The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You

by Patrick McKeown

  While adults may at first be wary of holding their breath, children often take to it like ducks to water. I usually work with five or six children to a group, ranging in age from four to fifteen years. Beginners are gently introduced to the exercises by walking a distance of 10 paces while they hold their breath. After 3 or 4 repetitions, the number of paces is increased in increments of 5 until the child understands the exercise and experiences a moderate need for air. Most children master the exercise in no time at all, and are soon in friendly competition with their peers to hold their breath for as many steps as possible.

  I usually expect children to hold their breath for 30 paces during the first session, increasing by 10 extra paces each week. Some children will make quicker progress and can learn to hold their breath for up to 80 paces in as little as two or three weeks without losing breath control or experiencing any stress. Even professional athletes would be impressed by this feat. More important, at 80 paces, in my experience, the child’s blocked nose, cough, wheeze, or exercise-induced asthma will have completely disappeared.

  The beauty of breath holding is that while the air shortage can be relatively extreme, it is entirely under our own control and for a short duration of time only.

  For premenstrual women, vegetarians, or those with a history of anemia, it may be necessary to take an iron supplement to support the production of normal red blood cells. If, despite sustained practice of these exercises, your BOLT score fails to increase, it may be useful to visit your doctor to have a complete blood count. If your hemoglobin is low, speak with your doctor about iron supplementation. In some individuals, I have witnessed iron supplementation making a remarkable difference to BOLT scores within just a few short weeks.

  The following Oxygen Advantage breath-hold training exercises provide simple ways to simulate the beneficial effects of high-altitude training and high-intensity training while allowing you to exercise in your usual way. Each exercise provides both a hypoxic (lack of oxygen) and a hypercapnic (high carbon dioxide) response. Combining these two effects produces important changes in the body, such as:

  • Lowering sensitivity to carbon dioxide

  • Increasing endurance

  • Reducing discomfort and fatigue from lactic acid buildup

  • Increasing the oxygen-carrying capacity of the blood

  • Improving breathing economy

  • Improving VO2 max

  By incorporating these easy techniques into your routine, you will find that your breath-hold ability increases quickly, and you will begin to see results within your training and your competitive performance.

  Using a Pulse Oximeter

  To get the best results from breath-hold exercises, it can be helpful to use a handheld device called a pulse oximeter that measures how loaded the blood is with oxygen. Convenient and noninvasive, using a pulse oximeter simply involves placing a probe on your fingertip to measure the oxygen saturation (SpO2) of your blood. A pulse oximeter can be purchased rather cheaply, but my advice is to purchase a better-known brand such as NONIN, as they tend to be more responsive. One of the main benefits of using a pulse oximeter is that it can be very motivating to witness the drop in oxygen saturation as you practice breath holds, reinforcing the success of the exercise. In addition, the device can help to ensure that you don’t overdo the exercises by lowering your SpO2 below 80 percent.

  Normal oxygen saturation at sea level varies between 95 and 99 percent (as we have seen), while the benefits from breath holding occur when the SpO2 level is dropped to below 94 percent. In the beginning, you may not notice much of a decrease to your oxygen saturation while performing breath holds. However, with practice and the ability to tolerate a stronger air shortage, the drop to oxygen saturation will become evident in as little as a few days.

  The effects of breath holding depend on two factors—oxygen saturation during training and the length of the exposure to reduced oxygen—but slow and steady is the way to go, just as it is whenever you start a new exercise program. To get the most out of breath-hold exercises, it helps to start gently, holding the breath until you feel a medium air hunger during the first two or three breath holds before gradually increasing the duration and intensity. This way, you will feel in control and be able to practice more effectively. As your BOLT score increases, you will find it easier to manage the sensation of air hunger, and your blood oxygen saturation will start to drop below 94 percent.

  Simulate High-Altitude Training While Walking

  We begin by introducing a simple walking exercise that enables you to achieve similar benefits to those experienced during intense physical training in as little as 10 to 15 minutes. The beauty of this exercise is that it can be performed anywhere and at any time, even if an injury is preventing you from engaging in normal training. Similar to any intense physical exercise, it is important to practice at least two hours after eating. Just as it is not advisable to go for a jog directly after eating, it is also best to practice breathing exercises on an empty stomach. Not only would it be uncomfortable to perform breath holds too soon after a meal, but the benefit of the exercise would be much reduced as the process of digestion increases breathing.

  During this exercise you will be practicing breath holds as you walk. For the first 2 to 3 breath holds, in order to gently acclimatize your body to lower levels of oxygen, it’s important to hold your breath only until you feel a medium hunger for air. For the remaining breath holds, challenge yourself by aiming to achieve a relatively strong need for air. Due to a delay in the pulse transit time, it is common for the decrease in oxygen saturation to take place not during the breath hold, but soon after it. Therefore, to get the most from the exercise, minimize breathing for about 15 seconds following the breath hold by taking short breaths in and out through the nose. If you have a pulse oximeter, you might enjoy observing the decrease to your oxygen saturation as you do this—effectively simulating high-altitude training and bringing the mountain to you.

  • Walk and hold: After a minute of continuous walking, gently exhale and pinch your nose to hold your breath. If you feel uncomfortable pinching your nose while walking in public, you can simply hold your breath without holding your nose. Continue to walk while holding your breath until you feel a medium to strong air shortage. Release your nose, inhale through it, and minimize your breathing by taking very short breaths for about 15 seconds. Then allow your breathing to return to normal.

  • Continue walking for 30 seconds and repeat: Continue walking for around 30 seconds while breathing through your nose, then gently exhale and pinch your nose with your fingers. Walk while holding the breath until you feel a medium to strong hunger for air. Release your nose and minimize your breathing by taking short breaths in and out through your nose for about 15 seconds. Then allow your breathing to revert to normal.

  • Repeat breath holds 8 to 10 times: While continuing to walk, perform a breath hold every minute or so in order to create a medium to strong need for air. Minimize your breathing for 15 seconds following each breath hold. Repeat for a total of 8 to 10 breath holds during your walk.

  This exercise will take about 12 minutes to complete and is highly effective at teaching your body to do more with less. At first you may only be able to hold your breath for 20 or 30 paces before you feel a strong air shortage (or less if you have asthma or are out of breath). As the number of paces per breath hold increases, the air shortage you experience will progress from easy to moderate to strong. As you feel an increased hunger for air, the breathing muscles in your abdomen or neck will begin to contract or spasm. An added effect of the contractions is to provide your diaphragm with a workout, thereby strengthening your main breathing muscle. During the longer breath holds, as you feel your breathing muscles spasm, focus on relaxing your body. Allow your muscles to go soft as you hold your breath. Relaxing the body in this way allows a longer breath hold with less stress.

  With repetition, as the weeks go by, you will find yourself being able to h
old your breath for 80 to 100 paces. Your ability to hold your breath will increase with practice and without stressing your body. Do not overdo it. Ideally, your breathing should recover easily and become calm within 3 or 4 breaths. While this exercise is a challenge, it should not be stressful.

  If you notice any side effects, such as an elevated or stronger than normal pulse for a prolonged period after completing breath holding, then it is best to refrain from performing the stronger breath holds. Instead, concentrate on breathing lightly both during rest and physical exercise to bring benefit to your health and sports.

  Breath holding can also be incorporated into a jog, run, or bike ride. While you may not be able to hold your breath for as many paces during a jog as you can during a walk, the quality of the exercise will be better because of the greater accumulation of carbon dioxide in the blood.

  Breath holding during training adds an extra load that would only otherwise be experienced during maximum intensity exercise.

  Here is a breath-hold exercise to try while jogging or running:

  • Run and hold: Ten to fifteen minutes into your run, when your body has warmed up and is sweating, gently exhale and hold your breath until you experience a medium to strong air shortage. The length of the breath hold may range from 10 to 40 paces and will depend on your running speed and BOLT score.

  • Break for 1 minute and repeat: Following the breath hold, continue to jog or run with nasal breathing for about 1 minute, until your breathing has partially recovered.

  • Repeat breath holds 8 to 10 times: Repeat the breath hold 8 to 10 times during your run, followed each time by a minute of nasal breathing. The breath holds should be challenging but should also allow breathing to recover to normal within a couple of breaths.

  If you find this exercise in any way stressful, or have difficulty recovering your breathing after a breath hold, then refrain from doing the exercise until your BOLT score has increased to at least 20 seconds.

  Breath Holding During Cycling

  A similar practice can be employed as you ride your bicycle:

  • After your body has warmed up, exhale and hold your breath for 5 to 15 pedal rotations.

  • Resume nasal breathing while continuing to cycle for about 1 minute.

  • Repeat this exercise 8 to 10 times throughout your ride.

  Breath Holding During Swimming

  Swimming is the only sport in which breathing volume is controlled, as the face is immersed in the water and the weight of the body on the water restricts breathing even further. Breathing through the mouth is probably the best option during swimming, as nasal breathing may result in water inhalation.

  To incorporate reduced breathing during swimming, you will need to increase the number of strokes between breaths. You can do this in gradual increments, increasing the number of strokes between breaths from 3 to 5 to 7 over a series of lengths. This exercise was employed by former Olympic swimmer and triathlete Sheila Taormina, who achieved the fastest 1.5 km swim during the Sydney Games in 2000. In my correspondence with Taormina, she explained how reduced breathing was used to create a training effect so that the swimmer would be challenged to do more with less. However, unlike some sports, such as underwater hockey, the breath hold is never pushed to an absolute maximum, in order to ensure the safety of the swimmer.

  In addition to the hematological benefits from breath-hold training, it has been found that breath holds also improve swimming coordination. After breath-hold training, swimmers have shown increases in VO2 peak as well as an increase in the distance traveled with each swimming stroke. During the front crawl it is necessary to turn the head sideways every few strokes in order to take a breath. However, each time a swimmer takes a breath, hydrodynamic drag takes place, which ultimately wastes energy and reduces performance. One of the benefits of having a high BOLT score is that breathing becomes more efficient, meaning that less air is required during a swim. Reducing the number of breaths minimizes drag, helping to conserve energy for improved performance.

  The same training has also been applied to underwater hockey players, who perform their sport below the surface of the water in a swimming pool. The object of the game is to pass a weighted puck along the bottom of the pool using an underwater hockey stick, scoring points in the opposing team’s goal. As play takes place underwater, it is advantageous, if not essential, that players are able to hold their breath for long periods of time. Part of the training of underwater hockey players includes prolonged and repeated breath holds and controlled breathing, which lead to a higher tolerance for carbon dioxide and an increase in breath-hold time.

  Researchers investigating the effects of short repeated breath holds on underwater hockey players found that these exercises reduced breathlessness and produced a higher concentration of carbon dioxide in the blood. In addition, lactate values were found to be lower in underwater hockey players compared to untrained individuals, meaning that the pain from lactic acid buildup was reduced. These athletes clearly have a high tolerance for carbon dioxide, most likely explained by their experience with prolonged breath holding for their sport. As we have already seen, reduced sensitivity to carbon dioxide translates into reduced breathlessness during exercise as less breathing is required to eliminate excess carbon dioxide. This allows greater physical exertion with lighter breathing—enabling your body to do more with less.

  Advanced Simulation of High-Altitude Training

  Normal oxygen saturation at sea level varies between 95 and 99 percent. To receive any benefit from hypoxic (reduced oxygen) training, oxygen saturation levels must drop below 94 percent (and ideally to below 90 percent). The effect of this method depends on two factors: oxygen saturation during training, and the length of the exposure to reduced oxygen.

  Lowering oxygen saturation below 90 percent for a duration of 1 to 2 minutes can significantly increase the production of EPO, and this can easily be achieved by using this exercise.

  Before you consider doing this exercise, please get the all clear from your physician. This exercise is only suitable for those who have good physical fitness, perfect health, a BOLT score of longer than 30 seconds, and are accustomed to performing intense physical exercise. In other words, if you wish to try this exercise, you must be familiar with experiencing strong air shortages. Please refrain from doing this exercise if any of the following statements apply to you:

  • You are in any doubt about your capabilities to perform intense physical exercise.

  • You are unwell.

  • Your BOLT score is shorter than 30 seconds.

  • You are not currently in a regular physical training program.

  This advanced exercise aims to readjust the composition of your blood and alter levels of oxygen and carbon dioxide. After months of experimenting, I have developed this exercise to lower the oxygen saturation of arterial blood and to maintain this decrease over a number of seconds. I have practiced this exercise hundreds of times and include the following guidelines to help you to perform it correctly and to be aware of potential side effects:

  • To regulate the decrease in oxygen saturation to below 94 percent and to ensure that it does not go below 80 percent, it is important to use a higher-quality pulse oximeter during this exercise.

  • This exercise should be practiced on a relatively empty stomach, at least three hours after eating.

  • The first breath hold is between 40 and 60 paces, or until you feel a medium to strong need for air.

  • After the first breath hold, subsequent holds are performed every 5 to 10 paces.

  • Following each breath hold, either exhale through your nose or take a sip of air in through your nose before the next breath hold.

  • A “sip of air” means taking a tiny breath in, the purpose of which is to relieve tension rather than take in air. It is about 10 percent of a normal breath.

  • Contractions of the diaphragm will strengthen as the air shortage progresses. Try to bring a feeling of relaxation
to your body as the air shortage increases.

  • With each successive breath hold, oxygen saturation will continue to decrease.

  • Continue to observe the pulse oximeter, ensuring that you do not go below 80 percent SpO2.

  • Challenge but do not stress yourself.

  • If the air shortage is too great, take a slightly larger breath and continue to relax.

  • Perform this exercise for 1 to 2 minutes.

  The objective of the exercise is to generate a reasonably strong air shortage in order to lower oxygen saturation and to maintain it at a lower level for a period of between 30 seconds and 2 minutes.

  Please note that it is not advisable or even necessary to lower your oxygen saturation below 80 percent. Maintaining an oxygen saturation of less than 91 percent for approximately 24 seconds can result in an increase of EPO of up to 24 percent, while maintaining this saturation for 136 seconds can result in an increase of EPO of up to 36 percent.

  Putting the Oxygen Advantage Program to the Test

  France is well known for its global cycling events. It is not only the home of the Tour de France but also to such legendary mountains as Mont Ventoux and Col le da Madone, which lure cyclists from around the world to conquer their slopes. The thriving French amateur road racing culture is steeped in folklore, setting such intense challenges that some athletes are unable to compete more than a few seasons due to injury, fatigue, or burnout.