sleep-disordered breathing — Blog — The Breathing Diabetic

Happy Monday. I hope you enjoy this edition with a cup of coffee : )

Enjoy 4 thoughts, 1 quote, and 1 answer (like "Jeopardy") related to breathing.

4 THOUGHTS

1. Understand This, and You Will Understand Breathing

Breathing information is often contradictory:

Wim Hof tells you to breathe more oxygen.
Patrick McKeown tells you to breathe less.
Oxygen is your body’s most important energy source.
But the exhale is the most important part of the breath.
You need to teach yourself to tolerate higher levels of carbon dioxide.
Carbon dioxide also causes fear in people who literally can’t feel fear.
Lung capacity determines longevity.
But you also shouldn’t take big breaths.
And on & on

To understand breathing, you must accept that all of these are right, and all of them are wrong. It depends on the circumstance.

Despite its simplicity, breathing is one of the most complex functions in the human body. Blanket statements on "right or wrong" simply cannot be made without context. We must embrace the contradictions.

2. Should You Be Breathing Even Slower?

A study published in 2006 found that resonance frequency was inversely correlated with height. That is, the taller you are, the slower you need to breathe to synchronize your heart rate, breathing rate, and autonomic nervous system.

In their excellent book, The Healing Power of the Breath, Richard Brown and Patricia Gerbarg give this specific recommendation: "For people who are over six feet tall, the ideal resonant rate is three to three and a half breaths per minute."

So, if you’re over six feet tall, you might find that breathing slower than the typical recommendation of 5-6 breaths per minute works better for you. I fall into that category, and I’ve found 3 - 3.5 breaths per minute (currently 7 sec inhale, 11 sec exhale) to be my sweet spot.

3. What is Hyperventilation?

"Respiratory alkalosis is caused by hyperventilation or a respiratory rate in excess of that needed to maintain normal PCO2." - Essentials of Pathophysiology, pg. 205
"Hyperventilation is a term that describes breathing beyond that which is required to meet the metabolic needs of the body as reflected in the production of carbon dioxide." - Respiratory Physiology, pg. 128

Here are two different textbook definitions of hyperventilation. It’s actually pretty straightforward. And, as you can see, it doesn’t involve huffing and puffing. Thus, we can hyperventilate without even knowing it.

Two easy ways to check if you are overbreathing are the BOLT score and the CO2 Tolerance Test.

Two easy ways to fix it are to breathe through your nose and make your breathing quiet while at rest.

Thanks to 411 reader W.H. for inspiring this thought.

4. Is Breathing Woo-Woo?

It fascinates me that breathing, your body’s most important function, has kind of a "woo-woo" reputation. It shouldn’t. There is a mountain of scientific evidence showing its efficacy for health and wellness. For example, I have reviewed over 80 scientific papers, and HHPF seems to post a new one every day.

But you actually don’t need any of the science. Here is the quickest way to determine for yourself:

Hold your breath.

I think you will agree "breathing" isn’t woo-woo after only a few seconds.

Thanks to fellow breathing nerd R. vdC. for inspiring this thought.

1 QUOTE

"The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function."
- F. Scott Fitzgerald

1 ANSWER

Answer: The estimated prevalence of this condition is about 23% in women and 50% in men.

…

(Cue the Jeopardy music.)

…

Question: What is sleep-disordered breathing?

A FEW MORE…

Here are a few interesting articles I came across this week—maybe one or two headlines will jump out at you.

In good breath,
Nick

P.S. U Just Never Know.

Charles Dickens just walked into a hotel room. The year is 1860. As arguably the most famous author alive, you might think he set up his writing station and poured a glass of Brandy. Instead, he pulled out his compass and rearranged the place [1].

Dickens’ Odd Fix for Insomnia

Dickens believed that sleeping with his head toward the north helped with his insomnia. This sounds funny but is probably more helpful than his previous solution, which was to walk all night, sometimes covering up to 30 miles [2].

Although Dickens’ sleeping habits were peculiar, it was his keen observations of others that changed sleep science.

Joe’s Snoring and Sleep Science

In 1836, Dickens began writing The Posthumous Papers of the Pickwick Club, also known as The Pickwick Papers. In it, Dickens’ character “Joe” displayed all of the classic characteristics of sleep apnea. Joe was always tired, he fell asleep during the day, and he snored loudly.

Sleep scientists credit this work as being the first accurate observations of sleep-disordered breathing [3], recording it 120 years before the science caught up.

Modern Sleep Science Catches Up

Today, estimates of sleep-disordered breathing are, well, breathtaking. The term “sleep-disordered breathing” itself is rather generic. It covers a wide range of issues related to sleep and breathing (most commonly, obstructive sleep apnea).

However, in 1996 a review study was published that sheds light on the mechanisms that cause sleep-disordered breathing. This research helps explain why it is so common and provides suggestions as to what we can do about it.

Sleep and Breathing State-of-the-Art Review: Sleep-Induced Breathing Instability

(Published in Sleep in 1996 — Click Here to Read Full Summary)

The main conclusion from this study is that your breathing system does not work the same during sleep as it does during wakefulness.

For example, there is less input to the muscles that keep your upper airways open, which can narrow or collapse them. This narrowing of the upper airways also increases breathing resistance. Additionally, sleep dampens the chemoreflexes that usually keep blood pH in a tight range.

Interestingly, this “State-of-the-Art Review” concluded that carbon dioxide (CO2) could potentially help with sleep-disordered breathing. CO2 could stimulate the chemoreflexes that keep breathing steady. Additionally, CO2 is a smooth muscle dilator, which would help increase blood flow to the muscles that keep the airways open.

Two Ways You Can Start Tonight

1. Tape Your Mouth

You can start adding CO2 to your breathing tonight by taping your mouth during sleep, which will reduce breathing volume and increase CO2.

Paradoxically, while nose breathing increases resistance during the day, it reduces upper airway resistance during sleep. This small change will help you breathe better during sleep and wake up feeling refreshed and energized.

2. Breathe Less During the Day

You can also practice light breathing during the day to train your body to tolerate more CO2. By doing this consistently, you can reset your baseline CO2 back to normal values and ultimately improve your breathing during sleep.

In good breath,
Nick

P.S. I think we all need a smile like this right now.

References

[1] Source: https://www.pharmaceutical-journal.com/opinion/blogs/how-dickens-got-a-good-nights-sleep/11074673.blog (I made up the little hotel story to go with it…he might have in fact poured some Brandi too…)

[2] Source: https://academic.oup.com/sleep/article/15/3/264/2749285

[3] Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3365094/

The Breathing 411 - Understand This, and You Will Understand Breathing