“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 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.
The many functions of breathing include:
- Gas Exchange
- 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. That is, over-breathing or Hyperventilation Syndrome (HVS) can increase the number of free radicals in body and add to the body being more acidic. Lactic acid produced by anaerobic exercise also lowers pH making the body more acidic. The drop in blood's pH stimulates chemoreceptors in the blood system to increase the rate of breathing.
- Warming the Body When you breathe properly. That is when you breathe through the nose, into the belly, at a slow relaxed pace the body will actually warm up.
- 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.
- Speech Normal breathing permits normal speech.
- Breathing is involved in non-verbal expression such as sighing.
- 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 and the fluid of the body (lymph and blood) moves more easily.
- Spinal mobilitiy It helps maintain spinal mobility through regular, mobilizing, thoracic cage movement.
- 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. When the diaphragm is functioning normally if enhances digestive function via rhythmic positive and negative pressure fluctuations.
- 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).
- 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.
Internal and external factors impact not only the rate of breathing but breathing function itself. Over time, bad breathing patterns become habitual and are often referred to Hyperventilation Syndrome (HVS). 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 overridden. 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 breaths and a tendency to hold one’s breath.
- 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.
- 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 sleeping 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.
- Personal factors
- 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.
|Article||The Effects of Meditation and Exercise on Acute Respiratory Infections, NMJ, , 2012 October|
- 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.
- Medications: A number of different prescription medications can alter breathing patterns and the rate of breathing.
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 dysfunctional breathing often go hand-in-hand. In some cases the underlying respiratory condition impairs proper breathing; yet in many cases improper breathing contributes 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 then 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., 
- Pain Whenever pain is present it is helpful to assess breathing function. Deep breathing releases endorphins 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 breathing pattern disorders. 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. Breathing pattern disorders can provoke existing cardiovascular 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.
- Headaches and breathing pattern disorders are closely linked.
- Stress Incontinence Respiratory function is connected to pelvic floor functionality.   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 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.
- Asthma and breathing pattern disorders 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.
- Allergies: Breathing pattern disorders 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 breathing pattern disorders. Chronic fatigue syndrome can actually be the result of chronic habitual over breathing.
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 breath. The normal rate of breathing varies by age. The normal breathing rate for newborns is about 44 breaths per minute (bpm), infants 20 - 40 bpm, toddlers 20 - 30 bpm and for adult between 12 and 25 bpm. Proper breathing includes the following:
- Breathe through the nose Breathing through the nose is important for a number of reasons:
- The hairs in the nose play an important role in filtering the toxins in the air and preventing them from entering the lungs.
- The mucosa of the nose warms cold air before it enters the lungs. If cold air enters the lungs it can worsen conditions such as asthma.
- Breathing through the nose is an important part of the pH balancing effect of breathing.
- The chi or energy that is in the air enters the brain more easily when breathing is done through the nose.
- Breathing through the mouth is common when activity levels are high. The aim is to return to breathing through the nose as quickly as possible.
- Diaphragmatic and intercostal breating When you breathe properly the primary muscle that is engaged is the diaphragm. When the diaphragm is engaged what you notice is that:
- On inhalation, the lower abdomen expands and the lower ribs should expand slightly.
- On exhalation the lower abdomen retracts. With normal breathing there should be no movement of the chest.
- Rate and volume of breathing The rate and the volume of your breathing should reflect your activity level.
- When you are sitting still your breathing rate and volume should be low.
- 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.
- 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 breathe through their chest.
To develop proper breathing habits try the following breathing exercises:
Deep breathing: Proper breathing is slow, deep and rhythmic and involves inhalation and exhalation through the nose. Deep means that the initial movement is from the abdomen and from the lower ribs. With the Complete Breath the movement starts in the low abdomen due to contraction of the diaphragm and on the sides of the body then moves up to the chest. To check your breathing, put one hand on your low abdomen and one on your chest and take a deep breath. What do you notice? If your chest rises up first you are probably using your neck muscles to breathe, not your diaphragm. Another way to check your breathing is to put your hands on your side, just below the chest. When you inhale your hands should move away from the body. Incorrect breathing contributes to neck and shoulder tension, shortness of breath, digestive concerns, gastric reflux and heart burn and a host of other health concerns.
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. It also emphasizes the importance of breathing from the nose versus from the mouth. 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.
Buteyko Method encourages slow, rhythmic shallow breathing, as well as breathing through the nose and increasing the pause in breathing. This method encourages the body to tolerate a higher CO2 level. There are a number of YouTube videos that explain this method.
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.
- ↑ 1.0 1.1 1.2 1.3 Chaitow Leon, Bradley Dinah, Gilbert Christopher (2002) Multidisciplinary Approaches To Breathing Pattern Disorders Churchill Livingstone.
- ↑ Lum LC (1987) Hyperventilation syndromes in medicine and psychiatry: a review Journal of the Royal Society of Medicine;80:229-231. 
- ↑ Ford MJ, Camilleri MJ, Hanson RB, Wiste JA, Joyner MJ (1995) Hyperventilation, central autonomic control, and colonic tone in humans. Gut;;37:499-504. 
- ↑ Kern Brian, Brenner Barry Hyperventilation Syndrome Accessed April 2012. 
- ↑ Chaitow Leon (2007) Chronic pelvic pain: Pelvic ﬂoor problems, sacroiliac dysfunction and the trigger point connection. Journal of Bodywork and Movement Therapies;11:327–339. 
- ↑ Stress Incontinence Accessed April 2012 Medlineplus. 
- ↑ Eterovića Davor, Strinićc Tomislav , Dujićb Željko , Bobanb Mladen (1999) Blood Gases and Sex Hormones in Women with and without Genital Descensus Respiration66(5):400-406. 
- ↑ Tavel ME (1990) Hyperventilation syndrome--hiding behind pseudonyms? CHEST;97(6):1285-1288. 
- ↑ Weiner P, Azgad Y, Ganam R, Weiner M (1992) Inspiratory muscle training in patients with bronchial asthma. CHEST;102(5):1357-1361. 
- ↑ Rosen SD, King JC, Wilkinson JB, Nixon PG (Dec 1990) Is chronic fatigue syndrome synonymous with effort syndrome? J R Soc Med;83(12):761–764.