There are believed to be many benefits to slow, controlled breathing. Researchers may have found another – a surprising protection against Alzheimer’s.
Gerry Gajadharsingh writes:
“I am not surprised, but it’s good to see more research backing up sound scientific principles of optimising breathing patterns and heart rate variability (HRV). Prior to the pandemic, remember those days, I was asked to give a presentation to a group of postgraduate osteopaths. I accepted but agreed with them that I wasn’t going to present on backpain! So, I presented on the topic “Can an integrated osteopathic approach to medicine slow down cognitive decline”, based on a protocol, I had been developing over several years, looking at the functional and lifestyle interventions to slow down cognitive decline.
After the event the organiser Bob Gupta DO, kindly wrote the following:
Gerry everyone was blown away by your lecture! It was truly a masterclass performance and opened our eyes into comprehending blood tests, using nutritional knowledge, understanding the biochemistry of breathing and its relationship to lifestyle and good health, and many other aspects.
The benefits of breathing exercises – sometimes called “breathwork” – have been recognised for millennia. In more recent DECADES, scientific studies seem to support what people in many cultures, particularly in Asia, have long practiced: that deliberate breathing may help to improve a variety of health conditions, including hypertension, stress, anxiety, and even chronic pain. There are numerous scientific studies on the effects of optimising breathing patterns, especially its effect on heart rate variability (HRV) and its benefits to Health. It is known, that increasing heart rate variability is one of the aims these interventions and an increased heart rate variability is associated with numerous health benefits. The most recent research detailed below builds on this evidence.
In the latest study, researchers measured biomarkers in blood plasma of 108 patients, that are associated with a higher risk of developing Alzheimer’s, particularly amyloid beta 40 and 42. Given the recent news on the latest medications for Alzheimer’s, such as Donanemab (a monoclonal antibody), to target the removal of amyloid, it targets amyloid, a sticky, neuron-damaging protein, in the brains of people with dementia, this research gives an alternative lifestyle intervention (breathing) to such drugs without the risk of significant side-effects. Donanemab, made by Eli Lilly in the USA, in phase 3 clinical trials, the drug slowed clinical decline by 35% compared to placebo, but about half of all participants did not complete their course of treatment by 12 months, there are apparently numerous side effects.
In the recent research at the University of Southern California, they divided their patients into 2 groups, those given “Mindfulness” exercises and the other group breathing exercises.
I personally don’t like the term mindfulness. It is now so overused and I’m not sure if people are actually using it the way it was meant to be used.
http://www.thehealthequation.co.uk/think-this-is-mindfulness-youve-got-it-wrong/
The link to the blog above describes that in my experience, it’s far more important to optimise someone’s breathing behaviour before introducing so-called mindfulness.
When they looked at participants’ blood samples four weeks into their practice (either mindfulness or breathing), the results came as a “surprise”, says Mara Mather, professor of gerontology, psychology and biomedical engineering at the University of Southern California and one of authors of the study. The breathing exercises aimed at increasing heart rate variability decreased levels of amyloid beta. The mindfulness exercises, which decreased heart rate variability, made those levels higher. Both groups practiced the technique (mindfulness or breathing) twice a day, for 20 to 40 minutes each time, for five weeks.
Mather and her team hadn’t expected the levels of amyloid beta to be “affected so robustly”. And it wasn’t just for older adults who already might have been more susceptible to having higher levels of amyloid beta. “The effects were significant in both younger and older adults,” Mather says.
The researchers aren’t sure why, exactly, this might be. But one hypothesis is that slow, deliberate breathing may mimic some of the benefits of deep sleep, which research has found might clear neurotoxic waste products from the brain and nervous system at a faster rate. The build-up of these waste products seems to play a role in the development of Alzheimer’s. One of the principles in osteopathic medicine is “the rule of the artery is supreme”. What this means in practice is that both increasing arterial supply to structures and improving venous and lymphatic drainage away from those structures (from a brain respective these tend to be the cerebral veins, the venous sinuses and the internal jugular vein) allows better removal of debris. All cells of the body produce toxic materials that need to be cleared away.
The key factor seems to be how each exercise affected heart rate variability (HRV), which reflects how much fluctuation there is between heartbeats. Research has indicated that heart rate variability is a good metric for the functioning of the autonomic nervous system, and, therefore, an indicator of overall health and various health conditions, from depression and chronic stress to viral infection and sepsis. Intriguingly, more variability (i.e., a less consistent pattern) seems to be far healthier, perhaps because it shows the body’s ability to adapt to stressors.
“We don’t yet know what dose (of breathing exercise) is optimal. But it probably doesn’t have to be every day – my guess at this point is that doing 20 minutes 4-5 times per week would have benefits,” she says.
I always find responses like this intriguing. Many people think they just have to do breathing exercises for a few minutes a day. My point is that we are breathing 24 hours a day and many of us breathe sub optimally. Why not teach someone to optimise their breathing, to try to make it their normal habitual pattern, so that the vast majority of time they are actually breathing in optimised regulated way?
“What we do know is that breathing at whichever pace between nine and 14 seconds per breath that increased that individual’s heart rate oscillations (HRV) the most was effective at reducing plasma amyloid beta levels,” Mather says. This equates to between 4 and 6.5 breathing cycles per minute a cycle is one breath in and breathe out. The average UK breathing rate is around 14 cycles a minute. In my experience aiming to optimise breathing rate at between 6 and 8 cycles at the minute is generally achievable for most patients. I think breathing at 4 cycles per minute, it’s not sustainable for most people.
HRV can also be confusing. Many devices use the measurement of HRV, using a SDRR (standard deviation of all the R-R intervals). Clinically, I don’t find it that helpful. My preferred measurement for HRV is using something called respiratory sinus arrhythmia, or breathing heart wave, which essentially is the heart rate variability correlated to a persons breathing pattern. When a person breathes in, as it’s part of the sympathetic or stress autonomic nervous system response their heart rate goes up and when a person breathes out, which is part of the parasympathetic or relaxation autonomic nervous system response, their pulse goes down. Therefore, in my opinion it’s a much easier way of understanding HRV. For example, if your pulse was 80 bpm when you breathe in and 60 bpm when you breathe out that gives you an HRV of 20. The range varies from around 0 to 40 and the higher the HRV, the more beneficial it is to health, because it shows good elasticity/balance between the stress part of the nervous system and the relaxation part of the nervous system. The Autonomic nervous system also called the subconscious nervous system is around 90% of brain and nervous system activity. It is controlling things in the background without you having to think about it. Many patients are in sympathetic upregulation, that targets the heart, lungs, muscles and liver as these are the systems we use in a stress response, and this can be a good thing (short term). The parasympathetic nervous system, conversely, targets, digestive function, hormonal reproduction, and parts of the immune system. The aim generally, with most patients is to down regulate their overactive, sympathetic nervous system, and up regulate their underactive parasympathetic nervous system, this is evidenced by an increase in heart rate variability.
But this study is far from the only study in recent years to have found health benefits of breathing exercises. Studies have found, for example, that breathwork may reduce blood pressure in people with hypertension, help relieve symptoms of anxiety and depression an reduce insomnia. A recent meta-analysis, meanwhile, found that it could lower stress and improve mental health.
There are many other things that can be helpful in intervening with complex health problems of which cognitive decline is just one have a list of many. But optimising breathing is probably one of the most important interventions I make in many of my patients. Hopefully clinicians and patients will start taking this a little bit more seriously.”
http://www.thehealthequation.co.uk/monitoring-heart-rate-variability-hrv/
BBC
By Amanda Ruggeri
Stop scrolling. Now inhale slowly, concentrating on expanding your lungs, to a count of five. Exhale, just as slowly and deliberately, as you count to five.
You might find that, in just that 10 seconds, you suddenly feel just a little bit more relaxed or centred. Follow the same practice for 20 minutes a few times a week and – according to the research – you might not just reap the benefits of feeling calmer. You may also be helping to prevent the onset of various diseases, including, a recent study has suggested, even Alzheimer’s disease.
The benefits of breathing exercises – sometimes called “breathwork” – have been recognised for millennia. In more recent decades, scientific studies seem to support what people in many cultures, particularly in Asia, have long practiced: that deliberate breathing may help to improve a variety of health conditions, including hypertension, stress, anxiety, and even chronic pain.
In the latest study, researchers measured biomarkers in blood plasma that are associated with a higher risk of developing Alzheimer’s, particularly amyloid beta 40 and 42. Half of the 108 participants were told to try to bring themselves to a place of calm by imagining a serene scene, listening to relaxing sounds, and closing their eyes – essentially, mindfulness meditation. The goal was to decrease their heart rate oscillations, encouraging their heart rate to have a steadier, more consistent beat.
The other group followed a breathing exercise on a computer screen – when a square rose over the course of five seconds, they inhaled, and when it dropped for five seconds, they exhaled. This kind of deep, slow breathing has been found to increase heart rate oscillations – making the time interval between heart beats more variable (hence a higher “heart rate variability”). Both groups practiced the technique twice a day, for 20 to 40 minutes each time, for five weeks.
When they looked at participants’ blood samples four weeks into their practice, the results came as a “surprise”, says Mara Mather, professor of gerontology, psychology and biomedical engineering at the University of Southern California and one of authors of the study. The breathing exercises aimed at increasing heart rate variability decreased levels of amyloid beta. The mindfulness exercises, which decreased heart rate variability, made those levels higher.
Although no definitive single cause has been identified for causing Alzheimer’s, clumps of amyloid beta protein known as plaques have been found to be one of the key features of the disease. Certain types of this protein can be particularly toxic when they clump together inside brain cells, causing them damage that affects their normal function and causes them to die.
Mather and her team hadn’t expected the levels of amyloid beta to be “affected so robustly”. And it wasn’t just for older adults who already might have been more susceptible to having higher levels of amyloid beta. “The effects were significant in both younger and older adults,” Mather says.
“This is an intriguing finding because, in healthy adults, lower plasma levels of amyloid beta are associated with lower risk of getting Alzheimer’s disease later,” she says. “Slow-paced breathing might have benefits not only for emotional well-being – but also for improving biomarkers associated with Alzheimer’s disease.”
The researchers aren’t sure why, exactly, this might be. But one hypothesis is that slow, deliberate breathing may mimic some of the benefits of deep sleep, which research has found might clear neurotoxic waste products from the brain and nervous system at a faster rate. The build-up of these waste products seems to play a role in the development of Alzheimer’s.
The key factor seems to be how each exercise affected heart rate variability (HRV), which reflects how much fluctuation there is between heartbeats. Research has indicated that heart rate variability is a good metric for the functioning of the nervous system, and, therefore, an indicator of overall health and various health conditions, from depression and chronic stress to viral infection and sepsis. Intriguingly, more variability (i.e. a less consistent pattern) seems to be far healthier, perhaps because it shows the body’s ability to adapt to stressors.
A regular practice of deliberate, slow-paced breathing seems to be something that could benefit most people
Regardless of the exact mechanism, Mather says, a regular practice of deliberate, slow-paced breathing seems to be something that could benefit most people.
“We don’t yet know what dose is optimal. But it probably doesn’t have to be every day – my guess at this point is that doing 20 minutes 4-5 times per week would have benefits,” she says.
The study didn’t compare different types of breathing techniques, so they don’t know yet which type of breathing pattern might be most effective. “What we do know is that breathing at whichever pace between nine and 14 seconds per breath that increased that individual’s heart rate oscillations the most was effective at reducing plasma amyloid beta levels,” Mather says.
The research has also yet to be replicated in larger numbers of patients to confirm whether a meaningful long-term effect can be seen. Some scientists have also expressed doubts about how effective or reliable breathing techniques could be compared to drug treatments.
But it is far from the only study in recent years to have found health benefits of breathing exercises. Studies have found, for example, that breathwork may reduce blood pressure in people with hypertension, help relieve symptoms of anxiety and depression an reduce insomnia. A recent meta-analysis, meanwhile, found that it could lower stress and improve mental health.
Breathwork is starting to make its way beyond yoga and meditation classes to corporate retreats and even schools. In New York City, mayor Eric Adams recently announced that all public schools will have to teach daily mindful breathing sessions to students. As he put it: “There’s a science to breathing.” There are plenty of researchers, it turns out, starting to agree with him.
HOPE IN THE FIGHT AGAINST AMYLOID PROTEIN
A new drug called donanemab has shown promise in a global trial for helping to clear the build-up of amyloid beta protein associated with Alzheimer’s disease.
The drug has been described as a turning point in the fight against Alzheimer’s after it appeared to slow the pace of the disease by around a third.
The results suggest that removing amyloid beta clumps from the brain can help to alter the course of the disease and help patients to retain much of their daily routine.