Breathing is something that we do from when we get here to when we leave but that doesn’t mean that we do it well. The average person breathes around 30,000 times a day and if each breath is only a fraction off normal the overall effect is significant. People tend to change their breathing in response to stress, fear, habit and pain. People with back pain for an example tend to brace with their superficial abdominal muscles and their diaphragm meaning that it doesn’t descend as much as it’s supposed to. The true anatomical core muscles, which are deep to that, don’t fire well. It means that people are unable to breathe low and in their trunk like they normally would and instead breathe in their upper chest. Interestingly breathing regulation is all about carbon dioxide not oxygen like you think it might be. The most important respiratory sensors are actually for CO2. The amount of CO2 in our system is supposed to be between 35-45 millimetres of mercury (it is measured in pressure because it is a gas). If you’re not breathing well you blow off too much CO2 and you develop what is called hypocapnia or too little CO2. This happens when you over breathe by increasing the rate, volume or both.

Breathing is the only essential process that has both reflex and voluntary control. We can override the reflex symptoms both consciously and most importantly unconsciously. Our emotions have a big part to play in changing breathing. We can overuse this “voluntary override” through habits which can have a negative impact on the brain stem breathing reflexes.

When we over breathe we change the CO2 levels, causing a response at the cellular level that increases cellular activity which increases its requirement for oxygen, the fuel of cellular activity. The problem however is that there is decreased oxygen delivery because the muscle bands around the arteries are constricted and it’s hard for the oxygen to get into the cell. That causes trouble because there’s an increased requirement for oxygen and a decreased delivery of it. This poor oxygen delivery that happens in response to poor breathing is particularly hard on the nervous system including the brain. The brain is 2 percent of the body weight but it uses 20 percent of the oxygen. This means it requires blood and as John Medina says, “Any tissue without enough blood supply is going to starve to death. Your brain included”. There is some literature that suggests that people with chronic back pain and with fibromyalgia have decreased brain tissue density.

On the other hand, it has been shown that people who meditate (which involves attention to breath) have thicker brain tissue, more complex blood flow and more coordinated brain processing.

Breathing can be evaluated using capnography. This is a medical grade instrument that is used in critical care settings such as operating rooms and emergency rooms all over the world. Breathing can then be quantified and the problem areas identified making it far easier to improve breathing specifically.

Symptoms of poor breathing leading to hypnocapnia or too little CO2 can involve symptoms in neurological, psychological, respiratory, cardiovascular, muscular, gastrointestinal/urogenital and general body systems.

In the neurological system, people can feel pins and needles or have visual disturbance. It can be a cause of general headache including migraines as well as dizziness and faint feelings. Psychologically poor breathing is highly correlated with anxiety, panic disorder, cognitive dysfunction, depression and phobias. Interestingly approximately 25 percent of the population experience an anxiety disorder during their lifetime and many people have both anxiety and depression. More than 1 in 30 Canadians suffer from some sort of depressive illness. Breathing can be negatively impacted by stress. The world health organization calls stress a worldwide epidemic. It is thought to have a negative effect on health with well over 50 percent of primary care physician visits being attributed to it. It costs roughly 300 billion dollars US per year.

In the respiratory system people can complain of shortness of breath, an irritable cough, tight chest, a sense of not getting a satisfying breath and asthma. 9 percent of US children below the age of 18 had asthma in 2001 compared to 3.6 percent in 1980. The world health organization reports that 8 percent of the Swiss population suffers from asthma today compared to 2 percent 25-30 years ago. Interestingly it is most prevalent in affluent countries. Studies have shown benefit with breathing retraining. People with poor breathing often start to have symptoms in many body systems. There is a study that shows a surprisingly high prevalence of anxiety and depression in people with chronic breathing disorders.

In the cardiovascular system poor breathing can lead to coronary artery spasm, changes in ECG that are correlated with poor blood flow to the heart. Symptoms can include palpitations, a rapid heart rate, atypical chest pain, cold hands and feet and poor blood flow to the extremities. This can lead to high blood pressure and an increased tendency for plaque formation in your arteries. Heart disease and stroke is the underlying cause of death in 1 out of 3 Canadian’s. A study was done in the Netherlands showing improved outcome post heart attack when breathing mediated relaxation training was added to the treatment of people who have had heart attacks.

The musculoskeletal system people can complain of cramps, pain in the head, neck and shoulders, tremors, weakness, stiffness and increased muscle tone.

Symptoms related to the gastrointestinal and urogenital area include difficulty swallowing, flatulence, belching and bloating. Poor breathing is also highly correlated with irritable bowel and irritable bladder. It can cause increased urinary frequency. Irritable bowel syndrome affects 13-20 percent of Canadians and is one of the most common disorders that doctors diagnose. Stress is thought to be a big factor and it is more common in woman. Part of the reason for this could be the gender differences in breathing. Generally men have a higher CO2 level than women and progesterone has been found to increase both respiratory rate as well as causing women to over breathe. This happens in the phase of menses between ovulation and getting your period. This has been shown to be related to premenstrual syndrome. There are increased levels of progesterone in pregnancy and CO2 levels have been shown to decrease. Perhaps some of the symptoms related to pregnancy could have their source in over breathing such as swollen hands and feet, carpel tunnel, poor sleep, shortness of breath, stomach upset etc.

Poor breathing can cause sleep disturbance in the form of insomnia or even sleep apnea. People complain of weakness, exhaustion, night sweats and night mares.

The essentials of breathing well are made up of 5 components: Nose, Low, Slow, Let Go and Quiet.

Nose: Breathing through your nose rather than your mouth

Low: Breathing in your lower chest rather than upper chest

Slow: Breathing at 8-14 breaths per minute while at rest

Let Go: Being relaxed when you breathe out

Quiet: Breathing quietly ensures you don’t breathe too much air at a time

Breathing poorly can be changed and symptoms alleviated. Having your breathing tested with capnography is a way to isolate what aspect of breathing you are doing incorrectly and give specific feedback about how to improve.

Feel free to contact ProActive Health to book your capnography assessment. This can be done in our Oakville, Ontario location or can be arranged to be done virtually online if it is more convenient to do in your home or office. If you prefer the virtual option, we can arrange a rental capnography to be couriered to your location and a desktop sharing session can be scheduled. If you have any questions feel free to contact us either through email: admin@proactivehealth.ca or by phone: 905 338-2898