The wellness brigade believe how you breathe affects your mental and physical health. Scientists think it can improve your memory as well.

Harry Wallop

The Times

Gerry Gajadharsingh writes:

 “It’s great that breathing “properly” is becoming more main stream and I agree with the general thrust of the article below. But I wish people knew more about the science of breathing instead of propagating pseudoscience!

 Having assessed more than 3,000 patients clinically and taught many clinicians to use capnography and Heart Rate Variability so that they can help their patients, please indulge me for a moment.

 Its correct that many people mouth breathe and it is better to nose breathe for many reasons. The are some very high-profile sports people who are chronic mouth breathers and it is highly likely that they will run into trouble physically and mentally (if they have not done so already). It’s a pity that their medical teams have not flagged this up to them.

 The main source of Nitric Oxide in the body is in the paranasal sinuses, as the article points out Nitric Oxide is a potent vasodilator and therefore its useful to increase this for various reasons. Nose breathing stimulates its release it does not produce it as suggested in the article.

 CO2 is different, it’s a waste product of cellular metabolism but paradoxically we need to retain adequate levels of CO2 to allow oxygen (which we breath in from the air), to move into cells, this is the Bohr effect, in essence an exchange mechanism moving one gas from a higher to a lower concentration. Usually O2 into cells and Co2 out of cells. Many people when assessed by capnometry have low CO2, therefore compromise their ability to deliver O2 on a cellular level. The Bohr effect refers to the shift in the oxygen dissociation curve caused by changes in the concentration of carbon dioxide or the pH of the environment. Since carbon dioxide reacts with water to form carbonic acid an increase in CO2 results in a decrease in blood pH, resulting in haemoglobin proteins releasing their load of oxygen. Conversely, a decrease in carbon dioxide provokes an increase in pH, which results in haemoglobin picking up more oxygen. It is not to do with sticky haemoglobin as suggested in the article.

 The article says that Breathing less, ironically, is a more efficient way of raising oxygen levels in your body, the method claims. Its more than a claim its accepted physiology.

 The article describes “cardiac coherence”, recently cited in Scientific America. It is essentially Heart Rate Variability, specifically Breathing Heart Wave. It is true that Pranayama breathing somehow “discovered” over 2,000 years ago that, a shorter inbreathe and a longer out breathe is good for health. We now know that it does this by affecting the autonomic nervous system, which controls many of the major systems and organs of the body. Breathing in stimulates your stress (sympathetic) nervous system and your heart rate goes up, breathing out is a parasympathetic (relaxation) nervous system response, so your heart rate goes down. This variance is called Breathing Heart Wave (cardiac coherence) and is a type of Heart Rate Variability and we can measure it by various devices.

 I think one of the article contributors are getting confused when they are suggesting that “breathing coherence” is what we are after. This does not make physiological sense. The aim should be to shorten the in breath and lengthen the out breathe (bit by bit) which would have far greater effect of downregulating the “stress” systems, such as lowering heart rate and blood pressure.

 I find breathing re-education a prelude to meditation. Many people have busy brains and simply can’t meditate. If we can teach them to alter their breathing patterns’ they find meditation much easier. Doing something routine moves us from our pre-frontal cortex (our thinking brain), to the more relaxed parts of our brain. So, repeating good breathing technique can be beneficial for this simple reason. Never mind the physiological effects of retaining better CO2, increasing O2 delivery on a cellular level, adjusting pH (a far quicker way then changing your diet, although pH is very complicated as it’s a dynamic homeostatic mechanism, between breathing and buffer control via the kidneys) and balancing autonomics.

 By the way I have been developing an App with my friend and colleague Dr Bob Kissner, a clinical psychologist from Vancouver. He and I lecture together on breathing, capnometry and Heart Rate Variability. Watch this space!

 Now that I have got that off my “chest” I’ll go for dinner.”

You might think breathing is as natural as, well, breathing. Most of us are able to complete the school run or pop to Pret for a bang bang chicken salad without giving the oxygen we inhale and the carbon dioxide we exhale a second thought.

“But most of us don’t breathe correctly,” says Jill McGowan. “Most people breathe through their mouths; our mouths were designed for speaking and eating, not breathing. We should breathe through our noses.”

The former midwife is now a breath coach, which sounds as ludicrous as a walking coach. But don’t sneer. Breathing has become big business. There are now thousands of breathing coaches in the UK, and hundreds of apps that promise to “biohack your breathing”. Meanwhile, upmarket gyms and luxury spas are now marketing “clean breathing” alongside their saltwater pools. Practise “correct” breathing and you will have harder abs, lower levels of anxiety and will sleep better, its proponents claim.

It’s not just the wellness industry that has embraced breathing. Scientific researchers have studied the benefits of particular methods and concluded that, if harnessed fully, nasal breathing can improve not only athletic performance, but, surprisingly, your memory too. According to Artin Arshamian, a neuroscientist at the Karolinska Institute in Stockholm, Sweden, inhaling through the nose stimulates neurons in the olfactory bulb, which is connected to the hippocampus, the brain’s memory hub.

Breathing has the ability to stir controversy too. Last month Scientific American, the US’s oldest magazine, which can boast Einstein as a former contributor, published a long article extolling the benefits of “cardiac coherence”, a technique that attempts to co-ordinate your breath with your heartbeat. “Cardiac coherence’s stabilisation of the heartbeat can dampen anxiety powerfully,” the article claimed.

Cue howls of protest on social media, not refuting the science, but furious that its source hadn’t been properly credited. Cardiac coherence, Twitter users pointed out, was a core part of Pranayama yoga, which has been practised for 2,500 years.

Well, yes and no, say breath coaches. “Coherent breathing equalises the inhale and the exhale and you will notice a drop in blood pressure and a drop in heart rate. That’s been around for ages,” says Alan Dolan, a breath coach who runs breathguru.com. However, one aspect of cardiac coherence makes it very much a 21st-century technique. Namely, it uses a “biofeedback device”, a gizmo that can monitor your breath along with your heartbeat, and flash up your performance on a screen.

Most breathing workshops do not use a machine. “I’ve never used appliances like that,” Dolan says, “because when I do my breath work it’s so obvious.” He does, however, have an app called the Breath Guru, which for £3.99 guides people through a daily ten-minute breathing exercise, which you could argue is a form of very basic “biohacking” — although it doesn’t monitor your heart rate.

Dolan admits breath work is a form of meditation. “This is a physical mantra. You are focused on repeating that breathing pattern. I often say breath work is meditation for people who can’t meditate; for those people who say they can’t clear their mind.”

He says that 70 per cent of his clients come to him with anxiety-related problems, depression or insomnia, and breath work is the ideal cure. “The vagus nerve is incredible. It is a cranial nerve which goes right into the stomach. Which is why so many people talk about the stomach being the second brain, because there are so many nerve endings there, and that’s why when we are anxious we get butterflies in our stomach.” By breathing more “consciously” you can learn to control the vagus nerve and reduce stress, he says.

To find out more, I attended a connected breathing class held by Rebecca Dennis. She used to work in advertising, but set up a practice called Breathing Tree a decade ago. “I used to have clinical depression. I was on medication [fluoxetine] for 15 years and every time I tried to come off it, I couldn’t function. I tried to take my life ten years ago and then two months after trying to take my life, I came to a breath workshop. Within a few months I came off my medication and I haven’t taken it for ten years.”

Before I attend she warns me that I should not drink coffee because I don’t want to be “buzzing” and that her workshops can be “very physical, people can get very hot, they can get very cold. Sometimes people are laughing hysterically, sometimes people get very light-headed. It is emotional, it can be spiritual — and has to be held in a safe space.”

The safe space is in a large yoga studio in Marylebone, west London. And there are about forty participants. I am one of only two men. I lie on my yoga mat as Dennis and her team run through various exercises.

After monitoring my breathing, she points out that I am breathing incorrectly. “You are moving your shoulders. Your shoulders are not breathing muscles.” To control the vagus nerve, I need to learn to breathe from the diaphragm. “That’s your breathing muscle.” She adds: “Research shows that the average teenager and adult is only using a third of their respiratory system.”

It is true that the average person, when at rest, fills their lungs — which may have a total capacity of six litres — with only about half a litre of air. But they are not falling down dead in the streets, I suggest. “But they could be coping a lot better,” Dennis says. Her breath exercises partly involve trying to recreate the full breath of a baby (“the perfect breath guru”) and she regularly prods your diaphragm to ensure you are engaging it.

It was certainly very relaxing lying mostly on my back for more than an hour, breathing in and out, and Dolan is right that it is perfect for those who struggle with traditional meditation. Whenever I am told to imagine a happy place I start to wonder what I am going to eat for supper. Trying to breathe in for a certain number of seconds, then hold it, then exhale for a certain amount of seconds, then hold it takes a surprising amount of concentration. And I do feel pleasantly light-headed by the end as a result of my blood pressure dropping.

But since the primary purpose is to connect with your emotions, I am not sure connected breathing is for me. I don’t have anxiety, I already sleep well, I tell Dennis. “I don’t know anyone who doesn’t have some sort of emotional baggage,” she insists.

The Buteyko method, in contrast, promises to be less psychological and more physiological. It is named after a Ukrainian doctor of the 1950s and is eye-catchingly counterintuitive because it involves repeated, shallow, nasal breathing. “You have to breathe less to get more air,” explains Jill McGowan, who says the method — which focuses on nasal breathing — cured her acute asthma. “When I first heard this, I thought, ‘This doesn’t make sense. You are always told to take deep breaths.’ ”

Buteyko posits that most people are hyperventilating without realising, triggering something called the Bohr effect. “With the Bohr effect, molecules of haemoglobin, a protein in your blood cells which carries oxygen, stick together like glue,” explains McGowan. This means that, although you are taking great lungfuls of air, the oxygen is not actually making it into your brain cells or muscle tissues. Breathing less, ironically, is a more efficient way of raising oxygen levels in your body, the method claims.

No large peer-reviewed clinical study has proved the Buteyko method to be a better way of getting oxygen into the cells and tissue of the body, nor that it
is a cure for asthma, but McGowan and other nurses are convinced that it works.

Yet even if the experts can’t agree on the benefits of shallow breathing, they can agree on the benefits of nasal breathing, not least because nasal hairs act as a natural filter for various pollutants. Second, breathing through the nose warms and moisturises the air, which helps to increase blood flow. Third, breathing out through the nose produces nitric oxide, a molecule that is crucial to good health. The nitric oxide combines with the body’s carbon dioxide
to act as a smooth-muscle relaxant. “If you have high blood pressure you take drugs to relax your smooth muscles; if you breathe in and
out through your nose you
produce CO2 and nitric oxide, which brings the blood pressure down,” McGowan says.

Mouth-breathing does not release nearly as much nitric oxide. This
also means that — although it is instinctive to breathe through the mouth during heavy exertion — your recovery times are not nearly as fast. Sanya Richards-Ross, who won gold at the London 2012 Olympics in the 400m, and is a proponent of Buteyko, hardly opens her mouth as she does a full circuit of the track.

If you haven’t got the discipline of an Olympian, resort to a bit of tape, McGowan suggests. “Any time I run now, I run with my mouth taped,” she says. “I even tape it at the gym because there is always the urge to breathe through your mouth.”

This sounds truly bizarre, but mouth-taping is becoming increasingly common and is being promoted by many as a way to improve sleep and stop snoring —
by forcing you to breathe through your nose. You can buy mouth tape on the internet.

I try it, running around my local park. I get very odd looks. It is also incredibly difficult. I gave up after about five minutes, after I thought I was going to choke. One thing is certain: it makes you think about your breathing. And even if you aren’t keen on releasing any emotional baggage, spending ten minutes in the middle of the day focusing on your breathing and lowering your blood pressure is probably no bad thing.