At a time when we are doing anything we can to stay on top of our health, we like to pass on anything we feel can help. We look at all aspects of health and wellbeing both practically and in research, try and find what works best and deliver this information to you that we really feel you could benefit from. So please, can I ask that you read this with an open mind. Really start thinking about small changes you can make for your health, fitness and performance just by slightly altering something you already do every minute of every day. If somethings worth doing, it’s worth doing right.
Our respiratory system is a hot topic currently with Coronavirus having such a big impact on our lungs. So other than exercising to make our respiratory and cardiovascular system healthy and strong, what other small changes can we make day in, day out to give us the best possible foundation to stay healthy?
The way we breathe is one of those aspects we feel can help at the moment and is so often overlooked. Obviously, it is too early to have any evidence of the effect of breathing techniques on Covid-19. But as always, we listen to the leaders in their field and make our logical conclusions. The information below, however, can be beneficial in both current circumstances and long-term.
I have discussed breathing techniques in previous blogs and posts. They are something I use every day; they are simple enough for anyone to do and with the current circumstances they have just gone up on my priority list! I’m sure some of you are reading this thinking “I know how to breathe; if I didn’t, I wouldn’t be alive”. Touché, but what most people are doing now is exactly that – they are breathing to survive, not for better health and performance. There are subtle changes we can all make instantly to both improve our mental and physical health, but also make a marginal gain that may well be very important to our immune system.
So, would it be ok if I ask you to stop reading and just breathe for 30 seconds before you read the rest of this article? Really pay attention to how you breathe, how quick your breaths are and if you’re using your nose or mouth.
MOUTH BREATHING VS NASAL BREATHING
You have just taken 30 seconds to concentrate on your breathing. How did you breathe, was it exclusively through your nose or was some of it through your mouth?
Did you know that how you breathe as a child can have a big impact on both your looks and cognitive function? We have always been told to breathe in through our nose and out through our mouth, but there is no significant evidence of why this is recommended. We should ALWAYS be breathing through our nose, whether inhaling or exhaling. Even when we are training, the goal should always be to breathe through our nose. The mouth performs zero breathing functions, no medical textbooks identify the mouth as breathing apparatus.
Chronic mouth breathing in children has shown to narrow the upper jaw (maxilla) into a V-shape rather than a wider U-shape. This results in a change in aesthetic and function, the mouth becomes crowded and too small for the tongue. This results in crooked teeth and also forces the lower jaw to be pushed back. Children who breathe solely through the mouth have also been shown to be daydreamers in school and have reduced cognitive ability. In the extreme, a systematic review of literature in 2016 showed that 80% of research has shown chronic mouth breathers to have a higher incidence of learning difficulties.
Having a well-developed maxilla improves the nasal airway and breathing performance. Breathing solely through the nose helps to activate the diaphragm breathing muscles (more on diaphragmatic breathing later). It also has been shown to increase oxygen uptake in the blood, and in turn increase oxygen uptake in the cells by 10%. Now think of the impact that could have on performance and recovery alone.
A 2018 study took recreational athletes for 6 months. 50% of the group were taught to nasal breathe even during exercise, the other 50% did not. The nasal breathing group had an average breathing rate of 39 breaths per minute compared to the other groups 49 breaths per minute. They were able to complete the same amount of exercise and intensity with 22% less breathing ventilation.
STRESS MANAGEMENT & MENTAL HEALTH
When the World Health Organization call stress “The health epidemic of the 21st Century” and it costs USA businesses around $300 billion per year, you know things need to change! Certainly, more things need to change than the way we breathe, but let’s look at how it can help.
Breathing through the mouth initiates our fight or flight response. The shallow and fast breathing that we perform when mouth breathing is what triggers this response. This in turn triggers the release of cortisol, also known as the stress hormone. If we are at work or training and already stressed and releasing cortisol, what do we think is going to happen to our stress levels when we increase that even further just by the way we breathe?
Breathing slow and deep through the nose and initiating the diaphragm can help to calm the mind and reduce the release of cortisol. In turn helping to reduce stress levels and improve sleep performance. If you have read and watched our previous posts, you know how highly we value sleep in health and stress management.
You may think that it’s too late for you to change as you have been breathing the way you have for 30,40 or 50 years. But changing your breathing habits NOW can have a huge impact on how you manage stress. People aged 40+ are most likely to breathe through their mouth whilst sleeping, which reduces oxygen uptake in the time that it’s most important to help recover. If you wake up regularly with a dry mouth, chances are it is because you are mouth breathing all night, which dries your mouth up. There are techniques that can be done to decongest the nose and reduce mouth breathing at night, which we will go on to later. And if you get used to just nasal breathing in the day, you will have a better chance of not doing it in your sleep.
IMMUNE SYSTEM & CORONAVIRUS – WHAT THE EXPERTS SAY
On this topic of breathing techniques, the most renowned in the field that you may have heard of is Wim Hof. He is known as the Iceman for various feats in freezing conditions, such as the world record for distance swimming under ice.
Despite Wim Hof’s achievements and best-selling books, I have recently favoured another leader in the field in Patrick McKeown. I was made aware of him by a friend a while back and have been reading his work ever since. Both have similar breath holding techniques, but I have found Patrick McKeown’s methods to be a little more practical and evidence based. The main difference being that McKeown appreciates the positive role carbon dioxide has to play in breathing performance, as it is the main stimulus for our breathing, not oxygen.
Patrick McKeown recently put his perspective on the role breathing has to play on our immune system and fighting viruses.
Firstly, the facts we all know about nasal breathing;
- The nose is the first line of defence against airborne viruses
- It acts as a filtration device for air entering the body
- Regulates air temperature coming into the body
The biggest effect nasal breathing can have on our immune system is based around its ability to generate nitric oxide, however. Nitric oxide produced in the nasal cavity is carried into the lungs, it helps to open up your airways and redistributes blood around the lungs. Nitric oxide is important for our immune system because it sterilises the air coming into the body, which could help with fighting viruses being inhaled. If we do not breathe through our nose, the nitric oxide in the nasal cavity goes unused, and therefore the first line of our bodies defence against the virus is breached without even a fight.
As stated previously, it is too early for any research to be done on Coronavirus and nasal breathing, but a 2013 study on influenza stated that nitric oxide production through nasal breathing had been proven to prevent influenza viruses. Another study in 2005 was published just after the SARS outbreak, and found that Nitric oxide had a key role to play in stopping the virus being spread when the body first comes into contact with the virus.
Therefore, we cannot conclude that nasal breathing can have the same positive effect on Coronavirus, but if Influenza and another similar virus that affects the respiratory system can be inhibited by it, then we should be taking notice at the very least.
Breathing techniques and exercises are a great way to improve the quality of your breathing, and also get used to breathing through your nose solely.
Mentally they are a great way to unwind, also. If like me you struggle to switch your brain off enough to meditate, then breathing techniques are the next best thing. In fact, they are a form of meditation, as they take your mind away from all the days stressors and get you thinking in the present, concentrating on breathing and only breathing.
Measurement – Bolt Score:
First of all, let’s go with a measurement technique called the Bolt score. It measures breathing volume and breathlessness. This works slightly differently to other tests, where you hold your breath AFTER you breathe out. This is to test your tolerance to carbon dioxide, as I said earlier this is the main driver behind our breathing. The longer you can hold your breath in this test, the more tolerant you are to carbon dioxide and the less air your lungs will need to breathe in.
The International Journal of Sports Physical Therapy found that if you can hold your breath in this test for 25 seconds or higher, there is an 89% chance that dysfunctional breathing is not present.
Below is a link to an instructional video to perform the test:
You have probably heard me talk about this one quite a lot. Take a second to watch your body as you breathe. Is it your chest that’s moving the most or is it your stomach/trunk?
Your diaphragm is a thin muscle at the bottom of your lungs and top of your abdomen. Using our diaphragm to breathe allows a greater capacity for the lungs and creates intra-abdominal pressure, which is essentially what is required for us to brace our core. That’s why it transpires over to our training too as bracing of the core is key to our strength in so many ways.
It is also a great stress reliever too. If you take 10 minutes out of your day to practice this, it can be a really positive way to reduce stress. It is as close as I can get to meditation, it clears the head and has been shown to lower our stress hormone levels (cortisol).
Below is a very simple illustration of how to start practicing diaphragmatic breathing, although it takes some time to get used to. We will do our own video on this soon to give you a better idea, but take a look at this one for now. The only thing I would change from the video is to make sure you breathe through your nose in both inhalation and exhalation.
Some of you may be thinking that this is all well and good but you often have a blocked up or congested nose. Me too!
Here is a great little tool to decongest the nose, and only takes a few minutes.
This is potentially the most powerful for our fitness and performance and fighting off any long-term respiratory problems.
Hypercapnic-hypoxic training is where we reduce the amount of oxygen in our body and increase the amount of carbon dioxide. We do this by taking a deep breath in followed by a deep breath out. At the very end of our deep breath out, we hold our breath until we feel starved of breath and go back to normal breathing.
This can help to increase our tolerance of carbon dioxide in the body and lower the breathing volume required when we are low on oxygen. Perform this process, then calm your breathing down after and try it again when your breathing is back to normal. Repeat this 5 times, and add on 1 more round after a few days.
This has been shown to increase our Haemoglobin by 5% and increase our capacity to take in oxygen.
I hope you read this with an open mind, and found it useful. If you would like to know more on any of the techniques, or you want the references to any papers I have mentioned then let me know. I don’t like to bombard you with references in a blog like this!