vagal tone

One Breath, Three Components, and the Most Effective Stress Remedy


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A New Three-Component Protocol for Reducing Stress

A reminder that I’m leading a 4-week course starting May 7th called Breathing for Better Mental and Emotional Health.

Learn more about the course and enroll here.

The course is centered around a super simple yet extremely powerful protocol combining breathing, mindfulness, and remembered wellness.

As a 411 subscriber, you get a special 55% discount until April 23 using EARLYBIRD55.

You can also share the discount with any friends or family you think will benefit from the course 🙏

4 THOUGHTS


1. Stored Power: A Pretty Incredible Benefit of Slow Breathing

When you regularly practice slow breathing, you store its power away as potential energy in the form of vagal tone. It’s kind of like a bank account for slow breathing.

You then unconsciously draw from it throughout the day.

It might show up as a micro-moment of joy with the gas station attendant. Or randomly laughing with your spouse. Or having more patience with road construction. And on and on.

Thus, slow breathing has not only instant benefits, but also long-term physical and mental ones stored in vagal tone. Pretty incredible.

2. The Most Effective Stress Remedy

“[V]oluntary control of respiration patterns (breath control) is perhaps the oldest stress reduction technique known. It has been used for thousands of years to reduce anxiety and to promote a generalized state of relaxation.”

- Everly and Lating (2019)

 

This was from a chapter in a book called A Clinical Guide to the Treatment of the Human Stress Response.

It’s always amazing to see the power of the breath acknowledged in academic settings, but it was particularly neat to see in a book on the stress response.

Make sure you take advantage of the great gift we’ve been given—breath control—this week 🙏

3. Useful Links: Resistance Breathing Device + Airheads Breathwork Masterclass

Resistance Breathing:

Last week, I shared the Airofit breathing device. A reader responded and said this one is really good, plus it’s cheaper: Breather Fit.

Airheads Masterclass

A friend informed me of this Airheads Masterclass, which looks awesome. They’ve assembled quite an impressive list of rockstars…

***

P.S. Although I don’t know him IRL, I’m a huge fan of one of the hosts’ (one of the “Airheads,” Tom Granger) work with music and breathing. So, just wanna give that music a plug here.

4. A One-Breath Meditation: I’ve Never Seen This One Before

“This is a wonderful day. I’ve never seen this one before.”

- Maya Angelou

We can use a play on that quote as a one-breath meditation you can say silently in your head anytime, anywhere:

This is a wonderful breath. I’ve never seen this one before.


1 Quote

[A]s long as you are breathing, there is more right with you than there is wrong, no matter how ill or how hopeless you may feel.”
— Jon Kabat-Zinn

1 Answer

Category: Breathing and the Brain

Answer: One way breathing may positively (or negatively) affect our emotions is through its influence on this brain region.

(Cue the Jeopardy! music.)

Question: What is the amygdala?


In good breath,

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


P.S. The Meme-ing Diabetic?


* 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.


Sign Up For The Breathing 411

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.

 

Why Breath Control Matters, -148°F, and Engaging Fully in Life


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4 THOUGHTS

1. A Remarkable Fact About the Upper Airways (-148°F)

“…the upper respiratory tract is able to warm and saturate inspired air so that in climates as cold as minus 100°C [-148°F] air entering the alveoli has attained body temperature and is saturated with water vapor.” 

- Walker and Wells (1961)

My brain can’t fully grasp how remarkable that is over such a short distance…

Our airways are incredible.

2. Oral Posture and Nasal Breathing

“Try it for yourself: Open your mouth and place your tongue on your upper palate. Now try to breathe through your mouth. While it is possible to draw a wisp of air into the lungs, it will not feel right. It follows therefore that the tongue of a mouth breather will tend to rest on the floor of the mouth or suspended midway.”

– Patrick McKeown, The Oxygen Advantage

Patrick’s explanation here is perhaps the most commonsense reason for maintaining optimal oral posture: It promotes nasal breathing simply because breathing through your mouth is awkward when the tongue is against the roof of the mouth. 👏

3. Why Voluntary Breath Control Matters

“We can hold our breath, or breathe faster, or breathe slower, at any time, by choice. Why does this control matter? It matters because breathing is the link between our inner and outer experiences … It is also the link between the physical and emotional reactions we have to those experiences. In other words, what is happening within our bodies and minds is channeled through our breathing.”

- Anyen Rinpoche & Allison Choying Zangmo, The Tibetan Yoga of Breath

I have nothing to add except a few of these 🤯 🤯 🤯

4. A Neat Study on Slow Yogic Breathing and Vagal Stimulation

“These findings raise the possibility that mind-body techniques that use slow breathing at rest exert their breathing-related relaxation effects through vagal mechanisms.”

- Vagal Mediation of Low-Frequency Heart Rate Variability During Slow Yogic Breathing

This ingenious study separately blocked the parasympathetic and sympathetic nervous systems and then measured HRV during slow yogic breathing. By doing this, they conclusively found that increases in HRV were primarily due to increased vagal activity.

In other words, slow breathing is vagus nerve stimulation 👏

***

P.S. You get the full Science 411 on this paper when you sign up for the Breath is Life Learning Center.


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1 Quote

Mindful Breathing is a useful practice in its own right. … However, I’d like you to think of it as a versatile training tool to help you engage fully in every meaningful task in your life.”
— Russ Harris

1 Answer

Category: Diagnostic Breath Exercise

Answer: This physiological exercise is basically a forced exhale against a closed glottis, mouth, and nose.

(Cue the Jeopardy! music.)

Question: What is the Valsalva maneuver?


In good breath,

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


P.S. literally me every time


* 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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My New Favorite Therapy, Self Love, and Your Breathing Headphones


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4 Thoughts



1. Reading Can Produce Healing (my new favorite word & therapy)

“Bibliotherapy is based on the assumption that the simple act of reading can produce healing of various health conditions, including depression. The definition of bibliotherapy has broadened over the years to include using any type of reading material that is uplifting or emotionally sustaining.”

 - Herbert Benson, MD, Relaxation Revolution

 

As someone obsessed with reading, bibliotherapy might be my new favorite word and therapy : ) However, I’ve always thought that reading alone is not enough; we must also act. 

Maybe I’m wrong…

As Dr. Benson says, one study found “Therapeutic reading ranked toward the top of the interventions, along with CBT and supportive-expressive groups, as a highly effective method of decreasing depressive symptoms.” <— 🤯

I hope these 411s serve as bibliotherapy for you 🙏

2. The Relaxation Response for Stress-Related Diseases

“Taken together, the RR has been shown to be an appropriate and relevant therapeutic tool to counteract several stress-related disease processes and certain health restrictions, particularly in immunological, cardiovascular, and neurodegenerative diseases/mental disorders.”

Esch et al. (2003)

This study found that regularly eliciting the relaxation response can counter the adverse effects of stress and serve as a free therapeutic tool in many chronic diseases, especially immunological, cardiovascular, and neurodegenerative/mental disorders.

Want to use it in your life? Here’s a short video showing you how.

***

P.S. If you want to use the relaxation response to conquer stress, check out the latest Science 411 on this paper or the new Book 411 on Relaxation Revolution, released this past Friday.

3. Breathing as Spiritual Headphones

Breathing exercises are like spiritual headphones: You can tune in, not bother anyone, and no one will ever know what you’re “listening” to.

4. Breathing is Self-Love, a Pre-Requisite for Loving Others

Last week, we learned that high vagal tone = high loving potential; thus, slow breathing increases our loving potential.

But the key word there is “potential:”

“While these activities do not directly create positivity resonance, they can set the table for an eventual feast of love. … They condition your mind, heart, eyes, and ears to be more prepared for positivity resonance when true connections become possible.

- Barbara Fredrickson, Ph.D., Love 2.0

So, we might say that a daily breathing practice is self-love, which prepares your heart and mind to love others.


1 Quote

We must meet hate with love. We must meet physical force with soul force.”
— Martin Luther King, Jr.

1 Answer

Category: Stress

Answer: When free radical production exceeds antioxidant defenses, it creates this kind of stress.

(Cue the Jeopardy! music.)

Question: What is oxidative stress?

P.S. The relaxation response helps counter this stress, too.


In good breath,

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


P.S. I’ve been really missing my friends


* 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.


Sign Up For The Breathing 411

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More Loving Potential, Cold Showers, and the Healing Power of Mind


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4 Thoughts



1. How to Improve Your Loving Potential

High vagal tone, then, can be taken as high loving potential. … Compared to people with lower vagal tone, those with higher vagal tone experience more love in their daily lives, more moments of positivity resonance.”

- Barbara Fredrickson, Love 2.0

High vagal tone = high loving potential. That’s pretty awesome.

And fortunately, we can immediately increase our vagal tone with just a few minutes of slow breathing. We can also improve our baseline vagal tone with just 10-20 minutes of slow breathing every day.

So breathe less, love more.

2. Do Cold Showers Improve Breathing Efficiency? (my guess is yes)

“It’s very simple. A cold shower a day keeps the doctor away.”

- Wim Hof, The Wim Hof Method

Wim also tells us that when we practice cold exposure, we exercise our “sixty-two thousand miles of veins, arteries, and capillaries,” ultimately improving blood flow.

This matters because we need adequate blood flow to get oxygen and nutrients to the cells. Thus, better blood flow = better breathing.

So, in addition to keeping the doctor away, we might guess that a cold shower a day keeps us breathing in an efficient way…

Learn more cold benefits in the Book 411 and Science 411s available as part of the Wim Hof Wisdom Bundle.

3. One Reason (of many) We Began Habitually Mouth Breathing

There are lots of reasons why mouth breathing is so prevalent, but this is one I hadn’t heard that makes a lot of sense:

“Of course it's often tough to avoid mouth breathing, especially since we started living much of our lives indoors. … Enclosed spaces are areas where allergens (substances that cause allergies) tend to concentrate. … In turn these allergy-friendly environments increased the odds that children would early on develop upper respiratory problems.”

- Sandra Kahn & Paul Erhlich, Jaws

4. A Small Thought on Adding Meaning

Your birthday, January 1st, or any holiday are all just ordinary days.

What makes them so fun is that we add meaning to them.

And what’s amazing is that we can use this power of meaning anytime we want.

We can make an ordinary breath practice extraordinary by adding meaning to it.

We can make anything extraordinary by adding meaning to it.


Being with Diabetes: Meditation as Medicine

Just a quick reminder from last week. The Diabetes Sangha’s Being with Diabetes course starts January 15th.

I hope you’ll check it out if you have diabetes or live/work with people that do 🙏

Here’s the 20% discount code they graciously offered 411 readers/listeners:

Discount Code: BREATHE-20

Click Here to Learn More


1 Quote

Gradually, study after mind body study, carried out with the most careful scientific protocols, produced incontrovertible evidence that the mind can indeed influence—and heal—the body.”
— Herbert Benson, MD

1 Answer

Category: Airway Anatomy

Answer: The roof of the mouth can equally be called the floor of this.

(Cue the Jeopardy! music.)

Question: What is the nasal cavity?


In good breath,

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


P.S. New Year’s resolution off to a good start


* 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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5 Breaths for Focus, Better Sleep, and Your Own Finely Crafted Program

 

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4 Thoughts



1. Thirty Days to Better Sleep and Higher Vagal Tone

Taken together, our results suggest that slow-paced breathing performed before sleeping may enhance restorative processes at the cardiovascular level during sleep.

- Laborde et al. (2019), Journal of Clinical Medicine

Here’s another excellent study from Laborde & colleagues, with lots we could cover. But the take-home messages were that 15 min of slow breathing (6 breaths/min) before sleep for 30 days led to:

  • Significantly better subjective sleep quality

  • Significantly higher nighttime vagal tone (via HF-HRV)

  • Higher (but not significant) morning vagal tone

Not bad for just 15 minutes a night 👏

2. The Centering Breath (and 5 Breaths for Better Focus)

[B]reathe in for six seconds, hold that breath for two seconds, and then breathe out for seven seconds. When you modulate your breathing this way, you're controlling your state of arousal and corralling your body's natural response to stress.

- Dr. Jason Selk & Tom Bartow, Organize Tomorrow Today

Here’s a nice breath to try whenever you need to re-center. In for 6, hold for 2, exhale for 7. Even just one of those is enough to reset your focus.

***

P.S. Here’s a guest blog I recently wrote for ResBiotic all about breathing & focus: Why Breathing Gets You Focused (and 5 ways to do it)

3. Perfect Advice for Applying the Power of Breathing in Your Life

It’s not difficult to experience the psychological and social benefits of movement. … There’s no training formula you have to follow. There is no one path or prescription except to follow your own joy. If you’re looking for a guideline, it’s this: Move. Any kind, any amount, and any way that makes you happy. Move whatever parts of your body still move, with gratitude.” (my emphasis)

- Kelly McGonigal, Ph.D., The Joy of Movement

Although Dr. McGonigal is talking about movement, this is also the absolute perfect advice for breathing:

Breathe. Any kind, any amount, and in any way that makes you happy. And breathe with gratitude for this beautiful life we have, thanks to the breath.

4. Your Own Finely Crafted Breathing Program

The Craftsman Approach to Tool Selection: Identify the core factors that determine success and happiness in your professional and personal life. Adopt a tool only if its positive impacts on these factors substantially outweigh its negative impacts.

- Cal Newport, Deep Work

And to piggyback on Thought #3, here is the perfect way to choose which breathing practices (or any self-improvement practices) we perform.

Here’s to finely crafting our own unique breathing programs, this week 🙏



1 QUOTE

[W]e must seek awareness, and that can begin with the awareness of your breath, the foundation of your totality as a human being.
— Al Lee and Don Campbell
 

1 ANSWER

Category: Nasal Breathing

Answer: Nasal breathing not only synchronizes electrical activity in the olfactory bulb, but also in these two areas, helping explain why it influences our emotional state.

(Cue the Jeopardy! music.)

Question: What are the amygdala and hippocampus?


In good breath,

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

P.S. any other thing I can help with today?

Breathing for Diabetes:

If you love learning about breathing, or just want to live an overall healthier life, 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.


Sign Up For The Breathing 411

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.

 
 

Vagal Tone, Perfect Advice, and How to Experience More Joy

 

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4 Thoughts



1. Breathing, and the Key to High-Level Success

The key to high-level success is to pick one thing to change—yes, just one—and master it.

- Dr. Jason Selk & Tom Bartow, Organize Tomorrow Today

Since breath is life, I can’t think of any better “one thing” to master.

2. Extend Your Exhalation to Increase Vagal Tone

findings showed that CVA [cardiac vagal activity] is higher when the exhalation phase lasts longer than the inhalation phase

- Laborde et al. (2019)

There is a lot we could cover from this study, but the take-home message is super practical: By slightly extending our exhale, we increase vagal activity.

Here’s a simple formula for doing it: 40% of your breath should be inhaling, and 60% should be exhaling. Simple, easy, and effective.

***

P.S. Thanks for 411 reader B.W. for sending me this paper 🙏

3. How to Experience More Awe, Gratitude, & Joy

University of North Carolina psychologists Barbara Frederickson, PhD, and Bethany Kok, PhD, demonstrated this beautifully when they asked 52 adults to track their positive emotions—awe, gratitude, joy—for 9 weeks. They found that the higher a subject’s HRV was at the beginning, the easier and more quickly he or she could experience positive feelings over the next 9 weeks.

- Leah Lagos, Psy.D., Heart Breath Mind

Do you want to experience more awe, gratitude, and joy? (who doesn’t?! 😂) Research suggests that having higher baseline HRV will let you.

And the best way to increase your baseline HRV? See #2 above…

***

Related: Perrin White and I recently discussed breathing and joy on her Breath to Breath podcast. You can jump right to it here. My explanation was different from this one…but it’s all interrelated : )

4. Perfect Advice for the Rest of the Week (and the rest of our lives)

So look for those little ways in the flow of life to feel a bit more relaxed, protected, strong, and at ease…and a little more grateful, glad, and successful…and a little more cared about and caring, and a little more loved and loving. One breath at a time, one synapse at a time, you can gradually develop an increasingly unshakable core inside yourself. The more often and deeply you do this, the greater the results.

- Rick Hanson, Ph.D., Neurodharma

Sounds good to me 🙏



1 QUOTE

We might say (every pun intended) that the richness lies right beneath our noses in any and every moment.
— Jon Kabat-Zinn (foreword to Breath by Breath)
 

1 ANSWER

Category: Etymology

Answer: This word is derived from a Greek word generally meaning “something that divides” or “a barrier.”

(Cue the Jeopardy! music.)

Question: What is diaphragm?


In good breath,

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

P.S. By the time you’re 30 you should have…

Breathing for Diabetes:

If you love learning about breathing, or just want to live an overall healthier life, 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.


Sign Up For The Breathing 411

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.

 
 

25 Thoughtful Quotes on Breath & Mind, and How to Make Meditation Fun

 
 

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4 Thoughts


1. Breath is Mind: 25 Thoughtful Quotes on the Breath-Mind Connection

1. “When you practice mindfulness of breathing, then the breathing is mind.” - Thich Nhat Hanh

2.  “I am as confident as I am of anything that, in myself, the stream of thinking…is only a careless name for what, when scrutinized, reveals itself to consist chiefly of the stream of my breathing.” - William James

3. “As we discover, when we pay attention to its natural rhythm, the breath becomes calm. Simultaneously, the mind quiets down. It all happens naturally. … Any force is counterproductive.” - Bhante Henepola Gunarantana

Keep Going…

2. Breathing Residue: Turning Setbacks into Assets

The problem this research identifies with this work strategy is that when you switch from some Task A to another Task B, your attention doesn’t immediately follow—a residue of your attention remains stuck thinking about the original task.

- Cal Newport, Deep Work

Attention residue. It’s a major setback to productivity.

However, let’s turn that concept into an asset with a new term:

Breathing Residue: The calmness that persists several minutes (sometimes hours) after performing a slow breathing practice.

We want less attention residue, more breathing residue : )

***

P.S. The nerds among you might prefer to call breathing residue by its more scientific name, vagal tone. But that’s not as fun 😊

3. How to Make Meditation Fun (no breathwork needed)

Here’s an easy way to make meditation fun: Instead of trying to “stop thinking,” try to “curate your thoughts.” Watch them all go by and see if you can find any good ones. Your mind thinks; you just listen for the fun and exciting stuff.

We can call it a curation meditation : )

***

P.S. I often do this when I wake up low and can’t sleep (it’s how some of these thoughts are made). It seems like it would make for a fun formal practice, too.

4. On Becoming Breathing Homo Exercens

We call ourselves ‘knowing man’ because we see ourselves as distinguished from our ancestors by our vast amount of knowledge. But perhaps a better way to see ourselves would be as Homo exercens, or ‘practicing man,’ the species that takes control of its life through practice and makes of itself what it will.

- Anders Ericsson and Robert Pool, Peak

I love this. We can “know” all we want, but it’s meaningless without practice. And there’s no better practice for taking control of our life than breathing.

So here’s to becoming breathing Homo exercens, today.

***

Related Quote:If learning is not followed by reflecting and practicing, it is not true learning.” * - Thich Nhat Hanh

 
 

 
 

1 QUOTE

“I am nothing more than a single, narrow, gasping lung floating over the mists and the summits.”

- Reinhold Messner

 
 

 
 

1 ANSWER

Category: The Thinking Mind

Answer: Recent research suggests we have about this many thoughts per minute.

(Cue the Jeopardy! music.)

Question: What is 6.5 thoughts per minute?

P.S. That’s a lot of thoughts to choose from during your curation meditation : )


In good breath,

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

P.S. okay time to sleep

 
 
 

* 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.


Sign Up For The Breathing 411

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.

 
 

Wim Hof vs. Slow Breathing, Part 2: The Famous Endotoxin Challenge

 
 

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4 Thoughts


1. Slow Breathing = Deep Meditation?

When researchers at Harvard, Yale, and the Massachusetts Institute of Technology scanned the brains of experienced meditators, they discovered increased thickness in regions of the brain's cortex, or grey matter, related to focus and attention…But what's intriguing about this study is that breathing rate was used to determine how deep in meditation the subjects were able to get. The slower the breathing rate, the deeper in meditation participants became. And, the more pronounced their increase in grey matter.” *

- Leah Lagos, Heart Breath Mind

That deserves a 🤯

If slower breathing rates are a byproduct (and measure) of deeper meditation, I wonder if we can reverse engineer it…

2. The Deep Breath Hypothesis

The Deep Work Hypothesis: The ability to perform deep work is becoming increasingly rare at exactly the same time it is becoming increasingly valuable in our economy. As a consequence, the few who cultivate this skill, and then make it the core of their working life, will thrive.

- Cal Newport, Deep Work

And similarly, this couldn’t be any truer:

The Deep Breath Hypothesis: The ability to perform deep breathing is becoming increasingly rare at precisely the same time it is becoming increasingly valuable to our physiology. Consequently, the few who cultivate this skill, and then make it the core of their waking life, will thrive.

3. Wim Hof vs. Slow Breathing, Part 2: The Famous Endotoxin Challenge

I’ve called Wim Hof’s endotoxin study the “4-minute mile” of breathing.

So, you can only imagine my excitement when I found a study basically doing the exact same thing, but with slow breathing (it was perhaps the most excited I’ve ever been reading a paper, lol).

I produced an in-depth comparison of the studies here.

But, here are some of the take-home messages:

  • The WHM reduced fever and all other flu-like symptoms.

  • Slow breathing reduced headaches and eye sensitivity to light, but did not reduce fever or other flu-like symptoms (e.g., nausea and chills).

  • Slow breathing improved autonomic functioning as measured by HRV, suggesting participants had greater resiliency. HRV was not measured during the WHM experiment.

  • The WHM significantly reduced inflammatory cytokines. Slow breathing did not.

  • The WHM significantly increased anti-inflammatory cytokines (by up to 194%). Slow breathing did not.

There are many (many) caveats and differences between the studies, so if you’re interested, see the full write-up for more details and additional thoughts.

But based on these results, the WHM was decidedly more effective than slow breathing at reducing acute inflammation and fighting off flu-like symptoms.

4. How to Change Our Species (hint: breathe)

And I would argue that we humans are most human when we’re improving ourselves. We, unlike any other animal, can consciously change ourselves, to improve ourselves in ways we choose. This distinguishes us from every other species alive today and, as far as we know, from every other species that has ever lived.” *

- Anders Ericsson and Robert Pool, Peak

We are the only species that can consciously change ourselves to improve in ways we choose. We’re also the only ones that can consciously change our breathing in ways we choose.

Maybe that’s a coincidence. But then again, maybe it’s not…

 
 

 
 

1 QUOTE

“Happiness lies in your own heart. You only need to practice mindful breathing for a few seconds, and you'll be happy right away.” *

- Thich Nhat Hanh

 
 

 
 

1 ANSWER

Category: Breathing Rates

Answer: These aquatic mammals breathe around 1.5 - 2.5 breaths per minute at rest.

(Cue the Jeopardy! music.)

Question: What are bottlenose dolphins?


In good breath,

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

P.S. haha anyways what’s up

 
 
 

* 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.


Sign Up For The Breathing 411

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.

 
 

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.


Sign Up For The Breathing 411

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.

 
 

Ujjayi isn’t Ocean, Well-Being, and Why You Should Teach “Brooklyn” Yoga

 
 

Listen Instead of Reading


 

This week, you’re going to learn:

  • That Ujjayi and Ocean breathing are different,

  • How to breathe for inflammation, and

  • A story I listened and laughed at more times than I’m proud to admit…

I hope you enjoy it!

 
 

 
 

4 Thoughts


1. Ujjayi vs. Ocean Breathing (turns out they’re different)

Ujjayi pranayama, which is performed by lightly tightening the glottis and breathing with a whispering sound and then exhaling out of either the left or right nostril, stimulates the vagus through massaging the larynx and downregulating the sympathetic nervous system. … Ocean breath is sometimes used synonymously with ujjayi, but the two are separate practices.

- Eddie Stern, One Simple Thing

I thought Ujjayi and Ocean breathing were the same thing. So, I found this passage fascinating (especially that Ujjayi uses an exhale through one nostril). I messaged Eddie about it, and he kindly responded with even more value.

He added that, for Ocean breathing, “the sound is made not so much by the tightening of the glottis, but by creating a continuum of pressure from the high nasal cavity, through the throat, into the thorax.

That means there are two key differences between Ujjayi and Ocean breathing:

  • Ujjayi: sound comes from the glottis, and the exhale is through only one nostril.

  • Ocean: sound comes from the nose to thorax, and the exhale is through both nostrils.

My favorite part about breathing is continuously learning that I have so much more to learn : ) Thanks, Eddie!

***

Related: Hatha Yoga Pradipika (#51-53)

Related: My Conversation with Eddie on All Things Breathing

Related Quote:The surest way to prevent yourself from learning a topic is to believe you already know it.” - James Clear

2. Slow Breathing for Oxidative Stress and Inflammation

Diabetes and its associated blood sugar fluctuations lead to chronic oxidative stress and inflammation. What can slow deep breathing do?

  • JACM (2011):Diaphragmatic breathing, likely through the activation of the parasympathetic nervous system…reduces reactive oxygen species production.

  • Nature (2017):…our results lead to the hypothesis that slow breathing may exert some antioxidant effect, possibly via parasympathetic stimulation.

  • PLOS One (2013):RR [relaxation response] practice…reduced expression of genes linked to inflammatory response and stress-related pathways.

Taken together, these results suggest that slow breathing could be a simple and effective way to reduce oxidative stress and inflammation in diabetes. 

But you don’t need diabetes to benefit. These two complications are present in many acute and chronic conditions, so the above results will help everyone.

3. “Why Your Breath is Connected to Your Well-Being”

As deep breaths slow your heart rate, for example, your vagus nerve recognizes the cues of safety and sends that information to parts of the body so they can turn off their defenses, such as those that arise from a sense of anxiety or threat.

- Why Your Breath is Connected to Your Well-Being

This is an awesome little article on breathing and well-being, focusing mainly on the vagus nerve.

You will learn how vagal tone is connected with social situations, how compassion can increase respiratory sinus arrhythmia (a marker of vagal activity), and 4 simple ways to calm your whole body.

I hope you enjoy it as much as I did.

4. Why You Should Start Teaching “Brooklyn” Yoga

One new meditator kept coming to interviews with a chronic lament: ‘The breath is so boring!’

Finally, I asked him if he'd ever heard of Brooklyn yoga? He said no. I told him to close his mouth tight and close off both nostrils with his fingers. We sat that way for some time until finally he let go of his nose and gasped for air.

‘Was that breath boring?’, I said.

- Larry Rosenberg, Breath by Breath

I must have listened to this story about 10 times in a row and laughed more with each one. It brilliantly captures the importance of breathing—no science or technical jargon needed.

So if anyone tells you breathing is boring, doesn’t work, or is pseudo-science, teach them a little “Brooklyn” yoga—you might just change their mind : )

***

P.S. When I ran in and told my wife the story (yes, I was excited, lol), she didn’t get the “Brooklyn” part. Neither do I, but I think that’s the point : )

Related: Is Breathing Woo-Woo? (Thought #4)

 
 

 
 

1 Quote

“If one wants longevity, one should let the spirit and the breath pour into each other.”

–Tao Tsang

Translation from The Primordial Breath

 
 

 
 

1 Answer

Category: Vagus Nerve Function

Answer: Activation of the vagus nerve releases this chemical, which stimulates muscle contractions in the parasympathetic nervous system and slows the heart rate.

(Cue the Jeopardy! music.)

Question: What is acetylcholine?


In good breath,

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

P.S. No I don’t “meditate”

 
 
 

Sign Up For The Breathing 411

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.

 
 

On Excellent Scientific Statements and Being Reasonable with Breathing

 

Greetings,

Here are 4 thoughts, 1 quote, and 1 answer related to breathing. Enjoy!

 
 

 
 

4 THOUGHTS

1. 18 Excellent Statements from Scientific Papers

"With breathing interventions being relatively rapid interventions to implement and also demonstrating a wide range of positive clinical outcomes, breathing interventions warrant closer consideration from healthcare professionals."

- Psychophysiology (2017)

Over the past few years, I have accumulated over 500 pages of notes on over 100 scientific articles on breathing. I’ve recently been going back through them as part of a project I’m working on.

In this post, I share 18 of the best "one-liners" I’ve come across. Enjoy!

2. Breathing, Autonomic Function, and Diabetes

One of the most significant benefits of slow breathing is its positive effects on autonomic function. This is typically measured by heart rate variability (HRV) and baroreflex sensitivity (BRS)—higher HRV and BRS indicate better function.

Perhaps unsurprisingly, people with diabetes generally suffer from lower HRV (Benichou et al. 2018; Kudat et al. 2006) and BRS (Bernardi et al. 2017; Esposito et al. 2016). This is due to many factors, such as fluctuating blood sugars and resting tissue hypoxia, which cause autonomic imbalance (Bianchi et al. 2017).

Encouragingly, slow breathing at a rate of 4-6 breaths per minute is an effective way of increasing HRV (Steffen et al. 2021; Russell et al. 2017; Tavares et al. 2017; Chen et al. 2016; Lin et al. 2014; Van Diest et al. 2014; Vaschillo et al. 2006) and BRS (Rosengård-Bärlund et al. 2011; Bernardi et al. 2011; Joseph et al. 2005).

Slow breathing improves these markers by stimulating the vagus nerve, which activates the calming parasympathetic nervous system (Gerritsen and Band 2018). This helps people with diabetes restore autonomic balance.

It is simple and immediately useful, seeming too good to be true. But alas, science agrees: “Slow breathing could be a simple beneficial intervention in diabetes.

3. How Stuff Works: Why Breathing Through Your Nose Is Best

"But wait, there's more. Breathing through your nose also increases the amount of oxygen in your blood more than mouth breathing, which is essential to virtually every cell, organ and tissue in your body."

- How Stuff Works
Why Breathing Through Your Nose is Best

This excellent article succinctly summarizes the benefits of nose breathing. It’s short, sweet, and packed full of great information. Enjoy!

4. With Breathing, Be Reasonable Not Rational

"Do not aim to be coldly rational when making financial decisions. Aim to just be pretty reasonable. Reasonable is more realistic and you have a better chance of sticking with it for the long run, which is what matters most."

- Morgan Housel, The Psychology of Money

I find many parallels between health and wealth. Here is another. We often get too bogged down with doing everything rationally. "This study said 20 minutes of slow breathing is best" or "That one said three times a day is needed."

Rather than following scientific studies exactly, I believe it’s better to aim for being "pretty reasonable." Find the time of day that works best with your schedule. Find the method that works best for you. Two slow breaths are better than no slow breaths. Four minutes a day is still better than zero minutes a day.

With breathing, be reasonable, not rational.

 
 

 
 

1 QUOTE

But the nostrils, with their delicate and fibrous linings for purifying and warming the air in its passage, have been mysteriously constructed, and designed to stand guard over the lungs.

– George Caitlin (1864), The Breath of Life

 
 

 
 

1 ANSWER

Answer: The internal surface area of these organs can be a great a 100 sq. meters, about half the size of a tennis court.

(Cue the Jeopardy! music.)

Question: What are the lungs?


In good breath,
Nick

P.S. No I need these

 
 

Stop Breathing Sugar

 

Happy Monday!

Let’s get right to it. Here are 4 thoughts, 1 quote, and 1 answer for this week.

 
 

 
 

4 THOUGHTS

1. Breathing is so Cliché

"Defense wins championships // The best defense is a good offense.

Birds of a feather flock together // Opposites attract.

You get what you pay for // The best things in life are free"

- Neil Pasricha, The Happiness Equation

For any situation you’re in, you can find a cliché to help you through. And as seen above, clichés are often contradictory. Likewise, breathing clichés are also contradictory, as we saw about a month ago:

Wim Hof tells you to breathe more. // Patrick McKeown tells you to breathe less.

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

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

For breathing, I suggested that we embrace these contradictions. But from a practical perspective, I like Neil Pasricha’s advice: "Any cliché, quote, or piece of advice that resonates with you only confirms to your mind something you already know."

We’re all different. So if you notice a specific breathing method standing out, it’s probably confirming something you already know to be right for you.

2. Stop Breathing Sugar

"Cutting sugar-sweetened beverages from your diet is the single-biggest thing you can do to improve your health."

- Mark Hyman, Food Fix

Many different diets work for many different people. But they all pretty much agree on one thing: remove processed sugar. And Mark Hyman’s number one recommendation is even more straightforward: "Don’t drink sugar."

Similarly, despite all the inconsistencies in breathing advice, there is one thing we can all agree on: don’t breathe through your mouth. Mouth breathing is like drinking sugar. It’s easy and it feels good, but it is detrimental to your health.

Let’s cut this processed "breathing sugar" from our diets. It may very well be the most important thing we can do for our health.

Thanks (for the millionth time) to Brian Johnson for inspiring this thought.

3. Nitric Oxide Reduces Alveolar Dead Space

"Alveolar dead space…represents alveoli, typically in the apex of the lung in an upright person, that do not receive blood flow"

- Respiratory Physiology, A Clinical Approach, pg. 96

By redistributing blood flow in the lungs, inhaled nasal nitric oxide reduces the alveolar dead space described above. Specifically, it allows more alveoli to receive blood flow, which allows more gas exchange to occur. This is something you won’t find in textbooks because the science is just too new.

This remarkable effect has led some to postulate that nasal nitric oxide is an evolutionary adaptation that helped allow us to walk upright. Pretty neat.

4. Slow Breathing is Better Than Social Media for Sleep

"Slow-paced breathing appears a promising cost-effective technique to improve subjective sleep quality and cardiovascular function during sleep in young healthy individuals."

- Journal of Clinical Medicine (2019)

This study found that 15 minutes of slow breathing (6 breaths/min) before bed led to better subjective sleep quality than 15 minutes of social media use. Slow breathing also led to higher overnight vagal activity.

Although these results might seem like common sense, I thought they were still compelling nonetheless. Here's to putting away our phones and focusing on our breath before bed.

 
 

 
 

1 QUOTE

"The hardest thing in the world is to simplify your life because everything is pulling you to be more and more complex."

- Yvon Chouinard

 
 

 
 

1 ANSWER

Answer: This condition drops 21% two days after we gain an hour moving from Daylight Savings Time to Standard Time.

(Cue the Jeopardy! music.)

Question: What are heart attacks?


In good breath,
Nick

P.S. lmao ok fine.

 
 

Heart Rate Variability, Stress Response, and PTSD

low_vagal_tone_may_account.png

In post-traumatic stress disorder (PTSD), physiological arousal is increased when a person is reminded of their traumatic experience.  This is somewhat unsurprising. 

An over activated sympathetic nervous system almost certainly plays a role in this. However, under activation of the parasympathetic nervous system, or “low vagal tone,” might be equally important. 

The goal of the paper I’m sharing this week was to examine these two components and determine which might be responsible for the enhanced stress response in PTSD.

As with most things, the answer is likely “they both matter.” But here is what they found.

Low Heart Rate Variability Linked to Enhanced Stress Response

(Read the Full Summary Here)

They measured high-frequency heart rate variability (HRV) as a marker of parasympathetic tone. Then, the participants were read a trauma script and their physiological response was recorded.

Results showed that patients with a higher baseline HRV did not experience as much stress.  The subjects with lower HRV showed a higher heart rate peak, followed by a slower deceleration of heart rate.  That is, they showed an elevated stress response.

The patients with lower baseline HRV also had longer half-recovery times, meaning that their stress response was not only elevated, but also prolonged. 

These findings suggest that low parasympathetic tone, rather than just increased sympathetic activity, might help explain the increased physiological stress response in PTSD.

Two Takeaways

  1. HRV measurements might provide insight into the severity of a person’s PTSD and predict how well they respond to stress.

  2. Slow breathing is one of the easiest ways to improve HRV, both immediately and long term.

If HRV predicts the stress response, and HRV can be increased via breathing exercises, it is conceivable that breathing practices could improve stress resiliency in PTSD.  (In fact, a 2013 study found that a yoga breathing program significantly improves PTSD symptoms in Australian Vietnam veterans.)

Finally (and importantly), these takeaways might be applicable to conditions other than PTSD, such as anxiety disorder, cardiovascular disease, and diabetes.

In good breath,
Nick