Are you breathing correctly? You were taught to breathe slowly and deeply and this has made you feel more relaxed. Do you know what your C02 level is? Do you know your 0xygen saturation level? You may have heard that inhaling slowly is good? How do you exhale? Yoga breathing is supposed to be good for you. Did you know that acid-base balance is more a factor of proper breathing than the food you eat? Breathing is natural. You can tell by looking at someone whether they are hyperventilating or not?
I will in this article attempt to address the above issues and explain why they may be mythical. There are numerous teachers of breathing offering their kind services and no nothing of Carbon Dioxide. I will start out by saying that the only way to know if you are breathing in a healthy way for your body is to know intimately your level of Carbon Dioxide in the expelled breath.
For many years teachers of breathing have extolled the benefits of slow, deep breathing. While it may be extremely beneficial to someone who is chest breathing, it may also not be leaving in the blood the needed level of Carbon Dioxide. I have measured many a slow deep breather and in most cases their CO2 is better than a chest breather. However, it is possible to breathe in slowly, blow out equally and retain a low level of CO2. This would still be called hyperventilation or over-breathing. Yes, it can happen with slow, deep breathing.
Our text books throughout our years of education have told us that Carbon Dioxide is bad and told us to get rid of as much as possible by breathing it all out. This notion has led us to think Carbon Dioxide is a bad thing and we should get rid of it. It is more or less correct that we should breathe it out with each exhalation, but the benefits of keeping a certain blood level of Carbon Dioxide on board is critical to Oxygen availability. The real truth about exhalation is we exhale not to get rid of carbon dioxide but to regulate the amount left in our bodies. Habitually bad breathing occurs when the way one breathes disrupts the proper regulation of C02 allocation. Unfortunately, most teachers of breathing are paying attention to the mechanics of breathing, where and how, or slow and deep, rather than the behavior and emotions associated with breathing. How do you breathe while you are thinking, feeling or doing?
Carbon Dioxide plays one of the most significant roles in body health and well-being. Our text books tell us that the normal blood level arterial PCO2 (PaCO2) of Carbon Dioxide should be 40mmHg. At this level the blood pH (H+ levels) will be normal at pH of 7.4. Improper, or over or under breathing, can cause these to change, causing the blood to become alkaline or acidic respectively. Eating to change blood pH is akin to a race between the tortoise and hare.
What does Carbon Dioxide do for the body? First and most important it regulates the distribution of Oxygen in the body. Second, it is the body's relaxer. CO2 is the body's way of dilating the arteries, especially those in the brain, the heart and the periphery (hands and feet). Thirty seconds of unaware over-breathing can cause the brain's blood vessels to constrict up to 60%. In most cases, people who have cold hands and feet are hyperventilators and are giving off too much C02 with exhalation. Those with angina can effect the same result of taking nitroglycerine by exhaling correctly with two or more breaths done properly. I worked in a cardiology office and that cardiologist would refer all nitroglycerine patients to me to learn breathing. In Holland, legislation requires that all cardiac rehabilitation centers offer breathing training to cardiac patients. This has resulted in a documented savings of 45% savings over a 5 year period for heart attack patients.
In reality it is difficult to talk about the positive effects of the proper level of CO2 in the arterial blood as we are talking about 'healthy and normal'. The list of effects of lower levels of CO2 in the blood is incredibly long and gets longer and with more and more serious consequences as arterial CO2 level drops even more. In summary, higher levels (40mmHg) lead to normalization of the brain and body's functions, to relaxation, and to better blood flow throughout the body, especially the brain, the heart and the periphery.
Well, if you aren't getting enough oxygen, how about going to an oxygen bar? The response will only be momentary as you will return to your normal low level of CO2 and consequently lack of oxygen availability as soon as you return to your unconscious habit of over breathing, which should be almost immediately, as O2 is not a relaxer.
I am a nurse and I can honestly say we were never properly trained in this area, nor are the doctors. I have given many a talk on teaching breathing around the world and have never had a doctor not totally appreciate my information. I have read the respiratory text books doctors are trained with in medical school. Breathing is an incredibly complicated issue, mediated by need, habits (good and bad), by stress, by emotions, by training (yoga), by TV programs, by climate, allergies and so on. It is not a simple issue. Therefore, being aware and continually improving on that awareness is truly a life journey. You don't learn it and then "you've got it". It is more likely that you have unlearned very early the good breathing you were born with if you were an average kid. In the United States most children by three years old are over-breathing.
Because breathing chemistry is so tied to continually changing circumstances, feelings, thoughts and actions, the demand for 02 is constantly changing as well. Fear, anger and stress habitually lead to over-breathing. Awareness is the only key we have to staying "as best we can" on target with proper breathing. With awareness, we need the knowledge of what to do, and then how to change our habitual breathing response to that situation in that moment. This requires an on-going awareness and this is rather impossible unless we are sitting in a cave with nothing else to do and no one to disturb our consciousness. We will never totally master this as we are human and are constantly affected by and dealing with life's challenges. It is my belief though that breathing is the primary avenue to a higher consciousness and the more we can be aware, the more conscious we are.
What is your O2 level and what does it mean? Hospitals today are innovated with oximeters to measure your O2 level. They are using this equipment today in lieu of the old fashioned way, i.e., the nurse coming around, counting your respirations and blood pressure. The number of respirations per minute was essentially determined to be good or bad. If you were between the text book numbers of 12-20 you were ok, if lower or higher often times you would be visited by the head nurse who would recheck your vitals and perhaps call your doctor.
The pulse oximeter is being used today to measure oxygen saturation and number of respirations. Oxygen saturation is the amount of oxygen bound to hemoglobin in the blood expressed as a percentage of the maximal binding capacity. Now hospitals are using the pulse oximeter to determine this percentage of oxygen that is bound to hemoglobin. Do they know how to interpret it? It is generally thought to be good if the reading on the oximeter is 99%. After all, we have learned that 99 is better than 98, or 97 or 96 or 95. I certainly did when it came to grades and the difference in school between an A or B.
Well, unfortunately, nurses are not well trained in this area of breathing chemistry. A reading of 99% on the oximeter is indicating that your 02 is bound to hemoglobin and you are hyperventilating or over-breathing. Remember that over-breathing means decreased PCO2 and increased pH predispose oxygen to bind itself to hemoglobin, and thus, O2 in its full capacity is not available to the tissues. The higher the percentage on the oximeter, the more likely this is happening. So, conversely, increased PCO2 and reduced pH cause a release of Oxygen and nitric oxide, a potent vasodilator, resulting in increased blood vessel diameter, more volume flow and thus more oxygen to the cells. The whole process is far more complicated, but for a basic understanding for those who teach breathing and medical personal who use an oximeter, this is sufficient. In summary, the higher the percentage on an oximeter reading the more you are hyperventilating and most of your oxygen is bound to hemoglobin and not available to the tissues. Perhaps a percentage around 97 might indicate better healthy?
How do you breathe? Do you inhale quickly or slowly? Does it matter? Yes, it matters very much. When you are calm and relaxed and not expending energy, as in meditation, inhaling slowly is not problematic. When you are hiking up Mt. Everest, or even a hill back home, you may want to get the next mouthful (supply) of oxygen as quickly as possible. Let your body be your guide in terms of inhalation.
Exhalation is a different matter. There are many ways to exhale, a sigh or rapid exhale (also a hyperventilation), even exhale-to-inhale (as in most Yoga movements), breath-holding followed by a rapid exhale, an average rapid chest exhalation and so on. So what? Does it make a difference? Yes, but how significant is it? Actually, it may mean the difference between getting enough oxygen on a consistent basis or not. Notice how nearly everybody will tell someone who is stressed, just take a deep breath and breathe out slowly. Why? Because it is calming and intuitively we seem to know that. Why is it calming? Because blowing out slower raises the blood level of PCO2, thus unloading more oxygen off hemoglobin for performance and repairs of the body. CO2 is the body's natural relaxer of smooth and cardiac muscle. This means the blood vessels dilate and receive more blood flow and oxygen. Brain blood flow is mediated possibly entirely by blood level of CO2. The heart is directly affected by C02 level but also mediated at times by other body chemicals such as ACTH, adrenalin, cortisone, etc.
How do most experts on breathing breathe? Some are diaphragmatic, slow exhalers and probably are doing well when they are conscious of their breathing. How do most Yoga practitioners breathe? Interestingly, very evenly. They have learned the habit of 'even' breathing from their practice of yoga. Even breathing produces over-breathing. Do nurses and doctors and just normal people breathe well? For the most part, statistics garnered from medical professionals, using a capnograph, are telling us that most people are not breathing well. Sixty percent of ambulance runs in the United States are a direct consequence of hyperventilation; thirty three percent of visits to a doctor's office are because of symptoms generated usually long-term by hyperventilation. Having had a biofeedback/stress management practice, teaching breathing for many years, and working as a nurse, I can say with some assurance that migrainers, those with anxiety, most cardiac patients, those with cold hands, sleep apnea, pain, sleep problems, phobias, most pregnant women, asthmatics, and yoga teachers are nearly all hyperventilating or over-breathing. We have found the best breathers are babies and Tibetan lamas that chant san-scrit. These lamas spend hours per day chanting on a long exhalation. Their long exhalation becomes their habit of good breathing. This long exhalation keeps their C02 level elevated.
The ONLY way to know if you are breathing correctly is to use a capnograph to measure your blood level of CO2 or PCO2. Anything else is by inference only. Having measured many people, mostly normals and not patients,to our great surprise, most of the time one can not see hyperventilation. It is not like the movies with rapid chest heaving. Usually the person appears very calm. This myth of being able to detect by observation is one that is most important to dispel. With this myth exposed I feel breathing teachers can open to a new possibility. The only way to know or tell if a person is hyperventilating, excluding observing rapid chest breathing, is by using a capnograph to measure a person's C02 level. The capnograph will tell you breath by breath your blood level of CO2. A capnograph displayed on a computer breath by breath over time is an invaluable tool. Modified for training it can serve to teach good breathing as well. If your CO2 level is 40 mmHg you are in good breathing health. Anything lower should be an incentive to learn more about breathing. In this article I have barely touched on the subject, trying to keep it simple, understandable and pertinent. I hope this has tweaked your interest and you will visit my website to read more articles in depth. Also, if you are a breathing teacher, please avail yourself of an instrument to measure CO2 level. Without it you are really shooting in the dark when teaching breathing to your clients.
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