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Category: Breathwork

Breathwork is the practice of respiratory & physical exercises, aiming to improve one’s ability to control the breath. The 2 pillars of breathwork are: hypercapnia & hypoxia. It can be used to:

a. improve control of the Autonomic Nervous System (Improve body temperature control, activation of the Sympathetic or Parasympathetic Nervous System, slow down Heart Rate)

b. delivery of oxygen to working muscles and biomechanics during exercise (Release tension around the diaphragm, strengthen the diaphragm, improve oxygen delivery to working muscles during exercise, accelerate recovery time after training)

c. unconscious breathing (Improve respiratory function by enhancing Carbon Dioxide tolerance)

d. enter meditation (Help you enter into an empty state of mind)

Breathwork can be practiced in conjunction with physical exercises: dynamic; or on its own: static.

Under this category you will find articles discussing the use of breathwork through the Yoga tradition (Pranayama), Buteyko Method, and modern systems such as the Wim Hof Method. My aim is not to get stuck in the method but look into the effects each technique has on the body on a biochemical, biomechanical, and psychological level.

If you are interested in the role breathing plays in the Nervous System you should sign up for the #FreeBreathing mini-course.

Articles in this category

Breathing in yoga

5 things I learned from Wim Hof.

 

My Glycanage results (biological age)

Anti aging Breathing techniques

According to an Indian saying: “We come to this life with a set number of breaths. By breathing slower, we live longer.” Whether there is truth to that, I don’t know, but there is definitely sufficient evidence to support that there are breathing techniques with anti-aging effects.

 

In order to determine whether any intervention works we need to first objectively assess our health state. Measuring our biological age should be the first step if we are interested in slowing down or reversing our age. The Glycanage test is my choice of preference. Glycanage measures a series of immune markers, in our bloodstream, reflecting the biological age of our immune system. My most recent results are displayed in the image above.

 

Breathwork consists of 2 pillars, both of which have anti-aging effects: Hypoxia & Hypercapnia. In order to access the therapeutic effects of breathwork one needs to acheive these 2 states. Exercises that involve diaphragmatic or slow breathing, while still useful, are not going to have an effect potent enough to slow down aging.

 

Hypoxia regulates stem cell biology

Under hypoxia – a state where oxygen saturation in the blood is temporarily reduced – the body triggers a domino of processes [ref], often referred to as the diving reflex [ref]. In a nutshell: due to the reduction of oxygen availability, the body adapts by improving its ability to circulate oxygen and deliver it to peripheral organs, including the brain [ref].

Hypoxia Diving Reflex

EPO hormone’s benefits in human physiology are well researched [ref], and positive outcomes have been reported in healthy and chronically ill subjects.

The anti-inflammatory role of EPO hormone Neurotrophic role of EPO

 

 

 

 

 

 

 

 

 

CO2 tolerance is the cornerstone of healthy breathing

While hypoxia will enhance oxygen delivery for a few hours after the practice, hypercapnic training is what will keep your body well oxygenated at all times. There are many exercises that can get you into hypercapnia but ultimately training needs to be tailored to the individuals metabolic, biomechanical and respiratory capacity.

The reason why CO2 training is so improtant is because CO2 works synergistically with O2 in the body (due to the Bohr effect). A key component of CO2 training is to maintain nasal breathing at all times.

The implications of nasal breathing are far reaching, and beyond the scope of this article, but just keep in mind that nasal breathing at night will increase your production of Growth Hormone [ref]. Growth Hormone is used in Hormone Replacement Thrapy (HRT) for its antiaging properties. How useful would it be if you were to increase your Growth Hormone production by changing the way you breathe?

Breathwork's Benefits

Conclusion

Aging is part of life and should be honored similar to all other natural processes. If however, you want to look and feel good as you age, a proactive approach is needed. Anti-aging breathing techniques are part of my protocol keeping myself and my clients young. Please don’t underestimate the need for work, however. Regular practice is needed in order to gain benefits.

 

ps: Breathing techniques that involve hyperventilation (such as the Wim Hof Breathing) should not be considered breathwork or expected to have anti-aging properties.

 

 

References:

Abdollahi, H., Harris, L. J., Zhang, P., McIlhenny, S., Srinivas, V., Tulenko, T., & DiMuzio, P. J. (2011). The role of hypoxia in stem cell differentiation and therapeutics. Journal of Surgical Research165(1), 112-117.

 

Elia, A., Barlow, M. J., Deighton, K., Wilson, O. J., & O’Hara, J. P. (2019). Erythropoietic responses to a series of repeated maximal dynamic and static apnoeas in elite and non-breath-hold divers. European journal of applied physiology119(11), 2557-2565.

 

Kjeld, T., Pott, F. C., & Secher, N. H. (2009). Facial immersion in cold water enhances cerebral blood velocity during breath-hold exercise in humans. Journal of Applied Physiology106(4), 1243-1248.

 

Rey, F., Balsari, A., Giallongo, T., Ottolenghi, S., Di Giulio, A. M., Samaja, M., & Carelli, S. (2019). Erythropoietin as a neuroprotective molecule: an overview of its therapeutic potential in neurodegenerative diseases. ASN neuro11, 1759091419871420.

 

Triana, B. E. G., Ali, A. H., & León, I. G. (2016). Mouth breathing and its relationship to some oral and medical conditions: physiopathological mechanisms involved. Revista Habanera de Ciencias Médicas15(2), 200-212.

Cold Exposure

The popularity of cold exposure has increased since 2017 in continental Europe, US & Australia through the work of Wim Hof. Whether it is through cryotherapy or cold water immersion more and more people practice and hashtag: #coldexposure. Cold therapy has its roots back in South East Asian yogic traditions and Eastern European-Scandinavian cultures. In this article, I will cover 3 benefits, training with cold offers to those of us living a modern lifestyle.

 

How old is cold therapy?

The moment you ask this question you realize that cold has been accompanying humans from the very start of our existence. As temperatures in nature constantly fluctuate, humans have been exposed to cold: voluntarily or not for a long time.

From a therapy standpoint, cold exposure is listed in “The Edwin Smith Papyrus” dated 3,500 BC (Wang H et al., 2006). In certain parts of the globe (ie. Russia, Bulgaria, and Scandinavian countries) cold training has been part of the culture, practiced in banya or plunge pools, as well as a standard procedure in hospitals to prevent further damage in patients with cardiovascular (Ref) and neurological conditions (Ref).

In recent years Wim Hof (a dutchman Guinness record holder) popularised cold training through his workshops across the globe. It was my training with Wim in 2016 that initiated my journey in cold exposure.

 

1. Cold exposure improves Circulation & Cardiovascular Function

Think of cold exposure as a workout for the circulatory system.

Most people think of cardio when it comes to improving their cardiovascular function. Cold exposure though offers a unique way to strengthen one’s cardiovascular system (CVS).

Our cardiovascular system is surrounded by epithelial muscles which facilitate the circulation of blood. At low temperatures, the epithelial muscles surrounding the veins and arteries of our extremities constrict – preserving the blood and the nutrients carried in it for the more vital organs in the trunk and the head. When the body returns to higher temperatures the epithelial muscles in our extremities dilate again allowing for the blood to flow freely there. In a similar way that our biceps get stronger as they contract during bicep curls (or chaturangas) our cardiovascular system can get stronger through cold exposure.

Good circulation means no athlete’s foot, no cold extremities, better cognitive function, ability to heal/recover faster and perform better in sports.

 

2. Cold exposure as a meditation technique

Those that practice cold water immersions for some time report a sensation of stillness in mind (usually 30 seconds to a minute after the initial exposure). A friend of mine Luke Wills (founder of Ataraxia) said he reached a similar state of mind in his 2nd ice bath, with that on the 7th day of a vipassana meditation retreat. Anecdotal evidence like this was confirmed to be valid in a study published in May 2018 titled “Brain over Body“. In this study participants with no previous experience in cold exposure and Wim Hof, were interchangeably exposed to cold and neutral temperatures. One of the most striking differences between the inexperienced subjects and Wim was the Dutchman’s ability to reduce activity in the insular cortex part of the brain during cold exposure. The insular cortex is an area involved in emotional attachment to external stimuli and self-reflection. Activity in this part of the brain has been shown to be linked with meditation and control of emotional eating.

Meditation is the 5th of the 8 limbs of yoga. Cold exposure is one of the many ways to enter into a state of meditation.

 

3. Cold exposure helps us overcome fears

Cold exposure is demanding on many levels:

• the adrenal glands

• musculoskeletal system

• circulation and

• the brown fat tissue is activated at low temperatures.

Aside though the multiple biochemical adaptations in the rest of the body:

our brain changes through cold exposure.

The initial response is that of: “fight or flight”. A small area of the brain called the amygdala (Greek word for almond) – activates the HPA (Hypothalamic Pituitary Adrenal) axis – signaling a stress response to the rest of the body. While this initial stage is universal the way one deals with cold thereafter depends on his/her experience and ability to use her breath.

By training the body to deal with a stressful situation (ie. a cold immersion) in a controlled environment (such as a shower or a bath) we can reprogram our mind to deal with stressful situations which are out of our control. Our main tool is our breath. Dealing with fear was the focus of a workshop I gave in 2017 to a group of actors.

 

Additional reasons

The list above is not exhaustive of the benefits one can get from cold exposure.

• Controlling pain perception [Ref]
• Generation of Brown Fat [Ref]
• Strengthening of the immune system [Ref]
• Improved tolerance to cold [Ref]

are also good reasons for modern “over-civilised” humans to train with cold.

 

3D approach to Breathing Biomechanics

The Biomechanics of Breathing

The biomechanics of breathing involve the function of all the primary and secondary respiratory muscles that are involved in respiration. These can be grouped into the respiratory tract, respiratory support muscles, the abdominal muscles.

3D approach to Breathing Biomechanics

The respiratory tract

Yoga practices can affect the function of both upper and lower airways. Neti kriya, a cleansing technique, allows the bathing of the nasal passage. Ujjayi breathing can reduce dead space in the lungs and increase this way, the surface of oxygen diffusion to the bloodstream. While many asanas facilitate the delivery of air in one part of the lungs by restricting it in another, allowing this way the utilization of the entire organ. Finally, the diaphragm which seats at the bottom of the lungs can also get stronger through breathing exercises and/or asanas.

 

The supportive muscles

Muscles, fascia, and neurons all play an active role in supporting our respiratory function. While these tissues, cells and organs are not always classified as “respiratory”, failure of their function means compromised breathing.

 

Supportive muscles above the rib cage

Scalenes and sternocleidomastoid are 2 pairs of muscles sitting on either side of our neck. Their recruitment is often considered synonymous with upper chest breathing. It is my observation that when these muscles, alongside the trapezius, are tight there is zero movement possible in the upper chest and upper back, limiting this way the expansion of the lungs in this area.

 

Supportive muscles below the rib cage

Psoas and quadratus lumborum are 2 pairs of muscles on either side of the spine that attach posteriorly to the diaphragm. Having reviewed 1,000s of papers I am yet to see these 2 muscles mentioned in publications as respiratory or secondary respiratory muscles. There are 2 reasons why I think their structure and function are pivotal in breathing:

  1. As they both attach to the diaphragm, when they are tight, weak, or uneven (between the left and right side) they will restrict the way the diaphragm moves.
  2. Both muscles play an important role in our posture. A compromised posture will most likely cause restrictions in our breathing.   

 

Our posture

This is an area of the respiratory function that often does not get much attention. Think for a second of an old man bearing more weight on one foot, maybe having one shoulder higher than the other. Or a woman with pronounced scoliosis. How would these postural asymmetries affect the ideal symmetrical movement of the rib cage and diaphragm? Or someone with pronounced thoracic kyphosis. Do you see how the movement of his diaphragm will be restricted (ref)?

 

Diaphragmatic restriction due to kyphosis

Conclusion

It is my belief that yoga can improve the biomechanics of breath in most elements of this Venn diagram and it’s for that reason a lot of yoga practitioners with respiratory problems have benefited from practicing yoga without paying much attention to the volume of air they breathe which determines the biochemistry of respiration. At the same time, the benefits are amplified when someone pays equal attention to both qualities of breathing (ie. biomechanics & biochemistry).

 

Buteyko vs Yoga breathing

Buteyko vs Yoga Breathing

Both Buteyko and Yoga breathing techniques have benefited the health of many individuals and especially respiratory problems (ie. bronchitis & asthma). To the novice, the two systems may seem to contradict but I would argue there are more similarities and synergies between them.

 

While Pranayama is a component of the yoga tradition, which also consists of meditation and physical postures, Buteyko is a system solely focusing on breath training.

*ref

Pranayama vs Buteyko Breathing

So far there has been only one study from the University of Nottingham that compared the 2 systems (ref). The study was conducted among 90 individuals (69 of which completed the study) that suffered from asthma and were on corticosteroid medication. At the end of the study, which run for 6 months, the Buteyko group showed improvement in both symptoms and a reduction in bronchodilator use.

 

Buteyko vs Pranayama Corticosteroid Buteyko vs Pranayama symptoms

How do pranayama techniques compare with Buteyko breathing?

Pranayama techniques, primarily due to the lack of one reliable source, are practiced in different ways. A few practitioners use “Light on Pranayama” BKS Iyengar as a reference. Most exercises can be performed in an easier or more challenging way by modifying the duration of the volume of breath. It is beyond the scope of this article to explain how this can be achieved but to help you grasp the concept think of box breathing:

Version A:  Inhale for 2 sec, Hold for 2sec, Exhale for 2sec, Hold for 2sec. Perform x5 rounds.

Version B:  Inhale for 20 sec, Hold for 20sec, Exhale for 20sec, Hold for 20sec. Perform x10 rounds, while keeping the volume of air inhaled & exhaled low.

While most pranayama techniques are (unfortunately) instructed without much reference to the volume of air, by the time the duration of each cycle increases minute ventilation will unavoidably reduce. Reduction in minute ventilation is at the heart of the Buteyko Method which aims to prevent individuals from chronic and acute hyperventilation.

In the table below you can see a list of pranayama exercises. Those with a sign 〰️ can lead to hypercapnia, while the ones with an ❌ are likely to cause hypocapnia.

Hypercapnia is a key element of Buteyko training.

One of the hallmarks of yoga is Ujjayi breathing which often (and correctly in my option) it’s suggested to be performed at all times during asana. Given the different ways that ujjayi breath is practiced, it may appear to be diametrically opposite to Buteyko breathing or very much in-line.

Ujjayi breath is characterized by a sound during the exhalation caused by the constriction of the throat. The sound, for some unknown to me reason, is sometimes exaggerated making the breath loud. In my opinion, ujjayi should be performed as follows:

Both the inhalation and the exhalation take place through the nose with the tongue at the top of the pallet. The inhalation is soft. During the exhalation, the back of the throat gently constricts allowing the elongation of the exhalation further than normal. The exhalation to inhalation ratio is 2:1 or much higher. The breath is quiet.

When practiced like this, the ujjayi breath will lead to hypercapnia and thus cause an increase in body temperature, similar to all hypercapnic breathing exercises.

 

How to incorporate Buteyko in yoga?

To the extent that you want to support the oxygenation of your brain 🧠 and peripheral organs during your physical practice, you would benefit by breathing light from start to finish. Breathing this way is likely to cause a sense of air hunger, especially in classes where the pace is fast.

 

You can also incorporate hypoxic breathing in your practice depending on your level of experience and breathing capacity. It is always important to account for the challenges asanas cause to the breath during yoga.

 

The role of Control Pause in Yoga

Buteyko practitioners, like myself, like to use the Control Pause (CP) test as an approximation of clients’ respiratory capacity. CP can also be performed at the start of a yoga practice. Below is a list of factors that need to be considered:

• CP will tend to be lower later in the day

• CP will be affected by fluctuations in hormone levels. That is likely to be more pronounced in women.

• If the practitioner is seating on the floor (as opposed to a chair), limitations in his posture is likely to affect the CP negatively.

Normal Respiratory Rate

What is a normal respiratory rate?

Our respiratory rate (RR) depends on our age, phase of the menstrual cycle, health state, and heart rate. Having a normal respiratory rate will partially indicate healthy respiratory function but will not be sufficient to identify one’s respiratory capacity.

In this article, you can find out the benefits and limitations of controlling your RR.

Respiration Rate 1.01

How do you check respiration rate?

Respiratory rate is measured at rest. In order for the measurement to be accurate, it is useful to sit in a chair still for a few minutes. One breath will compromise one inhalation, a possible pause, and one exhalation, possibly followed by a second pause.

What is a normal respiratory rate?

Respiratory rate is the number of breaths we take per minute. It’s one of the body’s vital signs, alongside blood pressure, heart rate, and body temperature. Normal respiratory rate will vary with age.

While 12-20 breaths per minute (bpm) are often used as the normal reference range (ref), it is not necessarily optimal. Optimal breathing is determined by minute ventilation, ie. the total volume of air we inhale per minute. For adults, normal minute ventilation is 6-8.4 L/min. With a tidal volume of 500 to 600mL, if you take 12 bpm your minute ventilation is 6-7.2L/min (500mL x 12 bpm), which is the volume of our lungs. If instead of 12bpm you take 20bpm (at 500mL tidal volume), your minute ventilation is: 10L/min. With that in mind:

optimal respiratory rate range: 8-14bpm

What does respiratory rate indicate?

Respiratory Rate (RR) is one of the body’s vital signs, and as such changes in RR indicate improvement or deterioration in health. The other 5 vital signs are pulse rate, systolic blood pressure, level of consciousness, oxygen saturation, and body temperature.

What increases respiratory rate?

The respiratory rate will increase due to an increase in metabolic demands but also during anxiety, acidosis (referred to as Kussmaul’s respiration), asthma, COPD, dehydration, fever, heart conditions, lung conditions (including lung cancer), an overdose of aspirin or amphetamines. During pregnancy and the follicular phase of the menstrual cycle, RR also increases.

What decreases respiratory rate?

The respiratory rate will decrease when we are relaxed but also from alcohol consumption, brain conditions (including strokes and head injuries), consumption of narcotics (ie. marijuana), and sleeping apnea.

 

Respiration Rate and Breathwork

When you should focus on your respiratory rate?

Performing breathing exercises based on the respiratory rate offers some benefits, especially for beginners. Respiratory rate can:

• be measured independent of the body position

• be monitored by the practitioner as well as an observer

• be easily manipulated

So if you are starting out now with breathwork or have no experience with breath control:

Try to reduce your respiratory rate; it is likely to bring a profound sense of relaxation.

A lot of pranayama exercises, cadence breathing, as well as asana practices, focus on the number of breaths per minute. An exercise I developed to improve your concentration based on the manipulation of the RR is the following:

Why focusing only on respiratory rate will limit your breathing practice?

During most physical exercises (including yoga) you would benefit by reducing the volume of your breath so that it matches your metabolic needs. This is due to the role of CO2 in breathing. In this case, the focus should be on how much you breathe and not how often.

This is also the cornerstone of Buteyko breathing, which advocates reduced breathing aiming to avoid hyperventilation and improve breathing biochemistry. If you are not yet convinced think of the following 4 breathing disorders:

• Bradypnea: breathing abnormally slow.

• Tachypnea: an elevated respiratory rate. Fast breaths that are usually shallow.

• Dyspnea: shortness of breath, that can occur with a high, normal, or low respiratory rate.

• Hyperpnea: breathing deeply and labored.

Only 2 out of 4 problems can be addressed by focusing on the respiratory rate.

Even Cadence breathing can lead to Hyperventilation (ref).

Conclusion

While reducing the number of breaths per minute can be a great starting point, once confident start reducing the volume of air you breathe in order to become a better breather.

The Breathe Right 2-week online course is developed to help you breathe better when you are not conscious of your breath.

K Buteyko

Buteyko Breathing for sinus infection

Sinusitis is caused by swelling or inflammation of the tissue lining the sinuses, leading to nasal blockage and breathing discomfort. Those seeking natural relief can use Buteyko Breathing for sinus infection as it will help them restore their respiratory hygiene and function.

 

What helps breathing with sinus infection?

Those suffering from sinus infections can find relief through the following methods:

1. Use decongestant essential oils:

🍃 peppermint oil, which also has anti-bacterial (ref), and anti-inflammatory properties (ref).

🍃 eucalyptus oil (ref).

🍃 lavender oil, which also has pain-relieving properties (ref).
🍃 tea tree oil, that has antiviral, antifungal, and antibacterial properties (ref).

🍃 oregano oil, which can stop bacteria from growing (ref).

🍃 rosemary oil (ref).

🍃 clary sage oil, which acts as an antimicrobial agent (ref).

2. Massage the maxillary sinuses to encourage fluid drainage [ video ].

3. Have a hot bath, apply a warm compress (towel or water bottle) or breathe over a humidifier as the heat will loosen up the mucus in the nasal cavity.

4. Practice breathing exercises in line with the Buteyko Method.

Can breathing exercises help sinusitis?

The way we breathe determines our nose’s hygiene. Hyperventilation, mouth-breathing, and erratic breathing are types of dysfunctional breathing that promote inflammation in the sinuses and lead to a blocked nose. The Buteyko Method through the application of basic biochemical principles can help reduce inflammation and restore good respiratory function.

In order to unblock your nose, you need to increase your levels of CO2 and NO in your nasal cavity.

A quick way this can be achieved is by performing short breath-holds:

Inhale – Exhale – Pinch your nose for 60% of your max capacity – Inhale from the nose – take 3 recovery breaths – repeat x7

The longer the breath holds, the higher the build-up of CO2 and NO, while the more physically active you are CO2 will further increase. You can increase CO2 levels by moving your body from side to side on the spot or walking during the breath-holds. What matters most is to keep the recovery breaths short and nasal.

Does chronic sinusitis ever go away?

In contrast with acute sinusitis, chronic sinusitis is more likely to be caused due to chronic dysfunctional breathing patterns (ref). Increasing one’s Control Pause [video] to 30 sec will be a step in the right direction.

Sinusitis is considered chronic if it persists for 12 weeks or more. The symptoms may include:

  • Nasal congestion
  • Pus in the nasal cavity
  • Runny nose
  • headaches, tooth pain, bad breath
  • Fever

While the exercise with the short breath-holds described above can still be used, a more structured approach will be needed.

Conclusion

The way you breathe on a daily basis is going to play a significant role in the occurrence and severity of sinusitis. You can improve the way you breathe when you are not conscious of it with the 2-week online course Breathe Right.

 

FAQ:

Can deviated nasal septum cause sinusitis?

If the septum has deviated far enough it may block the nasal passage increasing the chances of sinusitis. The more one uses his nose 👃🏼 the less likely it will be for the nasal passage to get blocked and fluids to back up in the sinus cavity. For that reason, even following an operation, it can be beneficial for the individual to practice some breathwork in line with the Buteyko Method, such as CO2 Breathing Therapy.

Can sinusitis affect your lungs?

While sinusitis is considered an upper respiratory infection (URI) it is sometimes linked with poor diaphragmatic recruitment or lung function. As the respiratory tract operates as a system consisting of different organs, the function of breathing muscles needs to also be considered in respiratory infections.

In a paper published on the 23rd of March 2020 (ref) 12 patients (7 men and 5 women) with SARS-CoV-2 and symptoms of acute respiratory distress syndrome at the Jinyintan Hospital showed improved lung function when alternating between pronated and supine position vs supine only.