Breathe to Win: How Airway Health Shapes Athletic Performance

What Is The Impact Of Airway Health On Athletic Performance?

Breathing might be the most underrated performance enhancer you own. We take you inside the athlete’s airway—how it moves oxygen, manages carbon dioxide, and stays stable under pressure—so you can train harder, recover faster, and think clearer when the game is on the line.

We break down why nasal breathing matters for more than comfort. Nitric oxide produced in the nose supports blood vessel dilation and efficient oxygen delivery, while balanced CO2 keeps oxygen releasing into muscle where it counts. You’ll hear how over-breathing during stress narrows focus and fuels the classic “choke,” and why the best closers look calm: they control breath to control physiology. From marathon finishers breathing through the nose to sprinters protecting airway stability, we compare real-world patterns and highlight the few sports where mouth breathing is the exception.

Recovery gets equal focus. The first half of the night rebuilds the body; the second half repairs the brain with longer REM cycles. Sleep-disordered breathing can disrupt both, leaving you sore, foggy, and stuck despite perfect training. We outline the three pillars of airway performance—size, function, and condition—and share simple screens like the two-minute nasal test to spot hidden issues in adults and young athletes. You’ll come away with practical steps to reduce congestion, improve nasal flow, and build CO2 tolerance so your training translates into consistent results.

Ready to turn breath into a performance advantage? Listen now, try the two-minute test, and share this with a teammate who needs a calmer finish. If you’re finding value, follow the show, leave a quick review, and send us your biggest breathing win from this week.

To learn more about Dr. Mark A. Cruz, DDS. visit:
https://www.MarkACruzdds.com
Dr. Mark A. Cruz, DDS. 
32241 Crown Valley Pkwy #200  
Dana Point, CA 92629  
949-661-1006 

Transcript

Welcome And Airway Focus

SPEAKER_00 0:03

Welcome to Airway Focused Dentistry with Dr. Mark A. Cruz, the show where better breathing leads to better living. If your nights sound like a lawnmower chorus or your energy stuck on low battery, you're in the right place. Hosted by Dr. Mark A. Cruz, we explore how the airway impacts your sleep, your health, and your smile. So you can breathe, sleep, and be well. Take a deep breath, and let's get started.

SPEAKER_01 0:32

Athletes

Why Athletes Need Better Breathing

SPEAKER_01 0:33

often train harder, eat cleaner, and recover smarter, but many overlook the one factor that can make or break performance: the airway. Welcome everyone. I'm Julie Schwenzer, co-host and producer in the studio with Dr. Mark A. Cruz. Dr. Cruz, it's so great to be back with you.

SPEAKER_02 0:50

Well, likewise, thank you very much, Julie.

SPEAKER_01 0:53

Yes, thank you. So we'd really love for you to walk us through today's topic. And I know it's a big question to start, but what is the impact of airway health on athletic performance?

SPEAKER_02 1:04

Well, gosh, you know, it's pretty basic, just like uh any kind of performance, uh day-to-day performance, athletics is maybe functioning at a higher level in a competitive uh environment. But like any mammal, optimal um uh consumption of oxygen and availability of oxygen is super important for function. And it's confusing because you know, you can have athletes that have um deficient airways and yet they function at a very, very high level. And uh and that makes it confusing because they're at the top of their game regardless. The real question, I think, is really understanding um are they, even at that high performance, is it as easy as it would be if they had a really good um uh manifold, if you will, with good function? And I would argue that um no, they're not still at their best, but their best may be way better than any, you know, their competitors, right? So that can kind of create some confusion. So I'm always saying that the individual, we want the best version of that individual, regardless of where they are on the battle curve. Uh, and when it comes to athletics, clearly we know it's in the culture.

Oxygen, Nitric Oxide, And CO2 Balance

SPEAKER_02 2:27

Everyone's talking about, you know, breathe rights, nose dilators, understanding that when we breathe through our nose, which is the way we're designed, um, that uh that allows for the most efficient gas exchange because when you breathe through the nose, there's a release of nitric oxide that affects the entire endothelial system, vascular system. It dilates. And so that allows for really efficient distribution of uh oxygen. But then there's also the other gas that people forget about, and that's CO2. It's a waste gas. So we don't think that much about it. And in fact, a good friend of mine, world-renowned uh physiologist Peter Litchfield, has actually a school that teaches postgraduate um level training on uh breathing assessment and repatterning. And in fact, he has um um very big contracts with the Department of Defense, um, the CIA, um, the FBI, where they've done studies, uh pilots, uh, looking at peak human performance. Performance that is in a stressful situation where maybe the individual may over-ventilate, uh blowing off too much CO2 that stimulates an adrenaline response, where they don't function quite as clear-headed as they would if they were in more of a um uh an optimal breathing pattern. And so they've actually done these studies to show that it makes a big difference if you're in a stressful situation. Um, so that's an exciting uh uh yet largely uh unrecognized uh topic. You know, there are lots of uh blogs and and uh sites, uh websites that talk about yoga breathing and M-hof and cold plunges and things that may facilitate that, but um it it's there's a really a lot of sites that's underappreciated. And I really apologize uh that my voice is a little hoarse. I just finished a three-day um course where I was talking all day long to my colleagues, and so I've been uh uh my my my my throat is uh a little bit of all that. But hopefully you can hear what I'm saying. But yeah, so those are the two things um for athletes and athletic performance is proper uh um breathing through the nose, big manifold, and proper regulation of CO2. And of course, it's baked into our culture, into our psyche that we may or may not recognize. So I always say, you know, what do we say about an athlete who is at the free throw line with two seconds left and needs to make one free throw? And they typically have a 90% free throw um uh success rate, and then they miss it. Or that wide receiver that the ball hits them in the hands to win the game when they're in the end zone and they drop it when they would otherwise always hold on to it. What do we say in our culture? They choked. Heard that. And so what's that mean? That means that you stopped your breathing, you know, and that affected your performance. So all the really good athletes we know during crunch time, we want them to have the ball because they're actually breathing better. You know, we have posters of Michael Jordan in the air with his tongue out, you know, he's opening up his airway, Kobe Bryant, you know, jutting his job for. Um, and and so uh, yeah, it's super important and it does affect athletic performance. But you know, I've been on social media and and and blogs and discussions where, you know,

Choking Under Pressure Explained

SPEAKER_02 6:45

there'll be athletes, athletes that are high, high, uh very successful, they'll say, no, no, no, you gotta be able to breathe through your mouth. Well, I would say, sure, um, maybe when you get into oxygen debt at the very end where everyone else is huffing and puffing. But if you really look at the Kenyan marathoners who always break the tape before anybody else, you see them, those last miles, breathing through the nose, lips are together when everyone else is huffing and puffing. Or that 100-meter sprinter that's getting the gold medal, but by and large, they're breathing through their nose. And so the acceptance obviously would be swimming, because that does require world-title breathing. That's a different story. Uh, but for by and large, uh, we're intended to breathe through our nose very efficient and efficiently. So the larger the airway, the better that it functions, uh, the better the performance for that individual, relative to that individual, not relative to the other. So we always say it's three things. It's the size of the airway,

Nose Vs Mouth Breathing In Sport

SPEAKER_02 7:58

looking at the kinks in that hose, if you will, the function of the airway, meaning the collapsibility, like when you snore, it's a collapsible airway, and the condition of the airway, meaning that the congestion that you may or may not have, or inflammation, you're sick or you're congested. The airway may be large, uh, but it collapses or it's got a lot of congestion. So it's three things to consider for optimal performance, not only for athletics, but just moment to moment.

SPEAKER_01 8:29

Yeah, thank you for going into that and sticking with us even after your many days of speaking. We appreciate you.

SPEAKER_03 8:36

Yeah, thank you.

unknown 8:38

Thank you.

SPEAKER_01 8:38

The athlete of airway health, that's for sure. Could you speak to more uh more to um sleep disordered breathing and how that, you know, what role that plays in recovery and and you know the muscle repair?

SPEAKER_02 8:54

No, no question about it. So, I mean, just kind of basics in sleep. Um, we we know that roughly the first half, the first four hours, the focus in sleep and the sleep cycles that um one goes through optimally, mostly is repairing the body. And then the second half of the night, the last four hours, is uh mostly repairing the brain. So you have longer and more RAM cycles the second half of the night than you do in the fourth, uh in the first half of the night. And so that roughly gives uh an understanding

Three Pillars Of Airway Function

SPEAKER_02 9:35

uh of how sleep architecture works. So if you're not getting that deep sleep um in either half of the night, the body's not able to repair very well. We know that it affects the immune system, the um uh different cell lines that are required. Now, we don't really understand fully the mechanisms uh in in detail, although there are there are quite a bit of uh of details on that. But just in general, um, if you're always working out and you're conditioned, because you're always working out, but you're always kind of sore, um, they may be your quality of sleep may not be enough to repair your muscles day to day, or otherwise would because of the quality of sleep. And yet it's a conundrum, it's counterintuitive because you have a highly conditioned athlete, you know, they're they're just um functioning really uh at a high level, and yeah, uh they're they have these complaints. So um sleep is super important. And I the way I always say, think about it, um every human being spends a third of their life in this state called sleep. And nature would not invest that much

Sleep, Recovery, And Performance

SPEAKER_02 10:55

time in a function unless it was super important. The fact that we don't know as much about it and its function doesn't change it. Just like we don't know how uh a lot, we know more about the moon than we do about our oceans, the depths of our ocean, but it doesn't change the reality. There's a reality there, right? And so um as it pertains to sleep, that's that's what I would say.

SPEAKER_01 11:21

And then a last question for you, Doctor. You mentioned the poor sleeping could impact airway health and poor nasal breathing. Are there any other signs that young athletes maybe a little to look out for that there is an airway issue?

SPEAKER_02 11:36

Well, I mean, the the basic thing is can you breathe easily, always through the nose? Or is it congested from time to time, or um it's gotta be working 95% of the time. So uh regardless of uh if it's working most of the time, that's not the same as working all the time. So for instance, there's this phenomenon called the nasal cycle, where about every 90 minutes, 90 minutes to two hours, one external valve closes and the other one opens. And if both narys, nostrils are functioning well, you'll have no awareness of that. But if you have one side that has, say, a deviated septum and large turn it's where there's flow limitation, um, when the good side closes, the other side will have flow limitation and subconsciously you may or may not be aware of it. You may, you know, go to oral title breathing, some mouth breathing, or whatever the case may be, or maybe you struggle a little bit more. So any athlete, that's a good question to ask. For kids, what I do is I'll give them the two-minute test. Can they sit in the chair with their lips together, quiet, peaceful? And you'll find oftentimes is you know, kids may be able to do that, but you can almost see the stress in their face. You could see them kind of fidgeting around. You could see them wanting to interrupt and ask questions. They may take a little breath. So that tells you a lot about their nasal function. If you're not looking for it, you don't understand, you don't, you, you, you're not gonna detect it. So that's like a simple thing. A kid that's bouncing all over the walls gets diagnosed with ADDA, ADHD. Um, have them sit down and see if they can pass the two-minute test easily. And um,

Spotting Airway Issues In Kids

SPEAKER_02 13:45

adults could do that as well. How easy is this? Do you feel any anxiety, any anxiousness? So that's a simple task.

SPEAKER_01 13:52

Okay, Dr. Cruz, that's been very helpful as usual. We always appreciate you breaking these topics down for us.

SPEAKER_02 13:59

Great. My pleasure. Thank you.

SPEAKER_00 14:05

That's today's breath of fresh insight from airway focused dentistry with Dr. Mark A. Cruz. Remember, small changes in your airway can spark big changes in your life. Breathe, sleep, and be well. For more information, visit markacruzdf.com or call 949-661-1006. If this helped you, share the episode and maybe give your fellow a quieter night. See you next time.