“We live longer if we breathe better” - Leon Chaitow

Breath is life. It the first and last thing we do that defines us as living human beings. Breathing is one of the key determinants to health and is linked to all bodily functions and processes. It is defined as the process of taking in oxygen from the atmosphere and releasing carbon dioxide out of the body.

Breathing dysfunctions are a contributing factor to disease. Learning how to breathe properly and how to use breath therapeutically is an essential aspect of health and healing.  

  Mechanics of Breathing

 Breathing is a complex process that is under both conscious and unconscious control. It involves three distinct phases: inhalation, exhalation and the rest period.

 Inhalation, or breathing air in, is an active movement. During inhalation, the diaphragm contracts downward and a vacuum, or negative pressure, is created for air to move into the lungs. Inhalation is associated with “taking in life.” 

  During exhalation, or breathing air out, the diaphragm relaxes and recoils and the lungs deflate as air moves out. Exhalation is associated with “letting go” 

  The rest period is the time between the exhalation and the subsequent inhalation. The rest period is associated with “contemplation of life.”

 “Normal” relaxed breathing occurs at a rate of 4 – 4 - 4. A count of 4 for each phase – inhalation, exhalation and rest period.

 Proper breathing is done through the lower torso. During inhalation the belly, lower back and ribs expand while the shoulders, neck, face and chest remain relaxed.

 As air is inhaled through the mouth or nose, it travels to the lungs and proceeds to the alveoli where oxygen is picked up by the blood for delivery throughout the body. Alveoli are found in the lungs and are responsible for gas exchange within the body. At the same time, the blood unloads carbon dioxide into the lungs and upon exhalation, carbon dioxide is released in to the atmosphere.

 Unconscious breathing is under the control of the autonomic nervous system. The rate and depth of breathing is controlled by specialized centres, the medulla oblongata and the pons, in the brainstem. These areas alter breath depending on the level of carbon dioxide, or carbonic acid, in the blood. They also respond to changes in the blood’s pH.

 Conscious control. Through conscious awareness it is possible to alter the rate and depth of breathing. It is also possible to alter the muscles used in breathing. Conscious control of breath is part of meditation, yoga, fitness training, speech or vocal training and speaking itself.

Why Is Breathing Essential?

Provides Oxygen. Oxygen is an essential component of blood and is required by every cell of the body on a moment-by-moment basis.

Gas exchange. Breathing is responsible for the exchange of oxygen and carbon dioxide within the body. Oxygen is delivered to the cells and tissues of the body while carbon dioxide is removed and released through the lungs into the air. In addition to the removal of carbon dioxide, breathing results in loss of water from the body. Exhaled air has a relative humidity of 100% because of water diffusing across the moist surface of breathing passages and alveoli.

Maintain the pH of blood. When carbon dioxide levels increase in the blood, it reacts with the water in the blood, producing carbonic acid which decreases the pH of the blood. Lactic acid produced by anaerobic exercise also lowers pH. The drop in blood's pH stimulates chemoreceptors in the blood system to increase the rate of breathing.

Elimination of toxins. Carbon dioxide is a metabolic waste product that is released through exhalation. A build-up of carbon dioxide is toxic to cells, results in the body being more acidic and is associated with many diseases. Deep breathing and full exhalations are a primary pathway of toxin removal.

Supports every system of the body. Breathing is linked to every system of the body. When the diaphragm is appropriately engaged in deep breathing, the internal organs are massaged which helps them to function optimally.

 Nervous system: Assists the nervous system in calming down and allowing a person to appropriately react to stressful situations. The balance between the hemispheres of the brain is either enhanced or hindered depending on breathing style. Proper breathing improves the quality and quantity of sleep that one enjoys.

 Respiratory system: Improves respiratory function by relaxing tight chest muscles. Relieves respiratory difficulties like bronchitis and asthma. Opens up the chest to make breathing easier and fuller.

  Circulatory system: Improves blood circulation and relieves congestion. Enhances the delivery of oxygen and nutrients to every cell of the body.

  Endocrine system: Diaphragmatic breathing aides the endocrine system by helping to move lymph throughout the body and strengthens the immune system.

  Digestive system: Acts like a pump on the internal organs and aids digestion. It also directly impacts the nervous system movement of the large intestine ensuring proper bowel movements.

  Urinary system: Benefits the urinary system as edema is lessened with deep breathing and toxins are removed from the body, putting less stress on other organs of elimination.

  Muscles and joints: Aids in relaxation, relieves muscular tension, increases flexibility and range of motion. It facilitates strengthening of connective tissue, which prevents formation of adhesions and reduces the danger of fibrosis (stringy tissues).

 Skin: Improves skin tone, texture and moisture levels.

Energy & prana: Breath affects all the subtle energy system of the body such as meridians, chakras and auras. It supplies the body with energy (chi, life force, prana, kundalini, penuma). Reduces mental and physical fatigue. Strengthens a person’s sense of self and their connection to their spirit. Increases emotional stability and calmness. Breath is the essence of life.

The peptide-respiratory link is well documented. Virtually any peptide found anywhere else can be found in the respiratory center. This peptide substrate may provide the scientific rationale for the powerful healing effects of consciously controlled breath patterns. “Mind doesn’t dominate body; it becomes body. Body and mind are one. I see the process of communication we have demonstrated, the flow of information throughout the whole organism, as evidence that the body is the actual outward manifestation, in physical space of the mind. Bodymind. At this molecular level there really was no distinction between the mind and the body. 

-- Molecules of Emotion, Candace Pert.

 Factors That Influence Breath

 Internal and external factors impact not only the rate of breathing but breathing function itself. Over time, bad breathing patterns become habitual. It is because they are repetitive or constant that they feel normal and the centres of the body that are responsible for proper breathing are overrideen. Dysfunctional breathing is correlated with many ailments, yet breathing function itself is often overlooked as the cause. Hence, many expensive and extensive visits to the doctor are made in an effort to diagnose and treat the wrong problem. The factors that affect breathing include:

Thoughts & Emotions and breath share a relationship of reciprocity. Thoughts & emotions influence breathing and breathing has a direct and profound influence on a person’s thoughts and emotions.

 Calm and content: Breathing is a direct route to calmness. Slow, deep breathing increases your vitality, improves your resistance to disease and leads to a calm state of mind.

  Anxiety: In response to anxiety breathing typically becomes quick and shallow.

  Fear: Fearful situations cause breathing to be more guarded. It results in shorter breathes and a tendency to hold one’s breath.

Exertion: Breathing rate is meant to fluctuate with exertion level. 

  Increased exertion increases respiration rate due to the increased metabolic demands of the body. With exertion the level of carbon dioxide in the blood increases due to increased cellular respiration by the muscles.

  During rest, the level of carbon dioxide is lower, so breathing rate is lower.

Food influences breathing in two ways.

  Any food that stimulates the nervous system is likely to increase respiration rate.

  Food that causes an increase in mucous or internal inflammation is likely to interfere with breathing. This can cause breathing problems, an exacerbation of breathing-related conditions with exertion or can contribute to sleep apnea, snoring and overall discomfort.

Water: Exhaled air has a relative humidity of 100%. Dehydration impacts breathing ability.

Posture affects breathing function and vice versa.

  Good posture is more likely to lead to good breathing. When in neutral posture the lungs have the ability to expand fully and to contract. There is nothing impeding the movement of breath.

  Poor posture whether due to rounded shoulders, misaligned spine or contracted muscles often restricts the ability of the lungs to expand.

Temperature directly affects breathing and rate of respiration. As temperature increases, so does respiration rate; as it decreases respiration rate slows.  

Time of day: Respiration rate slows down while you are sleep and increases when you are awake.

Environment can have a big impact on the quality of breath. Factors such as altitude, humidity, and pollution play an important role in breathing.

  Altitude causes an increase in breathing rate to accommodate the reduction in oxygen availability.

  Humidity. Extreme heat stresses the entire body and acts as an additional energy requirement which forces the body to increase the amount of oxygen through altering breathing rate.

  Chemicals and toxins such as those found in cigarettes, pollution or toxins that are inhaled can impact the functioning of the lungs.

  Change in quality of air. The oxygen concentration in the air, especially in major cities has decreased as a result of pollution, global warming and change in environment.

Age: The rate of breathing changes with age. Typically a child’s rate of respiration is 120 beats per minute, whereas an adults is between 60 and 90 depending on how fit they are and their level of health.  

Disease: Increased respiration rate can occur as a direct result of disease that causes decreased levels of oxygen in the blood and increased levels of carbon dioxide. In this case, increased respiration rate is an appropriate response of the respiratory centers in the body.

 Hyperventilation Syndrome HVS

 Hyperventilation is a breathing pattern disorder (BPD) of over breathing often in response to physical, environmental or psychological stimuli. The stimulus overrides normal breathing pattern impulses which are tuned to maintain specific carbon dioxide levels within the blood. During hyperventilation, the rate of carbon dioxide exhaled exceeds the normal rate. As a result the pH of the blood increases (respiratory alkalosis) leading to reduced oxygenation of the tissues. This results in a decrease of oxygen to the brain, smooth muscle constriction, heightened pain perception, increased stress response and changes in calcium and magnesium levels of the blood. Hyperventilation is often overlooked in clinical settings as a cause for many symptoms of unknown origin. It is estimated that 10% of patients who present themselves to doctor’s offices suffer from HVS.

Acute HVS is less common though more easily detected than chronic HVS. Acute HVS is often identified as breathlessness or the inability to catch one’s breath. Symptoms of Acute HVS are often more dramatic than Chronic HVS and may include breathlessness or the inability to catch one’s breath, agitation, rapid and/or deep breathing, chest pain, dizziness, heart palpitations and loss of consciousness. Acute stress or anxiety often produces acute hyperventilation. The effects of hyperventilation can range from loss of consciousness to parasthesia, a loss of sensation or tingling in the body (sometimes mistaken for a stroke). This effects seems to be exacerbated by a combination of hyperventilation and low blood sugar.

Chronic HVS, although quite common, often remains undetected due to lack of awareness. Chronic HVS does not have a number of obvious signs and symptoms yet it frequently leads to or propagates a number of conditions - often those typically thought of as conditions the patient must simply live with such as Chronic Fatigue Syndrome, Anxiety, non-cardiac related chest pain and Irritable Bowel Syndrome.  This breathing pattern is often learned early in life generally in response to a prolonged amount of stress. The symptoms typically associated with chronic HVS include faintness, dizziness, and visual disturbances. Chronic HVS is due to exaggerated upper thoracic movement as the diaphragm is not engaged. It contributes to erratic breathing or breathing that is irregular in rate or rhythm. It contributes to frequent sighs, and audible expirations. Typically with HVS the rate of breath is 20 breaths per minute or greater.

 Impact of Breathing Problems  

Dysfunctional breathing can disrupt the balance of the body and lead to a variety of negative psychological, biochemical, neurological and biomechanical problems. Breathing is essential to life and it important to work with your naturopathic doctor to determine the cause of any breathlessness or difficulty in breathing.

Respiratory Problems and breathing dysfunctional breathing often go hand-in-hand. In some cases the underlying respiratory condition impairs proper breathing; yet in many cases improper breathing contributres to or causes respiratory problems.

Cardiovascular Problems are often linked to fast breathing rates. The heart requires adequate oxygen on an ongoing basis. If the amount of oxygen getting to the heart is not sufficient than cardiovascular problems such as hypertension, congestive heart failure and angina can result.

Irritable Bowel Syndrome (IBS) is a disorder commonly characterized by symptoms of gas, bloating, cramping, diarrhea and constipation. Although often overlooked the effects of hyperventilation are known to have a direct effect on muscle constriction affecting the colon and contributing to symptoms of irritable bowel syndrome.^{1, 2, 3}

Pain: Whenever pain is present it is helpful to assess breathing function. Deep breathing releases endorphines which are natural pain killers. Deep breathing can often alleviate general aches and pains and it can relax muscles, a major cause of neck, back and stomach pains.

  Up to 90% of non-cardiac related chest pain stems from BPD. Chest pain of this nature typically presents itself as angina that lasts for hours rather than minutes. In addition, it is usually relieved upon mild exertion rather than exacerbated. BPD can provoke existing cardiac conditions as a result of its vasoconstrictive effect on the smooth muscle of the body (including cardiovascular) leading to a possible blockage and subsequent damage to the heart. ⁴

  Headaches and BPD are closely linked.

Stress Incontinence: Respiratory function is connected to pelvic floor functionality. ^{5, 6, 7, 8}  Stress incontinence is often the result of pelvic prolapse, a weakening in the muscles located at the base of the pelvis. These muscles known as the pelvic floor muscles serve to hold the pelvic organs in place. When these muscles get weak they may allow organs within the pelvis to shift causing them to press against the vagina. Possible organs affected include the bladder, urethra, rectum, vagina and uterus. Involvement of the those organs responsible for urination results in stress incontinence.

Anxiety: Acute stress or anxiety often produces acute hyperventilation which can range from mild to extreme. The opposite is also true; hyperventilation leads to anxiety.^9,10

Asthma, and BPDs share some of the same signs and symptoms and as many as 30% of those labeled asthmatic, suffer from hyperventilation. Those who suffer from inflammation and narrowing of the airways typical in asthma can benefit from training the muscles of respiration. Asthmatics typically have thicker smooth muscles in their airways and they tend to breathe 2 to 3 times more than usual at rest. This type of work has been shown to strengthen healthy breathing patterns, reduce shortness of breath upon exertion, and often reduce or eliminate the need for medications. ¹¹

Allergies: HVS can exacerbate allergy symptoms to make them feel worse than they are.

Chronic Fatigue Syndrome (CFS) and Fibromyalgia:   It has been shown that almost all cases of CFS and fibromyalgia suffer from BPD. CFS can actually be the result of chronic habitual over breathing. 12

  Breathing Assessment

Observation: When observing breath you are looking and listening for whether or not a person breathes through their nose or mouth and what part of the torso moves with the breathe. Ideally breathing is done through the nose. The normal rate of breathing varies by age. The normal breathing rate for newborns is about 44 breathes per minute (bpm), infants 20 - 40 bpm, toddlers 20 - 30 bpm and for adult between 12 and 25 bpm. 

When you breath the lower ribs should expand slightly. On inhalation, the lower abdomen expands. On exhalation the lower abdomen retracts. With normal breathing there should be no movement of the chest.  

For more detailed information on breathing assessment refer to Leon Chaitow's book, Naturopathic Physical Medicine: Theory and practice for manual therapists and naturopaths. 2008, Churchill Livingston, Edinburgh.

  Treatment Options - Breathing

Awareness of breath. Find somewhere comfortable to sit or lie with your spine straight. Close your eyes and pay attention to your breath. Do not try to change it yet, simply pay attention for a couple of minutes. Most people notice that simply by paying attention to their breath their breathing will become more deeper, slower and more steady. With practice it may help restore normal breathing patterns.

Deep breathing: In optimal breathing, each inhale expands the lower torso, back and ribs while the shoulders, neck, face and chest remain relaxed. Upon observation the belly expands as inhalation occurs. During exhalation the belly retracts as the diaphragm relaxes. A person’s breathing can be assessed a number of different ways:

  One way to test whether you are breathing properly is to put your hand on your lower abdomen. When you inhale, you want to feel your abdomen expand. Many people are paradoxical breathers which means they breath through their chest.

To develop proper breathing habits try the following exercise:

Find a quiet spot to sit or lie with your spine straight. Close your eyes and pay attention to your breath. Put one hand on your chest and one hand on your abdomen. Notice the movements associated with each inhale and exhale. Upon inhalation, concentrate on brining the air into the abdomen. You should feel the abdomen rise as air is inhaled. As air is exhaled, the abdomen should fall. Movements of the chest should be slight if at all. With practice this exercise may also help restore normal breathing patterns.

Alternate nostril breathing: Alternate nostril breathing has been shown to improve brain function on both sides of the brain and serves to create balance between the right and left sides of the body. In addition, alternate nostril breathing is known to have a calming and revitalizing effect on the body. As well it soothes the nervous system and may help to improve sleep.

Find a quiet spot and sit with your spine straight. Close the right nostril with your right thumb and inhale fully through the left nostril. Immediately close the left nostril with the ring and little finger on the same hand and remove your thumb from the right nostril. Exhale fully through the right nostril. Next inhale through the right nostril (the same nostril you just exhaled from). Release your right and little finger from the left nostril and close the right nostril with your thumb once again. Exhale from the left nostril. That completes one full round. Start with one or two rounds and gradually increase. Sit for a few moments after you have finished.¹³

Cleansing breath: Cleansing breath or Kapalbhati is a breathing technique that uses forceful exhalation to remove stale air from the lungs and improve functioning of various systems of the body including respiratory, digestive, circulatory and nervous systems. Cleansing breath also strengthens and tones the muscles of the abdomen and pelvic floor.

Find a quiet spot and sit with your spine straight. Begin with an inhalation and then use the abdominal muscles to forcibly and audibly exhale. This is one round. Note that each inhalation following a forceful exhalation will be a passive response. Therefore attention should be paid to the exhalation with the inhalation happening naturally.

 

Breathing Articles:

 References:

1. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1290766/pdf/jrsocmed00176-0035.pdf
2. Lum LC, Journal of the Royal Society of Medicine, 1987, 229-231
3. http://gut.bmj.com/content/37/4/499.abstract
4. http://emedicine.medscape.com/article/807277-overview
5. http://www.leonchaitow.com/PDFs/ResearchPELVICPAIN.pdf
6. http://www.nlm.nih.gov/medlineplus/ency/article/000891.htm
7. http://content.karger.com/ProdukteDB/produkte.asp?Aktion=ShowFulltext&ArtikelNr=000029422&Ausgabe=226555&ProduktNr=224278
8. http://www.womenshealthmatters.ca/centres/pelvic_health/pelvic_prolapse/index.html
9. http://www.ncbi.nlm.nih.gov.ezproxy.ccnm.edu/pubmed/19669009
10. http://chestjournal.chestpubs.org/content/97/6/1285.long
11. http://chestjournal.chestpubs.org/content/102/5/1357.full.pdf+html?sid=7f6dcc59-11dd-4149-a32d-d82458ec05ed
12. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1292947/?page=3
13. http://www.ncbi.nlm.nih.gov/pubmed/17879663 
14.  http://emedicine.medscape.com/article/807277-overview
15. Multidisciplinary approaches to breathing pattern disorders - Chaitow, Bradley and Gilbert
16. http://www.breathing.com/articles/benefits.htm
17. Nieman, D. Can exercise help me sleep better. ACSM's Health & Fitness Journal, May/June 2005 Vol9. No 3