0033 - Do you know how to breathe?

We all breathe more than 20,000 times a day without thinking about it. Our body regulates our breathing depending on the situation, but it does not optimise it to control our emotions, our stress or to help us achieve better physical and mental health.

To optimise our breathing, we just need to pay attention to our respiration and decide how long or deep we want to inhale or exhale. This is very easy and can be done anytime, anywhere. It is one of the most underrated, simplest and quickest solution to regain control on many aspects of our physiology, to improve our mental state, reduce our stress, increase our physical performance and much more.

I have written about the sympathetic and parasympathetic systems in previous articles. Our sympathetic system—also called the "fight-or-flight" mode—is triggered automatically in a stressful situation. Our blood rushes to our muscles, our heart rate increases, our pupils dilate and other body functions are put on hold to help us deal with the stressor we are experiencing. A chronic sympathetic state causes anxiety, fatigue, sleep disorders, tensions and other unwanted side effects. The parasympathetic system, on the other hand, is a rest, digest and recovery mode that facilitates relaxation, healing, clear thinking, problem solving and creativity. Breathing techniques can help us switch to a parasympathetic mode to avoid chronic stress.

Athletes, successful businessmen and elite forces use breathing techniques for optimum performance and well-being. We can do it too!

The physiology of breathing

The number one rule of proper breathing is to breathe through the nose, not through the mouth. This has multiple benefits.

First, our sinuses produce nitric oxide. This gas improves the lungs’ ability to absorb oxygen and facilitates the transport of oxygen throughout the body, to our heart, brain and organs. It is also antiviral, antibacterial and antifungal: it can block viruses and parasites from entering our nose and helps destruct them. It also relaxes and dilates blood vessels, helps prevent blood clotting and arteries obstructions, facilitates erectile function, protects the skin from harmful radiation, regulates the secretion of digestive hormones and enzymes.

Second, the nose acts as a filtering system. It warms and humidifies the air and removes a significant amount of germs and bacteria. It reduces dehydration, bad breath, snoring and sleep apnea, as well as the risk of developing dental cavities and gum diseases.

Breathing through the nose rather than through the mouth helps maintain the parasympathetic tone. It can also help with blood circulation issues, cold hands or cold feet. It enhances our memory, learning and brain function, lowers our blood pressure, reduces inflammation, stress and anxiety, improves our sleep quality, increases our endurance and strength and strengthens our immune function.

On the other hand, mouth breathing elevates blood pressure and heart rate, worsens asthma and allergies, and deprives the heart, brain, and other organs of optimal oxygenation. It can result in fatigue, poor concentration, reduced productivity and other health issues. In kids, mouth breathing changes the structure of the face, resulting in narrow jaws, crooked teeth and smaller nasal cavity, which in turn perpetuates the mouth breathing habit. It also interferes with the development of their pulmonary strength and resilience to stressors.

It might be counter-intuitive but breathing more air through the mouth does NOT increase blood oxygenation. Our blood is already saturated with oxygen, at 95% to 99%. Our hemoglobin carries oxygen to our cells, tissues and organs and releases oxygen in the presence of CO2 (carbon dioxide). Remember this: CO2 is required to allow the oxygen to flow into the tissues. Once the oxygen is released, the CO2 is returned to the lungs for exhalation. Fast and shallow breathing through the nose and mouth breathing do not distribute oxygen optimally into our body and result in a greater loss of CO2. The mouth gets more air in but lets more CO2 and moisture out. We lose 42% more water through oral expiration. People who are breathing too hard exhale too much CO2, which prevents them from absorbing oxygen properly. This is a vicious circle, the harder you breathe, the less oxygen you absorb, which pushes you to breathe even harder. Mouth breathing should only happen in case of an emergency or intense effort.

How slow should we breathe?

We have established that we should breathe through the nose, but how many breaths should we take per minute? Is there an optimum respiration rate?

Most studies report that the most efficient breathing rate for health and well-being is of 5.5 to 6.5 breaths per minute, which means each breath should last 9 to 11 seconds. This is the frequency at which heart beats synchronise with blood pulse fluctuations and respiration, resulting in the most efficient gas exchange. It increases our physical and mental performance, reduces stress, anxiety, pain, depression, cravings, regulates our emotions, fastens recovery and optimises gastrointestinal and cardiovascular health.

With 20 breaths per minute, only 50% to 70% of the air goes to the lungs. With 6 breaths per minute, we are using 85% of the air inhaled by filling our lungs better, resulting in more oxygen delivery to our body.

The average respiratory rate in a healthy adult is between 12 and 18 breaths per minute, which is 2 to 3 times the optimised breathing rate. This is why most of us could benefit from practicing slow breathing exercises during the day: in the morning and in the evening, on your way to work or when you are watching telly for instance, inhale for 4 seconds and exhale for 6 seconds. Continue for 10 minutes. It will slow down your heart rate and reduce your blood pressure. If 10 minutes feels too long, start by 5 minutes several times a day, before a stressful meeting, when you are stuck in traffic or waiting in a queue. You will quickly feel more relaxed and more centered.

Deep breathing to combat stress or anxiety

Deep breathing is a very powerful tool to quickly control our stress response. Sit or stand with a straight back. Relax your shoulders and roll them back. Drop your tongue in your mouth and relax your jaws. Inhale slowly and deeply through the nose, silently, without moving your shoulders. Your belly should expand out. As you exhale, your belly should sink back in. You can also scan your body for pain or tensions, and focus to let go of them.

Here are several breathing rhythms that you can try:

1. Breathe in for 6 seconds, hold your breath for 6 seconds, breath out for 6 seconds and hold for 6 seconds. If these intervals are too long for you, shorten them to 4 seconds for instance. This is called "box breathing". Repeat for 5 to 10 minutes. This is a great exercise to practice when you feel anxious, scared or if you have a panic attack. Elite forces use box breathing to prepare for dangerous situations.

2. There is also the "4/7/8" breathing technique. Breathe in through the nose for 4 seconds, hold your breath for 7 seconds and breath out through the mouth for 8 seconds. Repeat 5 to 10 times. This exercise helps reset the vagus nerve that drives the parasympathetic control of the heart, digestive tract and other key body functions.

3. If you want to calm down during the day or relax before bed, there are many other variations of deep breathing that you can try: 4 seconds in, 8 seconds out and 4 seconds hold. Or 4 seconds in, 8 seconds hold and 4 seconds out. If your comfortable exhale time is shorter or longer, adjust the length but keep the ratios (for instance 5s/10s/5s or 3s/6s/3s...).

When exhaling, you can also make a humming sound to further activate the vagus nerve and the parasympathetic system and to increase the production of nitric oxide 15-fold.

Breathing for physical performance

Many athletes know that optimised breathing can significantly increase their physical performance. Even if you don't practice any competitive sport, try the following exercises to improve your performance and fasten your recovery.

Warm up for your work-out by holding your breath 2 to 3 times, until you get a moderate to strong urge for air. This will open-up your blood vessels and activate your sympathetic system. Then, take 20 quick breaths per minute for 3 minutes.

Breathing faster can help increase your performance just before an intense effort. This is something that weight-lifters do, for instance, before lifting heavy weights. There are many ways to practice what is sometimes called "super-ventilation". For instance:

1. Take 5 quick mouth inhales and exhales, followed by 5 quick nose inhales and mouth exhales and repeat for 3 minutes. Hold your breath for 30 seconds at the end.

2. Quickly inhale fully and exhale partially, 20 times in a row, through the nose. Exhale fully at the end and hold your breathe for 30 seconds. Take 5 slow breaths to recover and repeat the exercise.

3. You may have also heard of the Wim Hof over-breathing technique. It depletes CO2 and allows us to hold our breathe for longer, as it takes more time for our body to reach CO2 saturation. However, it is possible to black out before feeling the urge to breathe. So, don't do it before free diving!

When you exercise, keep breathing through the nose to benefit from the release of nitric oxide. If needed, reduce the intensity of your exercise until you can breathe properly through the nose. Or, if you don't want to reduce the intensity, exhale through the mouth but keep inhaling through the nose.

A greater tolerance for CO2 will reduce your breathlessness and deliver oxygen more efficiently to your muscles. The keen exercisers among you may have heard of "VO2 max": this is the maximum capacity of the body to transport and utilise oxygen in one minute, during exercise at maximum capacity. You can increase your VO2 max by increasing your tolerance for higher CO2 levels in the blood. When you hold your breath after exhaling, the oxygen saturation decreases and the CO2 increases, resulting in the production of red blood cells to offset the oxygen drop, which increases the VO2 max. It simulates training at higher altitudes and pushes the body to adapt. Even a small need for air for 10 seconds resets the brain receptors to tolerate a higher concentration of CO2. On the other hand, holding your breath before exhaling doesn’t increase the CO2 levels.

To increase your CO2 tolerance and your VO2 max, slow down your breathing, take a bit less air than you would like to when inhaling, breathe out gently and hold your breath until you feel a moderate urge for air. Continue for a few minutes, twice a day. You should feel warmth from the dilation of the blood vessels and may be some tingling in your fingers or toes. You can also practice this breath holding exercise to warm-up or cool-down to recover faster.

Last, after working-out or during your rest periods, practice slow, deep breathing for a few minutes to fasten recovery.

Breathing techniques for other health benefits

When your nose is blocked, take a big breath in and a big breath out, then hold your breath until you feel a medium to strong urge for air. Breathe normally and when your breath is back to normal, repeat. This practice increases the release of nitric oxide and has anti-inflammatory benefits.

To relax muscular tension, inhale for 4 seconds, hold your breath for 4 seconds, contract the part of your body that is stiff, then exhale for 7 seconds while relaxing your muscles. Breathe slowly for 20 seconds and repeat a few times.

If you breathe through your mouth at night, try mouth-taping. The tape on your mouth will force you to breathe through the nose. It is not dangerous, as the light tape will not block you from breathing through the mouth if your nose is blocked, for instance. Just make sure you use the right sort of tape! No duck tape please!

Test your breathing efficiency

If you want to know whether you breathing is efficient, the following tests will tell you how good you are.

Test your CO2 tolerance: take a few normal breaths, then inhale fully through the nose and check how long you can exhale through the nose without stopping. Less than 20 seconds is poor. 20 to 40 seconds is average. 40 to 60 seconds is good. 60 to 80 seconds is very good and more than 80 seconds is excellent. Establish your baseline just after waking up, several days in a row. Practice the exercise several times during the day and see whether you can improve your results.

The BOLT score is how long you can hold your breath after expiring gently, until the first distinct urge to breathe. If you need to take a big breath at the end, you have held your breath for too long. This test is also best done after waking up. Less than 15 seconds is poor and may indicate a sickness or excessive stress or anxiety. 15 to 25 seconds is average. More than 25 seconds is very good and above 40 seconds is excellent. 40 seconds should be the goal for healthy adults who exercise. Under 20 seconds may reflect an excessive breathing that eliminates too much CO2, leading to reduced oxygen uptake and a constriction of the blood vessels and airways. If your BOLT score decreases, that means you have not recovered from exercise or sickness.

As you can see, we can all learn to breathe more efficiently, whether it is to better control our stress or emotions, or to improve our energy levels, brain function or physical performance. The techniques are easy to practice every day. Just pay attention to your respiration and slow it down: you will feel better and healthier.

This article is for educational purposes only. It is not a substitute for professional medical advice and is not intended to diagnose, treat, cure, heal or prevent any disease or medical condition. See full Disclaimer here. I encourage you to do your own research and to discuss with a qualified healthcare practitioner the options that could work the best for your specific circumstances.

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