Ask Dr. H: Heart doesn't stop during a sneeze

Posted: February 20, 2012

Question: Is it true that the reason why people say "God bless you" after someone sneezes is that the heart stops beating?

Answer: Fortunately, the heart doesn't stop when we sneeze. The sneeze reflex is analogous to the cough reflex, in that it's an automatic response to an irritation. The walls of the nasal cavity are irritated, conducting nerve impulses to the brain. The uvula (which hangs down from your upper palate above the tongue) closes off the mouth area from the upper airway so that air is forcefully directed through the nose. However, most adults sneeze through their mouth, not their nose.

Looking at bright light can trigger the sneeze reflex, too, through accidental stimulation of the same nasal nerve receptors involved in the sneeze reflex.

A sneeze is a pretty violent expulsion. It momentarily decreases the flow of blood to the heart. Several hard sneezes may cause a momentary dip in your blood pressure, resulting in a second or two of lightheadedness. But that's not the same thing as your heart stopping. The heart may, however, skip a beat with sneezing. The next time you sneeze, feel your pulse at the wrist and you'll see for yourself.

The origin of "God bless you" reportedly dates back to the time of a plague in Europe. Originally started as a congratulation to the sneezer for expelling evil from his body, it evolved into a papal exhortation to bless the person against the plague. Today, we also say "gesundheit," which is German for "good health."

Did you know that the earliest surviving copyrighted motion picture is of a sneeze? It was made in January 1894 by W.K.L. Dickson, an assistant in Thomas Edison's New Jersey laboratory.

Coach/economy class syndrome

Q: Rapper Heavy D died last November from a fatal blood clot (embolism) to the lung. I read that he developed a blood clot in his leg a few weeks earlier when he was on a long flight between London and Los Angeles. Do you think he was a victim of "coach/economy class syndrome"?

A: I don't have any information on whether or not Heavy D, a talented but obese (344 pounds) musician, was sitting in a cramped seat in coach or a roomier seat in first class.

It really doesn't matter, because researchers have determined in a recent report in the journal Chest that "coach/economy class syndrome" is a myth.

Even during very long flights, less legroom by itself does not increase one's risk for developing a blood clot.

The greatest risk factor for leg clots is prolonged immobility. Sitting in a window seat, not stretching your legs, and not getting up often to walk around the cabin are much greater risk factors than the leg room difference between economy and first class. Add in the other risk factors for forming a leg clot: obesity; pregnancy; estrogen-based contraceptives; prior history of a leg clot/pulmonary embolism; cancer; recent surgery; and recent trauma. Dehydration and alcohol during flight are not conclusively linked to leg clots.

The best ways to prevent a leg clot are calf stretches, frequent walking around the cabin, sitting in the aisle seat, and the use of below-the-knee graduated compression stockings for flights longer than six hours if you're at higher risk of getting leg clots.

Ask your doctor if he advises taking an extra aspirin before the flight.


Mitchell Hecht specializes in internal medicine. Send questions to him at: "Ask Dr. H.," Box 767787, Atlanta, Ga. 30076. Due to the large volume of mail received, personal replies are not possible.

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