Every Breath We Take

Dr Ailsa Care

MBChB, MRCGP, AFMCP

May 19, 2021

We take breathing for granted, it just happens. We breathe in oxygen and we breathe out carbon dioxide. What could be simpler than that!

Actually the way that we breathe can alter our mind and body in so many ways. Altering the way we breathe is an easy way to make a big difference to our physical, mental and cognitive health and it costs nothing!

Lots of conditions affect the way we breathe, like asthma, allergies, COPD, heart conditions, anxiety, obstructive sleep apnoea. What if changing the way we breathe could help us to manage such conditions?

I first became aware of the science behind breathing when I was sitting in my dentist’s waiting room about 10 years ago. I picked up a book called Close Your Mouth by Patrick McKeown. It was all about a method called Buteyko breathing which it claimed could help with anxiety, cure snoring and manage asthma without medications. Even back then I was interested in finding drug free ways that patients could help themselves to manage their chronic health conditions.

There are a number of problems with the way that most people breathe.

The first is that 25-50 % of people breathe through their mouth rather than their nose. Our noses are designed to warm, moisten, filter and condition the air we breathe so that we are able to extract more oxygen from the air. A nasal breath results in 20% more oxygen than a breath through the mouth. When we breathe through our mouth we are exposing our lungs to everything in the environment that the nose would usually filter out. One of the main instructions with Buteyko breathing is to spend as much time as possible breathing through your nose.

Mouth breathing at night is associated with snoring and obstructive sleep apnoea (OSA). OSA has associations with depression, cognitive problems, metabolic issues like diabetes, increased risk of cardiovascular disease and raised blood pressure.

Breathing difficulty at night causes poor quality sleep, teeth clenching and grinding, waking with headaches and temporomandibular joint pain (due to clenching and grinding)

The second problem with the way we tend to breathe is that our breaths are too rapid so there is less time for the crucial gas exchange across the air sacs of the lungs.

The third issue is that along with this rapid breathing we tend to only use the upper parts of our lungs so not using them to their full capacity. This may be alright in a relaxed state when our muscles (including our heart) don’t need as much oxygen but we want to be able to take in oxygen more efficiently when we are active to provide oxygen to our muscles.

What can we do to improve our breathing?

  1. Be aware of whether you are breathing through your nose or your mouth and try to breathe more of the time through your nose. It won’t change overnight but the more you can breathe through your nose the better you will feel. When you breathe through your nose the tip of your tongue should lightly rest on the roof of your mouth just behind your front teeth.
  2. Some people find that sticking a 1cm strip of tape such as micropore across your lips at night is enough to remind yourself to keep your mouth shut. Just using a tiny piece of tape is not enough to stop you talking or breathing through your mouth if you need to. It shouldn’t feel claustrophobic. I tried this and for a few nights I found in the morning I had removed the tape at some point in the night. I sleep much better when I manage to keep the tape on all night and I’m less likely to need to get up to use the toilet.
  3. Count how many times in a minute you take a breath. Try to slow it down aiming for around 6 breaths per minute. As a rule, try to make your exhale slightly longer than your inhale, for example inhale for a count of 4 and out for a count of 6 or 8. It shouldn’t be too difficult, if it is start with fewer counts and gradually build up. There are lots of simple phone apps that can instruct you in various breathing patterns e.g Breathly, Breathe
  4. Think about breathing into all parts of your lungs. Remember they are a 3 dimensional structure so fill them in all directions. Start by placing a hand on each side of your chest, take a deep breath and feel the sides of your chest move outwards. Next place a hand at the top of your chest and at the bottom, take a deep breath and feel your hands move further apart. Lastly, put a hand on the front and the back of your chest and as you take a deep breath feel your chest expanding front and back.
  5. When you visit your dentist ask them to assess for dental problems that might affect your breathing especially if you snore at night. They can make you a night splint which holds your lower jaw forward when you sleep so that you are less likely to snore.
  6. Explore Buteyko breathing. Apart from breathing through your nose it involves training to pause on the exhale and lengthening this pause before inhaling again. Try exhaling gently and hold your breath for a few seconds until you feel a strong desire to inhale. Practice this multiple times per day.

If you want to find out more about breathing you may find the following resources useful: