Despite my passion for conscious connected breathing I’m also a little obsessed with daily breathing habits and the impact on our health. A while ago I read Patrick McKeown’s ‘Oxygen Advantage’. I implemented his training tools and after 36 years managed to quit my asthma inhalers! I cannot recommend this book and Patrick McKeown’s knowledge enough. I decided to take some of what I deemed to be the highlights of the book to give you a taster. If the following interests you, I promise, you will not be disappointed with the book and I urge you to read it in full.
The rate and volume of breathing is determined by receptors in the brain. When carbon dioxide (CO2) increases above a certain amount, these sensitive receptors stimulate breathing in order to get rid of the excess gas. However, part of your bodies quotient of CO2 is retained when you exhale as CO2 is the doorway which lets oxygen (O2) reach your muscles.
If this door is partially open, only some O2 passes through so we end up gasping during exercise, often with cramping limbs. However if the door is wide open O2 flows and we can sustain physical activity, at a high intensity for longer.
Chronic hyperventilation or over breathing simply means the habit of breathing a volume of air greater than that which our body requires. In this way, too much CO2 is exhaled (and removed from the blood). The door becomes partially closed and its more difficult for O2 to pass through. Short periods of over breathing is not a significant problem, however if we breathe too much for extended periods a biochemical change takes place and we become less tolerant to CO2. This results in our breathing volume remaining above normal as the receptors in the brain continuously stimulate breathing in order to get rid of CO2. To counteract these bad habits you must retrain yourself to breathe better!
Often people feel more tired than they should be despite blood O2 measuring within normal range. The problem is not lack of O2 in their blood it’s that not enough O2 is being released from the blood to tissues and organs, including the brain, resulting in feelings of lethargy and exhaustion. Many people in addition sleep with their mouths open, it is well documented that habitual mouth breathing during waking and sleeping results in fatigue, poor concentration, reduced productivity and bad mood. The same feeling of being drained physically and mentally can happen to individuals whose occupation involves considerable talking, such as school teachers and sales people. Often the exhaustion people in these professions feel at the end of the day is more likely due to the effects of elevated breathing during excessive talking. Many chronic over breathers have learned to tolerate the stunted levels of energy and fitness incorrect breathing leaves them with in day to day life. However changing our attitude towards our breath often produces more dramatic changes than any diet!
The Bohr Effect
Haemoglobin releases O2 when in the presence of CO2. Over breathing blows off too much CO2 (hypocapnia) so the haemoglobin holds onto the O2 resulting in reduced O2 delivery to tissues and organs = muscles cannot work as effectively. As counterintuitive as it may seem, when we hit a wall during exercise, we should avoid taking big, deep breaths. When breathing volume remains nearer to correct levels, CO2 levels in the blood are higher loosening the bond between haemoglobin and O2, facilitating the delivery of O2 to the muscles and organs.
Being able to perform physical exercise with easy, slow breathing is not only a sign of good fitness it is also healthier and safer. The sensitivity of your receptors to CO2 and O2 will have implications for the way your body copes with physical exercise. Having a greater tolerance to CO2 not only reduces breathlessness but also allows for much more effective delivery of O2 to your working muscles during exercise. Your body will be able to work harder with far less effort, breathing will be lighter during both rest and exercise. Efficient breathing means that fewer free radicals are produced, reducing the risk of inflammation, tissue damage and injury.
VO2 max refers to the maximum capacity of your body to transport and utilise O2 in 1 min during maximal exercise. It’s considered the best indicator of cardiorespiratory endurance. The ability to tolerate higher concentrations of CO2 in the blood means a higher VO2 max can be achieved, culminating in better delivery and utilisation of O2 by the working muscles.
Breathing cannot be efficient during sport if breathing during times of rest is inefficient.
You can determine your sensitivity to CO2 using the Body Oxygen Level Test (BOLT) which measures the length of a comfortable breath hold. It is simple, safe and quick.
Take a normal inhale and a normal exhale through your nose
Hold your nose with your fingers to prevent air from entering your lungs
Time the number of seconds until you feel the first definite desire to breathe or the first stresses of your body urging you to breathe (a need to swallow/constriction of airway/contraction in abdomen or throat)
NB: BOLT is not a measurement of how long you can hold your breath but simply the
time it takes for your body to react to a lack of air
Stop the timer, release your nose and breathe in through your nose. Your inhale at the end of the hold should be calm
Resume normal nose breathing
BOLT is not an exercise to correct your breathing, it a measure. Remember the score involves holding your breath only until you feel the first involuntary movements of your breathing muscles. If you need to take a big breath at the end of the breath hold, then you have held your breath for too long.
When your BOLT score is lower, your breathing receptors are especially sensitive to CO2 and your breathing volume will be greater as the lungs work to remove any CO2 in excess of programmed levels. However, when you have a normal tolerance to CO2 and a higher BOLT score, you will be able to maintain calm breathing during rest and lighter breathing during physical exercise.
If your BOLT score is below 20 seconds, depending on genetic predisposition, you will probably find you experience a blocked nose, cough, wheeze, disrupted sleep, snoring, fatigue and excessive breathlessness during physical exercise. Each time your BOLT score increases by 5 sec, you feel better, with more energy and reduced breathlessness during exercise. Ideally the aim is to increase your BOLT score to 40 seconds.
BOLT score is also an excellent measurement to evaluate respiratory condition and symptoms such as coughing, wheezing, chest tightness, breathlessness and exercise induced asthma. By improving BOLT score you will be able to quickly and easily improve your performance and eliminate symptoms of exercise induced asthma.
Three steps to increase your BOLT score
1) Stop losses of CO2
Breathe through your nose day and night
Stop sighing, instead swallow or suppress the sigh. One sigh every few minutes is enough to maintain chronic over breathing. If you accidentally sigh, counteract by holding your breath for 10-15 seconds
Avoid big breaths when yawning or talking
Observe your breathing throughout the day. Good breathing during rest should not be seen or heard
2) Improve your CO2 tolerance
Practice exercises designed to reduce your breathing volume to normal. The objective is to create a tolerable hunger for air
3) Simulate high altitude training
Breathing less than you feel you need to during physical training is an excellent method of conditioning the body to tolerate a higher concentration of CO2, whilst subjecting the body to a reduced concentration of O2
If you have any health problems or a BOLT score shorter than 10 secs, do not attempt breath holds involving a strong need for air, as the resultant loss of control of your breathing may aggravate your condition. Please do not attempt the nose unblocking exercise or any of the exercises to simulate high altitude training unless you have a BOLT score of more than 10 secs. It’s advisable to have a BOLT score of at least 20 secs before attempting breath holding during jogging/running.
Nose unblocking exercise (Avoid if BOLT less than 10 seconds/high blood pressure/cardio issues/diabetes/pregnant/other serious health concerns)
Breathing through the mouth causes blood vessels in the nose to become inflamed and enlarged. When blocked, the nose becomes much more difficult to breathe through, which perpetuates mouth breathing, continued mouth breathing leads to a more permanent state of nasal congestion, thus a vicious circle!
Take a small, silent breath in through the nose and a small, silent breath out
Pinch nose, hold breath
Walk as many paces as possible with breath held. Try to build up to a medium- strong air shortage
When you resume breathing, do so through your nose, aim to calm the breath immediately
After resuming, your first breath will probably be bigger than normal, calm the breath as soon as possible after. You should be able to recover normal breathing within 2-3 breaths. If breathing is erratic or heavier than usual, you’ve held your breath too long
Wait a minute, repeat for a total of 6 breath holds, creating a fairly strong need for air
Generally this exercise will unblock the nose but the effects will wear off quickly. However when you are able to walk a total of 80 paces with the breath held you will find your nose will remain decongested. By holding your breath, you sharply increase the concentration of Nitric oxide in your nasal cavity resulting in dilation of the nasal passages and smooth, easy nasal breathing once more
Nasal breathing at night
If our sleep is disrupted it can be difficult to rise the following morning and a lack of sleep can severely affect concentration, mood and even the most basic of activities. Our quality of sleep can be reduced by mouth breathing and heavy breathing. As we are unaware of how we breathe at night, the only way to ensure nasal breathing is to wear tape across the lips. All you need is approximately 10 cm of micropore tape, fold a tab over at both ends to make removal easier. Dry lips, close mouth, apply tape! If this feels strange/uncomfortable at first, practise wearing for short periods during the day
Breath light to breathe right ‘The foundation exercise’
The aim of this exercise is to slow down and reduce your breathing to create a tolerable need for air. The need for air signifies an accumulation of arterial CO2, the goal of which is to reset the respiratory centres tolerance to this gas. To assist, it’s very helpful to exert gentle pressure against your chest and abdomen with your hands. Try to maintain the need for air for around 4-5 min
Sit up straight, shoulders relaxed. Place one hand on chest and one on your belly
Feel your abdomen gently move outward as you inhale and gently move inward as you exhale
As you breathe, exert gentle pressure with your hands against belly and chest, creating resistance to your breathing
With each breath, take in less air than you would like, make the inhale smaller or shorter, slowing and reducing your breath until you feel a tolerable hunger for air
Exhale with a relaxed exhalation
When the inhale becomes smaller and the exhale is relaxed, visible breathing movements will be reduced
This simple method can reduce your breathing movements by 20-30%. If your muscles start to jerk or tense or the breathing rhythm becomes disrupted, the air shortage is too intense. Rest for 15 secs and then return. Remember you are trying to create an air shortage that is tolerable but not stressful. Practising 2 sets of 5 min per day is enough to help reset your breathing centre and improve your body’s tolerance to CO2.
Take breathe light to breathe right into your exercise activities
Whilst exercising keep your breathing regular and under control, always through your nose. If you find it too hard to exercise with your mouth closed, it simply means your pace is too fast at the moment. Slow down. As a test to see if you’re pushing too hard during exercise, exhale normally, hold your breath for 5 sec. When you resume breathing through your nose, your breathing should be controlled.
Following exercise, cool down by walking 3-5 min performing small breath holds:
Exhale through the nose, pinch your nose and hold the breath for 2-5 sec
Breathe normally through the nose for 10 sec
Repeat the first 2 steps throughout the cool down
Simulate High altitude training whilst walking
This simple walking exercise enables you to achieve similar benefits to those experienced during intense physical training in as little as 10 min.
After a minute of continuous walking, gently exhale and pinch nose to hold breath. Continue to walk whilst holding breath until you feel a medium to strong air shortage. Release your nose, inhale, continue to walk, minimise breathing by taking short breaths for about 15 secs, then return to normal breathing.
Continue walking for around 1 min whilst breathing through nose, gently exhale, pinch nose and repeat
Repeat holds 8-10 times whilst continuing to walk, perform a breath hold every minute or so
This exercise is highly effective at teaching your body to do more with less. At first you may only be able to hold your breath for 20-30 paces. Initially you may feel spasms in your body, focus on relaxing to allow a longer breath hold with less stress. With repetition you will find yourself being able to hold your breath for 80-100 paces. However don’t overdo, ideally your breathing should recover easily within a few breaths. Breath holds can also be incorporated into a jog, run or bike. Breath holding during training adds an extra load that would only otherwise be experienced during maximum intensity exercise.
Breath holds during a jog or run
Once warmed up, about 10 min into your jog/run. Gently exhale and hold your breath until you experience a medium to strong air shortage. Gently inhale and continue to jog/run with nasal breathing for about 1 min, until your breathing is partially recovered
Repeat 8-10 times, followed each time by a minute of nasal breathing. The holds should be challenging but should also allow breathing to recover to normal within a few breaths
If you find this exercise stressful or have difficulty recovering your breathing after a hold, then refrain until your BOLT score is at least 20 secs.
I encourage you to experiment with your breath and check out the book. Please reach out if you wish to connect more deeply with the amazing gift we have within us all; our breath.