Breathe, Exhale and Repeat: What Are the Benefits of Controlled Breathing

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By Dr. Mercola

The average person takes about 20,000 breaths a day, and you probably don’t give them much thought. Breathing obviously yields incredible power over your health, as it supplies your body with oxygen (and removes excess carbon dioxide [CO2]) to keep you alive.

However, when harnessed correctly, breathing can do far more than supply your cells with oxygen. The way you breathe — whether fast or slow, shallow or deep — sends messages to your body that affect your mood, your stress levels and even your immune system.

So-called controlled breathing, research is increasingly showing, can influence your health for the better, and all you have to do is learn how to use it. What’s interesting about breathing is that it’s both a voluntary and an involuntary process. Much like blood flow or digestion, your body breathes automatically.

However unlike the former two processes, you cannot decide to alter the flow of your blood or your digestive process. Not so with breathing. You can make a choice to take the reins and control your breathing — the speed, the depth and even whether you breathe through your mouth or your nose.

This is perhaps the first clue that you should take back control of your breathing at least some of the time. As you change the way you breathe, you’ll also change important aspects of your health.

Controlled Breathing May Trigger Your Relaxation Response

You may be aware that your body has a “fight-or-flight” response that kicks in when you’re under stress. Lesser known is that your body also has what’s essentially an opposite fight-or-flight response called the relaxation response.

Controlled breathing is one way to trigger your relaxation response, as it activates your parasympathetic nervous system, which in turn may slow down your heart rate and digestion while helping you feel calm.

By evoking your body’s built-in relaxation response you can actually change the expression of your genes for the better, according to an associate professor and pioneer in Mind Body Medicine at Harvard Medical School, Dr. Herbert Benson. As stated by one study in PLOS One:

“RR [relaxation response] elicitation is an effective therapeutic intervention that counteracts the adverse clinical effects of stress in disorders including hypertension, anxiety, insomnia and aging …

RR practice enhanced expression of genes associated with energy metabolism, mitochondrial function, insulin secretion and telomere maintenance and reduced expression of genes linked to inflammatory response and stress-related pathways.”

In short, slow, steady breathing activates your parasympathetic response while rapid, shallow breathing activates your sympathetic response, which is involved in releasing cortisol and other stress hormones.

Controlled Breathing: an Ancient Technique Backed by Modern Research

Controlled breathing, or pranayama as its known in the practice of yoga, is a central part of many ancient traditions.

For instance, yogic breathing exercises are described in an ancient Tamil script called Thirumanthiram and breath meditations have long been used in Buddhism as a way to help reach enlightenment.

Modern research suggests the benefits of controlled breathing are real and may improve health conditions ranging from insomnia and anxiety to post-traumatic stress disorder (PTSD) and depression.

“Breathing is massively practical,” psychologist Belisa Vranich, Ph.D., author of the upcoming book “Breathe,” told The New York Times. “It’s meditation for people who can’t meditate.”

In a preliminary study presented in May 2016 at the International Congress on Integrative Medicine and Health in Las Vegas, Nevada, researchers found 12 weeks of daily yoga and controlled breathing improved symptoms of depression similar to using an antidepressant.

Not only did the participants’ symptoms of depression significantly decrease but their levels of gamma-aminobutyric acid (GABA), a calming neurotransmitter, simultaneously increased.

Equally intriguing was research published in BMC Complementary and Alternative Medicine, which found that breathing exercises lowered levels of salivary cytokines associated with inflammation and stress in a group of healthy volunteers.

Controlled breathing exercises have also been found to modify stress coping behaviors and initiate appropriate balance in cardiac autonomic tone, which is a term that describes your heart’s ability to respond to and recover from stressors.

How Breathing Helps Relieve Symptoms of Stress, Anxiety and Depression

In a BMC journal study, breathing exercises called Sudarshan Kriya (SK) were used. SK is a type of rhythmic breathing used during the practice of Sudarshan Kriya Yoga (SKY). Such breathing practices range from slow and calming to rapid and stimulating.

For instance, during SKY you may engage in ujjayi breathing, which is slow breathing of three cycles per minute, followed by bhastrika, or rapid exhalation at 20 to 30 cycles per minute, followed by SK, which is breathing in a slow, medium and fast cycles. According to the International Journal of Yoga:

“There is mounting evidence to suggest that SKY can be a beneficial, low-risk [and] low-cost adjunct to the treatment of stress, anxiety, post-traumatic stress disorder, depression, stress-related medical illnesses, substance abuse and rehabilitation of criminal offenders.”

The breathing exercises are said to help balance your autonomic nervous system and influence psychologic and stress-related disorders through a number of mechanisms, including:

  • Increased parasympathetic drive
  • Calming of stress response systems
  • Neuroendocrine release of hormones
  • Thalamic generators

Lowered Blood Pressure, Brain Growth and Other Remarkable Benefits of Controlled Breathing

Beyond stress and anxiety relief, “Studies have demonstrated that SK can play an important role in promoting a healthy lifestyle by improving immunity, antioxidant status, hormonal status and brain functioning,” according to research published in the journal Advances in Mind-Body Medicine.

Yet another study in the World Journal of Clinical Cases concluded SK and other breath-based medication sequences have “the potential to help develop an individual's self-awareness and support better integration of the brain (i.e., mind) with other organ systems (i.e., body) for enhanced human performance.” More specifically, research suggests that harnessing the timing and depth of your breath may lead to the following:

  • Lowered blood pressure and heart rate, including lowering blood pressure in people with hypertension
  • An increase in brain size when used along with meditation
  • Immune support, by altering the expression of genes involved in immune function

Mouth Breathing Versus Nose Breathing: the Buteyko Breathing Method

Whether you breathe through your mouth or your nose also has important health implications, with the latter being far preferable. The field of breathing and breath-work has enormous potential for improvement, as most prevailing ideas about breathing promoted in yoga, Pilates and meditative methods tend to focus on taking big, deep breaths.

This may have benefits, as discussed, but according to the Buteyko Breathing Method, this is actually the opposite of what you should do. The Buteyko Breathing Method helps to reverse health problems associated with improper breathing, the most common of which are overbreathing and mouth breathing.

In the video above, Patrick McKeown, one of the top teachers of the Buteyko Method, examines dysfunctional breathing patterns associated with asthma, rhinitis and sleep disorders such as sleep apnea, and details the scientific rationale for improving your breathing habits.

When you stop mouth breathing and learn to bring your breathing volume toward normal, you have better oxygenation of your tissues and organs, including your brain. Factors of modern life, including stress and lack of exercise, all increase your everyday breathing.

Typical characteristics of overbreathing include mouth breathing, upper chest breathing, sighing, noticeable breathing during rest and taking large breaths prior to talking.

Why Mouth Breathing Can Make You Feel Like You’re Not Getting Enough Oxygen

Most people believe that taking bigger breaths through your mouth allows you to take more oxygen into your body, which should make you feel better and more clear-headed. However, the opposite actually happens. Deep mouth breathing tends to make you feel light-headed, and this is due to eliminating too much CO2 from your lungs, which causes your blood vessels to constrict. So, the heavier you breathe, the less oxygen is actually delivered throughout your body.

And, contrary to popular belief, CO2 is not merely a waste gas. Although you breathe to get rid of excess CO2, it's important to maintain a certain amount of it in your lungs — and for that you need to maintain a normal breathing volume. When too much CO2 is lost through heavy breathing, it causes the smooth muscles embedded in your airways to constrict. When this happens, there is a feeling of not getting enough air and the natural reaction is to breathe more intensely.

But this simply causes an even greater loss of CO2, which constricts your airway even further. To remedy the situation you need to break this negative feedback loop by breathing through your nose and breathing less.

Clinical trials involving asthmatics show they breathe between 10 to 15 liters of air per minute and people with chronic heart disease tend to breathe between 15 to 18 liters of air per minute. On the other hand, normal breathing volume is between 4 and 7 liters of air per minute, which translates into 12 to 14 breaths. This suggests breathing less is a sign of better health. Conversely, the more you breathe, the more likely you are to experience significant health problems.

A Simple Breathing Technique to Reduce Stress and Control Anxiety and Panic Attacks

Controlling anxiety and quelling panic attacks is one of the areas where the Buteyko Method can be quite useful. If you’re experiencing anxiety or panic attacks, or if you feel very stressed and your mind can’t stop racing, try the following breathing technique. This sequence helps retain and gently accumulate carbon dioxide, leading to calmer breathing, and reduces anxiety. In other words, the urge to breathe will decline as you go into a more relaxed state:

  • Take a small breath into your nose, followed by a small breath out
  • Then hold your nose for five seconds in order to hold your breath, and then release your nose to resume breathing
  • Breathe normally for 10 seconds
  • Repeat the sequence

3 Steps to Proper Breathing

In his talk, McKeown led a group demonstration of proper breathing, summarized as follows. These steps will help your breath to become lighter, such that the hairs in your nose barely move. This type of breathing helps you to enter and remain in a calm, meditative state while lowering your blood pressure and reducing nasal congestion for easier breathing.

You may feel a slight air shortage at first, but this should be tolerable. If it becomes uncomfortable, take a 15-second break and then continue.

  • Place one hand on your upper chest and the other on your belly; feel your belly move slightly in and out with each breath, while your chest remains unmoving.
  • Close your mouth and breathe in and out through your nose. Focus your attention on the cold air coming into your nose and the slightly warmer air leaving it on the out breath.
  • Slowly decrease the volume of each breath, to the point it feels like you're almost not breathing at all (you'll notice your breath getting very quiet at this point). The crucial thing here is to develop a slight air hunger. This simply means there's a slight accumulation of carbon dioxide in your blood, which signals your brain to breathe.

After three or four minutes of air hunger, you'll start experiencing the beneficial effects of CO2 accumulation, such as an increase in body temperature and an increase in saliva. The former is a sign of improved blood circulation, the latter a sign that your parasympathetic nervous system has been activated, which is important for stress reduction.

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