Breathwork & Breathing Re-training
A Clinical Approach to Breathing Pattern Disorders
At The Health Equation, we assess and help retrain inefficient or dysfunctional breathing patterns that may contribute to breathlessness, frequent sighing, dizziness, anxiety, fatigue, disturbed sleep, reduced exercise tolerance, headache and persistent pain.
Led by Gerry Gajadharsingh DO, Osteopath and Diagnostic Consultant in Integrated Medicine, our approach combines detailed clinical assessment with capnometry, heart rate variability (HRV), personalised breathing exercises and, where appropriate, osteopathic treatment. The aim is to help patients develop quieter, more efficient and better-regulated breathing that supports respiratory function and wider health.
Who May Benefit from Breathing Assessment and Re-training?
Breathing pattern disorders can present in many different ways and do not always feel like an obvious breathing problem. Assessment may be helpful for people experiencing:
- Unexplained breathlessness or a feeling of not being able to take a satisfying breath
- Frequent sighing, yawning or breath-holding
- Rapid, shallow or predominantly upper-chest breathing
- Dizziness, tingling, chest tightness or feelings of panic
- Headache, migraine, brain fog or poor concentration
- Neck, shoulder, jaw or upper-chest tension
- Persistent pain, fatigue or disturbed sleep
- Reduced exercise tolerance or unusually slow recovery
- Symptoms aggravated by stress, illness or prolonged talking
- Asthma or other respiratory symptoms that remain troublesome despite appropriate medical treatment
When symptoms are persistent, complex or unexplained, we usually begin with a Diagnostic Consultation to consider the breathing pattern within the patient’s wider clinical history and regulatory health.
Why Do Breathing Patterns Matter?
Breathing is regulated automatically, but it is also influenced by posture, movement, pain, stress, illness, learned behaviour and emotional state. Over time, breathing may become faster, deeper or more effortful than the body requires.
Persistent over-breathing can reduce carbon dioxide levels—a condition known as hypocapnia. Carbon dioxide is not simply a waste gas; it plays an important role in blood pH, circulation, nervous-system regulation and the release of oxygen from haemoglobin to the tissues. When levels fall, susceptible people may experience breathlessness, dizziness, tingling, chest tightness, palpitations, headache, muscular tension, anxiety or difficulty concentrating.
A breathing pattern disorder may therefore affect more than respiratory function. Through the Integrated Regulatory Systems Framework (IRSF), we consider how breathing interacts with the neural, circulatory, endocrine, immune and inflammatory, metabolic and musculoskeletal systems.
Why Do Breathing Patterns Matter?
Breathing is regulated automatically, but it is also influenced by posture, movement, pain, stress, illness, learned behaviour and emotional state. Over time, breathing may become faster, deeper or more effortful than the body requires.
Persistent over-breathing can reduce carbon dioxide levels—a condition known as hypocapnia. Carbon dioxide is not simply a waste gas; it plays an important role in blood pH, circulation, nervous-system regulation and the release of oxygen from haemoglobin to the tissues. When levels fall, susceptible people may experience breathlessness, dizziness, tingling, chest tightness, palpitations, headache, muscular tension, anxiety or difficulty concentrating.
A breathing pattern disorder may therefore affect more than respiratory function. Through the Integrated Regulatory Systems Framework (IRSF), we consider how breathing interacts with the neural, circulatory, endocrine, immune and inflammatory, metabolic and musculoskeletal systems.
Breathing Re-training Within Wider Clinical Care
Breathing assessment and re-training may form part of the management of:
- Breathing pattern disorder and dysfunctional breathing
- Hyperventilation syndrome and hypocapnia
- Anxiety-associated breathlessness and panic symptoms
- Asthma and other respiratory conditions, alongside appropriate medical care
- Headache and migraine
- Persistent neck, shoulder, jaw or thoracic tension
- Chronic pain and central sensitisation
- Fatigue, poor sleep and reduced concentration
- Functional neurological and other persistent physical symptoms
- Voice, speech and upper-airway problems
- Reduced exercise tolerance, sports performance or recovery
Breathing dysfunction is not assumed to be the cause of every symptom. The purpose of assessment is to establish whether it is clinically relevant, how it interacts with other regulatory systems and whether targeted re-training is likely to be helpful.
Download Our Breathing Brochure
For a concise explanation of breathing pattern disorders, capnometry, HRV and the breathing re-training approach used at The Health Equation, download our patient information brochure.
Click the image above to open or download the brochure.
Video Conversations About Breathing
Award-winning saxophonist Amy Dickson speaks with Gerry Gajadharsingh DO in a series of short videos exploring breathing physiology, habitual breathing behaviour and the potential benefits of developing a quieter, more efficient and better-regulated breathing pattern.
These conversations consider the relationship between breathing, performance, stress, emotional regulation and wider physical health.
How Our Breathing Re-training Programme Works
1. Assess
Assessment is tailored to the individual and may include:
- Clinical history and symptom review
- Observation of breathing rate, rhythm and pattern
- Assessment of nasal, diaphragmatic and upper-chest breathing
- Capnometry to measure end-tidal carbon dioxide (ETCOâ‚‚)
- Heart rate variability (HRV) to explore cardiorespiratory and neural regulation
- Assessment of the neck, thorax, rib cage and diaphragm
- Consideration of sleep, posture, pain, stress, exercise and other contributing factors
2. Re-train
The programme may include:
- Quieter, slower nasal breathing
- Improved diaphragmatic and lower-rib movement
- Individually selected breathing cadence and pauses
- Capnometry biofeedback to help patients see their breathing changes in real time
- Osteopathic treatment where musculoskeletal or fascial restriction affects breathing
- Simple exercises that can be incorporated into everyday life
- Strategies for breathing during speech, exercise, stress and sleep
3. Review and Maintain
Progress may be reviewed through symptoms, breathing behaviour and repeat capnometry or HRV measurements. The aim is not simply to perform breathing exercises for a few minutes each day, but to establish a more efficient breathing pattern that becomes increasingly natural and sustainable.
What to Expect at Your First Consultation
New patients usually begin with a 60-minute Diagnostic Consultation. This provides sufficient time to understand the symptoms, consider relevant medical investigations and assess whether dysfunctional breathing is a primary problem or one component of a more complex clinical presentation.
The consultation may include:
- A detailed clinical history and screening for relevant medical concerns
- Observation and assessment of breathing behaviour and mechanics
- Capnometry and HRV assessment where clinically appropriate
- Examination of the neck, thorax, rib cage, diaphragm and related musculoskeletal function
- A clear explanation of the findings and their possible clinical significance
- A personalised management and breathing re-training plan
The consultation includes a comprehensive written report. Depending on the complexity of the assessment, there may or may not be time to begin treatment during the initial appointment.
Breathing, Emotion and Physical Regulation
Breathing and emotion influence one another. Stress, fear, pain and emotional pressure can alter breathing rate, depth and rhythm; equally, an inefficient breathing pattern may reinforce physiological arousal and feelings of unease.
This two-way relationship helps explain why breathing has an important role in practices such as meditation, yoga, Tai Chi, Qigong and Pilates. However, no single breathing technique is appropriate for everyone. The most useful approach is based on the individual’s symptoms, physiology, medical background and measured breathing behaviour.
For some patients, breathing dysfunction is the principal problem. For others, it is one contributing factor within a more complex interaction involving pain, sleep, stress, respiratory health, musculoskeletal function and neural regulation.
Book a Breathing Assessment
New patients begin with a 60-minute Diagnostic Consultation with Gerry Gajadharsingh DO. This is particularly important because many patients have persistent or complex symptoms and may already have consulted several healthcare professionals.
The consultation is available at The Health Equation clinics in Harley Street, London, and Alton Barnes, near Marlborough in Wiltshire. It includes a detailed assessment, an explanation of the findings and a comprehensive written report.
Further Reading
For a more detailed discussion of breathing mechanics, physiology and clinical breathing re-training, you can read Gerry’s article originally published in CAM Magazine.
Professional and Patient Perspectives
Gerry’s up to date knowledge of Breathing Mechanics and physiology combined with Osteopathy, make a potent and immediately effective intervention in breathing disorders and stress management. Highly informative and recommended.
I have seen Gerry regularly and continue to be impressed with his ability to evaluate and respond to symptoms in a holistic manner, treating the person not the symptoms. I never hesitate to recommend him to others with similar complaints, whose feedback suggests their experiences have been at least as positive as my own.
I first came across his work as an Advanced Breath Practitioner over three years ago and to this day I still quote his lecture and the revelation of the therapeutic benefits of a good and coordinated breath.
It certainly changed my scope of practice.
Take the Next Step
If breathlessness, frequent sighing, upper-chest breathing, fatigue, anxiety, persistent pain or reduced exercise tolerance may be associated with an inefficient breathing pattern, a structured clinical assessment can help establish whether breathing re-training is appropriate.
The aim is not to impose a standard breathing technique, but to understand your individual breathing physiology and develop a practical, personalised approach that can be incorporated into everyday life.