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The Breathing 411 - What do 5,649 and 28,800 Have in Common?

 

Hello and Happy Monday. Welcome to another edition of The Breathing 4.1.1.

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

 
 
 
 

4 THOUGHTS

1. What do 5,649 and 28,800 Have in Common?

"The average daily step count required to induce feelings of anxiety and depression and decrease satisfaction with life is 5,649. The typical American takes 4,774 steps per day. Across the globe, the average is 4,961." - Kelly McGonigal, The Joy of Movement

Active people become anxious and lose life satisfaction when their step count drops to 5,649 or less. That’s a bit staggering, given the U.S. and global step count statistics Kelly cites.

That passage got me thinking, "I wonder if there is a similar idea for breaths per day?" However, with breathing, it would be opposite: The more breaths you take, the more unhealthy you are. Sure enough, there is something close:

"Recent evidence suggests that an adult with a respiratory rate of over 20 breaths/minute is probably unwell, and an adult with a respiratory rate of over 24 breaths/minute is likely to be critically ill.” - Respiratory Rate: The Neglected Vital Sign

If your spontaneous breathing rate is over 20 breaths per minute, you are "probably unwell." That comes out to about 28,800 breaths per day.

So, do you want to feel unwell and anxious?
Take less than 5,649 steps and breathe more than 28,800 breaths per day.

Want to be happy and healthy?
Walk more, breathe less.

P.S. That 28,800 number might even be too high. James Nestor shares some great ancient wisdom on this:

"Chinese doctors two thousand years ago advised 13,500 breaths per day, which works out to nine and a half breaths per minute. "
- Breath

2. The Most Fundamental of the Fundamentals

Last week, Kobe Bryant provided an excellent example of the importance of practicing the fundamentals. We talked about how we don’t need to worry about the "latest and greatest" breathing technique. Instead, we need to focus on the fundamentals. They’re simple, but they’re not easy.

We can take that thought step farther: Breathing itself is the most fundamental of the fundamentals. We’re all in the sport of life. And that requires breathing…at least 13,500 times a day : ) So, let’s optimize that first, then work on the fundamentals of your particular sport or profession.

3. Bring Attention & Intention to Your Breathing

"Attention without intention is wasted energy." - Chris Bailey, Hyperfocus

This quote makes complete sense in terms of productivity, self-improvement, and group workouts (CrossFit, yoga, etc.). But the minute you apply it to something like sitting down to breathe, it can get misinterpreted:

"Set an intention for your breathing practice."

"Be intentional with your breathing today."

It’s just begging to be put in the "woo-woo" category and not be taken seriously.

But intentions are powerful (hence the quote from Chris Bailey). So a compromise I have made is to set scientific intentions before each slow breathing practice. "I am going to increase my heart rate variability" or "I am going to balance my autonomic nervous system."

These are just facts that I state at the beginning of my practice that work as intentions, without feeling woo-woo.

I find it to be an excellent way to give the practice more meaning. (And don’t forget to celebrate afterward!)

4. Slow Breathing for Hypertension

Slow, controlled breathing (<10 breaths per minute) has consistently been shown to be beneficial for reducing blood pressure. So much so that it is recognized by the American Heart Association for its positive effects. (They’ve given it a Class IIa, Level of Evidence B. Here’s what that means.)

This got me thinking about a paper published back in 2005 that I loved. They concluded:

"Slow breathing showed the potential to be a simple and inexpensive method to improve autonomic balance and respiratory control and reduce blood pressure in hypertensive patients." - Joseph et al. (2005)

The interesting part was that the authors provided an exciting hypothesis for how that’s occurring using autonomic function as the foundation. That hypothesis inspired me to create this little graphic to help get the point across.

Read the Full Summary for More Details.

 
 
 
 

1 QUOTE

My new favorite definition of success:

"To know that even one life has breathed easier because you have lived. This is to have succeeded."

- Ralph Waldo Emerson

 
 
 
 

1 ANSWER

Answer: The largest lung capacity of any mammal.

…

(Cue the Jeopardy music.)

…

Question: What is 5,000 liters (or 1,320 gallons)?

(For reference, the human lung has a capacity of about 6-liters.)

In good breath,
Nick

P.S. How I Feel Shopping on Amazon Now.

 
 

The Breathing 411 - The lung microbiome, David Blaine, and a perfect breath

 

Happy Monday! Welcome to another edition of The Breathing 4.1.1.

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

Thank you for reading!

 
 
 
 

4 THOUGHTS

1. On Practicing the Fundamentals

"If someone at Kobe’s level needs to commit hours to practicing the fundamentals, then so do all of us. Kobe taught me a pivotal lesson that morning. The basics are simple, but not easy."
- Alan Stein Jr., Raise Your Game

Imagine the best basketball player on the planet allows you to watch him practice. Then, he spends hours working on his fundamentals. Nothing fancy, no showboating, just the basics. That’s exactly what Alan Stein saw when he watched Kobe Bryant practice during his prime.

We talk about breathing here, not the highest level of basketball ever played. But the message is the same.

With all the fancy breathing techniques and new approaches, it’s easy to be looking for the "next thing" (—> guilty here <— ). But let’s not forget that it all comes down to the basics. They’re simple, but they’re not easy.

(This idea, like many, was inspired by knowledge from the Optimize Program.)

2. Oxygen Therapy Harms the Lung Microbiome

We’ve discussed how inhaled oxygen can lead to adverse effects in people with diabetes. Specifically, high levels of inhaled oxygen can reduce arterial function. But there might be other problems with oxygen therapy, especially when done over prolonged periods.

For example, your lungs have their own microbiome (pretty neat). And a recent study showed that inhaled oxygen harms this microbiome, leading to an increased risk of lung damage. This idea is especially relevant during COVID-19:

“Upon hospitalization, these patients are administered oxygen in an attempt to bring their levels back up to normal. However, a new study hints that this universal therapy may have unintended consequences via an unexpected source -- the microbiome.”
- ScienceDaily

Read the whole summary from ScienceDaily here:

Oxygen Therapy Harms Lung Microbiome in Mice

3. David Blaine on Breath Holds, CO2, and 45 Minutes Without Air

David Blaine was recently on the Joe Rogan Podcast. They began talking about breath-holds within 5 minutes (this link should take you right to it).

Here are two quotes I loved from it:

"The breath-holding thing is all about like, a CO2 build up in the bloodstream, and it’s about a tolerance level to it…"

And when Joe asks about the panicked feeling you get when holding your breath, David’s reply is:

“That’s not an O2 deprivation. That’s a trigger from a CO2 build-up, which is giving you an alert…"

All of you "breathing nerds" already knew this. But it is little tidbits like these that help the general population learn.

He goes on to talk a little about pre-breath-hold hyperventilation, blacking out, and how we can go 45 minutes without air.

In addition to the breath-hold stuff, it’s a fascinating interview.

4. Is there a Perfect Breath?

“What is the perfect breath? Far from being some noble yet unreachable goal that takes years of rigorous practice to master, a perfect breath is any breath you take for which you are completely and mindfully aware.” - Al Lee & Don Campbell

That definition is, well, perfect. But let’s not forget about James Nestor’s perfect breath, which has deeper roots in science and physiology:

"They discovered that the optimum amount of air we should take in at rest per minute is 5.5 liters. The optimum breathing rate is about 5.5 breaths per minute. That’s 5.5-second inhales and 5.5-second exhales. This is the perfect breath."

 
 
 
 

1 QUOTE

"Your quality of sleep is closely related to how you breathe, both when you sleep and when you are awake."

- Anders Olsson

 
 
 
 

1 ANSWER

Answer: The amount of time it takes blood to circulate around your entire body.

…

(Cue the Jeopardy music.)

…

Question: What is one minute?*

(This fun fact came from James Nestor’s Breath.)

 
 

The Breathing 4.1.1. - The Best Breathing Class You Haven’t Heard Of

 

Hello, and Happy Monday! Welcome to another edition of The Breathing 4.1.1.

Thank you for reading this. Putting together the 411 emails each week is one of my favorite things to do, so I appreciate that you’re here reading it.

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

 
 
 
 

4 THOUGHTS

1. Breath Practice versus Breath Training

Breath Practice: Time you spend every day performing breathing exercises that are comfortable and beneficial to you. Think of it as self-care. For me, this would include my 15 minutes of slow breathing first thing in the morning.

Breath Training: Time you spend deliberately pushing yourself to improve your breathing. For example, if you can comfortably box breathe with a 4-4-4-4 rate, you might spend some time at 5-5-5-5 rate as training.

Breath Training is always Breath Practice, but Breath Practice is not always Breath Training.

(This thought was inspired by pages 51-53 of Breathe to Perform.)

2. The Best Way to Make Your Breathing Practice Stick: Celebrate!

"Celebration will one day be ranked alongside mindfulness and gratitude as daily practices that contribute most to our overall happiness and well-being." BJ Fogg, Tiny Habits

Are you trying to make your breathing practice a habit? BJ Fogg, creator of the Behavior Design Lab at Stanford University, says that if he taught you his "Tiny Habits" approach, the first thing he would do is help you celebrate better.

If you spend 1 minute focused on your breath, celebrate it. If you already have a solid practice, try adding some celebration to the end.

I started doing this and love it. After my slow breathing session, I reward myself with a small celebration. After my breath holds, the same thing.

Is it cheesy? Kind of. Is it rooted in science from the leader in habit development at Stanford? Yes. Will anyone know? Nope. Give it a shot.

(See the P.S. below for a great example of celebrating the small stuff.)

3. The Best Breathing Class You Probably Haven’t Heard Of

That celebration idea came from Brian Johnson’s Optimize program (I adapted it for breathing, but it can be used in any aspect of life). If you’ve been following my work for a while, you probably know that Brian Johnson is one of my favorite teachers on the planet. Actually, he is my absolute favorite.

He has an "Optimal Breathing 101" course that is phenomenal. He combines research from all of the best books on breathing into a succinct and practical course. It’s awesome.

He also recently reviewed Breath: The New Science of A Lost Art. Again, phenomenal.

4. Why Are You "Breathing"?

"Don’t mistake the finger pointing to the moon for the moon itself." - Buddhist Saying

Let us not forget that "breathing" is only the finger.

 
 
 
 

1 QUOTE

The first "tiny habit" to build:

“Replace the habit of taking short shallow breaths into the top of the lungs with the practice of taking a full deep breath. Nearly all of the benefits begin with this one simple change.”

- Al Lee, Don Campbell, Perfect Breathing

 
 
 
 

1 ANSWER

Answer: This is the world record for the longest case of the hiccups.

…

(Cue the Jeopardy music.)

…

Question: What is 68 years?*

In good breath,
Nick

P.S. How To Celebrate.

* I found this on dozens of websites. However, I could not find an official record anywhere on Guinness (I even tried some "dorking"). So, I can’t be sure it’s 100% legitimate. But, it’s a fascinating story nonetheless!

 
 

The Breathing 4.1.1. - Slow or Control? (+ Seneca on Walking & Breathing)

 

Happy Monday to you! Welcome to a new edition of The Breathing 4.1.1.

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

 
 
 
 

4 THOUGHTS

1. Breath Rate or Breath Control: Which is More Important?

Last week, we talked about a powerful evolutionary advantage: Rather than evolving to breathe slowly, we evolved the ability to control our breathing.

We know slow, controlled breathing is beneficial, but what about just the controlled aspect itself?

A study published in 2017 examined this by having participants perform controlled breathing at 12 breaths per minute. This rate is on the low end of average for spontaneous breathing.

They found that this practice reduced sympathetic activity. There was something about the act of consciously controlling the breath that helped promote autonomic balance, despite the rather ordinary rate.

Slow breathing provides a host of additional benefits. But let us not forget the power of simply controlling your body’s most important function: breathing.

2. While We’re on the Subject: Slow Breathing Restores Balance in COPD

People with COPD have similar complications to diabetics, such as increased sympathetic tone and reduced baroreflex sensitivity (BRS).

A study published in 2008 found that slow breathing at 6 breaths per minute for 4 minutes significantly reduced sympathetic activity and increased BRS in COPD patients. That is, it helped restore cardio-autonomic balance. 

Their words are always better than mine:

“In summary, patients with chronic obstructive pulmonary disease showed sympathetic excitation and depression of the baroreflex. Slow breathing counteracted these changes.” - Raupach et al.

3. Another Non-Breathing Tip: I Take This Every Morning

To build off of my #1 non-breathing tip (2-4 hours between dinner and bedtime), here’s another one I use every day: baking soda.

Baking soda has been shown to improve performance and even help with autoimmune conditions. From a breathing perspective, it has also been shown to increase breath-hold time (something I have anecdotally experienced).

Here’s how I take it every morning:

  • 2 tablespoons of apple cider vinegar

  • 1/2 teaspoon of baking soda

  • Mix and "enjoy"

It sounds disgusting, but it’s actually not too bad. Apple cider vinegar might also help control blood sugars, so that’s an added bonus for us diabetics.

4. A Race for the Future

"Looking at the evidence, it’s hard not to conclude that our entire physiology was engineered to reward us for moving." - Kelly McGonigal, The Joy of Movement

I love Physiology First, its mission, and the people behind it. On August 15, they are holding a run/walk to collectively cover 1,000 miles. You can join virtually anywhere (my wife and I will be joining from here on the Space Coast of Florida).

It’s been a while since my 100-mile ruck, so this is a great reason to get out and move for a good cause. Every mile helps, and there is no minimum. I hope to "e-see" you there!

More Details:

A RACE FOR THE FUTURE
(We’re signing up for the "1000 Miler")

 
 
 
 

1 QUOTE

Speaking of walking and breathing:

“We should take wandering outdoor walks, so that the mind might be nourished and refreshed by the open air and deep breathing.” —Seneca, On Tranquility of Mind

(I found this quote in Ryan Holiday’s Newsletter.)

 
 
 
 

1 ANSWER

Answer: The number of oxygen molecules in each red blood cell.

…

(Cue the Jeopardy music.)

…

Question: What is 1 billion?

In good breath,
Nick

P.S. Keeping Cool During COVID.

 
 

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.

 
 

The Breathing 4.1.1. - Breathing That Makes You Smarter

 

Happy Monday and welcome to another edition of "The Breathing 4.1.1."

Below, I share 4 thoughts, 1 quote, and 1 answer (think "Jeopardy"). Enjoy!

 
 
 
 

4 THOUGHTS

1. Why Increasing Your CO2 Tolerance Just Makes Sense

i. Carbon dioxide is your primary stimulus to breathe. When you feel breathless or air hunger, that is due to high levels of CO2, not low levels of oxygen.

ii. Carbon dioxide helps you use oxygen more efficiently via the Bohr effect.

Therefore, being able to tolerate more CO2 just makes sense. You’ll delay the onset of breathlessness while simultaneously improving oxygen delivery.

2. Should You Be Doing Breathing Exercises All Day?

Not in my opinion. The goal of all of this "breathing stuff" is to reset your breathing to healthy levels so you don’t have to think about it all the time.

3. Can Your Breathing Make You Smarter?

Nasal breathing synchronizes brainwave oscillations in the piriform cortex, amygdala, and hippocampus. This coherence improves cognitive function when compared to mouth breathing.

Read More: Nasal Breathing Synchronizes Brainwave Activity and Improves Cognitive Function

4. If You or Your Child Suffers from This Condition…

If you’re reading this, the adverse health effects of mouth breathing probably seem obvious to you by now. But maybe not everyone else.

That’s why it is always great to see an article about it in a more mainstream publication like ScienceDaily. The final paragraph is both wonderful and comical (without trying to be):

"At this time, many health care professionals are not aware of the health problems associated with mouth breathing. If you or your child suffers from this condition, speak with a health care professional who is knowledgeable about mouth breathing."

Read The Full Article on ScienceDaily:

"Mouth breathing can cause major health problems"

 
 
 
 

1 QUOTE

"We can’t learn how to breathe, but we can learn how to stop not breathing."

- Richard Rosen, The Yoga of Breath

 
 
 
 

1 ANSWER

Answer: The only human organs that can float in water.

…

(Cue the Jeopardy music.)

…

Question: What are the lungs?

In good breath,
Nick

P.S. Nostalgia.

 

The Breathing 4.1.1. - Are Type 1 Diabetics Protected from COVID-19?

 

Welcome to the "The Breathing 4.1.1."

Below, I share 4 thoughts, 1 quote, and 1 answer (think "Jeopardy"). Enjoy!

 
 
 
 

4 THOUGHTS

1. Are Type-1 Diabetics Protected from Serious COVID-19 Complications?

Not exactly breathing related, but a short article recently published in Medical Hypotheses proposed the following: Type-1 diabetics might be "spared" from the more severe complications of COVID-19 because we produce higher quantities of a specific class of pro-inflammatory cytokines called Th-1.

Thus, the reason our insulin-producing beta cells are destroyed might be the same reason we’re protected from COVID-19. Awesome, I guess?

Click Here to Read the Article

Thanks to Craig Kasper (also a type-1 diabetic) at Bravest for sharing this article with me!

2. Inhale-to-Exhale Ratio: Does it Matter?

Most studies show that either (1) an equal inhale-to-exhale ratio or (2) a longer exhale are both useful for improving cardiovascular and autonomic function. Longer exhalations are associated with more relaxation, whereas equal breaths are more balancing for the nervous system.

But the most critical factor is finding which approach feels most comfortable to you. And this is backed by science.

3. Inverting the Breathing Gears for Down-Regulation

The Skill of Stress course is excellent. I’m working my way through it slowly, but one thing I loved was Emily’s way of inverting the "Breathing Gears" to down-regulate.

Here’s the idea. If you’re stressed and breathing in and out through your mouth, don’t immediately try to switch to nasal in, nasal out. Gear down slowly. For example, you could follow this progression to downshift your nervous system:

  1. Mouth in, Mouth out (Progressive)

  2. Nasal in, Mouth out (Down)

  3. Nasal in, Nasal out (Regulation)

4. Why Wim Hof Doesn’t Care about Nose or Mouth Breathing

"Just breathe mother f*****!" is a famous Wim Hof one-liner. Along with his saying that "any hole will do" when asked how to breathe during his method.

But James Nestor nailed it when Joe Rogan recently asked him why Wim doesn’t care about nose or mouth: "He wants to make this easy and accessible for people…so many people can’t breathe through their noses…"

Wim’s advice to "use any hole" is to simply make it easier and more accessible. And it’s excellent advice if you’re going to do it for 20-30 mins a day. There will only be problems if mouth breathing becomes habitual (like it did for me).

 
 
 
 

1 QUOTE

"Therefore, any conditions to affect normal respiratory route during sleep (nasal breathing) can…have negative effects on sleep and daily life."

Park, C.-S., Sleep Medicine Research, 2014

 
 
 
 

1 ANSWER

Answer: The farthest distance droplets from a sneeze can travel.

…

(Cue the Jeopardy music.)

…

Question: What is 27 feet?

In good breath,
Nick

P.S. His Poor Elbows.

 

The Breathing 4.1.1. - Harder Breathing Techniques and Molecules of Air

 

Welcome to the second edition of "The Breathing 4.1.1."

Below, I share 4 thoughts, 1 quote, and 1 answer (think "Jeopardy"). Enjoy!

 
 
 
 

4 THOUGHTS

1. We Don’t Need Harder Breathing Techniques

I recently finished the two-part interview with David Bidler on the Bravest Podcast. I highly recommend listening to both episodes. My favorite idea from David was this: We don’t need harder breathing techniques, we need to apply simple breathing methods to harder challenges. Well said.

Episode 1

Episode 2

2. HHPF High School Slow Breathing Program

Speaking of using simple breathing practices in hard situations, the Health & Human Performance Foundation (HHPF) partnered with Girard High School to implement a slow breathing program for the students. The program improved the students' tolerance to CO2 and decreased their anxiety. Pretty amazing stuff.

Read More Here

3. Relaxation Breathing - A Way to Lower Blood Glucose

There have been two studies examining a breathing technique called "Relaxation Breathing." I don’t hear much about it in the breathing community, but it appears to be helpful for lowering blood glucose. Here’s the method:

Inhale 2 Seconds, Exhale 1 Second
Inhale 2 Seconds, Exhale 2 Seconds
Inhale 2 Seconds, Exhale 3 Seconds
… (Exhale keeps getting longer) …
Inhale 2 Seconds, Exhale 10 Seconds

The progressively longer exhale is both relaxing and challenging near the end. I sometimes practice it when falling asleep. Give it a shot and see what you think.

If you’re interested, here are the two studies:

Relaxation breathing significantly lowers blood sugar after an oral glucose tolerance test

Slow breathing improves blood sugar by reducing body’s endogenous production of glucose

4. Oxygen Advantage + Yoga = High Altitude Yoga

My wife and I put together a class that combines yoga and breath-hold techniques from the Oxygen Advantage®. We’re calling it High Altitude Yoga™.

We’re holding a combined Virtual Masterclass where I teach the breathing principles and she teaches the yoga. If you’ve been in the breathing world for a while, the breathing concepts will not be new to you. But, combining them with yoga is both fun and challenging (we’ve had SpO2 drops in the mid-to-low 80s).

It’s going to be July 18th from 9:00 - 11:00 a.m. Eastern on Zoom. I hope you’ll join us!

Learn More & Sign Up Here

 
 
 
 

1 QUOTE

"By voluntarily changing the rate, depth, and pattern of breathing, we can change the messages being sent from the body’s respiratory system to the brain."

- Richard Brown & Patricia Gerbarg, from "The Healing Power of the Breath"

 
 
 
 

1 ANSWER

Answer: The number of molecules in each breath we take.

…

(Cue the Jeopardy music.)

…

Question: What is 25 sextillion? [1]

(Note: That’s 25,000,000,000,000,000,000,000 molecules!)

In good breath,
Nick

P.S. $98,000. (Ages 3 & Up.)

[1] Worrall S., “The Air You Breathe Is Full of Surprises,” National Geographic, Aug.13, 2012. View Article Here

(I found this through "Breath: The New Science of A Lost Art")

 

The Breathing 4.1.1.

 

I am trying a new format this week. I’m calling it “The Breathing 4.1.1.”

Below, I share 4 thoughts, 1 quote, and 1 answer (think “Jeopardy”). Enjoy!

 
 
 
 

4 THOUGHTS

1. Expert Q&A on Sleep Tape

James Nestor’s first "expert Q&A" episode has been released. It’s on sleep tape with Dr. Mark Burhenne. I especially appreciated Dr. Burhenne’s confidence in recommending that people wear mouth tape. Watch Interview Here.

2. An Easy Hack for Dropping SpO2 during Breath Holds

I’m always playing around with my breath holds. Lately, I’ve been performing a full exhale before each hold.

Normal Breath In —> Fast and Complete Exhale Out —> Hold

I’ve seen additional SpO2 drops of 5-10% (!). My breath holds are not as long, but I’m getting into intermittent hypoxia easier. I really try to empty my lungs as much as possible to get more significant drops in SpO2.

3. Is Tissue Hypoxia Really the Problem?

“In this, chronic overbreathing will not create ‘hypoxia’ in tissues; this is a fact that many Buteyko adherents consistently get wrong.  The real damage from overbreathing comes from the constant energy the body has to expend to run more cells anaerobically and to constantly buffer for carbon dioxide deficiencies.” - James Nestor, Breath

I talk about tissue hypoxia a lot. Here, James says that it’s not necessarily tissue hypoxia that’s the problem, but the body’s response to prevent it from happening that causes the damage. In any case, the underlying issue is the same: We need to get an adequate supply of oxygen for our cells to function correctly.

4. A Simple Way the Breathe Light

Teaching people to breathe "light" is often tricky. However, in Restoring Prana, Robin Rothenberg provides one of the most practical ways I’ve heard: Imagine taking up less space with each breath. I imagine less air being pulled into my nose with each inhale, and each exhale disturbing less air around me. Give it a shot.

 
 
 
 

1 QUOTE

“He who tastes a grain of mustard seed knows more of its flavor than he who sees an elephant load of it.” - Yogi Mamacharaka, Science of Breath

 
 
 
 

1 ANSWER

Answer: The amount of water used to humidify the air we breathe each day.

…

(Cue the Jeopardy music.)

…

Question: What is 1 pint? [1]

In good breath,
Nick

P.S. Coming to you live from…

[1] Essentials of Pathophysiology (3rd Edition), Carol Mattson Porth

 

Breathe The Change You Want to See (In Your Body)

 

"To say…that a man is made up of certain chemical elements is a satisfactory description only for those who intend to use him as a fertilizer." - Herbert J. Muller

 
 
Breathe_the_Change_1_New.png
 
 

When I first started a “breathing” practice, it seemed a bit silly. But then I started seeing dramatic improvements in my sleep, energy, and blood sugars. How could something as simple as breathing do so many things? The more I thought about it, the more I realized it wasn’t silly or crazy at all.  

Close your mouth and pinch your nose.  

In a few seconds, you’ll begin feeling a desire to breathe so strong it’s almost uncontrollable. This simple act of holding the breath helps us appreciate just how important it is.

Why would an urge like this exist? One that can be felt by people who, quite literally, have no fear.  

It’s because there is more to breathing than just breathing. It’s biomechanics and biochemistry. It’s psychology and physiology. It’s in your brain, and it’s in your core. Breathing provides the link between your mind and your cardiovascular and autonomic nervous systems.  

How to Breathe the Change You Want to See

Breathing is also very unique. It’s automatic, yet it is also under our conscious control. It’s up to us whether we want to take advantage of this.

For example, there is a cluster of neurons in your brain that monitors your breathing. If you breathe slowly and calmly, that message is sent to important regions of your brain. If you breathe fast and anxiously, that message is relayed as well.

Want to be anxious? Breathe anxiously.

Want to be calm? Breathe calmly.

Thus, we can consciously choose the messages we send with our breath. And this goes not just for the brain, but the cardiovascular and autonomic nervous systems as well. We can literally breathe the change we want to see in our bodies.

The First Place to Start

One of the most effective ways to “breathe the change” is with slow breathing. Slow breathing improves oxygenation, restores cardio-autonomic balance, increases heart rate variability, and so much more.

Give it a shot today. Breathe between 3 to 6 breaths per minute, for 5 minutes. Try it out for five days straight and see how you feel.

There’s no pill. There’s no money to be made. It’s just simple physiology.  

In good breath,

Nick  

P.S. “Sorry, but you’re going to need a pre-authorization.”

 

Can Overbreathing Cause Osteoporosis?

 

“Life-transforming ideas have always come to me through books.” - Bell Hooks

 
 
 
Overbreathing_Osteoporosis_1_New.png
 
 
 

This week, I want to look at a few fascinating passages on overbreathing from “Breath: The New Science of A Lost Art.”

Let’s start with James Nestor’s insight into tissue hypoxia (my bold for emphasis):

“In this, chronic overbreathing will not create ‘hypoxia’ in tissues; this is a fact that many Buteyko adherents consistently get wrong.  The real damage from overbreathing comes from the constant energy the body has to expend to run more cells anaerobically and to constantly buffer for carbon dioxide deficiencies.”

So James is saying that tissue hypoxia itself is not the problem with overbreathing. The damage occurs because of the body’s response to prevent tissue hypoxia from happening.

Overbreathing and Cell Metabolism

Aerobic = “With Oxygen”

Anaerobic = “Without Oxygen”

This damage occurs partially because of sustained anaerobic metabolism. We have all probably heard of aerobic and anaerobic exercise. Slow and steady is typically aerobic, fast and intense is usually anaerobic. We don’t have to think about it. When we push ourselves, our oxygen supply can’t keep up, and our body naturally switches to anaerobic metabolism.

This anaerobic switch creates a more acidic local environment, which will help release oxygen from the hemoglobin and help restore aerobic energy production.

But, with chronic overbreathing, this aerobic balance cannot be achieved.  So your cells are running as if you’re always doing high-intensity training…not the most efficient way to spend your day.

But that’s not even the worst part of overbreathing.

Restoring pH Balance Causes the Real Damage

The body is always trying to find balance, and this is especially true for pH. Blood pH is kept in a tight range (around 7.4) to allow the body to function correctly.

When we chronically overbreathe, we offload too much carbon dioxide, which increases pH. The body compensates through a process called “buffering,” where the kidneys begin releasing bicarbonate into the urine to restore pH balance. The real damage comes from what bicarbonate takes with it:

“This occurs because as bicarbonate leaves the body, it takes magnesium, phosphorus, potassium, and more with it. Without healthy stores of these minerals, nothing works right: nerves malfunction, smooth muscles spasm, and cells can’t efficiently create energy.” - James Nestor

Overbreathing Weakens Our Bones

All of which leads us to how overbreathing can contribute osteoporosis:

“Constant buffering also weakens the bones, which try to compensate by dissolving their mineral stores back into the bloodstream. (Yes, it’s possible to overbreathe yourself into osteoporosis and increased risk of bone fractures.)” - James Nestor

Alright, let’s break these steps down to see how this happens:

  1. Overbreathing offloads too much carbon dioxide, preventing adequate oxygen delivery to the cells.

  2. The cells compensate with chronic anaerobic metabolism.

  3. The kidneys compensate by excreting bicarbonate into the urine to balance pH.

  4. The excretion of bicarbonate “steals” important minerals from the blood.

  5. The bones then compensate by dissolving minerals back into the blood, which weakens them.

It is simultaneously amazing and scary what our bodies are capable of.  

There is Always Good News

Although this negative feedback loop is alarming, there is a way to prevent or reverse it: Stop overbreathing.

And the best way to do that? Breathe through your nose, breathe slowly, and breathe slightly less than you think you need.

In good breath,
Nick

P.S. Just Along for the Ride.

 
 

Could nasal nitric oxide help to mitigate the severity of COVID-19?

 

“We have too many high sounding words, and too few actions
that correspond with them.” - Abigail Adams

 
 
 
Importance_of_Nasal_NO_Updated.png
 
 

When the pandemic began, many people in the “breathing community” immediately started talking about nasal nitric oxide because of its antiviral and antimicrobial effects. Nose breathing seemed like washing your hands: Of course, no scientific studies were showing it worked for this specific virus yet, but it made it common sense to practice it anyways.

Now that we’re getting back to normal (despite the record number of cases in some parts of the world), nose breathing is more important than ever. And it looks like many in the scientific community agree.

Last month, a Commentary was published in Microbes and Infection titled “Could nasal nitric oxide help mitigate the severity of COVID-19?” [1]. (I saw this article through the Oxygen Advantage newsletter…thanks, Patrick!) It’s a short and easy read that I highly recommend. 

Click here to read the full commentary

Here’s one of my favorite quotes from it:

 
 

“Mouth breathing during sleep may therefore worsen the symptoms of COVID-19, consistent with the observation that symptoms of respiratory infections are usually worse in the morning.”

 
 
 
 

LA Times Article on Inhaled Nitric Oxide for COVID-19

About two months ago, a good friend, and reader of this newsletter, shared this article from the LA Times with me. I think it pairs nicely with the commentary above:

How a discovery that brought us Viagra could help those battling the coronavirus

Click Here to Read the Article

Here’s my favorite quote from that one:

“In 2004, researchers at the University of Leuven in Belgium discovered yet another property of nitric oxide: It killed coronaviruses.

More specifically, it killed the coronavirus that leapt from bats to humans and sparked the 2003 epidemic of severe acute respiratory syndrome, the disease better known as SARS.”

Here’s to putting science into action by simply breathing through your nose while you’re out and about.

In good breath,
Nick

P.S. How to Enunciate Correctly in 4 Steps.

[1] Martel, J., Ko, Y. F., Young, J. D., & Ojcius, D. M. (2020). Could nasal nitric oxide help to mitigate the severity of COVID-19?. Microbes and infection, 22(4), 168–171. Advance online publication. https://doi.org/10.1016/j.micinf.2020.05.002

 

Two Regulatory Effects of Breathing (+ James Nestor Breathing Q&A)

 
 

“Waste no more time arguing what a good man should be. Be one.” - Marcus Aurelius

 
 
 

You probably hate Zoom meetings by now. In fact, if you work in an office setting, you’re probably just tired of meetings in general. But every now and then, you have a truly important meeting. You prepare, rehearse, read, dress nice, and do everything you can to show up ready. 

Physiologically, we step into one of these “truly important meetings” approximately 25,000 times per day…no big deal, I know :) And we can choose how well we prepare for each one. We can send messages of calm, focus, and relaxation, or messages of anxiety, stress, and arousal.  

Whichever we choose, the messages we send with our breathing regulate many aspects of our health and well-being.  

How? Well, the answer to that is complex because breathing interacts with many systems of the body simultaneously (as we learned last week). But, the paper I am sharing this week goes through two significant regulatory effects of breathing.

 
 
 
 

Modulatory Effects of Respiration

Published in Autonomic Neuroscience: Basic and Clinical (2001)

Click Here to Read the Full Summary

 
 
 
 

The two main takeaways from this study are:

(1) Breathing modulates the cardiovascular system through respiratory sinus arrhythmia  

(2) Specific breathing patterns can reduce our chemosensitivity to carbon dioxide and hypoxia


1. Breathing and the Cardiovascular System

Respiratory sinus arrhythmia (RSA) measures how breathing, heart rate, and blood pressure all interact. Put simply, RSA is the increase in your heart rate as you inhale and the decrease in your heart rate as you exhale. RSA is thought to be an index of vagal activity and direct measurement of heart rate variability.  

When we breathe so that the length of our inhale matches our heart rate increase and our exhale matches our heart rate decrease, we maximize RSA. Typically, this occurs when breathing at around 6 breaths per minute. This coherence among breathing and heart rate maximizes heart rate variability and improves cardiovascular efficiency.

 

2. Breathing and Chemoreflexes

They reviewed a study conducted with yoga trainees and non-yoga trained participants. This study assessed how different breathing protocols affect sensitivity to high carbon dioxide (hypercapnia) and low oxygen (hypoxia). These sensitivities are known as chemoreflexes.

As we might expect, the chemoreflexes of the yoga practitioners at baseline were much lower than the non-trained participants. This means their breathing did not increase as much when exposed to hypercapnia or hypoxia.

Interestingly, when breathing at 6 breaths per minute, the controls' chemoreflexes decreased to levels similar to the yogis.  Therefore, the simple act of slow breathing reduced chemosensitivity to carbon dioxide and hypoxia, regardless of previous training.

Being able to tolerate changes to carbon dioxide and oxygen easily is a sign of respiratory and physical resiliency. And merely slowing down your breathing can improve this resiliency almost immediately.

 

How Will Your Next Meeting Go?

Breathing is fascinating because it’s both autonomic and under our control. Obviously, we can’t control every breath we take, and I think that would be an awful way to live.  But, we can deliberately set aside time to harness what we’ve learned from this study.  

Just a few minutes of slow breathing at around 6 breaths per minute can improve chemosensitivity and align your cardiovascular and respiratory systems.  This will help make the other 25,000 odd breaths you take that much more effective.

Here’s to being the regulator of our health and well-being.

In good breath,
Nick

P.S. I would be the first one captured.

 

James Nestor Q&A

James Nestor is holding a “Breathing Q&A,” where he is rounding up questions related to all aspects of breathing to sending them to be answered by experts in the field of respiratory science. I have a few to submit…you should too!

Learn More Here.

Yoga & Breathing Virtual Workshop

My wife is teaching a masterclass on breathing and yoga as part of a larger Virtual Yoga Festival. She’s mixing in slow breathing, CO2 tolerance, Oxygen Advantage, and The Art of Breath. I don’t “advertise” in my newsletter, but the studio hosting the event is donating all of the profits to No Kid Hungry. So if you’re into yoga and/or breathing, you can learn and support a good cause at the same time.

Learn More Here.



 

Breathing is the Compound Interest of Health

 
 

"He who labors diligently need never despair; for all things are accomplished by diligence and labor." - Menander (342 BC - 292 BC) 

 
 
 
Compound_Interest_Final.png
 
 

Correct breathing synchronizes many systems in the body. This coherence compounds over time.


Breathing improves your sleep [1,2]. Better sleep improves your cardiovascular system [3].


Breathing improves your cardiovascular system [4,5]. This improves your sleep.


Breathing restores autonomic balance [6]. Better autonomic control increases heart rate variability and baroreflex sensitivity [7,8].


Correct breathing improves tissue oxygenation [9]. This improves autonomic balance [10]. And insulin sensitivity [11].


The more control you have over your breathing, the more control you have over your emotions [12].


The more control you have over your emotions, the more control you have over your breathing [13].


The more control you have over your breathing, the more control you have over all the systems mentioned above [14].

Thus, all of these benefits are not isolated but integrated. It would still be rather amazing if breathing helped just one or two of these systems (since it’s free and everything). But, it helps so many different aspects of health and these benefits aggregate and compound over time.

But Nothing Happens Overnight

Well, maybe it does, because my first night of sleeping with my mouth closed literally changed my life.

But just like in financial investing, we have to keep contributing small amounts to our health consistently. Over time, those contributions will grow into something great, without any additional effort.

In good breath,

Nick

P.S. Best part of quarantine: No airports.

References

[1] Mouth breathing during sleep significantly increases upper airway resistance and obstructive sleep apnea

[2] The many important roles of the nose during sleep

[3] Obstructive sleep apnea causes hypertension

[4] Meta-Analysis: Slow Breathing Reduces Systolic Blood Pressure by 5.62 mmHg

[5] Slow breathing improves blood pressure in hypertensive type II diabetics

[6] Two minutes of slow breathing restores autonomic and respiratory balance

[7] Slow breathing decreases blood pressure and increases heart rate variability in hypertensive diabetics

[8] Slow breathing improves autonomic function in type 1 diabetics

[9] Nitric oxide might outweigh all other benefits of nose breathing

[10] Treat & reverse the root cause of diabetic complications (tissue hypoxia) with slow breathing

[11] Hypoxia Decreases Insulin Signaling Pathways in Adipocytes

[12] Slow, controlled breathing improves anxiety independent of CO2

[13] Breathing center in brain has powerful effects on higher-order brain functions…calm yourself by breathing slowly

[14] How slow breathing improves physiological and psychological well-being (hint: it might be in your nose)

 
 

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.

 
 

Finding Understanding in Explanation

 

“Simplify!” - Ray Dalio

 
 

In “A Mind for Numbers,” Barbara Oakley tells us:

“You may think you really have to understand something in order to explain it. But observe what happens when you are talking to other people about what you are studying. You’ll be surprised to see how often understanding arises as a consequence of attempts to explain to others and yourself, rather than the explanation arising out of your previous understanding.”

That’s fascinating. Have you ever had to explain something and afterward thought, “I didn’t even know I knew that?!?”.

Or, on the flip side (and what more commonly happens to me), you might have the experience of “I thought I understood that better, but I could not explain it the way I think it.”

Can Breathing Principles Change?

Both of these experiences have recently happened to me while making my first two podcast appearances (Bravest and Breathe Success Radio). Although I talk about breathing with my family, friends, and those I coach, it has been interesting to see the understanding (or lack thereof) that arises from these interviews.

The one thing that has stood out the most is this: I always come back to nose breathing as the most important change everyone can make to their breathing. And it is.

But, when I looked back at my Three Breathing Principles, I was focusing on slow breathing first, and then nose breathing (especially at night) second.

Before:

1. Breathe Slowly
2. Breathe Through Your Nose at Night
3. Hold Your Breath

So, this past week I rearranged the principles to reflect my thinking and the science better. I also added some pretty graphics.

After:

1. Breath Through Your Nose
2. Breathe Slowly
3. Hold Your Breath

The (sort of) New Breathing Principles

Each Principle has a new page that provides the basic science behind it and practical exercises you can apply in your life today. 

I hope this new arrangement is simpler and makes the website more comfortable for you to navigate when you begin applying the principles in your own life.

Principle 1 - Breathe Through Your Nose

 
 
 
 

Principle 2 - Breathe Slowly

 
 
 

Principle 3 - Hold Your Breath

 
 
 
 

In good breath,
Nick

P.S. Fourteen days in quarantine.

P.P.S. Here’s the link to the latest podcast interview on Breathe Success Radio. Click Here To Listen.

 

Slow Breathing & High Blood Pressure: What it Means for Diabetes and COVID-19

 
 
 
 

“Trees and plants depend on the weather to flourish but I make my own weather, yea I transport it with me.” - Og Mandino

 
 
 
 
 

Recent reports have shown that high blood pressure is associated with negative outcomes from COVID-19.  

As people with diabetes, we already knew we were at higher risk when it comes to COVID-19. But, anywhere from 40%-80% of diabetics suffer from hypertension. That, on top of our compromised immune systems, is why we have to be more vigilant than ever with our health and well-being.

Thus, keeping our blood pressure under control should be a primary focus during these uncertain times.

A 2019 Meta-Analysis Shows Significant Reductions in Blood Pressure

I say this often, but meta-analyses are my favorite studies to read. They synthesize findings from all of the scientific literature on a particular topic in an easy-to-follow format.  

The one I’m sharing this week looked at slow breathing and blood pressure:

Device and non-device-guided slow breathing to reduce blood pressure: A systematic review and meta-analysis

Published in Complementary Therapies in Medicine, August 2019

(Click Here To Read The Full Summary)

On average, they found that slow breathing reduced systolic blood pressure by 5.62 mmHg. Slow breathing reduced diastolic blood pressure by 2.67 mmHg.

Additionally, the longer participants practiced, the more significant the reduction in blood pressure. For example, in the studies where subjects practiced slow breathing for more than 200 minutes per week, the average drop in systolic blood pressure was 14 mmHg.

These improvements are significant. Blood pressure reductions of these magnitudes have been shown to reduce the overall risk of cardiovascular death. Obviously, there are no studies explicitly looking at COVID-19 yet. Still, it seems safe to assume that these reductions would be beneficial, especially if you have diabetes.

Breathing as a Complementary Therapy

Slow breathing is not a cure-all. As the name of this journal implies (Complementary Therapies in Medicine), it is complementary, not a replacement. But, slow breathing is free and has no adverse side effects, so why not use it as another way of controlling your blood pressure, stress, and anxiety during these unsettled times?

In good breath,
Nick

P.S. When Quarantine is Over.

P.P.S. Happy Mother’s Day to all of the amazing moms out there!

 
 

Lack of Oxygen Might be the Root Cause of Diabetic Complications

 
 

Since we cannot know all that there is to be known about anything, we ought to know a little about everything.” - Blaise Pascal

 
 
 
 

People with diabetes are at an increased risk of cardiovascular and autonomic problems. Diabetics also display altered respiratory control, for example, showing depressed (or enhanced) chemoreflexes.

However, previous studies have never examined these two aspects in an integrated fashion.

Integration Over Isolation

The problem with separately studying these systems is that the results might not be independent. For example, if a study shows that diabetics have decreased respiratory control, it might conclude that this is from diabetic nerve damage.

Likewise, if a study shows that cardiovascular function is depressed, it might also conclude that this is due to diabetic nerve damage.

However, if we study them together, we might find that there is a reciprocal relationship. Maybe the respiratory problems are causing cardiovascular issues? Perhaps it’s the other way around?

This study takes that approach and has some pretty remarkable conclusions.

Integrated cardiovascular/respiratory control in type 1 diabetes evidences functional imbalance: Possible role of hypoxia

(Click Here to Read Full Summary — I don’t say this often, but please read this one if you have diabetes)

Published in the International Journal of Cardiology, 2017.

In forty-six type-1 diabetics and 103 age-matched controls, they measured baroreflex sensitivity (BRS) as a marker of cardiovascular function and chemoreflexes as a marker of respiratory control.

Chemoreflexes estimate how sensitive you are to increasing CO2 (hypercapnic chemoreflex) and decreasing O2 (hypoxic chemoreflex).

The Hypothesis: If BRS and chemoreflexes are reduced, this would suggest diabetic nerve damage. However, if some are reduced while others are elevated, this reciprocal relationship might be showing autonomic dysfunction instead of diabetic nerve damage.

This is such an important distinction. “Damage” implies that the damage is done. “Dysfunction” implies that we could make it functional again.

Diabetics Have Worsened Cardiovascular and Respiratory Control

The results showed that subjects with diabetes had a lower BRS than the controls. They also had a suppressed hypoxic chemoreflex. However, they had an elevated hypercapnic chemoreflex. (Remember their hypothesis: if it was nerve damage, both of these chemoreflexes would be reduced.)

Interestingly, the diabetics also showed a lower oxygen saturation. And, they also had relatively high HbA1c’s (an average of 8.19%). A high HbA1c will decrease oxygen delivery to the tissues and cells.

Tissue Hypoxia is at the Root of Diabetic Complications

The reduced oxygen saturation and high HbA1c suggest a resting state of tissue hypoxia in diabetes. Over time, we become “numb” to this, which explains the decreased hypoxic chemoreflex.

The body compensates with an up-regulated hypercapnic chemoreflex, which leads to chronic activation of the sympathetic nervous system (fight or flight).  Chronic sympathetic activation then suppresses our cardiovascular control.

It’s a vicious cycle with negative long-term implications:


 
 
Root_of_Complications_Cycle.png
 
 

Dysfunction, not Damage: A Silver Lining

“We show in the present study that what is normally called ‘autonomic neuropathy’ could be in many cases a functional condition of sympathetic activation, driven by many factors, one of which seems to be resting hypoxia.”


This is all actually good news.  Their results suggest that diabetic autonomic imbalance is mainly functional and not related to nerve damage.  In fact, the authors suggest that this imbalance likely leads to nerve damage, rather than being the result of it. Therefore, therapies targeting cardio-respiratory control could help reverse/prevent diabetic complications if caught early enough.

Break Out Your Slow Breathing Hammer

What are these therapies? One is slow breathing. Slow breathing will immediately improve cardiovascular and respiratory reflexes. It will also enhance oxygenation (when breathing through the nose).

I hate sounding like all I have is a “slow breathing hammer,” but it is just too important not to stress over and over again.

Here’s to taking the first step toward protecting our long-term health as diabetics.

In good breath,
Nick

P.S. A great podcast was recently released with James Nestor, author of the soon-to-be-released book: “Breath - The New Science of a Lost Art”. (The book looks terrific, so I pre-ordered my copy about a week ago.)

You can basically learn everything you’ll ever need to know about breathing in this quick 35-minute interview. I loved it.

Listen to the podcast here.

 
 

The Best Way to Begin Slow Breathing

 
 

“The secret of making progress is to get started. The secret to starting is to divide your complex, overwhelming task into small, manageable tasks, and then start the first.” - Mark Twain

 
 
 

Slow breathing has many benefits. For example, it improves cardiovascular and autonomic functioning. However, as we mentioned last week, you can quickly get “lost in the crabgrass of details” if you’re not careful, which is basically what I do every day :)

For instance, there are several ways to breathe slowly. You can use equal inhales and exhales, extended exhales for more relaxation, or you can include ujjayi breathing if you’re a trained yogi.

The study I’m sharing this week examined some of these nuances to determine which is best for beginners.

Cardiovascular and Respiratory Effect of Yogic Slow Breathing in the Yoga Beginner: What Is the Best Approach?

(Click Here to Read Full Summary)

Evidence-Based Complementary and Alternative Medicine, 2013

The study had seventeen non-yoga practitioners perform several different breathing protocols:

  • Spontaneous breathing

  • Controlled breathing at 15 breaths/min

  • Slow breathing at 6 breaths/min, 5 sec inhale, 5 sec exhale (equal)

  • Slow breathing at 6 breaths/min, 3 sec inhale, 7 sec exhale (extended)

  • The above two slow breathing protocols, but with ujjayi

Measurements of baroreflex sensitivity (BRS), blood pressure, and several respiratory variables were taken during the experiment.

Most Improvements from Slow Breathing without Ujjayi

They found that slow breathing without ujjayi was the most effective at improving cardiovascular and autonomic function (as measured by BRS) and at reducing blood pressure.

However, keep in mind that these were not trained yogis. Therefore, the added effort of ujjayi likely dampened the parasympathetic response. The results would likely be different in a trained ujjayi practitioner.

Getting Started: Breathe at a Ratio That Is Comfortable For You

All of their results revealed that slow breathing with an equal inhale-to-exhale ratio performed best. However, the differences between the balanced and extended exhale techniques were small. Therefore, they concluded that “practitioners can engage in a ratio that is personally comfortable and achieve the same BRS benefit.”

For us, the take-home message is that slow breathing at a rate of 6 breaths/min improves cardiovascular and autonomic function. The best way to begin is to choose a ratio that is comfortable for you.

I suggest that you start with a 4 second inhale and a 6 second exhale and see how it feels. Begin with a five-minute session first thing in the morning and build up from there to reach three 5-minute sessions a day.

In good breath,
Nick

P.S. Me. Also me.

 

The One Percent Rule of Breathing (& Bravest Podcast Interview)

 
Nothing_Too_Small_to_Know.png
 
 

Craig Kasper invited me on his podcast, Bravest, to discuss all things breathing and diabetes. It should be released later today.

Craig is a type-1 diabetic and a genuinely good person. We had a lot of fun, and I hope you’ll give it a listen. 

Listen Here: Bravest

The Pareto Principle, or 80/20 rule, states that 20% of your efforts get you 80% of your results. Twenty percent of your customers account for 80% of your profit. A small number of NBA teams hold a majority of the titles. This rule holds true in many fields of life (here is an excellent article about the 80/20 rule) [1].

For breathing, I believe we can take this even farther.

The One Percent Rule of Breathing

In “To Sell is Human,” [2] Dan Pink describes a lesson he received during law school that stuck with him the rest of his life:

“Don’t get lost in the crabgrass of details, he urged us. Instead, think about the essence of what you’re exploring—the one percent that gives life to the other ninety-nine.”

“The one percent that gives life to the other ninety-nine.” I love that exaggeration of the Pareto Principle. In breathing, that one percent is your nose.

So Simple - So Complex

Slow breathing is simple and takes minimal effort. But, if you get “lost in the crabgrass of details,” it can become extremely complex.

But none of it would matter without the nose. The nose is the hidden engine driving all the benefits of “breathing.” Whether it’s slow breathing, sleep, or exercise, simply using your nose is the 1% that allows the other ninety-nine to occur.

How breath-control can change your life: A systematic review on psycho-physiological correlates of slow breathing

(Click Here to Read Full Summary)

Slow breathing has many benefits, which we covered in the infographic last week. To name a few: it reduces blood pressure, increases heart rate variability, enhances baroreflex sensitivity, improves arterial function, and increases tissue oxygenation.

The paper above concluded that the nose is the link connecting slow breathing to these benefits. It’s not just slow breathing; it’s nose breathing.

In good breath,
Nick

P.S. Coffee at home for me.


References

[1] I cannot overstate how much I enjoy James Clear’s work.

[2] To Sell is Human