Breathing Techniques for Greater Health and Fitness

By Dr. Mercola

Two years ago, I interviewed Patrick McKeown about the benefits of the Buteyko Breathing Method — a powerful approach for reversing many health problems associated with improper breathing.
Two of the most common problems are overbreathing (hyperventilating) and mouth breathing, both of which have adverse health ramifications, and can have particularly harmful consequences if done during exercise.
Patrick has now released a brand new book, The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You, which reviews the transformative power of correct breathing.
Because I believe so much in this work, I wrote the foreword to Patrick's book, and he allowed me to show you his DVD that he normally sells as part of his instructional DVD package.

Yes, There's a 'Right' and a 'Wrong' Way to Breathe...

While it may seem you certainly know how to breathe, considering you'd be dead if you stopped for more than a few minutes, most of us actually breathe in such a way as to put our health in jeopardy.^1,2,3
In fact, the whole field of breathing and breath-work has enormous potential for improvement, as most prevailing ideas about breathing promoted in yoga, Pilates, and meditative methods tend to focus on taking big, deep breaths — which is actually the opposite of what you should do.
The featured video is part of Patrick's online training course for Buteyko practitioners, which examines dysfunctional breathing patterns associated with asthma, rhinitis, and sleep disorders such as sleep apnea, and details the scientific rationale for improving your breathing habits.
His DVD set goes into other areas of health that may be affected by improper breathing, and from my point of view, learning to breathe properly is a really core facet of health, so this course may pay dividends in any number of ways.
For example, in this lecture you will learn that excessive breathing decreases hydrogen ion concentration in your blood, and in the last few years, a number of studies have emerged showing the value and importance of hydrogen ions in biological health.
This is really some of the most amazing new health information I have encountered in some time, and it offers robust scientific support for what Patrick is teaching. I will review these very exciting studies on hydrogen in future articles that relate to many of its exciting health implications.

Chronic Hyperventilation Syndrome

Chronic hyperventilation syndrome was initially documented during the American Civil War, at which time it was termed "irritable heart." The term "hyperventilation syndrome" was coined in 1937 by Dr. Kerr and colleagues.
The following year, another group of researchers discovered you could reproduce the symptoms of this syndrome simply by taking 20 or 30 big breaths through your mouth within a span of one or two minutes.
As noted by Patrick, once the habit of overbreathing is set in place, it tends to become and remain chronic, and to recover you typically need to use some sort of relearning technique, such as the one devised by Russian doctor Konstantin Buteyko (described at the end of the article).
In 1957, Dr. Buteyko came up with the term "disease of deep breathing," having researched the health effects of excessive breathing for over a decade.
While still in medical training, one of his assignments included monitoring patients' breathing volume. And he noticed something of interest. The sicker the patient got, the heavier they breathed.
Later, he also discovered he could lower his blood pressure simply by bringing his breathing toward normal, and in this way successfully "cured" his own hypertension.

Traits and Effects of Hyperventilation Syndrome

So what exactly is hyperventilation, or "overbreathing?" According to Patrick, hyperventilation is defined as "breathing in excess of metabolic requirements of the body at that time." Traits of dysfunctional breathing include:

Mouth breathing	Upper chest breathing, with lots of visible movement with each breath
Frequent sighing	Noticeable or audible breathing during rest
Taking large breaths prior to talking	Erratic breathing
Regular sniffing	Yawning with big breaths
Chronic rhinitis (nasal congestion and runny nose)	Sleep apnea4,5,6,7

The repercussions of chronic overbreathing include cardiovascular, neurological, respiratory, muscular, gastrointestinal, and psychological effects, such as:

Heart palpitations	Missed heart beats	Tachycardia	Sharp or atypical chest pain
Angina	Cold hands and feet	Raynaud's	Headache
Capillary vasoconstriction	Dizziness	Feeling faint	Paresthesias (numbness, tingling, and pins and needles)
Shortness of breath, or chest tightness	Irritable cough	Muscle cramps, pain, and stiffness	Anxiety, panic, and phobias
Allergies	Difficulty swallowing; globus (lump in the throat)	Acid reflux, heartburn	Gas, belching, bloating, and abdominal discomfort
Weakness; exhaustion	Impaired concentration and memory	Disturbed sleep, including nightmares	Emotional sweating

What Is Normal Breathing, and What Causes Dysfunctional Breathing?

Normal breathing volume is approximately four to six liters of air per minute during rest, equating to 10 to 12 breaths per minute. But rather than focusing on the number of breaths, Patrick teaches to breathe softly and calmly and has the saying "breathe light to breathe right."
Meanwhile, breathing volume for people with asthma tends to be around 13 to 15 liters per minute, and those with sleep apnea breathe on average 10 to 15 liters per minute.
In short, asthmatics and those with sleep apnea breathe far too much — upwards of three times more than normal — and this dysfunctional breathing pattern is part of their disease profile.

So what causes this dysfunctional breathing in the first place? According to Patrick, most dysfunctional breathing patterns are rooted in the modern lifestyle. Factors include:

Processed food (which are acid forming)	Overeating	Excessive talking
Stress	Believing it's good to take big, deep breaths	Lack of exercise
Asthma	Genetic predisposition or familial habits	High temperature indoors

Breathing for Stress Relief

Of these, stress plays an enormous role, if only for the fact that most of us experience a great deal of it these days. Unfortunately, conventional advice to "breathe deep" to release tension only worsens the situation. According to Patrick, one of the most effective ways to address stress is to slow down your breathing.
Stress makes you breathe faster and promotes sighing, so to counteract or release stress, you need to do the opposite — breathe slower, softer, and make your breathing more regular. Ideally, your breathing should be so light, soft, and gentle "that the fine hairs within the nostrils remain motionless."
Importantly, make sure to breathe through your nose, not your mouth. According to the late Dr. Maurice Cottle, who founded the American Rhinologic Society in 1954, your nose performs at least 30 functions, all of which are important supplements to the roles played by the lungs, heart, and other organs.⁸
Part of the benefits of nose breathing is related to the fact that there is nitric oxide in your nose, and when you breathe gently and slowly through your nose, you carry a small amount of this beneficial gas into your lungs.
Nitric oxide not only helps maintain homeostasis, or balance, within your body, it's also helps to open your airways (bronchodilation), open your blood vessels (vasodilation), and has antibacterial properties that helps neutralize germs and bacteria.

Nose breathing also helps normalize your breathing volume. This is important because when you chronically overbreathe, the heavier breathing volume that's coming into your lungs can cause a disturbance of blood gasses, including the loss of carbon dioxide (CO2).

How Your Body Regulates Breathing

As noted in the featured lecture, your breath is primarily regulated by brain receptors that monitor the concentration of carbon dioxide and pH level (and to a lesser extent the level of oxygen) in your blood.
Typically, we believe the reason we feel the need to breathe is because our body needs oxygen, but the stimulus to breathe is actually to get rid of excess carbon dioxide. However, carbon dioxide is not just a waste gas. It performs a number of important functions in your body. Your body does need a certain amount of carbon dioxide at all times, and one of the side effects of overbreathing is removing too much carbon dioxide.
 As carbon dioxide levels lower, so too does hydrogen ion leading to an excess of bicarbonate ions and a deficiency in hydrogen ions, which shifts the pH of your blood toward alkaline.
Now, if your breathing exceeds what your body requires over a period of time, even as short as 24 hours, your body becomes conditioned to increase its breathing volume. This is one of the ways stress ends up having a chronic impact on your biology.
Moreover, if you're chronically overbreathing, it doesn't take much to push your body over the proverbial edge — even a minor emotional stressor can now provoke symptoms, be it a panic attack or heart-related problem, as overbreathing produces constriction of your arteries, thereby reducing blood flow to both brain and heart (as well as the rest of your body).
But the issue that triggered the attack was not the stressor itself, the main issue was the fact that you're chronically breathing too much. One traditional  remedy for a panic attack was to breathe four or five breaths into a paper bag to increase carbon dioxide levels, allowing better blood flow to your brain. A more permanent solution is to address the way you breathe every day.

Hyperventilating Reduces Oxygen Delivery

Overbreathing not only reduces carbon dioxide, it also reduces the delivery of oxygen to the tissues and organs in your body — essentially the opposite of what people normally think happens when you breathe heavily. This is part and parcel why hyperventilating through your mouth during exercise is ill advised. In a nutshell, hyperventilation can cause severe constriction of your carotid arteries, and can reduce the amount of available oxygen to your brain by half.
This is why you may feel light headed when breathing too hard, and this may be one of the mechanisms that can lead to the sudden death of even very fit marathon runners — typically from cardiac arrest. So, during your workout, be sure to breathe through your nose the entire time.
If you start sucking air through your mouth, back off on the intensity so that you can go back to breathing through your nose. In time, you'll be able to exercise at greater intensity and still breathe through your nose, which is a sign that your fitness is improving. Breathing through your nose at all times is also a primary step that will help restore a more normal breathing volume.

The Buteyko Breathing Method

Dr. Buteyko discovered that the level of carbon dioxide in your lungs correlates to your ability to hold your breath after normal exhalation. The Buteyko Method includes a simple self-test for estimating your carbon dioxide levels. You can use a stopwatch or simply count the number of seconds to yourself. Here is the process:

1. Sit straight without crossing your legs and breathe comfortably and steadily.
2. Take a small, silent breath in and out through your nose. After exhaling, pinch your nose to keep air from entering.
3. Start your stopwatch and hold your breath until you feel the first definite desire to breathe.
4. When you feel the first urge to breathe, resume breathing and note the time. The urge to breathe may come in the form of involuntary movements of your breathing muscles, or your tummy may jerk or your throat may contract. This is not a breath holding competition — what you're measuring is how long you can comfortably and naturally hold your breath.
5. Your inhalation should be calm and controlled, through your nose. If you feel like you must take a big breath, then you held your breath too long.

The time you just measured is called the "control pause" or CP, and it reflects the tolerance of your body to carbon dioxide. Short control pause times correlate with low tolerance to CO2 and chronically depleted CO2 levels. Here are the criteria for evaluating your control pause (CP):

• CP 40 to 60 seconds: Indicates a normal, healthy breathing pattern, and excellent physical endurance
• CP 20 to 40 seconds: Indicates mild breathing impairment, moderate tolerance to physical exercise, and potential for health problems in the future (most folks fall into this category)
• CP 10 to 20 seconds: Indicates significant breathing impairment and poor tolerance to physical exercise; nasal breath training and lifestyle modifications are recommended (potential areas are poor diet, overweight, excess stress, excess alcohol, etc.)
• CP under 10 seconds: Serious breathing impairment, very poor exercise tolerance, and chronic health problems; Dr. Buteyko recommends consulting a Buteyko practitioner for assistance

In summary, the shorter your CP, the more easily you'll get breathless during physical exercise. If your CP is less than 20 seconds, NEVER have your mouth open during exercise, as your breathing is too unstable. This is particularly important if you have asthma. The good news is that you will feel better and improve your exercise endurance with each five-second increase in your CP, which you can accomplish by incorporating the following Buteyko breathing exercise.

How to Improve Your Control Pause (CP)

The first step to increase your CP is to learn how to unblock your nose with the following breath hold exercise. While this exercise is a perfectly safe exercise for the vast majority of people, if you have any cardiac problems, high blood pressure, are pregnant, have type 1 diabetes, panic attacks, or any serious health concern, then please do not hold your breath beyond the first urges to breathe. Repeat the following exercise several times in succession, waiting about 30 to 60 seconds in between rounds. And do the exercise on a regular basis.

• Sit up straight.
• Take a small breath in through your nose, and a small breath out.
• Pinch your nose with your fingers and hold your breath. Keep your mouth closed.
• Gently nod your head or sway your body until you feel that you cannot hold your breath any longer. (Hold your nose until you feel a strong desire to breathe.)
• When you need to breathe in, let go of your nose, and breathe gently through it, in and out, with your mouth closed.
• Calm your breathing as soon as possible.

Breathing Correctly Is a Simple and Free Way to Boost Your Health and Fitness

The Buteyko Breathing Method is a powerful and inexpensive tool that can help improve your health, longevity, quality of life, and athletic performance. I strongly recommend integrating it into your lifestyle, and when you're ready, into your exercise. Just remember to progress slowly with exercise and gradually decrease the time that you need to rely on mouth breathing.
To learn more, I highly recommend Patrick's excellent book, The Oxygen Advantage, as well as his DVD set. The book contains both detailed and simplified descriptions of each Buteyko breathing exercise, along with quick reference guides, case studies, and scientific details to help you understand and apply the Oxygen Advantage program to improve your health and fitness. You can also find more information on his website, OxygenAdvantage.com.