FUNCTIONAL BREATHING - HIGHLIGHTS FROM THE BREAK TO BREATHE ONLINE WORKSHOP MAy 2020
COULD YOUR BREATHING BE CONTRIBUTING TO ILL-HEALTH?
Even in the 1800s, physicians observed a frequency of symptoms that were unrelated to the established criteria of signs and symptoms in documented conditions, particularly cardiovascular-related diseases. Up to the end of World War 1, many of these studies involved observing thousands of hospitalised soldiers. The men appeared fit, well, with no heart murmurs. At the time, doctors attributed these symptoms to the stress of military campaigns and the "great and prolonged exertion with the most unfavourable conditions, possible-privation of rest, deficient food, bad water, and malaria.“
The symptoms included (in order of frequency):
breathlessness, palpitation, fatigue, sweats, nervousness, dizziness, left chest pain,
inability to hold their breath for 30 seconds or more,
sweaty palms, and a nervous demeanor.
More studies showed the same symptom picture and so a variety of names began to rise for the same symptom presentation - "cardiac neurosis," "disordered action of the heart," ‘muscular and nervous exhaustion’, "soldier's heart," "effort syndrome," or "neurocirculatory asthenia“.
While one could rationalise the soldiers symptoms were a consequence of the “unfavourable conditions” they spent months and years in, the turning point was the publication of scientific papers in 1920 and 1934 that gave emphasis to how common such symptoms were present in civilian practice. Most patients were women, their symptoms were typical, and there was no evidence of organic heart disease.
Further, in 1937, and doctor by the name of Dr Kerr documented a psychosomatic response which he explained as follows:
“An individual has a difficulty to meet. The reaction, psychologically, may be one of two types: the individual may face his problem squarely and find a solution; or he may attempt to ignore the difficulty and to deny its existence. Regardless of any attempt on the part of the patient to deny the existence of his difficulty, nevertheless it still exists. In our opinion, it is the suppressed emotion associated with the difficulty that directly stimulates the autonomic nervous system. The sympathetic nervous mechanism is aroused, and the most outstanding reaction is a stimulation of secretion by the adrenals. The cerebral cortical centres are stimulated directly, and also by over secretion of adrenaline. Adrenaline irritates also the cardiac and respiratory centres, causing at first a slow heart rate with a large stroke-volume output, and later a rapid heart rate. There is speeding up of the respiratory rate and increase in ventilation. With the increase in ventilation the carbon dioxide in the alveolar spaces is expelled, and more is shifted from the blood stream and tissues into the alveolar spaces.”
Dr Konstantin Buteyko, Russian trained doctor, on observing the breathing of terminally ill patients, undertook a practical assignment during his medical training in the late 1940’s involving the monitoring of breathing volume of patients. He documented a stark relationship: the sicker patients became, the heavier they breathed. This was further confirmed by Dr Lum in 1977 who observed that such symptoms were largely or entirely related to over breathing.
Stress & Breathing
We know under stress that we breathe:
faster
we sigh more (and sighing is an irregular breathing pattern)
we mouth breathe more, promoting tightness of the throat, and breathing is heavy and laboured in the chest.
our breathing is noticeable
we tend towards upper chest breathing, in turn making us use more of our upper chest muscles, contributing to neck and shoulder pain
we don’t get near enough oxygen to our tissues and organs, so our muscles tighten promoting back pain, upset tummy (or that knot feeling in the stomach), and possibly headaches
also, faster breathing results in what we refer to as over breathing, where we breathe beyond the metabolic needs of our body. This agitates the mind affecting our focus, mood, sleep, emotions, resilience, and appetite
The stress response is useful in acute situations because it is so effective at helping us get out of danger and to safety quickly. However, habitual stress and therefore repeated activation of the Sympathetic Nervous System (SNS) ‘stress’ response, also known as our fight or flight response, resets our breathing centre (in our brain). As a consequence, when the danger has passed or even when we may not feel stressed, our breathing reflects the traits listed above (i.e. sighing, effortful, upper chest breathing, mouth breathing). This pattern results in more carbon dioxide (CO2) being breathed out. When the partial pressure of CO2 in the lungs is lower than normal, this cascades into our blood, tissues, and cells also having reduced CO2 levels. Over time, the brain recognises the lower partial pressure and resets the respiratory centre. That’s why, even if the initial stressor is removed, the dysfunctional breathing habit continues as a result of particular receptors called chemoreceptors having been reset. Long-term, this continual stress places a demanding load on the cardiovascular system, and vessels harden and constrict. Constricted blood vessels have a harder time releasing O2 from red blood cells to tissues and organs, including the heart and brain.
a cyclical pattern: could it be turning TIGHTER AND FASTER?
Unfortunately, a cyclical pattern begins to establish: we are faced with a difficulty to meet, a stressor or provocation; we have an emotional disturbance in response to this stressor; this signals our SNS to activate, in turn signalling the adrenal glands to produce adrenaline, and oversecrete adrenaline; one of adrenaline’s roles is to alert the cardiovascular and respiratory centres of the brain to the perceived danger at hand, stimulating the activity of the heart and lungs; we consequently breath faster and harder and experience symptoms like breathlessness, fatigue, anxiousness, sweats, dizziness, and chest pain. The symptoms are intense and can themselves be the provocation that sets the cycle in motion again. Without opportunity to exit the cycle to ‘rest and digest’, stressors that once had little or no impact upon an individual, now exacerbate, intensify or prolong the emotional disturbance and activity of the adrenals, thereby continually irritating the cardiac and respiratory centres to promote a faster and harder breathing pattern that subsequently initiates symptoms more rapidly, more severely and over a longer duration.
What causes dysfunctional breathing?
Stress is the leading factor in establishing a habit of dysfunctional breathing, however, there are a number of factors that can contribute, including:
Sedentary lifestyle - moving muscles generate greater amounts of CO2. A lack of exercise results in a lower production of CO2, and therefore larger breathing volume
Diet comprising processed foods and overeating - Western diets are typically 95% acidic and 5% alkaline. Acidic foods like dairy, meat, bread, sugar, coffees and teas are mucus forming and acidify the blood. The body, in an attempt to maintain a neutral pH will stimulate breathing to remove CO2 (CO2 is acidic)
Jobs/tasks involving speaking a lot - large breaths of air are commonly inhaled between sentences
Mixed messages regarding breathing techniques and how/when to apply them
Symptoms related to asthma and other chronic respiratory conditions
High set temperatures within the home and indoor environments - we are less able to regulate body temperature through the skin and this promotes heavy breathing
Genetic predisposition/familial habits
What does functional breathing look like compared to dysfunctional breathing?
Dysfunctional breathing does not have a universally agreed upon definition. It can be described as any disturbance to breathing, including over breathing or hyperventilation, unexplained breathlessness, irregular breathing and breathing pattern disorders (sleep apnoea, breathing distress/dyspnoea).
When we compare dysfunctional breathing to functional breathing, the traits are polar opposites:
TRAITS OF DYSFUNCTIONAL BREATHING
Mouth open
Mouth breathing
Noisy
Regular sighing
Regular sniffing
Irregular, erratic, fast
Holding of breath (apnoea)
Taking large breaths prior to talking
Yawning with big breaths
Upper chest movement
Obvious visible movement
Effortful
Heavy – day and night
TRAITS OF FUNCTIONAL BREATHING
Mouth closed
Nasal breathing
Silent, quiet
Slow
Regular cadence
Calm and calming
Controlled with ability to keep under control
A natural pause between inhalation and exhalation
Adequately deep to naturally expand lowest ribs
Unnoticeable or minimal movement
Effortless
Light
“It has been estimated that three-quarters of the bacteria entering the nose are deposited on the mucus blanket and are thus eliminated. In fact, the mucus has its own antibacterial action.”
(Ballentine 1979; Holmes 1950 cited in The Hyperventilation Syndrome by Robert Fried).
What effect does functional breathing have compared to dysfunctional breathing?
Again, when we compare the effects of functional breathing to dysfunctional breathing, the contrast in negative and positive health benefits is stark. These include:
EFFECTS OF FUNCTIONAL BREATHING
Warming, moistening of airways
Protective - antiviral and antibacterial
Filtering
Regulates air volume
Dilates airways (increased production of nasal nitric oxide)
Greater gas exchange in lungs
Increased oxygen uptake
Parasympathetic nervous system (rest and digest) dominant
Encourages normal jaw development and correct tongue posture
Supports healthy saliva production, protecting oral cavity, teeth and gums
Improved symptoms related to fatigue, asthma, and chronic illnesses
Overall improvement in vitality – better sleep, better energy, better focus, resilience
EFFECTS OF DYSFUNCTIONAL BREATHING
Cooling, drying of airways
Risk of infection - 42% more moisture expelled via droplets through the mouth
Congesting, leading to nasal stuffiness
Irregular - tends towards over breathing and hyperventilation
Constricts/narrows airways
Suffocation sensation (continual air hunger)
Reduces oxygen delivery at the cell
Sympathetic nervous system (fight or flight) dominant
Underdeveloped jaw, promoting a narrow jaw and airways, over crowding of teeth
Higher risk of gum disease and tooth decay
Contributes and exacerbates symptoms of blocked nose, snoring, insomnia, fatigue, coughing, wheezing, breathlessness, exercise-induced asthma
Chronic hyperventilation - breathing volume is excessive during sleep, rest and physical exercise; encourages excess use of energy contributing to fatigue
Air hunger is the most common driver of mouth breathing.
It is the feeling of suffocation, be this mild or severe, when breathing through the nose.
You just don’t feel like you can get an adequate amount of breath.
Why do I breathe through my mouth?
Air hunger is the most common driver of mouth breathing. It is the feeling of suffocation, be this mild or severe, when breathing through the nose. You just don’t feel like you can get an adequate amount of breath.
This may be due to a few factors:
A small nose
Deviated septum
Allergic rhinitis
Hay fever
‘Stuffy nose’
Habit
If a deviated septum, polyps or other features causing obstruction are present, this does need to be addressed by an ENT or specialist because it is part of the root cause. AND breathing should be considered part of the treatment and therapy moving forward. It is very likely that deviated and blocked nasal structures have driven air hunger and therefore mouth breathing.
Am I a mouth breather? How can I tell?
dry mouth on waking
bad breath
higher risk of gum disease and tooth decay
susceptible to skin conditions i.e. Acne rosacea, psoriasis, eczema
in children - susceptible to crooked teeth, teeth crowding, bed wetting, sleep disturbances and disorders
in adults - grinders, sleep apnoea, snorers, stress, chronic fatigue
sleepiness, and a tendency to yawn more
age
changes in mood and mood swings
cold hands and feet
decreased focus/concentration
reduced physical performance
forward head posture (compensatory mechanism) in order to improve respiratory muscle function
breathing exercises are not so much about optimising breathing but rather normalising breathing in order to optimise health
How do I start to nasal breathe?
The Buteyko Breathing method and other breathing modalities or exercises are not so much about optimising breathing but rather normalising breathing in order to optimise health. For anything to become normal or second nature, regular repeated practice is essential.
The process is not fast – this is slow medicine.
Research assessing new habit formation has shown that it takes 66 days on average to build lasting habits. Neuroscientist Dr Caroline Leaf agrees that new life-long habits are developed over a 63-day period; 63 days is 3 x 3 weeks. A similar length of time, being 60-70 days, has been identified in research surrounding retraining the breathing centre in your brain to form the lasting habit of functional breathing.
Nasal breathing is a calmer breathing pattern, yet you may find it intense to begin with. With practice, it will improve and you’ll soon wonder how you ever coped with mouth breathing.
Start with the steps outlined in the pyramid below, beginning with a strong and holistic foundation of instilling healthful practices into your day and that resonate with your values. Think ‘whole health for whole body’ through adequate sleep and rest, regular physical activity, predominantly whole food dietary pattern, connecting meaningfully with self and others and practicing mindful breathing. Symptoms triggers are equally as important to identity and limit or avoidance as much as is possible. Rate your symptoms - it’s important to see where you’ve come from, and where you’re headed, and self-reported ratings are one of the quickest ways to effect change, motivate focused consistent effort, and monitor progress. At first you may find you need to carve out specific times in your day to practice your new breathing exercises, or use specific circumstances as a trigger to commence the exercises. For instance, on waking or going to bed, when driving in your car, while eating a meal, when emotions feel heightened. Then try to catch yourself at other more random parts of your day where you can remind yourself to nasal breathe or practice a specific exercise like box breathing or diaphragmatic breathing.
Begin the change to functional breathing with a good foundation
Photo by Esther Driehaus on Unsplash
Breath: The power of breathing; life; Life Force.
While an underrated topic, breathing is our life force.
Give it the space and place it deserves in your life - in this moment now, for your health, and for your future.
that breath you just took … that’s a gift.
Rob Bell
references
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Da Costa, J. (1871). On Irritable Heart: A Clinical Study of a Form of Functional Cardiac Disorder and its Consequences. The American Journal Of The Medical Sciences, 61(121), 17-52. https://doi.org/10.1097/00000441-187101000-00001
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