How to Breathe Correctly for Optimal Health, Mood, Learning & Performance

Breathing and its Importance

• Breathing is essential for life
• Subtleties of how we breathe (duration, intensity, inhales, exhales) define our state of mind and body
• By controlling our breathing, we can control our mental health, physical health, and performance

Breathing: Unique Brain and Body Function

• Breathing lies at the interface between our conscious and subconscious behavior
• Represents a bridge between the conscious and subconscious in the brain
• Breathing does not require attention or awareness; it carries on involuntarily
• At any moment, we can consciously take control of how we breathe
• By controlling breathing, the brain is attempting to control its own state of mind

Changing Breathing Patterns Affects Brain Function

• By changing your pattern of breathing, you can quickly change what your brain is capable of doing
• Inhaling is better for learning and remembering information than exhaling
• Breathing techniques can be used for various purposes, such as learning, memory, physical performance, and stress reduction

Oxygen and Carbon Dioxide in Breathing

• Oxygen and carbon dioxide are the main players in breathing
• Oxygen is necessary for life, while carbon dioxide is a waste product
• Oxygen cannot diffuse through our skin, so we need to breathe to bring oxygen to the cells deep in our body
• Brain cells are the most metabolically active cells and require a lot of oxygen

By understanding the science behind breathing and applying various breathing techniques, we can improve our mental and physical health, as well as enhance our performance in various aspects of life.
Understanding Breathing and Respiratory System

Mechanical and Chemical Aspects of Breathing

• Breathing is essential for delivering oxygen to cells and removing carbon dioxide
• Too much carbon dioxide is not good, but it is necessary for efficient oxygen delivery
• Mechanical and chemical aspects of breathing are crucial for understanding how to optimize it

Key Components of Breathing

• Mechanical components:
  • Nose and mouth: entry points for air
  • Larynx: rigid pipe connecting nose/​​mouth to lungs
  • Lungs: expand and contract like a pump, contain hundreds of millions of small sacs called alveoli 
    • Alveoli increase surface area, allowing more oxygen to enter the bloodstream and more carbon dioxide to be removed
  • Diaphragm and intercostal muscles: control lung expansion and contraction 
    • Diaphragm: thin muscle below lungs, contracts to create more space for lung inflation
    • Intercostal muscles: between ribs, contract to move rib cage up and expand during inhalation
• Chemical components:
  • Oxygen and carbon dioxide levels in the bloodstream
  • Understanding the balance between these gases is crucial for optimizing breathing

Physiological Sigh: Reducing Stress Quickly

• Double inhale through the nose, followed by a long exhale through the mouth
• Balances oxygen and carbon dioxide levels, reducing stress and autonomic arousal
• Works better than any other known approach

Over-​​breathing: A Common Problem

• Most people breathe too often, removing too much carbon dioxide
• This can lead to a hypoxic state, where not enough oxygen reaches the brain and other tissues
• Can be an issue for people with obesity, sleep apnea, and certain personality types

Breathing and Personality

• Breathing can alter personality in positive ways
• Can lead to more calm, focus, alertness, and improved overall health

Nasal vs. Mouth Breathing

• Nasal breathing is generally more advantageous, but mouth breathing can be useful in certain situations
• Understanding the mechanical and chemical aspects of breathing can help determine the best approach for different activities

The Importance of Diaphragmatic Breathing

• Diaphragmatic breathing involves contracting the diaphragm to create more space for lung inflation
• Allows for more efficient oxygen delivery and carbon dioxide removal

• Can lead to better overall health and reduced stress levels
  Mechanical Components of Breathing

• Diaphragm and intercostal muscles move the lungs

• Nerves control muscles 
  • Phrenic nerve controls diaphragm 
    • Motor nerve: moves muscle
    • Sensory nerve: senses diaphragm position
• Intercostal muscles control rib movement 
  • Separate set of nerves control these muscles

Diaphragmatic Breathing

• Most efficient way to breathe
• Belly moves outward on inhale, inward on exhale
• Common in yoga and relaxation techniques

Intercostal Breathing

• Rib cage expands and contracts to control lung size
• No clear evidence that diaphragmatic breathing is better or worse
• Ability to control both types of breathing is beneficial for mental and physical states

Larynx

• Rigid tube structure
• Prevents collapse during vigorous breathing

Nose and Mouth Breathing

• Different resistances to air 
  • Nose has more resistance, allowing more forceful inhalation and more air intake
  • Mouth has less resistance, easier to breathe through but less air intake
• Breathing through the nose can be beneficial even if it’s more challenging

Chemical Aspects of Breathing

• Oxygen and carbon dioxide are key players

  • Oxygen needed by all cells and tissues
  • Carbon dioxide plays a critical role in delivering oxygen to cells 
    • Too much carbon dioxide can be problematic
  • Balance between oxygen and carbon dioxide is essential for proper functioning
    The Importance of Oxygen and Carbon Dioxide in Breathing

• Breathing air with too much carbon dioxide can induce panic

  • Even in people with no amygdala (associated with fear and threat detection)
• Oxygen and carbon dioxide are crucial for proper body function 
  • Oxygen inhaled from the air moves into the lungs’ alveoli, then into the bloodstream
  • Oxygen binds to hemoglobin in the blood, which delivers it to cells and tissues
  • Carbon dioxide is needed to liberate oxygen from hemoglobin 
    • Changes the shape of hemoglobin, allowing oxygen to be released
• Carbon dioxide levels affect the acidity or alkalinity of the body 
  • Low carbon dioxide levels increase blood pH (more alkaline)
  • Ideal body pH is around 7.4, with some exceptions (e.g., gut microbiome)

Hyperventilation and Its Effects

• Hyperventilation involves inhaling and exhaling more than usual 
  • Brings in more oxygen, but also removes more carbon dioxide
• Low carbon dioxide levels (hypocapnia) can cause: 
  • Increased anxiety
  • Vasoconstriction (narrowing of blood vessels)
  • Tingling sensations in extremities
  • Increased alertness and energy
• Hypoxia refers to reduced oxygen levels relative to normal

Breathing at High Altitudes

• At high altitudes, the air pressure is lower, making it harder to fill the lungs with air 
  • Oxygen masks are needed at very high altitudes (e.g., mountain climbing, high-​​altitude skydives)
• The difference in air pressure between the lungs and the outside environment affects the ease of breathing 
  • Air moves from high pressure to low pressure, filling the lungs more easily at lower altitudes

Throughout the episode, various techniques and adjustments to the oxygen and carbon dioxide ratios will be discussed to cater to different needs such as sleep, exercise, or mental work.
Breathing at High Altitudes

• At high altitudes, air pressure is lower 
  • Less steep gradient of high pressure outside the body to low pressure inside the lungs
  • Requires more effort to breathe air into the lungs
  • Diaphragm and intercostal muscles work harder
  • Shoulders may lift with each breath
• Inhaling is an active process, exhaling is passive 
  • At high altitude, more energy needed to inhale enough oxygen
• First few days at high altitude can cause lightheadedness, headaches, and carbon dioxide buildup 
  • Deliberate hyperventilation combined with breath holds can help adapt more quickly

Healthy vs. Unhealthy Breathing

• Sleep apnea: underbreathing during sleep 
  • Can lead to hypoxia (less oxygen being brought into the system)
  • Excessive daytime sleepiness, anxiety, and snoring are signs of sleep apnea
  • Serious health concern: increased risk of cardiovascular events, sexual dysfunction, cognitive dysfunction, and exacerbation of dementia
• CPAP (Continuous Positive Airway Pressure) device: common treatment for sleep apnea 
  • Not always necessary; behavioral interventions can be effective
• Nasal breathing during sleep can offset sleep apnea and snoring 
  • Taping mouth shut with medical tape during sleep encourages nasal breathing
  • Training to become a better nasal breather during the day can transfer to nighttime breathing patterns

Brain Centers Controlling Breathing

• Two main areas of the brain control breathing: 
  1. Pre-​​Bötzinger Complex: controls the basic rhythm of breathing
  2. Parabrachial Complex: modulates breathing based on various factors (e.g., exercise, stress, etc.)

• Understanding these brain areas is important for understanding how to breathe properly and maintain general health related to respiration
  Discovery of PreBötzinger Complex and Parafacial Nucleus

• Discovered by Jack Feldman, a professor of neuroscience at UCLA

• PreBötzinger Complex:
  • Controls rhythmic breathing (inhales follow exhales)
  • Fundamental discovery in neuroscience
  • Involved in breathing during sleep and when not consciously thinking about breathing
  • Disruption of its function may cause sudden infant death syndrome
  • Opioid overdoses can shut down this structure, leading to death from lack of breathing
• Parafacial Nucleus:
  • Controls non-​​rhythmic breathing (doubling up inhales/​​exhales, deliberate pauses)
  • Involved in conscious control of breathing
  • Used during speaking, physiological sigh, and box breathing
  • Both structures often work in parallel

Breathing and Brain Excitability

• Balustrino and Somjen’s paper in Journal of Physiology (1988) states that by regulating breathing, the brain controls its own excitability
• Excitability is the threshold at which a neuron can be active or not
• Different patterns of breathing impact the overall state of the brain and its ability to respond to sensory stimuli

Effects of Hyperventilation on the Brain

• Hyperventilation causes a decrease in carbon dioxide levels in the blood (hypocapnia)
• Low carbon dioxide levels prevent oxygen from being liberated from hemoglobin and reaching the brain
• Results in a 30–40% reduction in oxygen delivery to the brain
• Reduction in carbon dioxide also prevents normal vasodilation (opening up of capillaries)
• Brain becomes hyperexcitable, leading to increased anxiety and reduced efficiency in processing information
• Hyperventilation can trigger seizures in seizure-​​prone patients due to low levels of carbon dioxide in the brain

Box Breathing

• A pattern of breathing involving inhales, holds, exhales, and holds
• Useful for adjusting anxiety levels

• Involves both PreBötzinger Complex and Parafacial Nucleus
  Healthy Breathing Patterns

• Normal healthy breathing is about 6 liters of air per minute

  • Roughly 12 shallow breaths per minute
• Studies show most people breathe too much per minute (15–30 shallow breaths) 
  • Overbreathing leads to brain hyperexcitability and less efficient learning and focus
• Healthy breathing involves nasal breathing and pauses between breaths 
  • Nasal breathing delivers more oxygen and generates more air pressure to fill lungs
  • Pauses between breaths help prevent overbreathing

Carbon Dioxide Tolerance Test

• Helps determine if you’re overbreathing or underbreathing
• Test procedure:
  1. Inhale deeply through your nose, filling your lungs as much as possible
  2. Start a timer and slowly exhale through your nose, controlling the exhale until your lungs are empty
  3. Note the time it takes to completely empty your lungs
• Test results:
  • 15–30 seconds: May be overbreathing
  • 45–60 seconds: Better control of breathing and carbon dioxide management
  • Over 60 seconds: Exceptional control of breathing and carbon dioxide management

Adjusting Breathing Patterns

• Spend a minute each day paying attention to your breathing rate while at rest
• Aim for a balance between underbreathing and overbreathing
• Nighttime: People tend to underbreathe
• Daytime: People tend to overbreathe (hyperventilate)

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Determining Healthy Breathing Patterns

• Perform the carbon dioxide tolerance test to assess your current breathing pattern
• Adjust your breathing pattern to achieve a healthier balance between oxygen and carbon dioxide delivery

• Practice nasal breathing and include pauses between breaths for optimal breathing patterns
  Carbon Dioxide Tolerance Test and Box Breathing Exercise

• Carbon dioxide tolerance test measures neuromechanical control of the diaphragm

  • Not related to fitness level
  • Can vary depending on stress and relaxation levels
• Test results:
  • 20 seconds or less: low carbon dioxide tolerance (write down number 3)
  • 25–45 seconds: moderate carbon dioxide tolerance (write down number 5–6)
  • 50 seconds or longer: high carbon dioxide tolerance (write down number 8–10)
• Box breathing exercise: 
  • Equal duration inhale, hold, exhale, hold, repeat
  • Duration based on carbon dioxide tolerance test results 
    • Low: 3 seconds each
    • Moderate: 5–6 seconds each
    • High: 8–10 seconds each
  • Perform for 2–3 minutes, once or twice per week
  • Increases neuromechanical control over the diaphragm through neuroplasticity
  • Can improve resting pattern of breathing, leading to numerous benefits 
    • Increased calm, reduced stress, improved nighttime sleep
• Retake carbon dioxide tolerance test after a few weeks to track progress
• Aim to do all breathing through the nose, if possible

Stanford Study on Brief Structured Respiration Practices

• Explored box breathing and other forms of breathing compared to meditation
• Goal: find shortest and most effective practice to reduce stress and improve mood and sleep
• Used WHOOP straps to measure heart rate variability and other physiological parameters
• Collected subjective reports about mood and feelings of well-being

• Data collected remotely, allowing for more realistic settings than a laboratory environment
  Breath Work Practices for Stress Reduction

• Study with over 100 subjects measuring the impact of breath work practices on physiological parameters and subjective mood

• Breath work practices led to greater reductions in stress than meditation (5 minutes per day for a month) 
  • Meditation still useful for improving focus and memory
• Three types of breath work explored: 
  1. Box breathing
  2. Cyclic sighing
  3. Cyclic hyperventilation
• Participants were divided into groups and swapped between practices to serve as their own control

Results of the Study

• Cyclic sighing was the most effective practice for stress reduction, improving sleep and mood 
  • Inhale deeply through the nose, second inhale to maximally inflate lungs, long exhale through the mouth until lungs are empty, repeat for 5 minutes a day
• Meditation, box breathing, and cyclic hyperventilation also reduced stress, but not as much as cyclic sighing
• One physiological sigh (double inhale through the nose, extended exhale through the mouth) is the fastest way to introduce calm and reduce stress in real time 
  • Discovered by physiologists in the 1930s
  • Occurs spontaneously in humans and animals to rebalance oxygen and carbon dioxide levels

Implications and Recommendations

• If you only have 5 minutes a day to invest in stress reduction, cyclic sighing is the most effective practice
• One physiological sigh can be used for real-​​time control of stress
• Physiological sighs are not a “hack” but a natural process to rebalance oxygen and carbon dioxide levels

• People often shift between overbreathing and underbreathing, which is not ideal for maintaining proper oxygen and carbon dioxide levels
  Physiological Sigh and its Applications

• Reduces stress in real time or as a daily practice

• Highly compatible with neural circuits controlling breathing
• Useful for removing side stitch during exercise 
  • Side stitch often caused by spasming of the phrenic nerve or inefficient breathing
  • Performing physiological sigh during exercise can alleviate side stitch pain

Breathing and Heart Rate

• Inhales increase heart rate, exhales decrease heart rate 
  • Diaphragm moves down during inhale, creating more space in thoracic cavity 
    • Heart temporarily enlarges, blood flow slows, nervous system signals to speed up heart rate
  • Diaphragm moves up during exhale, reducing heart volume 
    • Blood flow accelerates, nervous system signals to slow down heart rate
• Controlling heart rate through breathing 
  • To increase heart rate: inhale longer and more vigorously relative to exhales
  • To decrease heart rate: make exhales longer and/​​or more vigorous than inhales
• Respiratory sinus arrhythmia (heart rate variability) is the basis of most breathing practices 
  • Practices emphasize inhales, exhales, or have equal duration and intensity of both
• Applications in sports, military, and clinical contexts 
  • Marksmen exhale before taking a shot to lower heart rate
  • Extended exhales used to bring heart rate down quickly between rounds of martial arts
  • Physiological sigh being explored as a tool to prevent panic attacks and anxiety attacks

Mastering the Skill of Extended Exhales

• Actively relaxing the diaphragm and intercostal muscles during exhale
• Allows for better control of heart rate and stress management
• Useful for people with high interoceptive awareness, especially those prone to anxiety
  Managing Hiccups and Breathing Techniques

Hiccups: Causes and Solutions

• Hiccups occur due to spasms of the phrenic nerve 
  • Phrenic nerve originates from the cervical region (C3, C4, and C5)
  • Controls the diaphragm and has a sensory branch
  • Sensory branch detects contractions within the diaphragm and liver
• Stopping phrenic nerve spasms can stop hiccups 
  • Breathing into a bag, drinking from the opposite side of a glass — not always effective
  • A more reliable technique: inhale three times in a row through the nose, hold breath for 15–20 seconds, and slowly exhale

Breathing Techniques

Cyclic Hyperventilation

• Involves 25 deep breaths, inhaling through the nose and exhaling through the mouth 
  • Can be active inhale and passive/​​active exhale
• Increases autonomic arousal and adrenaline levels 
  • Useful for extending breath holds
  • Popularized by the Wim Hof Method and Tumo Method
  • Caution: avoid doing this near water due to risk of shallow water blackout

Benefits of Cyclic Hyperventilation

• Removes the impulse to breathe by expelling more carbon dioxide 
  • The trigger to breathe is an increase in carbon dioxide levels
• Releases adrenaline from adrenal glands and epinephrine from the locus ceruleus 
  • Increases alertness and stress levels
• Acts as a form of self-​​induced stress inoculation 
  • Allows individuals to control the release of adrenaline and maintain a calm state of mind during stress

Practicing Cyclic Hyperventilation

• Practice one or two times per week to explore and manage stress

  • Expect to feel tingly and agitated due to the reduction in carbon dioxide
  • Helps individuals lean into the stressful aspects of life and maintain control over their reactions
    Breathing and Cognitive Function

• Breathing patterns affect cognitive function, memory, and reaction time

• Inhaling through the nose improves brain function, memory retrieval, and memory formation
• Olfactory system is the most ancient sensory system and plays a role in these effects
• Nasal inhalation increases activity in brain areas like the hippocampus, involved in learning and memory

Study: Nasal Respiration and Cognitive Function

• Published in the Journal of Neuroscience in 2016
• Showed that reaction time is greatly reduced when people are inhaling
• Participants had to detect and discriminate between different types of stimuli
• Faster reaction time to fearful stimuli when inhaling through the nose
• Inhaling enhances the ability to detect novel stimuli and unexpected events
• Changes in pupil diameter and hippocampus activity during inhalation

Takeaways

• Inhaling through the nose can improve cognitive function, memory, and reaction time
• Practice rhythmic breathing and nasal inhalation for better brain performance
• Use this knowledge to manage stress and improve cognitive abilities in various situations
  Enhancing Cognitive and Physical Performance Through Breathing

Breathing Techniques for Different Goals

• Increase duration or intensity of inhales for better focus and information retention
• Exhale during voluntary movements for more power and efficiency (e.g., sports, martial arts)

Nasal Breathing vs. Mouth Breathing

• Nasal breathing is generally better for overall health
• Benefits of nasal breathing:
• Inflates lungs more due to increased resistance
• Warms and moisturizes air for better lung health
• Produces nitric oxide in nasal passages, promoting relaxation and vasodilation
• Improves facial aesthetics and jaw structure
• Mouth breathing can be damaging to respiratory functions if done chronically
• Nasal breathing should be the default pattern, with mouth breathing reserved for speaking, eating, or intense exercise

Breathing Exercises for Various Outcomes

• Carbon Dioxide Tolerance Test: measures how well you manage carbon dioxide levels
• Physiological Sigh: helps decrease stress in real-time
• Cyclic Hyperventilation: can improve breath hold times and eliminate hiccups
• Breathing to Eliminate Side Stitch: helps during exercise
• Breathing for Improved Learning and Memory: focus on inhaling for better cognitive function

Improving Nasal Breathing

• Deliberate nasal breathing can increase ability to breathe through the nose
• Adding space within the palate of the mouth allows the tongue to sit more completely on the roof of the mouth
• Children can especially benefit from practicing nasal breathing
• Book recommendation: “Jaws: A Hidden Epidemic” by Paul Ehrlich and Sandra Khan