high altitude

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Intention, 25 Breath Ideas, and Sincere but Never Serious

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Listen Instead of Reading

If you enjoy listening, you can subscribe to the audio version on Spotify, Apple Podcasts, and Audible so you don’t even have to look at the email 😊

Reading Time: 1 min 37 sec

I hope the next 20’ish breaths are the most nourishing of your day.


4 THOUGHTS

1. 25 One-Sentence Breathing Ideas for 2025

1. Don’t take ten breaths; take one breath, ten times.

2. The breath will continue to outgrow any clothing you give it.

3. You will float through life so long as you treat the breath as your ocean.

4. Don’t go around air expecting not to breathe.

Continue reading them all here.

2. Ultimately, It’s Not About Breathing

“We can form an intimate relationship with our breath, our nervous system, and thus understand on a deep level the way our mind works. Ultimately, this is not about simply breathing; it is about finding a deep connection to our inner life.”

- Eddie Stern, Healing Through Breathing

Here is an excellent reminder that breathing isn’t “just breathing.” It’s “about finding a deep connection to our inner life” so we can better understand how our bodies, minds, and souls work 👏

3. This is What Counts

“Before doing anything, we should examine the underlying motivation, because as the Buddha said, “Karma is intention.” It is not so much what we do but why we do it. … This is why when we are undertaking any action it is important for us to see as honestly as possible the underlying intention behind us performing this action of body or speech. … It isn’t just the action performed or words that we speak, but how it is said or done and with what intention. That is what counts.”

– Jetsunma Tenzin Palmo, The Heroic Heart

👏👏👏

4. Sincere But Never Serious

“You must understand that I am not a serious person. I may be sincere, but never serious, because I don’t think the universe is serious. And the trouble comes into the world largely because various beings take themselves seriously, instead of playfully.”

– Alan Watts, Still the Mind

“I may be sincere, but never serious.” That might just be my new life motto. It perfectly captures the paradox of giving life our all while simultaneously laughing at ourselves and approaching it all with humor and playfulness 👏

1 Quote

“When your intentions are clear and strong, the appropriate actions naturally follow.””
— John Yates, Ph.D., and Matthew Immergut, Ph.D.

1 Answer

Category: The Nose

Answer: These are curved, bony structures inside the nose that are covered in mucus and help filter, warm, and humidify incoming air.

…

(Cue the Jeopardy! music.)

…

Question: What are nasal turbinates?

In good breath,

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

P.S. please don’t take this personally

Wisdom, Summarized for Action

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The Breathing App for Diabetes

This is the first program specifically made for people with diabetes to help manage their stress through breathing and mindfulness practices. In addition to the amazing program inside the app, we have some really neat things coming up, so sign up now!

Learn more here.

Amazon Associate Disclosure

I’ve been recommending books for almost 6 years. Yet somehow, I just discovered that I could be an Amazon affiliate [face-palm]. In any case better late than never. Now, any Amazon link you click is an affiliate link. As an Amazon Associate, I earn from qualifying purchases. So, if you’d like to support my work, buying books through these links is helpful : )

* An asterisk by a quote indicates that I listened to this book on Audible. Therefore, the quotation might not be correct, but is my best attempt at reproducing the punctuation based on the narrator’s pace, tone, and pauses.

 
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New Mouth Tape Study, Universal Rhythm, and the Ego Hates This

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Listen Instead of Reading

If you enjoy listening, you can subscribe to the audio version on Spotify, Apple Podcasts, and Audible so you don’t even have to look at the email 😊

Reading Time: 1 min 44 sec

I hope the next 21’ish breaths are the most nourishing of your day.


4 THOUGHTS

1. New Study Published on Mouth Taping

“This is the first comprehensive literature review on nocturnal mouth-taping. It aims to ascertain what research is available that evaluates mouth-taping during sleep and to summarize this research. Additionally, it compares these research findings with the most common claims regarding mouth-taping on TikTok.”

– Fangmeyer et al. (2024)

As a fan of mouth-taping, I view this study (published earlier this month) as essential reading. It distinguishes proven benefits from anecdotal claims, offering the first review that coaches and educators can use to provide evidence-based information to those they help.

Read the full thing above, or you can get my summary and 12:40 podcast discussion as a member of the Breath Learning Center. (After you sign up just go to "Science 411s" and it will be the top one.)

2. The Universal Rhythm

“The expansion and contraction of the abdomen, lower abdomen, and chest are parts of the universal rhythm. Everything in the universe has the same rhythm of expansion and contraction just like our breath and body. All of them are rising and falling.”

– Bhante Gunaratana, Mindfulness in Plain English

I have nothing to add but a few of these 👏👏👏

3. Going with the Flow, a Great Force, and Laughter

1. Breath control isn’t always necessary—the art is knowing when to go with the flow, and when to take control.

2. Demonstrations of breathing are small compared with the great force hidden behind them.

3. The best and most therapeutic form of mouth breathing is laughter.

4. The Ego Hates This

“It is also helpful to maintain a sense of humor, as it greatly diffuses anger and humiliation. If we can see the funny side of things then we can laugh. The ego hates to be laughed at; it takes itself very seriously, so it is important to practice not taking ourselves so seriously whenever the opportunity arises.”

– Jetsunma Tenzin Palmo, The Heroic Heart

Here’s our reminder that the ego hates to be laughed at…which means we should do it every chance we get 😊

1 Quote

“In any athletic discipline, the alignment of body and breath is critical. The synchronization of what you are doing with your breathing is the whole art.””
— Alan Watts

1 Answer

Category: High Altitude

Answer: When exposed to low oxygen levels, our bodies produce more of this molecule, which promotes the release of oxygen from the hemoglobin into the tissues.

…

(Cue the Jeopardy! music.)

…

Question: What is 2,3-bisphosphoglycerate (BPG)?

In good breath,

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

P.S. Is this really all there is to life?

Breathing and Mediation Instructors:

The Breath Learning Center is a mountain of modern science and timeless wisdom. It’s summarized, organized, easy to read, and immediately actionable.

If you want to supply those you help with the best program possible, the wisdom and science in the Learning Center will be invaluable to your practice.

Click here to learn more.

The Breathing App for Diabetes

This is the first program specifically made for people with diabetes to help manage their stress through breathing and mindfulness practices. In addition to the amazing program inside the app, we have some really neat things coming up, so sign up now!

Learn more here.

Amazon Associate Disclosure

I’ve been recommending books for almost 6 years. Yet somehow, I just discovered that I could be an Amazon affiliate [face-palm]. In any case better late than never. Now, any Amazon link you click is an affiliate link. As an Amazon Associate, I earn from qualifying purchases. So, if you’d like to support my work, buying books through these links is helpful : )

* An asterisk by a quote indicates that I listened to this book on Audible. Therefore, the quotation might not be correct, but is my best attempt at reproducing the punctuation based on the narrator’s pace, tone, and pauses.

 

How I Trained for Altitude and Why We All Benefit from Breath Training

 
 

Listen Instead of Reading

 

Autonomic Neuroscience says slow breathing is for diabetes & hypertension.

Harvard Medical School says yogic breathing is for stress.

And Tibetan Yoga says breath training is for everyone.

Let’s see how…

 
 
 
 

4 Thoughts


1. How I Trained for High Altitude (it’s not what you might think)

I thought, “I’m The Breathing Diabetic. I better be able to handle some altitude.”

But I didn’t train how you might think. Of course, I initially started with more breath holds. But I realized that the issue at altitude is lower air pressure.

- How I Trained for High Altitude Blog Post

This one was slightly too long to fit in as a “Thought,” so I made it a really short blog post.

Give it a read to learn my somewhat odd training method for my recent hike up to 13,200 feet…and to see if it actually worked (pictures included).

Please respond to this email if you have any thoughts on my reasoning…it was my first time at altitude, so I’d appreciate any feedback or thoughts you have.

***

Related: How To Breathe To Live Longer

2. Slow Breathing for Diabetes and High Blood Pressure

“Even in already well controlled diabetic patients, guided breathing had beneficial influences on cardiovascular autonomic control and a measurable impact on BP control.  It enriches available options for non-pharmacological blood pressure…reduction.”

- Effects Of Guided Breathing On Blood Pressure And Heart Rate Variability In Hypertensive Diabetic Patients

According to Johns Hopkins, approximately two-thirds of adult diabetics have high blood pressure or take medication for it. And people with diabetes and hypertension are 4x more likely to develop heart disease.

Fortunately, this study found that just 12 minutes a day of slow breathing (with no changes to medication) led to significantly lower blood pressure, increased heart rate variability, and a reduced spontaneous breathing rate (indicating reduced sympathetic arousal).

All of which led to this remarkable final statement: “If consistently used, guided breathing enhances restoration of physiological autonomic balance in patients with diabetes and hypertension.” Amen 🙏

Here’s to controlling our breath to control of our blood pressure, today.

3. Harvard Medical School: “Yogic Breathing Improved University Students' Response to Stress”

“When we anticipate a stressful situation, our breathing and heart rates naturally go up…but the yogic breathing group seemed to show protection against that type of stress. Their heart rate increased only slightly when they knew a stressful situation was coming.”

- Yogic breathing improved university students' response to stress

Enjoy this excellent and quick write-up showing that yogic SKY breathing can significantly reduce the stress response. It’s from the Beth Israel Deaconess Medical Center, a world-class teaching hospital of Harvard Medical School.

The next thought builds off of this idea of “protection against stress”…

4. What Turbulence Can Teach Us About Breathing

When you’re flying and hit turbulence, you’re told to put on your seatbelt.

It’s reactive.

It’s similar to when turbulence hits in our lives. We react. We start eating healthy or meditating or exercising more.

But a regular breathing practice is proactive.

It helps you avoid turbulence altogether.

Or, if you can’t avoid the turbulence, it’s like your seatbelt. You’re already fastened in. You don’t need to rush back to your seat. You’re ready.

 
 
 
 

1 Quote

“Because the breath is such an excellent and abundant support for life and vitality for every being on the planet, everyone can benefit from training in the breath.”

– The Tibetan Yoga of Breath

 
 
 
 

1 Answer

Category: Hypoxia and Red Blood Cells

Answer: During hypoxia, this organ releases additional red blood cells to increase your oxygen carrying capacity.

…

(Cue the Jeopardy! music.)

…

Question: What is the spleen?

In good breath,

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

P.S. “sorry, it’s my first day!”

 
 
 

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.

 
 

How I Trained for Altitude (it's not what you might think)

View of Mount Audubon from Mitchell Lake

View of Mount Audubon from Mitchell Lake

“Everyone has a plan 'till they get punched in the mouth.”

- Mike Tyson

I live in Florida, basically below sea level : ) So when my best friend invited me to hike up to 13,200 ft, I put a ton of pressure on myself to do it. I thought, “I’m The Breathing Diabetic. I better be able to handle some altitude.”

But I didn’t train how you might think. Of course, I initially started with more breath holds. But I realized that the issue at altitude is lower air pressure. To breathe, our lungs expand, the pressure decreases in our lungs, and air flows in from the atmosphere due to the pressure difference. However, at altitude, the lower air pressure will make that process harder.

If each breath is harder, your diaphragm and other breathing muscles will fatigue quicker, and you’ll feel out of breath. Maybe I’m wrong, but that seemed like the biggest issue when I considered everything I’ve learned.

So I decided to focus on lung capacity. With greater lung capacity, the lungs can expand more, pressure can decrease more, and breathing can be easier at altitude. Is this proven? I don’t know. But it made sense to me.

So I did a lot of Wim Hof breathing, a lot of work with the Oxygen Advantage Sports Mask, and a lot of extended exhalations. I also used ocean breathing during my morning breathing practice for added resistance.

Did it work? I’m not sure since I don’t have a control to compare against. But I made it. It was extremely challenging, and all of my plans went out the window once we hit about 11,000 ft. The winds were insane, my hands were freezing, and the continuous uphill was way more brutal than I expected.

To cope, I did some periodic breathwalking, and every few minutes, I took 10 massive Wim Hof style breaths. Going up, I was probably around 40% nasal, 60% mouth breathing (I went into it not caring which hole I used, as long as I made it). Going down was about 90% nasal and 10% mouth.

When I got to the summit, my oxygen saturation was steadily 81-85%. Crazily, my blood sugar was 404 mg/dL (!), which wasn’t helping the situation. But I made it. Mission accomplished.

If you have any thoughts about altitude or my training approach, please send me an email at nick@thebreathingdiabetic.com with the subject “High Altitude.” It was my first time, so I have no clue if what I’m saying makes sense : )

More Pictures

SpO2 was hovering around 81-85% right when we reached the summit. This was with normal nasal breathing.

SpO2 was hovering around 81-85% right when we reached the summit. This was with normal nasal breathing.

IMG_0692.png
IMG_0672.png
“Strategically” giving my diaphragm a rest before we started one of the last pushes. I wasn’t tired, just meditating 😂😂😂

“Strategically” giving my diaphragm a rest before we started one of the last pushes. I wasn’t tired, just meditating 😂😂😂

Me (left) and James (right) at the peak hiding from the insane winds. Gusts felt like they were over 60 mph.

Me (left) and James (right) at the peak hiding from the insane winds. Gusts felt like they were over 60 mph.

James taking in the view.

James taking in the view.

The Breathing 4.1.1. - Can This Acid Help You Digest Oxygen Better?

 

I hope this edition of "The Breathing 4.1.1" helps start your week off right.

Below you’ll find 4 thoughts, 1 quote, and 1 answer (think "Jeopardy"). Enjoy!

 
 
 
 

4 THOUGHTS

1. My #1 Non-Breathing Tip to Improve Your Breathing

There are non-breathing ways to improve your breathing. Here’s the easiest and most helpful one I’ve found: Add 2-4 hours between dinner and bedtime.

For example, I now eat dinner around 5:30 p.m. and go to bed around 7:45 - 8:00 p.m. (I used to eat closer to 7:00 p.m. with the same bedtime).

After one or two nights of the earlier dinner, my CO2 tolerance increased by about 20 seconds. And it’s remained that way ever since. If you’re not already, give it a shot and see how you feel after a couple of nights.

(As a side note, I also lost about 5 lbs after 1-2 weeks of doing this. So, when I saw this article on ScienceDaily, it jumped off the page at me: People who eat a late dinner may gain weight.)

2. Can This Acid Help You Digest Oxygen Better?

"Oxygen is what we breathe in. CO2 is what we internally produce in order to allow us to use that oxygen most efficiently." - David Bidler, Breathe to Perform

I love that interpretation. Rather than thinking of CO2 as a waste product, why don’t we instead view it as something our body produces to use the oxygen we breathe in.

While reading this passage, I also thought of a new analogy. It’s not technically correct, but I think it helps get the point across:

Your body produces stomach acids to digest food. It produces blood acids to digest oxygen.

3. Why Don’t We Breathe Slowly, 24/7?

I talk about the benefits of slow breathing a lot (maybe too much). With all of those benefits, it begs the question: Why didn’t we evolve to breathe slowly all the time? (Thanks, Ben!)

Rather than breathing slowly all the time, I believe we evolved something even more powerful: The ability to control our breathing.

We have been given access to our autonomic nervous system. We can choose to ramp it up or choose to slow it down. We can respond to our outer environment while being in control of our inner one.

With great power comes great responsibility. It’s up to us if we use it or not.

4. How Your Body Remembers High Altitude (1-Minute Podcast)

This episode of 60-Second Science from Scientific American explains how our red blood cells "remember" exposure to high altitude:

Red Blood Cells Remember Your Mountain Vacation

Although breath holds and high altitude exposure are not the same thing, we can elicit similar drops in blood oxygen saturation, presumably leading to similar effects. But, they’re not permanent:

"So the longer you stay at sea level before you re-climb to high altitude, then such memory will gradually disappear." - Yang Xia, UT Health Science Center

That’s why I’m also a fan of consistency over intensity to hep keep the benefits around.

 
 
 
 

1 QUOTE

"However, there is a bridge between our conscious mind and the subconscious action of the autonomic nervous system – breathing."

- Stephen Elliot with Dee Edmonson, The New Science of Breath

 
 
 
 

1 ANSWER

Answer: In 1978, two mountain climbers achieved this monumental feat for the first time.

…

(Cue the Jeopardy music.)

…

Question: What is climbing Everest without supplemental oxygen?

In good breath,
Nick

P.S. When You Finish Your To-Do List.