I think everyone reading this will agree that if you don’t breathe, you will die. If you don’t breathe well, you get sick. Not breathing well deprives you of oxygen. The general consensus by the lay public as well as doctors is that oxygen is good for you. The more, the better. However, this may not always be true. We all need the proper amount of oxygen to be healthy, but rather than focus on the amount of oxygen we take in, how we’re able to use the oxygen that’s available can be just as important, if not more important.
One helpful tip that changed my life a few years ago was a way to breathe better. It was described by Dr. Andrew Weil, noticed integrative medicine practitioner and health guru. It’s a yoga breathing technique called the relaxing breath. Basically, you breathe in through your nose slowly for a count of 4, hold for 7 seconds, and then breathe out slowly through your mouth for a count of 8. This cycle is repeated 3 to 4 times in a row, spaced many times throughout the day.
When I started doing this on a regular basis, I noticed a dramatic improvement in my stress levels and felt more calm throughout the day. It is thought that nhalation is controlled by the sympathetic nervous system (stress mode), whereas exhalation is controlled by the parasympathetic nervous system (relaxation mode). So by taking longer breathing out, the more time you’re spending in the parasympathetic, relaxation state. You can demonstrate this on your own by measuring your heart rate on a digital monitor while you perform the relaxing breathe. You’ll see that your heart rate slows down during exhalation.
There are countless proven breathing techniques in addition to the relaxing breath, including Buteyko, diaphragmatic breathing, and pranayama techniques. However, all these methods focus on how well you breathe during the day. They also assume that you have adequate structural passageways to be able to breathe without too much resistance. Breathing in and out through a very large straw (7-Elevin’s Big Gulp Slurpee straw) will be much easier compared to breathing through a small caliber coffee stirrer.
If you have the upper airway anatomy of a modern human, you’re likely to have dental crowding and smaller upper air passageways due to the various reasons I describe in my book, Sleep Interrupted: A physician reveals the #1 reason why so many of us are sick and tired. Having a smaller mouth can lead to crowding of the soft tissues inside the mouth (tongue, soft palate, etc.) and obstructed breathing when muscles are most relaxed during deeper levels of sleep. Partial obstruction can lead to arousals from deep to light sleep, while longer and more severe pauses can lead to apneas or hypopneas (10 seconds or longer pauses).
Based on these concepts, here are 7 reasons why better breathing in general may not make you healthier:
- Controlling your breathing only helps during the day. Proper breathing while awake is important, and should be implemented with any health regimen, but you have no voluntary control over breathing while you’re sleeping. You’re at the mercy of your your autonomic nervous system, which regulates your normal breathing patterns when awake or asleep. If you have narrowed passageways, your only protection against obstructed breathing (partial or total) is to increase muscle tone, waking you up from deep to light sleep. Fragmented deep sleep is a common reason for daytime fatigue and lack of productivity. A number of other factors affect your air passageways during sleep, including neck position, sleep position, sleep stage, nasal congestion, hormonal status, and age.
- You don’t know that you’re not breathing well. One of the most common responses I get from patient during an exam is a “WOW” experience after spraying the nose with a nasal decongestant and lifting up the nostrils. They’ve had nasal congestion all their lives, so they don’t know what normal nasal breathing feels like. Typically, some patients have no space behind the tongue when lying flat on their backs, but when I have them thrust the lower jaw forward, the airway opens up significantly, which is a good sign that a mandibular advancement device may help.
- Good posture (and breathing) can only occur during the day. There are a number of gadgets and devices to promote good posture (Lumo Lift, chest straps). However, it’s challenging to have good posture at night while sleeping. Staying off your back is the simplest and most commonly prescribed remedy. Traditionally it’s been recommended to sew a tennis ball to the back of your pajamas. A more modern and convenient way is to use something like Slumberbump.
- Without good nasal breathing, you can’t get completely healthy. Most people with dental crowding also have nasal congestion. When the roof of your mouth doesn’t develop downwards, you’re left with a high arched hard palate. This leads to a narrow distance between the molars on your upper jaw and a smaller mouth. The nasal septum, which is a midline sheet of cartilage and bone, buckles to one side as it grows if the floor or the nose (roof of the mouth) doesn’t drop appropriately. Additionally, the side walls of the nasal cavity are closer together, since they follow the molars. Lastly, the angle between the nasal septum and the nostrils are more narrow, leading to more collapsibility. In this situation, no amount of breathing exercises during the day will change the deviated septum. Certain breathing or tongue exercises may help with inflammation to limited degrees, but will not change basic bony anatomy. Not breathing through your nose has another negative health consequence: The nose makes a gas called nitric oxide. When inhaled into your lungs, it increases oxygen uptake by 10 to 20%.
- Using oxygen gives doctors a false sense of security. It’s routine to place nasal prongs on patients’ noses and given oxygen after waking up from surgery. After being given anesthesia, your muscles are more relaxed, and it’s a given that you won’t be able to take full deep breaths. Patients are given oxygen through the nose with the assumption that since they’re not able to take deep breaths, you need to increase oxygen concentration in the bloodstream by giving more oxygen. However, another major reason for low oxygen levels is because of obstructed breathing. Anesthesiologists in the know will typically place an airway stent through the nose (nasal trumpet) or the mouth (oral airway) to bypass the obstruction. Being forced to lay flat on a stretcher is not conducive to good breathing for most people, especially if your tongue is relaxed after anesthesia.
- Poor breathing during sleep leads to low tissue oxygen levels during the day. Frequently interrupted breathing and arousals during sleep will lead to a physiologic state of stress. When your body is under stress, it will automatically shout down what are called the “end organs,” such as your digestive system, reproductive organs, skin, hand/feet, and even certain parts of your brain. This will lead to lowered amounts of blood flow and nervous system innervation going to these particular areas of the body. This can result in the typical digestive problems, sexual dysfunction, or cold hands and feet.
- Does stress makes you breathe poorly, or does poor breathing makes you more stressed? This is the proverbial chicken or the egg question. Without question, stress can alter your breathing patterns. However, most modern humans have facial structural crowding and upper airway narrowing that predisposes to improper breathing during the day and during sleep. Oftentimes treating breathing problems with myofunctional therapy and functional appliances will lead to better posture. It’s clear that one affects the other and vice versa. One argument that for the latter (poor breathing leads to stress and less oxygen) is the theory behind Buteyko breathing. In their model, over-breathing through the mouth leads to mild hyperventilation, leading to a slight rise in your blood pH level, causing your hemoglobin in your blood to hold on to more oxygen, making it less available to your body’s tissues. But having physically narrowed nasal passageways can predispose to mouth-breathing and over-breathing as well.
What’s unfortunate is that we as modern humans now have to be mindful of our breathing, rather than letting it occur naturally on its own. With our hectic and interruption-filled lives, it’s no wonder we all feel more stressed and out of control. Add to this an anatomic reason why we’re not able to breathe as well as we used to in past centuries, and these detrimental effects are only compounded. With the advent of various health promoting breathing techniques, the focus is on getting more oxygen to your body. However, these techniques completely miss the fact that we literally can’t physically breathe properly during the day and especially at night, leading not so much to lack of oxygen intake, but to lack of blood flow to the body despite adequate levels of oxygen that’s coming in.
What do you think? Does stress makes you breathe poorly, or does poor breathing makes you more stressed? Please enter your comments below.