Weekly Blog

August 14

It started a few weeks ago as these things often do on our team. Someone brought up a study they had recently read, and others began to chime in, expanding on the subject and revealing some very intriguing ideas. This time, the discussion centered on breathing and the potential positive health impacts associated with deliberately training ourselves to breathe differently. It's not a new topic; we've covered it before, but as (un)luck would have it, a few days later in a rugby match I took a hard shot to the ribs which made deep breathing painful for a day or two. Then, less than a week later, as if the universe was listening and totally unrelated to my sore ribs, I received a text from a colleague (not affiliated with our team) connecting me to a physician in the space who was developing a product targeting the pulmonary (lung) side of endurance exercise and wanted to bounce some ideas off a willing ear. It was an interesting conversation, and although I ultimately felt I wasn't the best fit for him (and referred him to a different member of our team), it definitely got my wheels turning. Then, as if the internet was listening (ok, it is), by this time last week I started seeing ads for breathing apps for athletes with claims so significant that I felt compelled to step down the rabbit hole. So here we are.

The idea that deliberately working on breathing techniques can improve health is not new. In fact, according to one wildly popular voice, it is among the oldest health practices known. The general gist for modern humans is that we tend to run a little hot. Our normal breathing rate of 12-20 breaths per minute, double or triple the 6 breaths per minute most often advocated to reduce stress and improve resilience—a rate referred to as "coherent breathing"—suggests we may be letting our breathing apparatus become flabby by relying on rapid, shallow upper-chest breathing instead of relaxing, deeper "in through the nose" belly breathing. This habit might lead to a low tolerance for carbon dioxide, an indicator potentially worth a closer look. You can test this by taking a deep breath in through your nose and timing a full and slow exhale as described here. While slightly surprising given my current and heavily aerobic exercise load, my very pedestrian 34 seconds suggests it could use some work; maybe my social media "big brother", lurking as it may, was right this time. However, the jury is still out on the best way to do so.

While a stable research base supports the benefits of calming our nervous systems by controlling our breathing—and some version of 6 breaths per minute is extremely common across many cultures and used in many protocols—at least one rigorous, randomized, and placebo-controlled study published in 2023 showed that the rate itself may not matter as much as the intentional practice of stabilizing it. Subjects who performed controlled breathing exercises at 6 breaths per minute had about the same (significant) improvement as those tasked with the placebo rate of 12 controlled breaths per minute over the same 4-week period. While structured, even breaths (matched inhale and exhale) with no pauses are the consensus favorite for slowing us down, adding a breath hold (or other technique) to garner very specific effects associated with brief increases in carbon dioxide concentration is an emerging area of interest.

Take, for example, the study that started the conversation. It showed that brief increases in carbon dioxide benefited a group suffering from Parkinson's Disease by helping their bodies clear byproducts from the brain. Another suggested that a similar protocol might help the body fight cancer. In athletics, a few rounds of breath holding prior to training significantly improved Oxygen uptake and allowed trained athletes to exercise longer before showing signs of exhaustion. Another study, which asked trained athletes to sprint after exhaling (and then hold their breath during the sprint), also showed improved fatigue resistance. A recent review of the literature on the topic concluded that while the findings are plausible and promising, they are not definitive; more research is needed. With this in mind, after reviewing hundreds of studies, at least one researcher advocates implementing a 5-5-2 method: a 5-second inhale, 5-second exhale followed by a 2-second hold, especially for those in high-stress professions like emergency responders.

Breathing is a curious one. It is both automatic when we're not thinking about it and under our control when we are. There are very few physiological levers that set off a cascade of reactions as fast as consciously altered breathing. While there is still plenty to learn, and the best technique will almost definitely depend on our goals - one size never really fits all - becoming aware of our current patterns and working to expand, quite literally, our capacities through breathwork is about as easy as it gets. Hold here; I'll let you know how those time-to-exhaustion protocols go in a few weeks.

Have a great weekend,

Mike E.