Breathwork

Most mornings, I begin my day with a few minutes of breathwork before a meditation. There are many exercises from the Wim Hof Method to yogic pranayamas (e.g., bhastrika, kapalbhati, bahya pranayam, nauli kriya, and sodarshan chakra pranayam). The American Lung Association shared 2 techniques taught by pulmonary rehabilitation specialists. Each of these techniques have their own benefits. With breath, I can regulate my physiology: change the ph balance of my blood, increase or decrease oxygen saturation, change my systolic blood pressure, increase body temperature, slow or raise heart rate, and strengthen my immune system (Kox, et al., 2014). I can also regulate my mind and increase mental alertness or change the pattern of brain wave activity. In a recent study, researchers found potential links between respiration and neural activity. The correlation between neural activity in the cingulate cortex and breathing rhythm suggests that breathing rhythms may impact emotional state, according to one of the lead researchers (Zhang, 2022).

Last week, I came across a headline that caught my attention: Daily 'breath training' can work as well as medicine to reduce high blood pressure.

HIghlights:

• A daily dose of muscle training for the diaphragm and other breathing muscles helps promote heart health and reduces high blood pressure.

• Doing 30 breaths per day for six weeks lowers systolic blood pressure by about 9 millimeters of mercury.

• Those reductions are about what could be expected with conventional aerobic exercise such as walking, running or cycling.

• A normal blood pressure reading is less than about 120/80 mmHg. A patient is diagnosed with high blood pressure if their average reading is consistently 130/80 mmHg or higher.

• The impact of a sustained 9 mmHg reduction in systolic blood pressure is significant. Many common blood pressure medications lead to about a 9 mmHg reduction. A 10 mmHg reduction correlates with a 35% drop in the risk of stroke and a 25% drop in the risk of heart disease.

So, how exactly does breath training lower blood pressure? Endothelial cells, which line our blood vessels, promote the production of nitric oxide — a key compound that protects the heart. Nitric oxide helps widen our blood vessels, promoting good blood flow, which prevents the buildup of plaque in arteries. "What we found was that six weeks of IMST [inspiratory-muscle strength training] will increase endothelial function by about 45%," one of the researchers explained.

A training regimen consisting of only 30 breaths per day would be very helpful in endurance exercise events, according to the study. Researchers used the PowerBreathe breath trainer. However, people have been training without devices for millennia. It has long been known that deep diaphragmatic breathing can help lower blood pressure. And humming on the exhalation can increase nitric oxide 15 fold (Weitzberg, 2002).

Elite cyclists, runners and other endurance athletes also benefit from breathwork. Six weeks of inspiratory-muscle strength training increased aerobic exercise tolerance by 12% in middle-aged and older adults.

There are other breathwork protocols found to improve athletic performance. Short breath holds simulate the effects of high-altitude training by inducing both a hypoxic (lack of oxygen) and hypercapnic (high carbon dioxide) response. These two effects lower sensitivity to carbon dioxide, increase endurance, reduce the discomfort and fatigue from lactic acid build-up, increase the oxygen carrying capacity of the blood, improve breathing economy, and improve VO2 max (McKeown, 2015).

Several times a week, I'll take a CO2 tolerance test and measure my BOLT (Body Oxygen Level Test) score. This is a measure of pulmonary capacity and may be correlated to one's ability to manage stress.

I use the breath to calm the mind. When I slow my breath to a frequency of 6 or less (I use the Paced Breathing app), my respiration, heart rate, and metabolism slow. If I close my eyes and relax the muscles of the body, I reduce demands on the brain even further. I can drop into an alpha state quickly. The screenshot below captures recent brain wave activity during a meditation session on a lunch break at work. The blue line, representing the alpha state, is dominant. All other bands (gamma, beta, delta, and theta) are relatively subdued. These brain wave frequencies from fastest to slowest are gamma, beta, alpha, theta, and delta. They refer to cycles of electrical activity within the brain. Alpha is often associated with relaxed, passive attention.

Sometimes, the brain may be sluggish and dull. I might not want to calm my mind, but stimulate it. There are breathing exercises to do this. Two are ancient: Bhastrika and kapalbhati pranayam. These stimulate the sympathetic nervous system. In one study, researchers found that 20 minutes after kapalbhati, the nervous system returned to parasympathetic dominance. In other words, we can introduce mild stressors with breathwork, just as exercise does, but return to a state of calm post-exercise.

The screenshot below captures EEG data during a morning meditation session after a few rounds of vigorous breathwork. Alpha, beta, and gamma waves are dominant. This is the profile of concentration.

A recent headline caught my attention: Breathwork study: Largest controlled trial to date finds no psychological benefits beyond placebo effect. “We wanted to compare daily coherent breathing to a placebo for ~1 month to see if there were any differences on subjective mental health and wellbeing outcomes."

I prefer harder empirical data to subjective questionnaires. Below are results from my experiments.

Today was a stressful day, but I took time to reset. I took 5.5 breaths per minute just as participants did in the study. While the stressful conditions did not magically go away, I was calmer, my head was clearer and I could more properly respond to each situation. There are other benefits which contribute to well-being. I sleep optimally most nights. I do not carry stress with me to bed. Stress doesn't dysregulate my gut microbiome. I do not have elevated biomarkers related to stress.

There is an additional psychological benefit. I know I have a tool right under my nose to help me self-regulate. I also know how to use the breath to optimize performance. This is definitely not a placebo effect.