How to Breathe while Wearing Face Mask?

so welcome everybody it's Patrick macchione here and what I want to do is I want to discuss how can you breathe or change your breathing patterns in order to make wearing a mask easier and there's a lot of information about wearing masks some people are talking about as you're breathing into the mat putting carbon dioxide it's increasing carbon dioxide to dangerously high levels in the blood and it's also controversial what people are saying to hypoxia and I just want to talk about data let's talk about the gas carbon dioxide carbon dioxide is not just a waste gas and you know it's really very fundamental in human life and discovered back in 1904 is was by a Danish physiologist called Christian Bohr and it's called the Bohr effect and that's Bo hate you're and basically that the pressure of carbon dioxide in the blood is a catalyst for the release of oxygen from the red blood cells to the tissues now too often we hear that oxygen is good and that carbon dioxide is bad it's not just quite as simple as that so when you take a breath of air into your lungs oxygen transfers from your lungs into the blood and the majority of oxygen is carried in the blood by hemoglobin molecules and as I said the catalyst for the release of oxygen from the red blood cells to the tissues and organs including the brain is carbon dioxide now atmospheric concentrations of carbon dioxide are about point zero four percent of the atmosphere so they're very very low and the concentration of carbon dioxide in your blood is 5% so it kind of gives you an idea that the human body needs a concentration of carbon dioxide it's far beyond what's contained in the atmosphere now when you breed with a mask any masks and especially a mask that's well tight-fitting and if there's difficulty in particles escaping of course it's going to pool carbon dioxide now carbon dioxide will increase but it's not going to increase to dangerously high levels because you're literally breathing out carbon dioxide from that from the lungs from the blood through the lungs the co2 that coming out of out on your breath is going to be about 5% of atmospheric pressure or 40 millimetres of metric it's not dangerously high that's what's already in your blood it's in the arterial blood now how might you feel and the problem with wearing the mask is the feeling of discomfort and discomfort is because of the air hunger that's generated by wearing the mask so as carbon dioxide is collecting and pooling inside of the mask and you were briefed rebreathing that carbon dioxide back into your lungs you're feeling air hunger there how you respond to the feeling of air hunger will depend on individual to individual some individuals with for example if they are prone to panic disorder if they are prone to anxiety if they are prone to asthma if they are prone to breathing problems if they have a breathing pattern disorder and also females during the luteal phase of the monthly cycle when progesterone levels are high they can have an increased sensitivity to the buildup of carbon dioxide so it depends on genetic predispositions it depends on your background and for females it can depend on the monthly cycle it's very important in good health any way to reduce your body's sensitivity to carbon dioxide so what I would say is when you're wearing a mask and if you have to wear a mask is part of your workplace don't launch into wearing a mask for 3-4 hours straight start with 15-20 minutes and not only about breathing while wearing the mask and I will go through how to breathe while wearing the mask to reduce air hunger but also to improve alveolar ventilation it's also vital to have your mouth closed and breathe only through your nose during physical exercise during walking during rest and during sleep and the reason being if you continuously breathe through your nose it can help to improve and reduce your sensitivity to carbon dioxide buildup so therefore when you wear a mask it would be easier to tolerate now in terms of oxygen you will read reports that blood oxygen saturation is dropping when people are wearing a mask and I just like to shed some light on - number one in terms of it takes quite a lot of work just I'm just moving everybody it takes quite a reduction in airflow to drop blood oxygen saturation the feeling of air hunger that you experience while wearing a mask is not because oxygen is dropping because the primary stimulus to breathe is carbon dioxide that feeling of air hunger that you experience while wearing a mask is an accumulation of carbon dioxide now I already said that as carbon dioxide increases in the blood it causes what's called the right shift of the oxyhemoglobin dissociation curve but basically haemoglobin releases oxygen in the presence of carbon dioxide and as a result it will show as a lowering in your spo2 but that's not necessarily bad so when you're thinking of spo2 or sio2 you're talking about how fully-loaded are the red blood cells with oxygen and hemoglobin is the main carrier of oxygen it's a protein and within the red blood cells it's the main carrier of oxygen and in the presence of carbon dioxide hemoglobin releases oxygen more readily and this will show in a drop to your spo2 but you have to bear in mind that the reason that there's a drop in your blood oxygen saturation is because your hemoglobin is releasing oxygen more readily to the tissues and organs so don't see the drop in spo2 as being bad and because you know for example I'll have you do a couple of breathing exercises for by will purposely create our hunger and if you're wearing if you were wearing pulse oximetry during this time you will see that your blood oxygen saturation will hardly drop at all that that feeling of air hunger is due to carbon monoxide buildup okay your ability to tolerate your mask is going to be influenced in part by your breath whole time and your breath whole time we call a bolt in the oxygen advantage and basically your breath whole time gives you a feedback of your body's chemo sensitivity to carbon dioxide now to measure your breath whole time what I would like you to do is you're sitting down for about five minutes taking breath in through your nose a no more breath out through you know is in pinch your nose with your fingers and your timing it in seconds until you feel the first definite desire to breed and when you feel the first definite desire to breed let go and breed and your breathing should be fairly normal the measurement that you get there provides feedback of the degree of how well you breed and a paper by professor Keisel a professor in physical therapy that was published in 2018 looking at 51 subjects he used the ball scored the description of the ball score same as the control percent Beauty committed his conclusion was if you have a bold score of greater than 25 seconds there is an 89% chance the dysfunctional breathing is not present now what does both scorer measure all score measures your degree of breathlessness dyspnea how fast you breed and it typically provides feedback of how if you're breathing using the upper chest or if you're breathing fast versus low so as your ball score increases you are more likely to breed low using the diaphragm and as your ball score increases your response rate is typically slower so people with a low bowl score if they have a bowl score of 10 seconds they have a stronger key more sensitivity to carbon dioxide buildup when weight when they wear a mask and they are pooling carbon dioxide and rebreathing that gas back into the lungs which is going to increase carbon dioxide in the blood that they will have a stronger reaction in terms of air hunger so remember it's carbon dioxide that is the primary stimulus to breed and the feeling of air hunger that you feel when you're wearing the mask is because of the build-up of carbon dioxide however we need to reduce the body's scheme or sensitivity or sensitivity to carbon dioxide we need to but make the body more tolerant to carbon dioxide and actually that's good there is a reason that we have athletes trained with masks on and the reason being is because we use masks to expose them to hard carbon dioxide to reduce their body's chemo sensitivity to carbon dioxide so that when they do physical exercise they have less breathlessness okay so when you were so my whole point here is that it's your everyday breathing and your boat score that's going to influence and the feeling of air hunger so when you wear the mask I would say don't launch into wearing the mask for a long period of time but expose your body gently to ish and the pooling of carbon dioxide and rhe breathing it in if you do use pulse oximetry just to realize that the drop in your blood oxygen saturation is not necessarily because of the the the you know the restriction to breathing in terms of bringing oxygen in because the masks are pretty porous and you'll also find that there's probably going to be it's not going to be tightly sealed it's not a mask like this you know it's not a mask for by its completely tight again so there's plenty of room for air to come in um and the risk pooling of carbon dioxide so the drop that you witness to your blood oxygen saturation can be due to a right shift of the oxyhemoglobin dissociation curve due to an increase of carbon dioxide the drop to blood pH in other words haemoglobin releases oxygen and from the blood to the tissues in other words your tissues are getting more oxygen but in the blood the spo2 is showing as being lower and as I said it's not necessarily a bad thing I'd like you just to practice this in terms of learning and understanding about carbon dioxide if you put one hand on your chest and put one hand just above your navel and I would like you to tune into your breathing and if you've got panic disorder just go very gentle with it but otherwise it's pretty safe for everybody so I would like you to tune into the airflow coming into your nose and to tune into the airflow as its leaving your nose and to really feel the airflow as is coming into your nose and to feel the air flow as it's leaving your nose and as you're breathing what I would like you to do is to gently slow down the speed of the air coming into your nose and at the top of the bread bring a total feeling of relaxation to the body and have a relaxed and gentle breath out the objective here is when you're feeling the airflow coming into your nose I would like you to breathe less air I would like you to slow down your breathing sufficiently to the point that you feel a hunger for air I want you to simulate the effects of air hunger that you will experience while wearing the mask and I want you to do it for about three to four minutes so I need you to feel slightly breathless slight air hunger a need that you would like to take in a bigger breath but don't give in to that I want you to purposely under bridge to allow carbon dioxide to accumulate in the blood because it's not leaving the blood so readily and we want to test what's happening to the body when you breathe less air when you breathe slightly less air what happens in terms of blood flow what I in terms of circulation in terms of oxygen delivery and also in terms of relaxation of the mind so even though you're feeling a little bit of an air hunger what are the effects there and it's not about being panicked so again you're focusing on the airflow coming into your nose you're really feeling the air flow coming into your nose you're slowing down the speed of your breath and at the top of the bread bringing a total feeling of relaxation to the body and allow a relaxed and gentle breath out the objective is that you're breathing now is less than what it was before you started I need you to hide your breathing I need you to take about 30% less air into your body how do you take 30% less air into your body really slow down the speed of air coming into your nose can you slow down your breathing so much almost that the fine hairs within the nostrils do not move almost that you feel hardly hardly any turbulence coming into your nose that your breathing is so light and deliberately expose yourself to that air hunger and then check what is happening to your body as a result of the air hunger the objective is not to feel stressed the objective is not to feel panicked but the objective is to feel that you would like to take in a bigger bread so again you're just gently focusing on the airflow coming into your nose you're really slowing down the speed of the air coming into your and at the top of the bread a total feeling of relaxation to the body that you have a relaxed and prolonged breath out and then when you feel the need to breathe in again you take a very soft and slight breath in so you're taking a really soft and slight and gentle breath then deliberately under breathing deliberately taking less air into your body deliberately breathing less air to allow carbon dioxide to increase in the blood and the body is very sensitive to a buildup of co2 for example a two to five millimeter increase of co2 can double ventilation so soft in your breathing your breathing should be about thirty percent less than what it was hide your breathing we should not see you breathing too much okay so you can take a rest at - now you were doing it correctly there's a large volume large group of people here and it's a hundred people so I can't really you know ask you personal questions right tonight - but you were doing it correctly if you feel air hunger now generally when people do that exercise and this is one exercise that we practice in terms of improving the biochemistry of breathing generally they notice that there's an improvement in the temperature of their hands not just because you have the hands to your body but internally because it's very common for people who have dysfunctional breathing patterns to have cold hands and cold feet the harder you breed the more you lose carbon dioxide from the blood through the lungs and the more your blood vessels constrict so if you think of 70,000 miles of blood vessels right the body you can have blood vessel constriction from breathing too hard now I know that can fly in the face of the belief that's out there that it's good to be taking big breaths and deep breaths and more air you breathe the better that is not correct if you look at people who are not well they typically have poor breathing people with different conditions people with chronic fatigue people would ask me people with COPD people with diabetes and when we have a problem with our health it can manifest in our breathing and if you look at an elite athlete you will hardly see their breathing their breathing is undetectable so as human beings it's that we are efficient with our breathing now what I would say is practice that exercise in the comfort of your own home don't worry if your breathing chest or diaphragmatic when you're doing it the whole purpose is just to tune into the biochemistry and that you were deliberately slowing down and softening the speed of your breathing to allow carbon dioxide to increase in the blood and check what happens your temperature of your fingers check what happens to saliva in the mouth for example as human beings when we get stressed or Matt goes dry so a dry mouth is often synonymous with stress that we're in that fight-or-flight response and when you deliberately slow down your breathing your mind is more anchored onto the branch because of the air hunger but when you have air hunger it signifies carbon dioxide is increasing in the blood and the increased carbon dioxide will increase blood flow to the brain the increased carbon dioxide will increase blood flow throughout the body and the increased carbon dioxide will have a right shift show a right shift of the oxyhemoglobin dissociation curve so more oxygen gets delivered and this can have a calming effect on the central nervous system okay so that's one aspect of breathing looking at the biochemistry now in terms of wearing the mask when you're feeling air hunger and especially if you have got a low boat score or as I said like females are more prone to this to dysfunctional breathing patterns much more than men and especially females and say below the ages of 46 47 48 50 years of age so when I'm talking about that just if any females are listening the the weeks following ovulation before menstruation progesterone levels can be increased and progesterone is a respiratory stimulant and it can't be during this time that your carbon dioxide levels dropped by 25% due to the impact of the change of hormones so during that time your breathing will typically get faster your breathing will typically get more chest your heart rate can increase a little bit heart rate variability can drop and you can be more prone to fatigue pain to to anxiety into panic because when we hyperventilate and burry too much air and the perception of pain increases and pain threshold lowers so anybody who's in chronic pain try not to breathe fast and shallow because it doesn't and it you know it doesn't help you and it's it's only going to heighten your pain as opposed to gently slowing down your breathing gently slowing down breathing now if you're looking for more information on the effect of progesterone on unbreathing look at the work by Lian shado who has been investigating this for about 50 years now he sadly passed on there but in terms of women with fibromyalgia they can be diagnosed with fibromyalgia Dirk during different times of the monthly cycle and not diagnosed at others and it was primarily because of the change to hormones it's very important and we've seen it as well with people sending us emails that when you practice slowing down your breathing you have to negate some of the effects of hyperventilation so my point is when you're wearing a mask and it's quite restrictive and there's pooling of carbon dioxide it would be a natural tendency to breathe through the mouth and there would be a natural tendency to breathe fast and shallow but the risk here is that it can cause you to brake too hard and too much to improve alveolar ventilation the worst thing that you could do is breathe fast and shallow and if you look at the work of the Italian cardiologist Luciano Bernardi he spoke about this and the reason being is because every breath that you take so much air of that air so much of that air remains in dead space and if you breathe fast so the name of the individual is Luciano Bernardi and he's got about he's got about 500 papers on PubMed and a lot of it he was a cardiologist in Italy and he was using breathing exercises with his patients with chronic heart failure he would see his patients with chronic heart failure and they had exercise intolerance so they were breathing quite hard during physical exercise and he asked a question is it the chronic heart failure which is causing the exercise intolerance or do these individuals have an increased chemo sensitivity to carbon dioxide in other words are they less tolerant to co2 in the blood co2 accumulation so we had them practice slowing down their breathing to six breaths per minute and this in turn is helping to influence the autonomic nervous system it stimulates the vagus nerve it increases sensitivity of our receptors and improves functioning of the autonomic nervous system but it also reduced breakfast --mess it reduced dyspnea so there are other papers looking at and there are other papers looking at individuals climbing altitude and what I might do is I might just try and pull up a couple of the papers I was trying to log in here earlier on with the zoom because it actually wouldn't let me log in and that's why I had to shut the whole thing down to log in and as a result and I didn't have time to am to get to get my two papers ready so I'm just gonna pull up this is the effects of slow deep breathing at altitude and I'm gonna do a share screen I think it's important to look at and in terms of how can you breed to improve and enhance alveolar ventilation and I also want to show you how to just in terms of that the numbers in what's going on there so if you just about me one second so I'm just looking at our first slide okay so I'm going to do a share screen and one moment I'm just waiting for the for the slide to appear and then run to a different screen here and so the first share screen that I'm looking at is this here and this is looking at how can you breathe to improve alveolar ventilation of what I'm talking about here is if for example you're wearing a mask and you're feeling air hunger and you're feeling that you're not getting enough air there's a natural tendency for you to breathe fast and to breathe shallow because you want to alleviate that feeling of suffocation now if you take 20 breaths of air into your body whether it's through the nose or to true them out and if your breathing shallow - the size of each breath the volume of each breath is 300 ml this gives you a minute ventilation of 6 liters so even though you're taking six liters of air into your body how much of that air has actually got down into the alveoli to the small air sacs for gas exchange can take place to find that out we have to subtract dead space this is the air that remains in the nasal cavity in the troche in the trachea and the bronchi and bronchioles so in this example here we have an individual who is breathing fast and shallow they're taking 20 breaths per minute their tidal volume is 300 mil but when we subtract dead space this is the air remaining in the conducting Airways and that's not reaching the small air sacs in the lungs for gas exchange can take place you see in this instance that only 3 liters of air actually is getting down into the small air sac so even though the individual is breathing 6 liters of air into their body 50% of that air is wasted in dead space it's wasted in the troche the nasal cavity the tract here the bronchi the bronchiole is now if you slow down the respiratory rate to 12 breaths per minute and I ear in this example I'm increasing the tidal volume to a half a liter so the individual is still taking 6 liters of air per minute but because the rest partial rate has dropped down to 12 there's less air lost to dead space so you see already by changing the respire to rage and also not by increasing minute ventilation because you don't want to be hyperventilating but in this example we increased the amount of air that's getting down into the small air sacs from 3 litres to 4.2 now if we go one step further down to 6 breaths per minute that we really slowed down the respiration and we allowed the tidal volume the size of each breath to increase proportionately we're still taking 6 liters of air per minute but you see how much more efficient and economical the air that we were taking into our lungs so as opposed to the individual who is breathing fast and shallow wearing the mask they are breathing fast and shallow but their breathing is so inefficient that they are losing 50 percent of the air 50% of that air that they are taking into their body is not reaching the smaller sacs in the lungs for gas exchange to take place by simply reducing the respiration by breathing slower by breathing deeper and I'll go through it with you we can increase our breathing to be so more efficient from 3 liters to 5.1 liters that's per minute now what improvement would that have on blood oxygen saturation so I'm just going to do another I want to show you another paper here and just burn me one second so this is a study that was conducted what individuals have altitude and they were in severe hypoxia because obviously an altitude I'm sorry pressure is reducing and they were exposing their body in terms of their blockage and saturation dropped down to 80% so I'm just going to show you so here in this example and you will see the paper so it's the effects the effects of slow deep breathing at high altitude on oxygen saturation now it's not just about high altitude because I've used this these these exercises when people would ask me people were chronic fatigue and people with chronic obstructive pulmonary disease people with chronic heart failure and I've seen changes in their blood oxygen saturation within a couple of minutes just by changing their breathing so in this example here you've got a group of climbers and they're staying at 4550 nine meters and you see in study a that the individuals their blood oxygen saturation was 80 point two percent which is severe hypoxia and by practicing reducing their breathing to six breaths per minute it increased their blood oxygen saturation from 80% to 89% that's mild hypoxia and in study B it increased our blood oxygen saturation from 81% to 88% and that's also with six breaths per minute now how might that be happening well part of is because of breathing becoming more efficient due to not so much air wasted in dead space and I'm saying like of course when you're wearing a mask you may experience a headache at the start because you are rebreathing carbon dioxide back into the lungs increasing it in the blood and carbon dioxide is a vasodilator so blood flow to the brain the carotid arteries are dilating blood flow increases and this could bring on a headache but again don't worry about that because it's if you just continue it's like we advocate all of our runners to run with the mouth closed why because when you have your mouth closed when you breathe through your nose during physical exercise and during nasal breathing and also when you have the mask on make sure you breathe through your nose and the reason being is because it was shown back in 1988 that nasal breathing increases the pao2 millimeters of mercury the pressure of oxygen in the arterial blood by 10% just by nasal breathing nasal breathing protects the Airways so runners who are breathing through an open mouth typically breathe fast and shallow it's reducing oxygen uptake in the blood and cut in contrast when you breathe through your nose there's a resistance to your breathing to slow down your breathing allowing gas exchange to take place from the lungs to the blood but also allowing carbon dioxide increase in the blood so my point here is that when runners first switch from out to nose breathing during physical exercise at the start it's difficult but we have them continue breathe through their nose during physical exercise their body adapts to the accumulation of carbon dioxide the feeling of air hunger diminishes takes a few weeks however when they adapt to doing their physical exercise with her mouth closed their oxygen delivery to the tissues and and working muscles etc is higher the fraction of expired oxygen is reduced they're better able to tolerate carbon dioxide there's less trauma to the Airways it's just much more efficient and our ventilation reduces during physical exercise so anytime you're doing your physical exercise keep your mouth and this also would prepare your breathing that you will be able to tolerate wearing a mask better okay the exercise in terms of improving alveolar ventilation we looked at six breaths per minute I'd like you to place your hands on either side of your lower ribs so to place your hands on either side of your lower ribs and literally what we are going to do is we're just going to tie a mesh to six breaths per minute to increase our viola or ventilation so anytime that you're feeling air hunger and how do you breathe to make your breathing more efficient so first of all you're breathing through your nose you have your hands on either side of your lower two ribs and as you breathe in I would like you to feel your lower ribs moving out but you shouldn't hear your breathing so we still want to have a balance between the biochemistry the biomechanics and the cadence of the branch so as you breathe in your lower ribs are gently moving out and as you breathe out your lower ribs are gently moving in and as you breathe in your lower ribs are gently moving out and as you breathe out your lower ribs are gently moving in as you breathe in your lower ribs are gently moving out and as you breathe out your lower ribs are gently moving in now what I would like you to do is to breathe in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 out 2 3 4 5 in 2 3 4 5 abs 2 3 4 5 in 2 3 4 5 out 2 3 4 5 I'd like you to continue with that that as you breathe in your ribs are gently moving out and as you breathe out your ribs are gently moving in in other words take fuller breaths but less often but in the process don't deliberately over breathe because if you over breed you get rid of too much carbon dioxide so it's a balanced breathing is not just about the biomechanics breathing is not just about breathing deeply using your greater amplitude of the diaphragm it's a balance between the biochemistry the biomechanics and the cadence of the breath because remember biochemistry is about don't worry too much air if you breathe too much air you get rid of too much carbon dioxide your blood vessels constrict many of you with a low boat score I am you of Court hands you've got cold fish you have brain fog so when you gently slow down your breathing to the point of air hunger you have to reduce your body's chemo sensitivity to carbon dioxide and by the way wearing the mask will do this as well you know if your jet if you're wearing the mask for periods of time thread today the very fact that you're cooling carbon dioxide and re breathing it back into the body it will help to reduce your chemo sensitivity to carbon dioxide the second aspect of breathing that we look at is the biomechanics and that's what lateral expansion and contraction of the lower ribs and the reason being is because also when you're breathing using the lower regions of the lungs it's where the greatest concentration of blood is if you're breathing fast and shallow true at the mouth you typically ventilate the upper regions of the lungs for example if you look down at your chest and if you take a breath through your mouth you'll see that you activate your per chest whereas when you're breathing through your nose you're harnessing nasal nitric oxide and by carry nitric oxide from your nasal cavity down your throat trachea into your lungs nitric oxide helps to redistribute the blood shred the lungs and this has been shown to reduce chest infections now by the way nitric oxide is antiviral and antibacterial and it's also a natural bronchodilator and you know even from a defense point of view and it's really really important use your nose to breed in order to reduce the viral load take less air into your body and if you're in crowded places breathe less and even hold your breath but also if there's a family member infected it's very important that they also use their nose to breed and you know you one can argue is to use a mask to help prevent the transmission of water particles into the atmosphere there is a 42% greater water loss breathing out through the mouth than the nose and when something is transmitted via airborne not via book via water particles airborne by breathing out through your nose your nose traps moisture and this doesn't just apply to kovat a lot of elderly people in nursing homes typically breathe through an open mouth but open my breathing is causing them to be dehydrated because of the loss of moisture through the mouth many of you wake up with a dry mouth in the morning and you know you can even just test the loss of moisture through your nose versus your mouth if you breathe in through your nose into your phone with your nose you will see the halo of moisture left on your phone try it with your nose and then do a similar breath with your mat and you will see that the halo of brett and moist your left by mouth breathing is much more mouth breathing is contributing to dehydration even on a very simple level chapped lips are a sign and very common with my breathing so you know I probably just draw to a close but in terms of because I didn't want to keep you too long but we also advocate breathing through the nose during sleep and it's really vital and I know researchers they published a paper was published in Elsevier during the week and I don't have time to find it at this moment but they talked about the evidence I'm actually gonna try and pull it up because I think it's a very good paper we've been talking about the importance of nasal breathing since you know but for last 20 years or so and and I'm just gonna pull up this paper here one second we'll just tell me because it's worth it's published in science direct and you know it's about the importance of nose breathing even to reduce not just talking about covert just reducing the common cold influenza and your nose is the your first line of defense in terms of airborne viruses coming into the body so I'm just gonna pull up this here and you see the title of it there if you see the paper could nasal nitric oxide how to mitigate the severity of kovat 19 and it's by virtue of when you're talking about reducing viral load you have to consider two things one is the dose how much of a dose of the virus are you taking into your body and the other is the duration there's two things going together there your nose helps to reduce the dose by virtue that you're breathing less air coming into your body by virtue by breathing through your nose because during wakefulness your nose imposes a resistance your breathing that's two to three times that of them out now nitric oxide is produced in the nasal cavity it's not produced in the mouth in the oral cavity and nitric oxide is antiviral and it's antibacterial but I'm just gonna bring it down here and they talked about the benefits of nasal nitric oxide and talking about nasal breathing here filtering humidifying warming affects nitric oxide in the airways it's antimicrobial effects mucus production see the movement vasodilation in other words the blood vessels of the lungs open up bronchodilation the Airways of the lungs open up and also reduce SARS covert viral load by breathing through your nose so if you're in a crowded place for a nice any length of time make sure keep your mouth closed and breathe little air don't breed so much air reduce the viral load now interesting here is our anecdotal observations also suggest favoring nasal breathing during sleep by sealing the mouth with adhesive tape that it reduces the common cold this phenomena may be due to the filtration and humidifying effects of the nose on inhaled air and to increase nasal nitric oxide levels in the airways which may decrease viral load during sleep and allow the immune system more time to mount an effective antiviral response and so we're not saying that nasal breathing is going to stop covert but what we're saying is that it can reduce the load in terms of what you're taking into the body now in terms of getting the mouth closed at night we developed strips going back quite well a few months because we've been advocating nasal breathing and taping of the mouth during sleep for close in 20 years there are a number of tapes that you can use and I'm going to give you different options and there is one tape by a dentist in Colorado called dr. Frank seaman and he is a tape called lip seal tape and then there's a tape then is our own tape and it surrounds them out but it helps bring the lips together so it's called my old tape and basically it's cotton elasticated and I'm just stretching it around them out and in terms this here it's the elastic tension by the tape which is drawing the lips together so it's bringing my lips together so that I'm breathing through my nose during sleep but there's no risk so for instance if there was emergency I can open my mouth etc but this is helping to maintain nasal breathing and I would really encourage you to look at you know in terms of obstructive sleep apnea in terms of snoring and the founding father of obstructive sleep apnea dr. Christian game law before he passed on last year he spoke about the crucial importance of breathing through the nose during sleep in terms of reducing sleep disorder breathing I is a kid because of having asthma I always have a stuffy nose because when you have a problem with your lungs it'll travel up you know it's a unified airway and because of his stuffy nose you are one point eight times more likely to have sleep problems so I had constant fatigue my concentration was affected and my dental health is impacted because if you're breathing through the mouth all the time your mouth is dry you're more prone to too bad brats to dental cavities to gum disease etc so we have to think of the nose and if you look at the functions of the nose so an anatomical model here we have to know as we have the lips so you see the side profile of the face and when you look at the function if you breathe in through your mouth your mouth is zero functions in terms of breathing because any air that you bring into your mouth that air goes straight down your throat and you look at the size of the nasal cavity here look at the amount of space in the skull occupied by the nose like we sometimes think that our nose is this but this is only about 20% of the nose you have according to dr. Maura Scotland he was an american ENT back in the 1970s and he said that the human nose is responsible for 30 functions in the human body 30 functions so I would say to everybody you know make it a constant habit of breathing through your nose be conscious of your breathing Motoring rest do all of your physical exercise which are my closed initially it a little bit more difficult but you know this is Wendy adaptations are taking place and also be conscious of how to breathe to optimize ventilation not to breathe fast and sharla but mouth breathing is typically fast and shallow and my breathing is more like the fighter flight where his nose breathing slows down the bright but also nose breathing is activating a greater amplitude of to die from breathing muscles and your diaphragm breathing muscle is not just for respiration but it's also connected with the emotions so it is true that when people say take a deep breath the instruction is good it's well intended however the interpretation is not good because when people are told to take a deep breath they often take in a big breath so I'm just going to answer help answer if I can any of your questions and your question about hmm so just spare me one second so for rhinitis we can show you how to help open up your nose with rhinitis and and this will also work for hay fever that this has been known since 1923 that if you hold your breath you can open your nose decongest your nose now I'm talking about reversible obstruction of the nose here say hey for example not a deviated septum but the wonderful thing about the human nose is the more you breathe through it the better it works don't do this next exercise if you're pregnant or if you have only gone if you've got serious medical conditions don't do the next exercise so to open up your nose I'd like you to take a normal breath in and out through your nose pinch your nose with your fingers are just hold your breath if you don't want a hip pinch your nose and hold your breath but gently nod your head up and down as you hold your breath and keep going until you feel a medium to strong air hunger then let go of your nose breathe in through your nose and then wait about thirty Seconds to a minute and do it again to open up your nose you have to hold your breath for at least 30 seconds and but some of you might not be able to hold your breath for 30 seconds quit practice and reduce breathing and nasal breathing and rattling you can increase - so I'm gonna wait 30 seconds and then we do it again and you will have better use of your nose when your bowl score is 20 seconds so anybody would hate fever with nasal stuffiness you will continue to have nasal stuffiness until you get your bowl score up to at least 20 seconds because at that point your breathing now is becoming more normal minute ventilation respiratory rate diaphragmatic breathing nasal breathing and that's when your Airways start to work better as well to try that exercise again to open up your nose take a normal breath in through your nose an or mille breath a pinch your nose out your nose gently nod your head up and down and it's not about holding your breath to the point of stress that's why i said kind of go easy with the first couple and when you get used to holding your breath and hold your breath for a little bit longer until a medium to strong air hunger and then to let go so i'm just going to look at again at questions so normal normal blood oxygen saturation is between 95 and 99 percent and it's when your blood oxygen saturation drops below 91 percent that it would be considered hypoxemia that you know the fraction of your hemoglobin occupied by oxygen is reducing now it takes a quite quite a degree I would be surprised if the mask dropped you down because even the mass that we use you'd have to be running with this on and this is a totally different in terms of the restriction and this is totally different because this is deliberately designed to restrict your breathing so even if you see your blood oxygen saturation dropping don't be too worried about it because it could be due to the increase of car it's actually likely due to the increase of carbon dioxide and as I said the right shift of the oxyhemoglobin dissociation curve the Bohr effect so any special kind of mask you recommend that will give me more mout room not too expensive to be honest which I don't know enough about different masks Linda there's so many different ones out on the market to increase your bow SCOR Karen you would have to practice slowing down your breathing nasal breathing and you're talking about during 40 to 60 minutes a day and that's including physical exercise but also get your mouth closed during sleep because think about the biochemistry of what is slow breathing doing just in a nutshell by reducing your breathing volume towards normal you can influence your blood circulation your King can increase oxygen delivery to the tissues and organs you can also help open up your Airways as some of you just have done you've opened up your nose by simply holding the bread the biomechanics is all about the relationship you need your diaphragm for stabilization of the spine so individuals with lower back pain for example often have dysfunctional breathing so when you're breathing low with lateral expansion and contraction of the lower ribs you're increasing oxygen uptake by virtue that you're taking the air deeper into the lungs for the greatest concentration of blood is you are also getting the benefits of diaphragmatic amplitude which is very important for sleep apnea and the reason being is because when you breed low with lateral expansion and contraction of the lower ribs it increases lung volume and when there's an increased along volume there's a dilation of the upper airway in other words the t'roat becomes stiffer and less likely to collapse so the worst thing that we could do with sleep especially if we are pros to sleep up if the worst thing that we could do during sleep especially if we are exposed to obstructive sleep apnea is the mout breed because mouth breathing is narrowing the architecture of the upper airway we're more prone to drying it out causing inflammation of the upper airway the airway is more liable to collapse mouth breathing is fast shallow breathing this in turn reduces lung volume and so you know and even if you and I won't really go into it now because there's a huge connection between your breathing and your sleep whether it's insomnia whether it's snoring whether it's obstructive sleep apnea so rhinitis I choke at night and I've gone into seizures due to oxygen falling it's really you need a sleep study done and in terms of fibromyalgia is also related to obstructive sleep apnea so if an individual is snoring and then they stop breathing and they stop breathing due to collapse of the upper Airways so here for example the soft palate might fall in against the airway or the tongue falls into the throat or the epiglottis falls into the throat or you have collapse of the Trojan South but it's really vital to breathe through your nose with your tongue resting in the roof of the mouth because your tongue has got two places to be it's either in the roof of your mouth or it's falling into your throat and to determine where your tongue should be you could do this sound so in order to make that sound you need to have your tongue resting in the roof of the mouth and when you wake up in the morning you should wake up with your lips together and your tongue resting in the roof of the mouth you shouldn't wake up with your lips apart with your mouth dry and because in order to breathe through the mouth you have to lower your tongue resting posture and when the tongue is Midway or low and in the mouth when the tongue is Midway are low in the mouth it's more likely to fall into the throat to reduce every size and of course as well you have the mandible falling back into the airway so for sleep light slow and deep breathing and just going through maybe a couple of the questions here it saved me when I had active kovat I still have symptoms 12 weeks later so mariann but I would say to is continued you know working to get your bowl score up and do everything very very gentle and we don't I don't agree with some of the forced breathing exercises but you will see them online that were sometimes um advocated for Ovid and the reason being is because it puts a stress on the ribs and on the lungs and we want to try and get bronchodilation but we want to do it by gently working with the breath itself and nasal breathing is really really a key part of it but it's not just enough about breathing through the nose it's also a breath breathing lighter and it's also about breathing deep and that other thing about cadence breathing 2/6 from minish it increases what's called heart rate variability and heart rate variability is a measure of vagal tone and individuals who were unwell either emotionally or physically they typically have reduced heart rate variability but that's a whole nother kind of ball game and but that's why I would say to you the six breaths per minute is not just about improving our viola ventilation it's also about stimulating the vagus nerve so from Jan I'm a fitness instructor preach nasal breathing Thank You Jan I'd a client contract covered and she credits her nasal breathing for the short duration and a recovery we have had doctors who are saying the same and some of our doctors who have been incorporating this into the practices so Robin rotten burns book who I know and she's a long-term yoga instructor so she wrote a book called restoring prana very interesting because when she went to the ancient yoga sutras they didn't talk about taking big breaths and full breaths they actually spoke about breathing subtle and about breathing life so DOM is breathing more slowly automatically going to make people it can do if you reduce the respiration it's normal that the tidal volume or the size of the bread can increase however just to make sure that it doesn't increase disproportionately the name of the individual who I was talking to about breathing was dr. Luciano Bernardi so he's an Italian cardiologist but if you put his name into PubMed you will you will see his work as a doctor we have to wear the n95 mask which I believe are quite restrictive the effort is too much so I think in terms of that it's going to be the same instance it's about increasing Bowl score reducing chemo sensitivity to carbon dioxide I understand that the effect of wearing the mask is going to vary person to person depending on your breathing pattern but those individuals with a lower Bowl score they are going to have a harder time wearing a mask for period of time because of an increased sensitivity to carbon dioxide and the whole purpose of changing your everyday breathing and breathing through your nose during sleep and rest and physical exercise is to reduce the chemo sensitivity of the body to carbon dioxide and from Nancy hi I know Nancy Rothstein is to sleep ambassador going back a long time and I'm sure Nancy will be will be an agreement about the imports of nasal breathing during sleep so so yeah so I'm gonna kind of leave it at - and I would say thanks very much on this you are going to hear more about breathing as time goes on there's a book currently at the moment it's destined to be a best-seller it's not my book I'm writing another book and but there's a book by James Nestor called Brett and it's currently one of the best-selling books on Amazon at the moment and it's talking about the stuff that we've been talking about for 20 years so finally simple breathing strategies are getting out there which is great so listen thanks very much and for staying with us I intended of course talking for 30 minutes and it's now 53 minutes but you know what that's just the way it goes and the best of luck everybody and take care bye by the way just and a final note we will put this up on to YouTube so you'll find it either on oxygen advantage shadows or Ambu take your clinic bye-bye

Channel: Buteyko Clinic International

Views: 67,222

Keywords: coronavirus, covid19, breathing, Patrick McKeown, masks, Breathing exercises, nasal breathing, buteyko, buteyko method, coronavirusnews, coronavirus survey

Id: uRzk-dilOdU

Length: 54min 19sec (3259 seconds)

Published: Wed Jul 08 2020