Breathe lightly & slowly, through your nose, using your diaphragm
Breathe lightly & slowly
I hate the stress of fluctuating blood sugars. Anytime my sugar is below 60 or above 180, I’m usually a little frustrated. I think my least favorite thing in the world is waking up with high blood sugar. As it turns out, that physiological and emotional stress has negative long-term consequences.
For example, blood sugar oscillations lead diabetics to have overactive sympathetic nervous systems (fight or flight) and an under-active parasympathetic nervous systems (rest and digest). That is, we’re always slightly stressed. And, you have probably seen that when people are stressed, they often take faster and bigger breaths. The chronic, low-level stress of diabetes also causes chronic overbreathing, leading to many negative consequences.
One of the most important is the loss of carbon dioxide (CO2). Carbon dioxide plays a key role in getting oxygen into our tissues and organs. Specifically, CO2 loosens the bond between hemoglobin and oxygen (known as the Bohr effect); therefore, in the presence of CO2, oxygen is more readily released from the hemoglobin into organs and tissues. I think of CO2 as being to oxygen what insulin is to glucose. You need insulin to get glucose out of your blood and into your tissues and organs. You need CO2 to get oxygen out of your blood into your tissues and organs. Therefore, with breathing, less is more.
It seems counterintuitive, but with breathing, less is more.
This is important for diabetics: chronic tissue hypoxia likely contributes to all diabetic complications. For example, tissue hypoxia has been shown to cause insulin resistance. By purposefully breathing lightly and slowly, we alleviate tissue hypoxia and improve our insulin sensitivity. For this reason, you might need less insulin once you begin breathing less.
As mentioned earlier, diabetics spend more time in a sympathetic state. The stress hormones produced in this sympathetic state increase the body’s endogenous production of glucose. By breathing lightly and slowly, we shift from a sympathetic state to a parasympathetic state, which reduces the glucose that your body produces naturally. This, paired with the improved insulin sensitivity, is where the magic happens.
“Our study supports the view that the intervention in the form of deep diaphragmatic breathing practice would improve the glycemic control and also decrease the cardiac autonomic impairment in IHD patients with diabetes mellitus.” - Kulur et al. (2009)
Finally, slow breathing has been shown to increase autonomic function, arterial function, and blood oxygen saturation in type 1 diabetic patients. It’s not that slow breathing is a panacea, it’s that incorrect breathing is at the root of many problems. Luckily, it can easily be fixed.
Through your nose
How many times would you say that you have you eaten through your nose? How about the number of times you have taken a breath through your mouth? The goal here is to get your second answer as close to your first as possible.
The nose warms, humidifies, and filters the air you breathe. The nasal cavity is also a warehouse for nitric oxide, a potent vasodilator that facilitates easier transfer of oxygen from the lungs into the blood. Evidence is also accumulating that inhaled nitric oxide plays a critical role in oxygenating the entire body. The nose is also extremely important for sleep, which is discussed in Principle 2. Lastly, the nose adds resistance to your breathing, which helps you naturally slow down and reduce the volume of each breath.
“Man should no more breathe through his mouth than he would attempt to take food though his nose.” - Yogi Mamacharaka in Science of Breath.
Using your diaphragm
The last portion of Principle 1 is to activate the diaphragm, that is, take a deep breath. However, I purposefully avoid using the word “deep” because most people associate taking a deep breath with taking a big breath. But the truth is, when you take a deep breath, you actually need less air. A deep breath simply brings air into the lower lungs where the largest concentration of blood is (due to gravity), which increases oxygen transfer into the blood (that is, it improves ventilation perfusion). And because of this improved gas exchange, you actually need less air.
Exercises for Principle 1
From the description above, you can see that Principle 1 is pretty simple: breathe in slowly through your nose, deep into your belly, and out slowly through your nose. In fact, the goal is to eventually make it your natural way of breathing 24/7. However, when starting, it is helpful to devote time to practice until it becomes natural. Here are some of my favorite exercises:
Breathe Light - (Here is a video explaining it.) Sit comfortably in a chair with a straight back, or lie down. Inhale and exhale through your nose, and focus on bringing the air into your belly. Begin to slow down your breathing. Now, purposefully take in less air than you need. Bring a slight feeling of air hunger. Make the air hunger tolerable, but enough so that you would like to take a bigger breath. Try to maintain this slight feeling of air hunger throughout the practice. Start with 2 minutes of this practice, and gradually build up to 10-15 minute sessions.
Slow Breathing - This involves breathing at a specific pace, between 3-6 breaths per minute. You can count the length of your inhales and exhales, but I suggest using an app so you can focus completely on breathing. I use a free app called “Breathing Zone” and usually set it to 3.5-4.5 breaths per minute. However, start somewhere comfortable (6, 7, 8 + breaths per minute) and work your way down to the 3-6 breaths per minute zone over time. Also, I suggest you practice “Breathe Light” first to train yourself not to overbreathe.
Wu-Wei Breathing - It’s easy to overcompensate and take big breaths when breathing slowly. So, first we practice Breathe Light, then we practice slow breathing, and then we combine the two. Sit or lie down and breathe slowly, while simultaneously reducing the volume of each breath. At first, focus on trying to experience slight air hunger while breathing at a rate of 3-6 breaths/min. Eventually, it will become natural and effortless. This breathing will combine all the therapeutic effects of slow breathing with the benefits of increased CO2.
Relaxation Breathing - This technique has been shown to lower blood sugar. To practice, inhale for 2 seconds, exhale for 1 second, inhale for 2 seconds, exhale for 2 seconds, inhale for 2 seconds, exhale for 3 seconds, and so on, until your exhale reaches 10 seconds. Then start over. By keeping your inhale at 2 seconds while your exhale gets progressively longer, you retain more CO2 and will likely begin to feel air hunger starting around the 6 second exhale. I commonly practice this technique at night when I’m laying in bed to go to sleep. Sometimes I fall asleep before I even complete one cycle!