts to malfunction in ways that can qualify for one or more traditional psychiatric disorders. Carbsyndrome
Scientific Problems with the CARB Syndrome Concept
1. It is not a recognized medical diagnosis. "CARB syndrome" has no entry in the DSM-5, ICD-11, or any major clinical guideline. It has not been validated by independent research groups or adopted in any peer-reviewed diagnostic framework.
2. The "one disease" claim is extraordinary and unsupported. The assertion that depression, bipolar disorder, ADHD, OCD, PTSD, IBS, and more are all just one dietary disease massively oversimplifies conditions with well-established distinct neurobiological substrates, genetic architectures, and treatment profiles. No peer-reviewed study supports collapsing all of these into a single syndrome.
3. The underlying diet-brain connection has real but limited support. This is where it gets more nuanced:
A high glycemic load diet has been identified as a risk factor for dementia, especially among APOE4 allele carriers, though its association with cognitive decline has required more investigation. MDPI
A diet rich in added sugars and refined carbohydrates has been linked to higher cognitive decline risk, because such foods can worsen insulin resistance, inflammation, and oxidative stress in the brain. Wiley Online Library
One longitudinal study found that higher daily intake of a high glycemic diet pattern, sugar, and total carbohydrate were related to more amyloid accumulation in the precuneus of cognitively normal older adults. nih
So: diet affects brain health — yes, real evidence. That all psychiatric disorders are caused by one carbohydrate-driven syndrome — no credible evidence.
4. Wilson himself acknowledges lack of formal study. Wilson has stated that his academic colleagues tell him "we need more studies to support the concept," calling it "a rather radical concept." His evidence base is clinical observation from his single practice, not controlled trials. Carbsyndrome
What Does The Invincible Brain by Fotuhi Actually Claim?
Fotuhi's book is a different animal with a different evidentiary status. The Invincible Brain argues that cognitive decline is not an inevitable consequence of aging, but a modifiable state driven largely by lifestyle, vascular, and metabolic factors. Waterstones
The book outlines five essential pillars of brain health — fitness, sleep, nutrition, mindset, and brain training — and claims that over 80% of patients in his 12-week program experienced significant improvements in cognitive functions, backed by MRI evidence indicating increased hippocampal volume in elderly patients. Storizen
Evaluating Fotuhi's Claims
What's well-supported:
The core premise that lifestyle factors (exercise, sleep, nutrition, stress management) influence brain health and can slow or partially reverse cognitive decline is supported by mainstream neuroscience.
Physical activity has been shown to help preserve hippocampal volume in individuals at increased genetic risk for Alzheimer's disease, with hippocampal volume decreasing by 3% in high-risk/low-physical-activity groups versus remaining stable in more active groups over 18 months. nih
The neuroplasticity framework — that the brain can grow and adapt — is scientifically well-established.
What is more contested:
Fotuhi has reported that 84% of patients with mild cognitive impairment in his 12-week program had statistically significant improvements in cognitive tests, and half increased hippocampal size by 1–3%. However, this data comes from his own uncontrolled clinical program, not a large independent randomized controlled trial. Hopkinsmedicine
A meta-analysis of 12 studies found no statistically significant effect of exercise intervention alone on hippocampal volume in older adults, casting doubt on how consistently and easily hippocampal regrowth can be achieved. Lippincott Williams & Wilkins
Claims about reversing "early Alzheimer's disease" are particularly strong and not yet broadly reproduced by independent trials.
The key takeaway: there is solid science connecting metabolic health and diet to brain function, but both "CARB syndrome" as presented by Wilson and the bolder claims in Fotuhi's book go considerably beyond what the mainstream evidence currently supports.
I like the British expression, “I’m going to have a lie-down.” It doesn’t necessarily mean falling asleep. I’ve found that simply getting horizontal for 20–30 minutes—even without dozing off—can be remarkably restorative. It gives the circulatory system a chance to redistribute blood from the lower body, and the quiet pause does a great deal to settle and refresh the mind as well.
Brilliant addition, thanks Stuart! I'm going to try that lie down today. Normally (too much information) if I lie down for a nap it puts me into a weird fitful REM type sleep, but if I doze off with my feet up in a reclining chair, I stay in different stages of sleep/rest that feel better awakening from. To each their own, truly. Cheers to your lie downs!
Your article brought to mind some famous nappers. Edison, Churchill, JFK and LBJ all were nappers.
Before retirement, during my breaks, I would find a quiet place to just close my eyes for 15 minutes to refresh. Train commuting could be dangerous when I was really tired. My train buddy would nap during our commute home. I know of someone who commuted by train, fell asleep and ended up in Grand Central Station. OOPS!! A co-worker use to go to her car to take a short nap and said she started doing it when her kids were little and never stopped. She would set a timer to get herself back to work. When the body speaks, it needs to be listened to.
Now retired and 70, I don't find myself needing a nap much at all. There are times, especially in the winter months, when I get that afternoon slump but not enough to nap. Being retired, on my own schedule, seems to have changed my need for napping. But it could change as I get older.
I did not know that about the famous nappers - good company! Edison got pretty terrible sleep from what I recall?
Those naps on trains are great, lulled to sleep by the rhythms and motion - but dangerous as I have missed a few stops over the years because of nodding off. Hopefully at 70 and retired you have more time to rest and exercise and find balance, with naps not as necessary as they once might have felt?
What I found interesting about the famous nappers, is Jackie Kennedy would take naps with JFK and nobody was to disturb him unless it was an emergency. She also told LBJ when he became President he should start napping too because she saw how much it helped JFK.
Seriously, I don't think these studies will overcome my body's basic desire to nap from 30 to 60 minutes. Sometimes it feels like my best sleep. I think I inherited from my grandfather who lived well over 90.
What I don't like is when the passengers in the vehicle interrupt my nap.
Different strokes for different folks, and I appreciate this personal basic desire... worked great for you grandfather, and I think this is the second testimonial to long life in a napper in this thread!
Interrupted naps are like a slap in the face... ugh!!!
I have never been able to nap and am envious of those who can. But this might be similar: in the afternoon, I do something meditative—right now it is going through vacation photos of art we saw on our trip (I have a gazillion), flagging the ones that turned out OK, and doing whatever little edits may be needed. There is something soothing about this—the mind at rest, a peaceful ritual.
Now, as for feeling guilty about napping: my prescription for you Doc, is that there is absolutely no reason for guilt. Au contraire, for all the reasons you note, and particularly this: “The strongest signal was for vigilance, which matters if you’re . . . a family doc tracking 5-25 chronic problems a visit . . . “. What is demanded of family docs, our first and most important line of defense for maintenance of good health, is extraordinary, and vastly under appreciated. Your nap is an aid in you ability to protect and promote the good health of your patients. Keep it up!
I appreciate that validation and permission thank you Susan! Probably a good sign that you have been a challenged napper. The meditative afternoon routine likely accomplished much the same in terms of resetting a bit, reducing stress hormones, etc. My 25 minute "siesta" today was probably about 50% sleep, 50% stage 1 meditative brain waves, so I'm there with you in the metaverse!
Another great piece, doc - thank you. I don’t nap often, but it’s usually around 4pm. Never seems to impact my ability to fall asleep at 10:30 or so. I do think I have lingering energy/fatigue issues from long COVID, albeit mild at this point so I can’t complain.
Can you explain the mouth tape directive? I’ve been doing this for a few years now. I seem to sleep better, my mouth stays more moist, and my husband appreciates that he’s not sleeping next to Darth Vader anymore 😂
Hi Amy! By all means if that nap works for your system, proceed at will!
Mouth taping has gained popularity for promoting nasal breathing during sleep, which does have real benefits (nasal breathing filters air, humidifies it, and supports nitric oxide production I think). However, if your nasal airway is blocked (due to congestion, a deviated septum like me, or allergies like me), taping your mouth shut can restrict your breathing and reduce oxygen intake. It can also be dangerous for people with undiagnosed sleep apnea, potentially worsening episodes by limiting the emergency "escape valve" of mouth breathing.
The research supporting it is still quite thin and low-quality. Most sleep medicine doctors suggest that if you're concerned about mouth breathing, it's worth seeing a doctor to address the root cause (like nasal congestion or airway anatomy) rather than taping. If you do try it, I've read that a loosely placed strip of gentle tape (rather than fully sealing the lips) is considered lower risk.
Eek! I read the book Breath by James Nestor, and this is what I based my mouth taping on. I do have a deviated septum, so I also wear Breathe Right nasal strips. The combination of those and the mouth tape (3M micropore tape) seem to work well. And I take some of the adhesive off the tape but putting it on my arm and taking it off a few times.
I also did a breathwork program in 2020 specifically for long haulers (at the time it was called Stasis), and they taught us how to unblock our nasal passages using breath holds to build up carbon dioxide. It was wild - I had no idea you could unblock your own nose like that.
I find tremendous benefit in the information you provide, but am so curious as to your comment about mouth taping where you say “don’t!” I have PAH. I’m on supplemental O2 at night & also while hiking, skiing & biking. I find mouth taping forces nasal breathing, which is critical for getting the extra O2 I need, as mouth breathing bypasses air supplied via the cannula. I began taping years ago after reading James Nestor’s “Breath” & other related books. With my O2 saturation rarely above 90% on room air (PAH + living 40 years at 9,600 ft + blunted brain response to O2 regulation) why would mouth taping be a bad idea? So curious to hear more regarding your opinion on that.
Hi KT! I'm so glad you find benefit reading these!
I'm going to copy and paste my response from the above comment in case you don't see it, and then add a little more:
Mouth taping has gained popularity for promoting nasal breathing during sleep, which does have real benefits (nasal breathing filters air, humidifies it, and supports nitric oxide production I think). However, if your nasal airway is blocked (due to congestion, a deviated septum like me, or allergies like me), taping your mouth shut can restrict your breathing and reduce oxygen intake. It can also be dangerous for people with undiagnosed sleep apnea, potentially worsening episodes by limiting the emergency "escape valve" of mouth breathing.
The research supporting it is still quite thin and low-quality. Most sleep medicine doctors suggest that if you're concerned about mouth breathing, it's worth seeing a doctor to address the root cause (like nasal congestion or airway anatomy) rather than taping. If you do try it, I've read that a loosely placed strip of gentle tape (rather than fully sealing the lips) is considered lower risk
HOWEVER...
Your situation is actually a unique case for mouth taping. Has your doc recommended this? The core concern with mouth taping is that it could restrict oxygen intake — but in your case, mouth breathing is reducing your oxygen intake by bypassing the cannula entirely, so taping directly addresses that problem, right? With PAH and chronically low saturations, maximizing the benefit of your supplemental O2 is a genuine medical priority, and nasal breathing is the mechanism that makes the cannula work.
The "don't!" advice is really aimed at average people with no diagnosed breathing issues who are chasing a wellness trend without understanding the risks. It doesn't meaningfully apply to someone managing a serious cardiopulmonary condition with medical oversight, high-altitude physiology, and years of real-world data on their own O2 sats. If your pulmonologist is aware and on board, you're doing exactly the kind of individualized, informed decision-making that blanket advice like "don't!" isn't sophisticated enough to account for. My bad on that one I think...
Love your reply! Thank you. And yes, I apply only a single strip of gentle mouth tape running vertically - treating mouth taping more as a physical reminder to self to nasal breath, rather than sealing my lips shut. I’m grateful for your full reply, because while for me mouth taping feels life-saving, your reply tells me why I should stop making a blanket recommendation to everyone I encounter that they should do the same.
My family medicine preceptor took a nap every afternoon between 1 and 2 pm. The rule was nobody disturbed Dr M unless somebody was arterially bleeding or delivering a baby in the waiting room. I expect it extended his working life by years.
Love this... probably made the residents better and more independent in some ways, but hopefully a few more urgent situations qualified for disturbance ;)
There are a few hacks for preventing burnout, but napping is never brought up by employers, except perhaps in Spain with the siesta.
My husband's grandmother, who lived a very active life until she died in 1971 at 99, claimed her good health was due to having a short nap after lunch every day throughout her adult life except the 10 years until her oldest turned ten and could look after the younger ones for 20 minutes.
Hard to argue with that vignette, and that short nap after lunch sounds delightful, especially with multiple children. The brain certainly needs a rest with even taking care of one! Thanks for sharing, Merry.
Ryan, how timely--I found myself looking at your previous insomnia posts (stress insomnia is an issue for me.) CBT-i hasn't been helpful for me. So, the issue of napping is relevant.
I'm not a habitual napper, but I can see the appeal. My husband is a habitual napper and I sent this to him. He's always done a short nap after lunch.
Could you revisit or repost the insomnia post? -so helpful and reassuring. Prior to the craziness of current events, you advised stepping back from the news. Great advice.
https://mccormickmd.substack.com/p/better-sleep-tips?utm_source=publication-search
Hi Jan! Can I also confess that CBT-i has not been helpful for the (rare) patient who actually commits to it!? I know we follow the evidence in medicine, but there are many times when the evidence does not line up with the experience.
I think the insomnia post you are referring to is this one:
https://mccormickmd.substack.com/p/good-sleep-and-690-days-lost-because
or this one:
Less likely this one:
https://mccormickmd.substack.com/p/1146-pm-its-bedtime
And I don't want to jinx it, but I am in the late stages working with an editor to have a new version of this idea published in a big time media source! Keep you posted...
I had to go take a nap after reading all this!! Seriously, another great in-depth analysis….. I learn so much by following you!
Hi Patti :) Glad to help with the sleep-inducing and curiosity-stimulating post... that's a tightrope and I'm guessing a few time I wobbled into too much jargon. Hope the nap was restorative ;) Take care!
At the tender age of 78, I rarely nap, and my brain function is better than it was 30 years ago. That's because I finally figured out how lifestyle affects brain function. The book "Invincible Brain" by Majid Fotuhi outlines these issues in detail. You also need to avoid getting CARB syndrome: https://carbsyndrome.com/
Excellent book. I’ve borrowed it from my local library, it’s due back. Haven’t gotten all the way thru it yet.
Check out my website, where I discuss many of the issues regarding the connection between diet and brain function.
Hi William. I honestly don't have time right now to read that book, as I have 12 more waiting for me to crack the covers! But I did ask Claude about the ideas you mentioned here, and this is what it synthesized. Seems reasonable?:
What is "CARB Syndrome"? (Dr. Bill Wilson, not Fotuhi)
Dr. Bill Wilson defines CARB Syndrome — Carbohydrate Associated Reversible Brain Syndrome — as a form of brain dysfunction triggered by the long-term consumption of ultra-processed food, foods loaded with excess sugar, high-glycemic carbohydrates, and omega-6 fatty acids from vegetable oils. Carbsyndrome
A central claim is that the symptoms of CARB syndrome overlap with many traditional medical and psychiatric disorders, and that physicians end up labeling patients with major depression, bipolar II, ADHD, IBS, anxiety disorders, OCD, PTSD, and other conditions, when patients "really only have one disease — CARB syndrome." Carbsyndrome
Wilson argues that the condition drains the brain of monoamine neurotransmitters such as dopamine, epinephrine, serotonin, and norepinephrine, and that without these chemicals, the brain starts to malfunction in ways that can qualify for one or more traditional psychiatric disorders. Carbsyndrome
Scientific Problems with the CARB Syndrome Concept
1. It is not a recognized medical diagnosis. "CARB syndrome" has no entry in the DSM-5, ICD-11, or any major clinical guideline. It has not been validated by independent research groups or adopted in any peer-reviewed diagnostic framework.
2. The "one disease" claim is extraordinary and unsupported. The assertion that depression, bipolar disorder, ADHD, OCD, PTSD, IBS, and more are all just one dietary disease massively oversimplifies conditions with well-established distinct neurobiological substrates, genetic architectures, and treatment profiles. No peer-reviewed study supports collapsing all of these into a single syndrome.
3. The underlying diet-brain connection has real but limited support. This is where it gets more nuanced:
A high glycemic load diet has been identified as a risk factor for dementia, especially among APOE4 allele carriers, though its association with cognitive decline has required more investigation. MDPI
A diet rich in added sugars and refined carbohydrates has been linked to higher cognitive decline risk, because such foods can worsen insulin resistance, inflammation, and oxidative stress in the brain. Wiley Online Library
One longitudinal study found that higher daily intake of a high glycemic diet pattern, sugar, and total carbohydrate were related to more amyloid accumulation in the precuneus of cognitively normal older adults. nih
So: diet affects brain health — yes, real evidence. That all psychiatric disorders are caused by one carbohydrate-driven syndrome — no credible evidence.
4. Wilson himself acknowledges lack of formal study. Wilson has stated that his academic colleagues tell him "we need more studies to support the concept," calling it "a rather radical concept." His evidence base is clinical observation from his single practice, not controlled trials. Carbsyndrome
What Does The Invincible Brain by Fotuhi Actually Claim?
Fotuhi's book is a different animal with a different evidentiary status. The Invincible Brain argues that cognitive decline is not an inevitable consequence of aging, but a modifiable state driven largely by lifestyle, vascular, and metabolic factors. Waterstones
The book outlines five essential pillars of brain health — fitness, sleep, nutrition, mindset, and brain training — and claims that over 80% of patients in his 12-week program experienced significant improvements in cognitive functions, backed by MRI evidence indicating increased hippocampal volume in elderly patients. Storizen
Evaluating Fotuhi's Claims
What's well-supported:
The core premise that lifestyle factors (exercise, sleep, nutrition, stress management) influence brain health and can slow or partially reverse cognitive decline is supported by mainstream neuroscience.
Physical activity has been shown to help preserve hippocampal volume in individuals at increased genetic risk for Alzheimer's disease, with hippocampal volume decreasing by 3% in high-risk/low-physical-activity groups versus remaining stable in more active groups over 18 months. nih
The neuroplasticity framework — that the brain can grow and adapt — is scientifically well-established.
What is more contested:
Fotuhi has reported that 84% of patients with mild cognitive impairment in his 12-week program had statistically significant improvements in cognitive tests, and half increased hippocampal size by 1–3%. However, this data comes from his own uncontrolled clinical program, not a large independent randomized controlled trial. Hopkinsmedicine
A meta-analysis of 12 studies found no statistically significant effect of exercise intervention alone on hippocampal volume in older adults, casting doubt on how consistently and easily hippocampal regrowth can be achieved. Lippincott Williams & Wilkins
Claims about reversing "early Alzheimer's disease" are particularly strong and not yet broadly reproduced by independent trials.
The key takeaway: there is solid science connecting metabolic health and diet to brain function, but both "CARB syndrome" as presented by Wilson and the bolder claims in Fotuhi's book go considerably beyond what the mainstream evidence currently supports.
I like the British expression, “I’m going to have a lie-down.” It doesn’t necessarily mean falling asleep. I’ve found that simply getting horizontal for 20–30 minutes—even without dozing off—can be remarkably restorative. It gives the circulatory system a chance to redistribute blood from the lower body, and the quiet pause does a great deal to settle and refresh the mind as well.
Brilliant addition, thanks Stuart! I'm going to try that lie down today. Normally (too much information) if I lie down for a nap it puts me into a weird fitful REM type sleep, but if I doze off with my feet up in a reclining chair, I stay in different stages of sleep/rest that feel better awakening from. To each their own, truly. Cheers to your lie downs!
Thanks for the compliment. I hope your lie-down was refreshing!
Your article brought to mind some famous nappers. Edison, Churchill, JFK and LBJ all were nappers.
Before retirement, during my breaks, I would find a quiet place to just close my eyes for 15 minutes to refresh. Train commuting could be dangerous when I was really tired. My train buddy would nap during our commute home. I know of someone who commuted by train, fell asleep and ended up in Grand Central Station. OOPS!! A co-worker use to go to her car to take a short nap and said she started doing it when her kids were little and never stopped. She would set a timer to get herself back to work. When the body speaks, it needs to be listened to.
Now retired and 70, I don't find myself needing a nap much at all. There are times, especially in the winter months, when I get that afternoon slump but not enough to nap. Being retired, on my own schedule, seems to have changed my need for napping. But it could change as I get older.
I did not know that about the famous nappers - good company! Edison got pretty terrible sleep from what I recall?
Those naps on trains are great, lulled to sleep by the rhythms and motion - but dangerous as I have missed a few stops over the years because of nodding off. Hopefully at 70 and retired you have more time to rest and exercise and find balance, with naps not as necessary as they once might have felt?
What I found interesting about the famous nappers, is Jackie Kennedy would take naps with JFK and nobody was to disturb him unless it was an emergency. She also told LBJ when he became President he should start napping too because she saw how much it helped JFK.
That’s some precious oxytocin between two nappers snuggled up. Glad they had that time.
Seriously, I don't think these studies will overcome my body's basic desire to nap from 30 to 60 minutes. Sometimes it feels like my best sleep. I think I inherited from my grandfather who lived well over 90.
What I don't like is when the passengers in the vehicle interrupt my nap.
Different strokes for different folks, and I appreciate this personal basic desire... worked great for you grandfather, and I think this is the second testimonial to long life in a napper in this thread!
Interrupted naps are like a slap in the face... ugh!!!
Especially when the passengers are screaming. ;0
I have never been able to nap and am envious of those who can. But this might be similar: in the afternoon, I do something meditative—right now it is going through vacation photos of art we saw on our trip (I have a gazillion), flagging the ones that turned out OK, and doing whatever little edits may be needed. There is something soothing about this—the mind at rest, a peaceful ritual.
Now, as for feeling guilty about napping: my prescription for you Doc, is that there is absolutely no reason for guilt. Au contraire, for all the reasons you note, and particularly this: “The strongest signal was for vigilance, which matters if you’re . . . a family doc tracking 5-25 chronic problems a visit . . . “. What is demanded of family docs, our first and most important line of defense for maintenance of good health, is extraordinary, and vastly under appreciated. Your nap is an aid in you ability to protect and promote the good health of your patients. Keep it up!
I appreciate that validation and permission thank you Susan! Probably a good sign that you have been a challenged napper. The meditative afternoon routine likely accomplished much the same in terms of resetting a bit, reducing stress hormones, etc. My 25 minute "siesta" today was probably about 50% sleep, 50% stage 1 meditative brain waves, so I'm there with you in the metaverse!
Another great piece, doc - thank you. I don’t nap often, but it’s usually around 4pm. Never seems to impact my ability to fall asleep at 10:30 or so. I do think I have lingering energy/fatigue issues from long COVID, albeit mild at this point so I can’t complain.
Can you explain the mouth tape directive? I’ve been doing this for a few years now. I seem to sleep better, my mouth stays more moist, and my husband appreciates that he’s not sleeping next to Darth Vader anymore 😂
Hi Amy! By all means if that nap works for your system, proceed at will!
Mouth taping has gained popularity for promoting nasal breathing during sleep, which does have real benefits (nasal breathing filters air, humidifies it, and supports nitric oxide production I think). However, if your nasal airway is blocked (due to congestion, a deviated septum like me, or allergies like me), taping your mouth shut can restrict your breathing and reduce oxygen intake. It can also be dangerous for people with undiagnosed sleep apnea, potentially worsening episodes by limiting the emergency "escape valve" of mouth breathing.
The research supporting it is still quite thin and low-quality. Most sleep medicine doctors suggest that if you're concerned about mouth breathing, it's worth seeing a doctor to address the root cause (like nasal congestion or airway anatomy) rather than taping. If you do try it, I've read that a loosely placed strip of gentle tape (rather than fully sealing the lips) is considered lower risk.
Eek! I read the book Breath by James Nestor, and this is what I based my mouth taping on. I do have a deviated septum, so I also wear Breathe Right nasal strips. The combination of those and the mouth tape (3M micropore tape) seem to work well. And I take some of the adhesive off the tape but putting it on my arm and taking it off a few times.
I also did a breathwork program in 2020 specifically for long haulers (at the time it was called Stasis), and they taught us how to unblock our nasal passages using breath holds to build up carbon dioxide. It was wild - I had no idea you could unblock your own nose like that.
I find tremendous benefit in the information you provide, but am so curious as to your comment about mouth taping where you say “don’t!” I have PAH. I’m on supplemental O2 at night & also while hiking, skiing & biking. I find mouth taping forces nasal breathing, which is critical for getting the extra O2 I need, as mouth breathing bypasses air supplied via the cannula. I began taping years ago after reading James Nestor’s “Breath” & other related books. With my O2 saturation rarely above 90% on room air (PAH + living 40 years at 9,600 ft + blunted brain response to O2 regulation) why would mouth taping be a bad idea? So curious to hear more regarding your opinion on that.
Hi KT! I'm so glad you find benefit reading these!
I'm going to copy and paste my response from the above comment in case you don't see it, and then add a little more:
Mouth taping has gained popularity for promoting nasal breathing during sleep, which does have real benefits (nasal breathing filters air, humidifies it, and supports nitric oxide production I think). However, if your nasal airway is blocked (due to congestion, a deviated septum like me, or allergies like me), taping your mouth shut can restrict your breathing and reduce oxygen intake. It can also be dangerous for people with undiagnosed sleep apnea, potentially worsening episodes by limiting the emergency "escape valve" of mouth breathing.
The research supporting it is still quite thin and low-quality. Most sleep medicine doctors suggest that if you're concerned about mouth breathing, it's worth seeing a doctor to address the root cause (like nasal congestion or airway anatomy) rather than taping. If you do try it, I've read that a loosely placed strip of gentle tape (rather than fully sealing the lips) is considered lower risk
HOWEVER...
Your situation is actually a unique case for mouth taping. Has your doc recommended this? The core concern with mouth taping is that it could restrict oxygen intake — but in your case, mouth breathing is reducing your oxygen intake by bypassing the cannula entirely, so taping directly addresses that problem, right? With PAH and chronically low saturations, maximizing the benefit of your supplemental O2 is a genuine medical priority, and nasal breathing is the mechanism that makes the cannula work.
The "don't!" advice is really aimed at average people with no diagnosed breathing issues who are chasing a wellness trend without understanding the risks. It doesn't meaningfully apply to someone managing a serious cardiopulmonary condition with medical oversight, high-altitude physiology, and years of real-world data on their own O2 sats. If your pulmonologist is aware and on board, you're doing exactly the kind of individualized, informed decision-making that blanket advice like "don't!" isn't sophisticated enough to account for. My bad on that one I think...
Love your reply! Thank you. And yes, I apply only a single strip of gentle mouth tape running vertically - treating mouth taping more as a physical reminder to self to nasal breath, rather than sealing my lips shut. I’m grateful for your full reply, because while for me mouth taping feels life-saving, your reply tells me why I should stop making a blanket recommendation to everyone I encounter that they should do the same.
My family medicine preceptor took a nap every afternoon between 1 and 2 pm. The rule was nobody disturbed Dr M unless somebody was arterially bleeding or delivering a baby in the waiting room. I expect it extended his working life by years.
Love this... probably made the residents better and more independent in some ways, but hopefully a few more urgent situations qualified for disturbance ;)
There are a few hacks for preventing burnout, but napping is never brought up by employers, except perhaps in Spain with the siesta.
America...