exhale

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Nose or Mouth, 23 Years Ago, and How to Make Spiritual Progress

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4 Thoughts



1. How to Make Spiritual Progress

“[B]reath is the animated, nonphysical aspect of your being. So that when you look in the direction of breath, when you focus your attention on your breath, you are really looking at your spiritual self.”*

- Andrew Weil, MD, Breathing: The Master Key to Self Healing

This is why Dr. Weil also says that “if you do nothing other than pay attention to your breath today, for a few seconds more than you did yesterday, you have increased your spiritual awareness. You have made spiritual progress.”*

Sounds good to me 🙏

P.S. My New #1 (and 23 Years Ago)

This tape, Breathing: The Master Key to Self Healing (released 23 years ago!), will now be my #1 recommendation for anyone beginning with breathing.

It’s not “perfect,” but it’s less than 2 hrs and has basically everything we need to start a breath practice. It was one of my favorite listens in a really long time 🙏

2. Should We Exhale through Our Nose our Mouth?

This is one of the most common questions I receive. There’s no perfect answer, but here are my rules of thumb, which you might find helpful:

  • Nasal exhales: This should be the default breathing we use most of the time.

  • Mouth exhales: This can be used for (1) deeper relaxation during slow breathing, (2) learning to extend your exhales, and (3) during exercise.

3. Strengthen the Inflammatory Reflex with Slow Breathing

“It was proof that as well as slowing the heart, the vagus nerve can act as a powerful brake on inflammation. Tracey called this the ‘inflammatory reflex.’ … If the brain detects a signal via the vagus nerve that inflammation has been activated in the body, it swiftly fires a return signal to calm it down again.”

- Jo Marchant, Cure: A Journey into the Science of Mind Over Body

Here’s another reason why a regular slow breathing practice, which increases vagal tone, is so powerful: it might strengthen our “inflammatory reflex.”

Here’s to using our breath to put the brakes on inflammation, today : )

4. Two Breaths at Once

You can’t breathe two breaths at once.

So focus on this one.

And watch your mindfulness and spiritual awareness grow.

1 QUOTE

“Of all the techniques that I have investigated for reducing stress and increasing relaxation, it is breathwork that I have found to be the most time-efficient, the most cost-efficient, and the one that most promotes increased wellness and optimal health.”
— Andrew Weil, MD
 

1 ANSWER

Category: Breathing-Related Reflexes

Answer: Another critical reflex that is modified by our breathing rate is this, which keeps blood pressure within safe limits.

…

(Cue the Jeopardy! music.)

…

Question: What is the baroreflex?

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. I think I’ve got her on the ropes

Breathing for Diabetes Online Course ($99):

If you love learning about breathing, want to live a healthier life, or just want to support my work, I think you’ll really enjoy this class (diabetes or not).

 
 

* An asterisk by a quote indicates that I listened to this book on Audible. Therefore, the quotation might not be correct, but is my best attempt at reproducing the punctuation based on the narrator’s pace, tone, and pauses.

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Wim Hof vs. Slow Breathing, and How to Start Something Meaningful

 
 

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4 Thoughts


1. How to Start Something Meaningful (hint: exhale)

“If you watch anyone on the verge of starting something that matters, you'll see them settle into the moment by taking a deep breath in and exhaling….It's the body rolling up its metaphorical sleeves and saying, ‘Okay.  It’s time. Let’s do this thing.’”*

- Michael Bungay Stanier, How to Begin

Starting something meaningful this year? Or just sending an important email or text? Roll up those metaphorical sleeves by taking a deep and relaxed breath in, and a relaxed and slightly longer breath out. “Let’s do this thing.”

2. Build Your Best Breathwork Practice

“You don’t have to build the habits everyone tells you to build. Choose the habit that best suits you, not the one that is most popular.”

- James Clear, Atomic Habits

Similarly:

You don’t have to use a breathing technique everyone tells you to use. Choose a method that best suits you, not the one that is most popular.

***

P.S. The next thought shows you why—two different methods, similar results.

3. Wim Hof “vs.” Slow Breathing, Part I: Indirect Comparison for Chronic Inflammation

A 2019 study looked at the full Wim Hof Method (breathing, cold, and meditation) in people with axial spondyloarthritis. They found that it reduced chronic inflammation, concluding:

“…our results are indicative that voluntary modulation of the immune response may not only be possible in acute inflammatory response due to microbial stimulation but also in chronic inflammation related to immune-mediated inflammatory diseases.”

A 2021 systematic review examined HRVB (aka slow breathing) in people with various chronic illnesses. They found evidence that there is an inverse relationship between inflammation and vagal nerve activity:

“…an increase in efferent vagal activity could suppress pro-inflammatory factors suggesting possible anti-inflammatory effects of HRVB.”

The point? Two wildly different approaches, two somewhat similar outcomes. It brings to mind the Chinese proverb, “There are many paths to the top of the mountain, but the view is always the same.” Choose which path is right for you.

***

P.S. I put quotations around “vs” because there’s no competition in breathing 😊Also, the word “indirect” in the title is critical. I’m being simplistic here and comparing apples to oranges, but I think the overall message is still helpful.

4. Operationalize Your Breathing Practice

“To make operational. To make ready for ‘live’ or ‘kinetic’ action.”

- Steven Pressfield

That’s Pressfield’s definition of “operationalize,” and it’s exactly what we need to do with our breathing. Make it ready for live action—for real life.

Of course, let’s use our practice as an escape into calmness, but let’s also remember to operationalize it so it’s useful in our everyday lives.

***

P.S. Everyday examples of how I operationalize breathing in my life:

  • Slow breathing while walking the dog.

  • Various slow and fast methods when I’m out surfing.

  • Slow, long exhales when my daughter throws a tantrum.

  • I’m not always successful with these, especially the last one : )

 
 
 
 

1 QUOTE

“Along the way of life, someone must have sense enough and morality enough to cut off the chain of hate. This can only be done by projecting the ethic of love to the center of our lives.”

- Dr. Martin Luther King, Jr.

 
 
 
 

1 ANSWER

Category: Nose and Smell

Answer: Cells responsible for scent regenerate this frequently.

…

(Cue the Jeopardy! music.)

…

Question: What is 30-60 days?

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. when your only friend is busy

 
 
 

* An asterisk by a quote indicates that I listened to this book on Audible. Therefore, the quotation might not be correct, but is my best attempt at reproducing the punctuation based on the narrator’s pace, tone, and pauses.

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Alternate Nostril Breathing, 70% Exhales, and How to be "Happy Right Away"

 
 

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4 Thoughts


1. A Friendly Reminder to Exhale More than 70%

In Heart Breath Mind, Leah Lagos discusses a fascinating study where a group of people were instructed to only exhale about 70% of their air with each breath.

Here’s what happened:

“After just 30 seconds of this subpar breathing, almost every subject reported a climb in unpleasant symptoms, including anxiety, dizziness, lightheadedness, and neck and shoulder tension.”

The fix? Slow breathing with full exhalations. Give it a try and see for yourself.

2. An Ancient Breath and the Door to Heaven

“By relying on the ‘door and the window’ (is meant) the nose as the door of heaven, and the mouth as the window of the earth.  It follows, then normally that the nose inhales and the mouth (should) exhale, and (this is) beneficial to breathing. ”

- The Primordial Breath, Volume I

This ancient approach was way ahead of science.

In fact, although the translation reads a bit choppy, we now know this method of nose-in/mouth-out can increase whole-body oxygenation by more than 10%.

Just don’t forget to exhale fully : )

***

P.S. “The nose as the door of heaven”…I felt compelled to re-emphasize that 😊

3. Two Yogic Breathing Experts Describe the Balancing Act of Alternate Nostril Breathing

“Ultimately, in the hatha yoga tradition, the intention with these nostril-specific practices is to establish balance between the two sides of the nervous system, so neither is dominant.”

- Robin Rothenberg, Restoring Prāna

It sounds counterintuitive, but the reason we practice alternate nostril breathing (or ANB) is for balance, so neither side is dominant.

I love the analogy Eddie Stern uses: “You can think about breathing through alternate nostrils in the same way that we think about stretching both the right and the left sides of our bodies when we do yoga postures.”

With ANB, we’re “stretching” different sides of the nervous system (since the right nostril is sympathetic and the left is parasympathetic). But the goal is the same: we train each side separately so they function better as a whole.

4. How to be “Happy Right Away”

“The group that holds the pen between their teeth (which, you may notice, creates a sort of smile) are HAPPIER at the end of the experiment than people who hold the pen between their lips (which, you may notice, creates a sort-of frown).”

- Brian Johnson, +1 On Smiling

This passage summarized a study showing that the act of smiling, even without a reason, makes you happier. And I think the same is true for slow breathing.

As Thich Nhat Hahn says beautifully, “You only need to practice mindful breathing for a few seconds, and you'll be happy right away.”

So let’s smile and breathe mindfully to be a little happier, today : )

Extra Thought: Breathing for Diabetes

I’m giving a short 15-min presentation on Breathing for Diabetes at the MAPS Modern Wellness Summit this Saturday, December 4th. It’s a free virtual event with a ton of amazing speakers, so sign-up if you’re interested:

Learn More about the Free Modern Wellness Summit

 
 
 
 

1 QUOTE

“Our breathing is designed to help us release any tensions that have become so much a part of us that we no longer sense their presence.”

- Carla Melucci Ardito

 
 
 
 

1 ANSWER

Category: Dysfunctional Breathing

Answer: When the chest and abdomen move in during inhalation and out during exhalation, it’s called this type of breathing.

…

(Cue the Jeopardy! music.)

…

Question: What is paradoxical breathing?

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. This certainly became clearer with age…

 
 
 

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Each Monday, I curate and synthesize information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing. It’s a fun way to learn something new each week.

 
 

Light and Calm, Start by Starting, and the 60/40 Rule of Slow Breathing

 
 

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4 Thoughts


1. How to Get Started with Breathwork

“But this doesn’t have to be all at once.  Start by starting.  Add in what you can right now, and as these practices begin to improve your performance, they’ll end up saving you time.”

- Steven Kotler, The Art of Impossible

Kotler is discussing practices for peak performance, but the exact same goes for breathwork. Start by starting. One minute is always better than none-minutes.

So go easy and have fun with it : ) Your practice will grow naturally with time.

2. The 60/40 Rule of Slow Breathing

Speaking of getting started, here’s a simple rule you can begin with for slow breathing (and it’s one I use every day), inspired by Heart Breath Mind:

40% of your breath should be inhaling

60% of your breath should be exhaling

Here’s what it looks like:

  • 6.0 breaths/min: 4 sec inhale, 6 sec exhale

  • 5.5 breaths/min: 4.4 sec inhale, 6.6 sec exhale

  • 5.0 breaths/min: 4.8 sec inhale, 7.2 sec exhale

  • and so on…

Note that it’s hard to be this precise with most breathing apps, so just do what you can. For example, I simply use 5 in/7 out to breathe at 5 breaths/min.

3. Breathing and the Brain’s Default Mode Network

“The resting brain turns out not to be resting at all. Left to its own devices, the human mind holds imaginary conversations, replays past experiences, and reflects on the future.”

- Kelly McGonigal, PhD, The Joy of Movement

If you’ve ever tried to rest your brain, this passage probably isn’t surprising : ) It’s called the brain’s “default mode,” and it has a negative bias: Our natural tendency is to ruminate, criticize, and worry. Not so good.

Luckily, McGonigal says there’s an easy way to quiet it down. “In brain-imaging studies, focused breathing, mindfulness, and repeating a mantra have all been shown to deactivate hubs of the default mode network.”

Sounds good to me. So here’s to practicing some 60/40 slow breathing to deactivate our default mode, and activate more joy, today.

***

P.S. Don’t have time for mindfulness or breathing? Kelly has an even easier hack, which is to exercise in nature: “Green exercise appears to do something similar to the brain, but without the need for such dedicated mind-training.”

4. How Breathing (literally) Makes You Prosper

“Did you know the word ‘prosperity’ literally means ‘to go forward with hope’?”

- Brian Johnson, +1 on Spiritual Economics

I did not know that. But now that I do, I can confidently say that breathing makes us prosperous. When you walk away from a slow breathing session (or yoga, meditation, exercise, etc.), you always “go forward with hope.”

I wonder if it’s because we quiet our amygdalae and deactivate that pesky default network…🤔

 
 
 
 

1 QUOTE

“If our breathing is light and calm, a natural result of conscious breathing, our mind and body will slowly become light, calm, and clear, and our feelings also.”

- Thich Nhat Hahn

The Heart of the Buddha’s Teaching

 
 
 
 

1 ANSWER

Category: Breathing 101

Answer: The portion of each breath that does not participate in gas exchange is called this.

…

(Cue the Jeopardy! music.)

…

Question: What is dead space air?

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. Good luck to her on this journey

 
 
 

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Each Monday, I curate and synthesize information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing. It’s a fun way to learn something new each week.

 
 

The 5 Exhales, Spirit, and How One Word Makes Breath Holds Easier

 
 

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4 Thoughts


1. The 5 Exhales of Slow Breathing

Here are 5 different exhales you can try during your slow breathing practice. Give them a shot and see which one brings you the most relaxation.

  1. Nasal exhale

  2. Audible pursed-lips (like blowing out birthday candles)

  3. Barely audible pursed-lips (like blowing on hot soup)

  4. Ujjayi

  5. Humming

I do a mix of these depending on how I’m feeling, but my defaults are 1 and 3.

2. How Changing One Word Makes Breath Holds Easier

Instead of saying “hold” your breath, use (or think) the word “pause.”

Holding implies tension and effort. Pausing is natural and effortless.

It’s a subtle change, but it can make a significant difference.

***

P.S. This idea was inspired by Eddie Stern’s Pranayama Week. He used the word “pause” instead of hold several times, and I found it brilliant.

3. Why Mindless Breathing is Good, Part II

“We now know that somewhere between 40% and 80% of what we do is done automatically … This is the exact strategy the brain uses to conserve energy, but especially if we've got the wrong habits, it can wreak havoc on our lives.”

- Steven Kotler, The Art of Impossible

Coming back to last week’s thought on mindless breathing, here’s another way of looking at it: 40-80%(!) of what we do is automatic. And with breathing, it’s probably 96-99%, depending on how much you practice.

But this isn’t a bad thing—it’s actually a blessing we can put to good use.

If we’re diligent and consistent with our precious gift of breath control, a mindful 1-4% investment can pay dividends on the other unmindful 96+%.

Which comes back to the main point: The goal of mindful breathing is to improve our mindless breathing.

4. A Beautiful Message and NOSEvember

“Breathwork is life changing. Whether reducing stress, controlling or eliminating disease symptoms, improving sleep, or even being a better person at work and at home. I truly believe that the breath is the key to unlocking our bodies abilities to heal themselves and perform at optimal capacity.”

- Dr. Tanya Bentley, HHPF Co-Founder & CEO

A beautiful message from a beautiful human being. Check out NOSEvember and consider supporting HHPF’s phenomenal mission. 🙏

 
 

Extra Thought (minus the bi-annual rant)

We just had another time change. I’ll spare you my normal rant on how almost every sleep scientist on the planet thinks it’s awful to change the time twice a year. But alas, we still do it : )

And if you’ve read this a while, you know I decided to ignore the time change when we “sprung forward” in March (be the change you want to see style). I loved it, and I plan on doing the same again with this one, if life allows…

 
 

1 QUOTE

“It means that breath is the root of the essence and of the soul, the life source and the ruler of the spirit.”

- The Primordial Breath, Volume I

 
 
 
 

1 ANSWER

Category: Exhalation and Nasal Nitric Oxide

Answer: This exhalation technique can increase nasal nitric oxide by as much as 15-fold.

…

(Cue the Jeopardy! music.)

…

Question: What is humming?

In good breath,

Nick Heath, T1D, PhD
“Breathing is the compound interest of health & wellness.”

P.S. The true test of longevity

 
 
 

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Each Monday, I curate and synthesize information from scientific journals, books, articles, and podcasts to share 4 thoughts, 1 quote, and 1 answer (like "Jeopardy!") related to breathing. It’s a fun way to learn something new each week.

 
 

The Breathing 411 - Understand This, and You Will Understand Breathing

 

Happy Monday. I hope you enjoy this edition with a cup of coffee : )

Enjoy 4 thoughts, 1 quote, and 1 answer (like "Jeopardy") related to breathing.

 
 
 
 

4 THOUGHTS

1. Understand This, and You Will Understand Breathing

Breathing information is often contradictory:

  • Wim Hof tells you to breathe more oxygen.
    Patrick McKeown tells you to breathe less.

  • Oxygen is your body’s most important energy source.
    But the exhale is the most important part of the breath.

  • You need to teach yourself to tolerate higher levels of carbon dioxide.
    Carbon dioxide also causes fear in people who literally can’t feel fear.

  • Lung capacity determines longevity.
    But you also shouldn’t take big breaths.

  • And on & on

To understand breathing, you must accept that all of these are right, and all of them are wrong. It depends on the circumstance.

Despite its simplicity, breathing is one of the most complex functions in the human body. Blanket statements on "right or wrong" simply cannot be made without context. We must embrace the contradictions.

2. Should You Be Breathing Even Slower?

A study published in 2006 found that resonance frequency was inversely correlated with height. That is, the taller you are, the slower you need to breathe to synchronize your heart rate, breathing rate, and autonomic nervous system.

In their excellent book, The Healing Power of the Breath, Richard Brown and Patricia Gerbarg give this specific recommendation: "For people who are over six feet tall, the ideal resonant rate is three to three and a half breaths per minute."

So, if you’re over six feet tall, you might find that breathing slower than the typical recommendation of 5-6 breaths per minute works better for you. I fall into that category, and I’ve found 3 - 3.5 breaths per minute (currently 7 sec inhale, 11 sec exhale) to be my sweet spot.

3. What is Hyperventilation?

"Respiratory alkalosis is caused by hyperventilation or a respiratory rate in excess of that needed to maintain normal PCO2." - Essentials of Pathophysiology, pg. 205

"Hyperventilation is a term that describes breathing beyond that which is required to meet the metabolic needs of the body as reflected in the production of carbon dioxide." - Respiratory Physiology, pg. 128

Here are two different textbook definitions of hyperventilation. It’s actually pretty straightforward. And, as you can see, it doesn’t involve huffing and puffing. Thus, we can hyperventilate without even knowing it.

Two easy ways to check if you are overbreathing are the BOLT score and the CO2 Tolerance Test.

Two easy ways to fix it are to breathe through your nose and make your breathing quiet while at rest.

Thanks to 411 reader W.H. for inspiring this thought.

4. Is Breathing Woo-Woo?

It fascinates me that breathing, your body’s most important function, has kind of a "woo-woo" reputation. It shouldn’t. There is a mountain of scientific evidence showing its efficacy for health and wellness. For example, I have reviewed over 80 scientific papers, and HHPF seems to post a new one every day.

But you actually don’t need any of the science. Here is the quickest way to determine for yourself:

Hold your breath.

I think you will agree "breathing" isn’t woo-woo after only a few seconds.

Thanks to fellow breathing nerd R. vdC. for inspiring this thought.

 
 
 
 

1 QUOTE

"The test of a first-rate intelligence is the ability to hold two opposed ideas in the mind at the same time, and still retain the ability to function."

- F. Scott Fitzgerald

 
 
 
 

1 ANSWER

Answer: The estimated prevalence of this condition is about 23% in women and 50% in men.

…

(Cue the Jeopardy music.)

…

Question: What is sleep-disordered breathing?

 
 

Relaxation Breathing Reduces Blood Sugar Spikes

 
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This week, I am sharing one of those amazing papers that I read and underline the whole thing. Despite having a small sample size, it hints at the incredible benefits of breathing for optimal blood sugars.

Relaxation Breathing Improves Human Glycemic Response

(Click Here to Read the Full Summary)

The study participants were randomized into a control group (n=13) and a relaxation breathing group (n=13). The relaxation breathing (RB) protocol used a constant inhale with a progressively longer exhale:

  • Inhale 2 sec, exhale 1 sec.

  • Inhale 2 sec, exhale 2 sec.

  • Inhale 2 sec, exhale 3 sec.

  • …

  • Inhale 2 sec, exhale 10 sec.

The participants performed this exercise once every 10 minutes for 30 minutes prior to an oral glucose tolerance test. Then, they did it every 10 minutes for 90 minutes after the test. Overall, they did the RB technique 3 times before and 9 times after the test. The control group simply took the glucose tolerance test.

The results showed that the RB group had a significantly lower blood sugar (~37 mg/dL lower) thirty minutes after the glucose tolerance test.  After an hour, the two groups were approximately the same. Thus, relaxation breathing reduced the blood sugar spike associated with the glucose tolerance test.

Although the exact mechanisms are not clear, it seems likely that activation of the parasympathetic nervous system improved the insulin response of the RB group, and might have also improved insulin sensitivity.

This study provides another scientifically-validated breathing technique we can use to improve our blood sugars. After reading this paper, I started using it quite often.  I’ve found it’s nice to do while lying in bed before sleep.  I also find it helpful at the beginning of a breathing/meditation session just to calm everything down. 

And, with how simple it is, you do not need a watch or app. You can simply count in your head. It only takes ~75 seconds to complete one cycle and it will leave you feeling calm and relaxed (and potentially lower your blood sugar).

Give it a try before your next meditation or breathing session as a way to prepare you for relaxation.

In good breath,
Nick

P.S. I am finalizing this post on Friday, Feb. 28, and do not plan to look at it again before Monday (I am assuming my body/mind will not be in any capacity to do so). Hopefully I made through the 100 miles with no major issues. If you still want to donate, it’s not too late. HHPF is always accepting donations to further their mission. Thank you for your support!