#39

Learn how to breathe for overall health and performance

Patrick McKeown

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Patrick McKeown is a world-renowned expert in breathing with nearly 20 years clinical experience. He has written eight books, three of which were bestsellers. Patrick has also been published in numerous publications and journals.

He studied at Trinity College Dublin and went on to study breathing with renowned Dr Konstantin Buteyko in his Moscow clinic. He became a practitioner and proponent of the Buteyko Method, which uses nasal breathing, breath control and breath holding as a treatment for health conditions. Patrick founded the Buteyko Clinic International based in his hometown Galway. 

His work helps use simple breathing exercises to improve the quality of life for people who suffer from asthma, sleep disorders, high blood pressure and just anyone interested in improving their overall health and wellbeing.

His latest book, ‘The Breathing Cure’, has been called “the definitive book on breathing”. It contains simple home practice exercises for adults and children, research-backed methodologies that help you to use breathing to improve your quality of life.

Join us as we unpack the science and health behinds quality breathing, entering the flow state and the breathing exercises and tests you can practise today.

Summary

3:31 Why breathwork has become so popular recently

• There’s a lot of misinformation
• Taking breathing out of the yoga to the mainstream

6:41 Breathing to manage lockdown anxiety

• Stress causes us to breathe faster and more shallow
• If you breathe through your mouth, you’re more likely to sleep lighter
• Nitric oxide, antiviral and antibacterial gas, is released into the nasal cavity, which can help inhibit Covid-19
• Focus more on the exhalation, not inhalation, to stimulate the vagus nerve
• Shallow, fast breathing tells the brain there’s a high stress environment
• The numbers of sleep disorder breathing amongst children
• “Society demands us to concentrate, but no one tells us how”
• Light breathers are healthy breathers
• The number one behaviour to master is to sleep with your mouth closed
• The link between depression and sleep quality
• 30% of Irish population will have rhinitis, an irritation and inflammation of the mucous membrane inside the nose
• Hold your breath to help decongest your nose
• You are 2 – 3 times more likely to have a sleep problem if you have a stuffy nose
• Patrick’s personal experience of treating his asthma
• 10% higher oxygen uptake in the blood through nasal breathing than mouth breathing
• Cold hands and feet are common for mouth breathers
• Breathing impacts our blood circulation, breathing airways, sleep quality, mental health, and physical performance
• Nasal breathing has a strong connection with the diaphragm, which impacts your spine stabilisation and can reduce back pain

28:31 Why we don’t breathe correctly in an intuitive way

• Analysing the skull structure of our ancestors, they had wider jaws
• Our current society is “training our brain to be distracted”
• We’re trained to think, but not how to stop thinking
• Patrick’s breathing exercise to calm anxiety: normal breath in and out, hold your nose for 5 seconds, breath normally for 10 seconds. 
• 15 – 20 minutes of slow and low warm up exercises for athletes
• The role of your spleen in breath hold
• Professor George Dallam’s study in 2018 with recreational athletes
• The BOLT score test helps identify if you have a breathing pattern disorder
• Professor Kyle Kiesel’s study on nasal breathing in 2018
• BOLT Score of 25 seconds+ indicates healthy breathing
• BOLT score test:

1. Take a normal breath in through your nose and allow a normal breath out through your nose.
2. Hold your nose with your fingers to prevent air from entering your lungs.
3. Time the number of seconds until you feel the first definite desire to breathe, or the first stresses of your body urging you to breathe. These sensations may include the need to swallow or a constriction of the airways. You may also feel the first involuntary contractions of your breathing muscles in your abdomen or throat as the body gives the message to resume breathing. (Note that BOLT is not a measurement of how long you can hold your breath but simply the time it takes for your body to react to a lack of air.)
4. Release your nose, stop the timer, and breathe in through your nose. Your inhalation at the end of the breath hold should be calm.
5. Resume normal breathing.

47:39 The distinction between oxygen and CO2, and their role in performance breathing

• 98% of oxygen in the blood is carried by haemoglobin – a protein in the red blood cells
• The aim is to get oxygen released to where it’s needed
• You shouldn’t be able to hear your breathing during rest
• The harder you breathe, the less the oxygen gets delivered

51:10 Using full lung capacity

• Mouth breathing engages with the upper chest, but the greatest concentration of blood flow is in the lower region of the lungs
• The Wim Hof Method is a short-term stressor so allow time to recover
• “The one thing about the breath is that it’s free, and you carry it with you”

55:36 Simple exercises to incorporate in your daily life

• Priority is to sleep through your nose during sleep, e.g. sleep with tape over your mouth
• The reason your nose gets stuffy is because you are breathing through your mouth
• Focus on your breathing throughout the day
• The drive to breathe is CO2, not oxygen
• Practise nasaling breathe when you exercise, and keep it up for 6 – 8 weeks
• Use a nasal dilator for assistance
• “Breathing is so simple, and maybe that’s part of its downfall sometimes”

1:01:52 Nitric oxide’s role in the body

• Nitric oxide is a gas that was first discovered in the human exhale breath in 1991
• Nasal breathing helps to open up the lower airways, carrying nitric oxide into the lungs, which helps to redistribute the blood throughout the lungs, therefore increasing oxygen uptake in the blood
• People with cystic fibrosis have low levels of nitric oxide
• Ireland has the fourth highest rate of asthma in the world
• Nitric oxide is the body’s way of helping to protect the lungs

1:04:16 How performance is impacted by V̇O2 max

• It is the maximum rate of oxygen consumption measured during exercise of increasing intensity
• People with a reduced sensitivity to CO2 have an increased VO2 max
• Repeat Sprint Ability (RSA)
• Nasal breathing during sleep is essential for recovery

1:13:57 How mouth breathing changed the human face over the century

• Jaws are less wide than 100 years ago
• A good airway is the size of your tongue
• Children should breathe through their nose and have their tongue resting at the roof of their mouth
• Jaws need to be more forward so the airways are more open
• Crooked teeth indicates that the jaw is too small
• Orthodontists need to raise more awareness about our airways

1:20:40 How to make a habit of nasal breathing whilst exercising

• “How you breathe during physical exercise is influenced by how you breathe when you rest and sleep”
• Begin by focusing on sleep
• When you first switch to mouth breathing, expect a 10% reduction in performance because the air hunger is too great
• Start by just applying nasal breathing to 25 – 50% of your exercise
• Review your breathing ability by measuring your BOLT score and maximum breathlessness test
• Nostril and nasal cavity size has a big impact on your ability to switch to nasal breathing 
• A stronger diaphragm is more efficient and less likely to fatigue
• If a diaphragm gets tired, blood will be taken from the legs to feed the diaphragm
• “Breathing trumps everything”

1:26:32 The walk and hold exercise 

1. While walking breathe in, breathe out and hold your breath
2. Walk 5 to 20 paces with your breath held
3. Resume breathing and continue to walk
4. After 30 seconds to 1 minute of walking with normal breathing, repeat breath hold as above
5. Repeat small breath hold every half minute to one minute
6. Ensure that your inner body is relaxed throughout
7. If there is tension in your tummy or chest, encourage this area to relax

Don’t do this if you are pregnant or have a serious medical condition

1:28:56 How breathing takes us into a flow state and impacts our cognitive abilities

• A wandering mind prevents us from concentrating, so we calm the mind through our breath
• Focus on fully exhaling to increase CO2 in the blood, which will have a calming effect on the nervous system
• LSD: Light, Slow, Deep
• Bring focused attention to your life
• Use your five senses in nature
• Calmness of the mind helps us “see more and miss less”
• “This is not about spirituality, it’s about human living”

1:38:52 Patrick’s experiences of silent retreats

• It brings attention to yourself when you remove all distractions
• Being able to enter a flow state when public speaking
• The difficulty of sitting in the lotus posture when meditating
• “The only way to endure pain is to surrender it”

1:46:02 Advice to people who want to enter a greater flow state and overcome heightened anxiety

• There’s a point where stress can be too much
• Bring attention to your body and tune into where the stress lies
• Slow down your breathing 15 – 20 minutes before you go to sleep
• “It doesn’t take much to get stressed”

1:53:02 The impact of breathing from the ovulation cycle

• During the post-ovulation stage of the monthly cycle there’s an increase in the hormone progesterone. This hormone is a respiratory stimulant – which means the breathing becomes faster and more in the upper chest. This increases fatigue, decreases pain tolerance and disrupts sleep.
• Women should track their BOLT score at different stages of the cycle
• Use breathing techniques to help ease the symptoms of PMS
• There is a known reduction in menopausal hot flushes as result of nasal breathing during sleep

Links Mentioned:

• Shut your Mouth and Change your Life – TEDxGalway
• ‘The Breathing Cure’ by Patrick McKeown
• YouTube: ‘How to Breathe while Wearing Face Mask?’
• Breathing Re-Education and Phenotypes of Sleep Apnea: A Review
• Role of Buteyko breathing technique in asthmatics with nasal symptoms
• Myotape
• Mindhacker’s Radio w/ Dr. Jay T. Wiles: Patrick McKeown on The Oxygen Advantage‬
• Comparison of maximal oxygen consumption with oral and nasal breathing by AR Morton
• ‘The Oxygen Advantage’ by Patrick McKeown