autonomic dysfunction

Breathing & Love, Rising Above the Clouds, and 4 Years in 4 Points

 
 

Listen Instead of Reading

 
 
 

4 Thoughts


1. Demonstrations of Breathing & Love

“Demonstrations of love are small, compared with the great thing that is hidden behind them.”

- Khalil Gibran

Call it what you’d like, prana, qi, & so on, but the same is true: Demonstrations of breathing are small compared with the great thing that is hidden behind them.

2. Breathing for Diabetes: 4 Years in 4 Bullet Points

Based on about 4 years of research and self-practice, the 4 key ways that regular breathing practices help diabetes are by:

3. Breathing for (non) Diabetics: “Raising Our Heads Above the Clouds”

“But many of the same interventions that can help us get our heads above water can just as effectively be devoted to raising our heads above the clouds.”

- Steven Kotler and Jamie Wheal, Stealing Fire

This is unquestionably true for breathing. Although everything I read, practice, and share is focused on keeping my “head above the water” as a diabetic, they can also “raise your head above the clouds” if you’re not diabetic.

Interesting side note: it’s typically broken people that find supplemental modalities like breathing—I guess because we need them the most : ) But if you’re not broken, all the benefits of breathing will be even more helpful.

So here’s to using our breathing to stay afloat, or rise above the clouds, today.

4. The Buddha, 20 Years after Enlightenment

Did you know that the Buddha was still meditating 20 years after his enlightenment? (I guess it never ends, folks 😄)

What kind of meditation, you might wonder? “Mindfulness of breathing.”

Extra Thought: Take High Altitude Yoga Alongside Me One Last Time

My wife is moving on to a new yoga adventure 🎉. But, she’ll be teaching the High Altitude Yoga class we designed together one last time.

The class incorporates slow breathing, breath holds, and yoga into a challenging but fun 45-min flow.

It’s $8 and happening tomorrow morning (Tuesday, Dec 14) at 6:15 a.m. EST. I’ll be there, and I hope you’ll join me in taking it!

 
 
 
 

1 QUOTE

“Relaxing the breath, breathe in. Relaxing the breath, breathe out. Then joy arises naturally.”

- Bhante Gunarantana

The Four Foundations of Mindfulness in Plain English

 
 
 
 

1 ANSWER

Category: The Diaphragm

Answer: This organ rests on the top of the diaphragm.

…

(Cue the Jeopardy! music.)

…

Question: What is the heart?

P.S. This was inspired by Jill Miller’s amazing line: “Thank you from the bottom of my heart. Which is of course, my diaphragm.” (Makes me laugh every time.)

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. and I’ve never respected anything more

 
 
 

Sign Up For The Breathing 411

Each Monday, I curate and synthesize information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing. It’s a fun way to learn something new each week.

 
 

On Excellent Scientific Statements and Being Reasonable with Breathing

 

Greetings,

Here are 4 thoughts, 1 quote, and 1 answer related to breathing. Enjoy!

 
 
 
 

4 THOUGHTS

1. 18 Excellent Statements from Scientific Papers

"With breathing interventions being relatively rapid interventions to implement and also demonstrating a wide range of positive clinical outcomes, breathing interventions warrant closer consideration from healthcare professionals."

- Psychophysiology (2017)

Over the past few years, I have accumulated over 500 pages of notes on over 100 scientific articles on breathing. I’ve recently been going back through them as part of a project I’m working on.

In this post, I share 18 of the best "one-liners" I’ve come across. Enjoy!

2. Breathing, Autonomic Function, and Diabetes

One of the most significant benefits of slow breathing is its positive effects on autonomic function. This is typically measured by heart rate variability (HRV) and baroreflex sensitivity (BRS)—higher HRV and BRS indicate better function.

Perhaps unsurprisingly, people with diabetes generally suffer from lower HRV (Benichou et al. 2018; Kudat et al. 2006) and BRS (Bernardi et al. 2017; Esposito et al. 2016). This is due to many factors, such as fluctuating blood sugars and resting tissue hypoxia, which cause autonomic imbalance (Bianchi et al. 2017).

Encouragingly, slow breathing at a rate of 4-6 breaths per minute is an effective way of increasing HRV (Steffen et al. 2021; Russell et al. 2017; Tavares et al. 2017; Chen et al. 2016; Lin et al. 2014; Van Diest et al. 2014; Vaschillo et al. 2006) and BRS (Rosengård-Bärlund et al. 2011; Bernardi et al. 2011; Joseph et al. 2005).

Slow breathing improves these markers by stimulating the vagus nerve, which activates the calming parasympathetic nervous system (Gerritsen and Band 2018). This helps people with diabetes restore autonomic balance.

It is simple and immediately useful, seeming too good to be true. But alas, science agrees: “Slow breathing could be a simple beneficial intervention in diabetes.”

3. How Stuff Works: Why Breathing Through Your Nose Is Best

"But wait, there's more. Breathing through your nose also increases the amount of oxygen in your blood more than mouth breathing, which is essential to virtually every cell, organ and tissue in your body."

- How Stuff Works
Why Breathing Through Your Nose is Best

This excellent article succinctly summarizes the benefits of nose breathing. It’s short, sweet, and packed full of great information. Enjoy!

4. With Breathing, Be Reasonable Not Rational

"Do not aim to be coldly rational when making financial decisions. Aim to just be pretty reasonable. Reasonable is more realistic and you have a better chance of sticking with it for the long run, which is what matters most."

- Morgan Housel, The Psychology of Money

I find many parallels between health and wealth. Here is another. We often get too bogged down with doing everything rationally. "This study said 20 minutes of slow breathing is best" or "That one said three times a day is needed."

Rather than following scientific studies exactly, I believe it’s better to aim for being "pretty reasonable." Find the time of day that works best with your schedule. Find the method that works best for you. Two slow breaths are better than no slow breaths. Four minutes a day is still better than zero minutes a day.

With breathing, be reasonable, not rational.

 
 
 
 

1 QUOTE

“But the nostrils, with their delicate and fibrous linings for purifying and warming the air in its passage, have been mysteriously constructed, and designed to stand guard over the lungs.”

– George Caitlin (1864), The Breath of Life

 
 
 
 

1 ANSWER

Answer: The internal surface area of these organs can be a great a 100 sq. meters, about half the size of a tennis court.

…

(Cue the Jeopardy! music.)

…

Question: What are the lungs?

In good breath,
Nick

P.S. No I need these

 
 

The Breathing 411 - On Becoming Indisfunctionable

 

Welcome to October and another edition of The Breathing 4.1.1.

Below, you’ll find 4 thoughts, 1 quote, and 1 answer (like "Jeopardy") related to all things breathing. Enjoy!

 
 
 
 

4 THOUGHTS

1. Breathing to Gain Traction

"On the left side is distraction, the opposite of traction...the word means the 'drawing away of the mind.' Distractions impede us from making progress toward the life we envision."

- Nir Eyal, Indistractable

I’ve never thought of "distraction" being the opposite of "traction." (Pretty neat.) Distraction, as Nir Eyal states, is the drawing away of the mind.

But what can we do to bring it back, to gain traction?

"It has long been claimed by Yogis and Buddhists that meditation and ancient breath-focused practices… strengthen our ability to focus on tasks. A new study explains for the first time the neurophysiological link between breathing and attention.…
The way we breathe, in other words, directly affects the chemistry of our brains in a way that can enhance our attention and improve our brain health." - ScienceDaily

That sounds like a great place to start. Here’s to combining ancient wisdom with modern science on our path to becoming indistractable.

(Thanks, a million times over, to Brian Johnson for inspiring so many of my thoughts.)

2. How to Become Indisfunctionable

In addition to improving focus, a staple of slow breathing is that it reverses autonomic dysfunction. It does this by promoting cardio-respiratory balance, in as little as two minutes, putting us back on the track to health and wellness.

In the process of becoming indistractable, we also become indisfunctionable.

3. Similar Lung Deficiencies in Diabetes and Asthma

"In a study of the pulmonary biopsies of 171 patients,(18) it was concluded that individuals with DM [diabetes mellitus] present an increase in basement membrane thickness similar to that seen in asthma patients." - Forgiarini et al. (2009)

I have often wondered why breathing principles that work so well for asthma also benefit people with diabetes. Here’s one interesting similarity: The oxidative stress from diabetes leads to similar lung structure changes seen in asthmatics.

Thanks to 411 reader T. P. for inspiring this thought.

4. Heavy Breathing at the Start of Exercise (it’s not just CO2)

Your breathing rate typically increases after just a few minutes of exercise…unless you’ve been reading this newsletter long enough :)

By now, we would all probably agree this increase in breathing is due to a build-up of CO2. But is that truly the case?

"The increase in ventilation does not appear to be the consequence of changes in arterial blood gases." - Respiratory Physiology pg 187

The reason is perhaps more impressive. It’s what this textbook calls "Phase 1: The Neurological Phase" of exercise. The movement itself might be sending neurological messages to the brain, instructing it to begin breathing more.

That is, your body has a built-in, anticipatory mechanism that links movement to the respiratory controller in the brain to help prevent blood-gas imbalances from ever happening. The result is that changes in breathing precede changes in CO2.

 
 
 
 

1 QUOTE

Same goes for breathing:

"It is easy to be heavy; hard to be light."

- G.K. Chesterton

 
 
 
 

1 ANSWER

Answer: The time it takes gas exchange to occur in the lungs.

…

(Cue the Jeopardy music.)

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Question: What is about 0.25 seconds?

In good breath,
Nick

P.S. Didn’t see that coming.

 
 

Breathing Restores Autonomic Control in Type-2 Diabetics with Complications

 

“Quit worrying about your health. It’ll go away.” - Robert Orben

 
 

As people with diabetes (type 1 or 2), we know our bodies are under extra stress. This is due to things like fluctuating blood sugars and chronic inflammation. These factors can gradually accumulate into nerve damage and a variety of other long-term complications.  

However, we have recently learned that some “long-term complications” are functional and reversible (at least in their early stages). One way to reverse them is slow breathing.

Slow breathing treats the root cause of many complications, tissue hypoxia, which then restores autonomic functioning. This has been proven in several studies involving people with type-1 diabetes. However, most participants had not yet developed severe complications.

Putting Slow Breathing to the Test

It seems reasonable to assume that slow breathing would have the same effects in type 2s. But, what if these people with type-2 diabetes have chronic kidney disease? With a severe complication such as this, could slow breathing still have the same benefits?

 
 
 
 

Trained breathing-induced oxygenation acutely reverses cardiovascular autonomic dysfunction in patients with type 2 diabetes and renal disease

Published in Acta Diabetologica, 2016

Click Here to Read the Full Summary

 
 
 
 

The Study Group and Breathing Protocol

This study had 26 type-2 diabetic patients, 12 of which had diabetic kidney disease, and 24 non-diabetic controls. The protocol was simple: They had the participants lay down and breathe normally for five minutes, followed by two minutes of slow breathing at 6 breaths per minute.

The primary outcome was a change in baroreflex sensitivity (BRS). BRS measures your body’s ability to quickly adjust blood pressure to meet the current demands of your situation. It is thought to be an overall measurement of autonomic and cardiovascular control. In general, diabetics have lower BRS scores than non-diabetics.


Slow Breathing Improves Autonomic Function in Diabetics With Kidney Disease

At baseline, the type-2 diabetics had a lower resting oxygen saturation and lower BRS. When they switched to breathing at 6 breaths per minute, their oxygen saturation and BRS both increased significantly. Their blood pressure also reduced.

Perhaps most importantly, these same changes were observed in the diabetics with kidney disease. Both sets of diabetics (kidney disease and no complications) showed similar increases in BRS and oxygen saturation.  This indicates that, even in diabetics with severe complications, slow breathing can acutely reverse autonomic dysfunction.


Getting Back to Tissue Hypoxia

The authors suggest that these improvements in autonomic function were due to increases in tissue oxygenation. Similar to the study we featured on type-1 diabetes, they indicate that by increasing tissue oxygen levels, sympathetic activity is reduced, and autonomic balance is restored.


A New Model of Diabetic Complications

These results again indicate that autonomic dysfunction is not an expression of nerve damage. Instead, it is a reversible phenomenon that might actually be the precursor to nerve damage.  This paradigm-shifting view opens the door to new opportunities for treating autonomic dysfunction in diabetics.


In good breath,

Nick

P.S. A Zoom Meeting I would Look Forward To.

P.P.S. James Nestor’s new book, Breath: The New Science of a Lost Art, comes out tomorrow. I don’t know James, but from the podcast interviews I’ve heard so far, this sounds like a must-read if you’re into all this “breathing” stuff :)

And if you really want to geek out, James and Patrick McKeown got together for an hour long conversation on all things breathing. Watch/Listen Here.