Since 2002 I have taught thousands of children and adults with asthma how to address the root cause of their condition—breathing too much. Triggers such as animal dander, dust mites, exercise, pollution, excessive hygiene, and changes in the weather are often cited to be the cause of asthma symptoms, but in my experience the vast majority of sufferers can take back significant control of their condition, regardless of their triggers, by simply learning to breathe light. The fundamental cause of ongoing asthma symptoms can almost always be attributed to breathing too much. As long as a student understands the exercises and devotes time to changing his or her breathing, positive results are consistent and reproducible.
Based on the fact that a number of clinical trials have shown that asthma symptoms and the need for asthma medication are significantly reduced following the employment of reduced breathing exercises, there is no doubt that overbreathing is a significant contributor to asthma. Of course, it is also normal for people prone to asthma to increase their breathing volume to compensate for a feeling of suffocation, but this action is simply part of a feedback loop. Elements of modern living increase breathing volume, which can activate asthma in genetically predisposed individuals. As their asthma takes hold, the individual breathes faster and more intensely, worsening the condition. While it is important to recognize this feedback loop, the first step to addressing asthma is to reduce excessive breathing habits.
I can relate to any child or adult with asthma because for more than twenty years I struggled with the same symptoms; I was unable to perform even the most basic physical exercise, my nose was constantly stuffed, and I continuously breathed through an open mouth. Year after year my asthma medication increased with no signs of my symptoms abating. My sleep, concentration, mood, and quality of life were all adversely affected. It was only by chance, when I learned of the work of Russian doctor Konstantin Buteyko, that I was able to reverse my asthma. Within a few short days my wheezing decreased dramatically, simply by learning to unblock my nose and normalize my breathing volume. I have now been wheeze-free for the past thirteen years, and all I did was to learn to breathe normally again.
This had such a tremendous impact on my life that I changed careers in 2001 and retrained under the auspices of the late Dr. Buteyko. In 2002, I founded Asthma Care to help publicize this information to children and adults with asthma. Our clinics are now offered in a number of countries.
The first step to addressing chronic overbreathing is to make the switch from mouth to nasal breathing. While nasal breathing is important for everyone, for people prone to asthma it is vital. When breathing volume is greater than normal, there is a tendency to open the mouth in order to allow more air to enter the lungs. People diagnosed with asthma often feel they are not taking in enough air while breathing through the nose, which causes them to breathe through the mouth.
Mouth breathing influences asthma in a number of ways:
• Air taken in through the mouth is not filtered of airborne particles, including germs and bacteria.
• The mouth is simply not as effective as the nose in conditioning air to the correct temperature and humidity prior to entering the lungs.
• Because the mouth provides a larger space to breathe through than the nose, breathing volume will be higher, causing too much carbon dioxide to be expelled from the lungs. Carbon dioxide is a natural “opener” of the smooth muscle in the airways. The loss of carbon dioxide therefore causes asthma airways to narrow even more.
• Unlike nasal breathing, mouth breathing does not allow us to benefit from nasal nitric oxide, which supports the lung’s defensive capabilities.
Taking all these factors into consideration, it is not surprising that mouth breathing causes a reduction in lung function in people with mild asthma and plays a significant role in the exacerbation of asthma symptoms.
Not only is it important to breathe through the nose during rest, it is also beneficial to nasal breathe during physical exercise. In a paper published in the American Review of Respiratory Disease, researchers studied the beneficial effects of nasal breathing on exercise-induced asthma. The study observed that most subjects with asthma spontaneously breathed with their mouths open when instructed to breathe “naturally.” The authors found that mouth breathing during exercise caused the airways to narrow even further. In contrast, when subjects were asked to breathe only through their nose during exercise, exercise-induced asthma did not occur at all. The paper concluded that “the nasopharynx and the oropharynx play important roles in the phenomenon of exercise-induced bronchoconstriction.” In simple terms, the effects of breathing through the nose are integral to reducing or avoiding exercise-induced asthma completely.
The fact that elite athletes with asthma often favor swimming above other forms of exercise is not a coincidence. During swimming, the face is immersed underwater, reducing the amount of air taken into the lungs and increasing the athlete’s tolerance for carbon dioxide. Although the swimmer may draw his or her breath in through the mouth, the protective effects of reduced breathing are still evident. A child or adult with asthma may also prefer swimming because the water exerts a gentle pressure on the chest and abdomen, further restricting breathing volume and improving athletic performance.
The difference between land-based exercise and swimming in terms of breathing pattern and volume is significant for people with asthma. On land, your breathing pattern during exercise is not restricted the way it is in water, meaning that you can very easily overbreathe, resulting in constricted airways, a reduction in the amount of CO2 in your blood, and a lower BOLT score. For an individual with asthma, overbreathing during rest leads to overbreathing during exercise, which in turn leads to exercise-induced asthma. However, exercising in water naturally causes you to restrict your breathing and lower your breathing volume toward normal, providing a much safer and more productive environment for people with asthma to exercise.
At the beginning of this chapter we looked at statistics that showed that in a group of athletes, narrowing of the airways affected 55 percent of football athletes and 50 percent of basketball players, but 0 percent of water polo players. With such a glaring disparity, what factors could possibly explain the difference? The answer, as you have probably guessed by now, is simple. Water polo training involves breath holding and swimming underwater, resulting in a higher tolerance to carbon dioxide, increased amounts of nitric oxide, and a reduced breathing volume. With a more normal breathing volume, asthma tendencies don’t appear.
However, if you have asthma and do not wish to take up swimming, there is a simpler way! The Oxygen Advantage approach incorporates all of the beneficial aspects of swimming and more. Although the act of swimming has its merits, it is well documented that spending time in chlorinated pools is not ideal for asthma, as the chlorine can cause damage to lung tissue. Furthermore, while swimming reduces breathing volume, it is still important to address poor breathing habits outside of the pool. Many swimmers remain habitual mouth breathers and continue to employ poor breathing habits that reduce their athletic performance and maintain their asthma.
Your success in addressing asthma will be based on your ability to increase your BOLT score using the Breathe Light to Breathe Right and simulation of high-altitude exercises described in this book. You will find a program specific to your needs in Part IV. The general aim is to increase your BOLT score to 40 seconds. The best time to measure your BOLT score to track your progress is first thing in the morning, and if your BOLT measurement remains less than 20 seconds, then your asthma symptoms will persist. However, when your early morning BOLT score is greater than 20 seconds, symptoms such as wheezing, coughing, breathlessness, and chest tightness will disappear. It’s important to note that you may still be susceptible to certain symptoms even when you have achieved a BOLT score of 20 seconds when exposed to a trigger; a BOLT score of 40 seconds is needed to fully eliminate your asthma symptoms.
As you work toward achieving a high BOLT score, y
ou may continue to experience symptoms, depending on your medical history and triggers. Your ability to stop the effects of asthma using the exercise below is dependent on two factors: how high your resting BOLT score is and how quickly you react to the onset of symptoms. The sooner you begin practicing the exercise, the easier it is to prevent symptoms from taking hold. By ignoring your symptoms and hoping they will go away by themselves, the effects of asthma tend to get worse and can take on a life of their own. If you often experience asthma symptoms, you will know that wheezing and coughing usually worsen over time, so it is important to intervene early on.
This exercise can help stop asthma symptoms, but please get your doctor’s permission to try it first. Then follow the instructions below during the early stages of chest tightness, wheezing, coughing, or a head cold. If you aren’t able to stop your symptoms within 10 minutes, then take your rescue medication. If you are experiencing severe symptoms, of course, then take rescue medication straightaway. If your rescue medication does not stop your symptoms within a couple of minutes, it is advisable to call a medical doctor immediately.
To stop asthma symptoms before they take hold, follow these steps:
• Take a small, silent breath in and out through your nose.
• Hold your breath and walk for 10 to 15 paces.
• Stop walking, release your nose, and resume gentle breathing in and out of your nose.
• Wait for 30 to 60 seconds and repeat.
• Continue to walk while holding your breath for 10 to 15 paces followed by resting with nasal breathing for 30 to 60 seconds.
• If your symptoms are mild, you may hold your breath for more than 10 to 15 paces.
• Do this exercise for at least 10 minutes.
In addition to employing nasal breathing and achieving a high BOLT score, it is also very important to warm up properly in order to avoid exercise-induced asthma. The minimum time spent warming up should be 10 minutes. A good warm-up consists of fast walking while practicing a medium to strong breath hold every minute or so. After the 10-minute warm-up, increase the pace so that you’re moving as fast as you can while maintaining nasal breathing. If you feel the need to open your mouth, slow down. Following your physical exercise, encourage your breathing to calm toward normal.
The positive results of reduced breathing exercises and nasal breathing on the symptoms of asthma are fast and astounding. With such a simple method, there really is no reason for anyone to suffer a single day more from the discomfort of asthma.
CHAPTER 13
Athletic Endeavor—Nature or Nurture?
In 1704, a racing stallion by the name of the Darley Arabian arrived in Britain from Syria, and 95 percent of today’s male thoroughbreds descend from him. Geneticist Patrick Cunningham and colleagues from my alma mater, Trinity College Dublin, traced the lineage of nearly one million horses from the past two centuries and determined that 30 percent of variation in performance in thoroughbreds is due to genetics alone. In the nature versus nurture debate, these results suggest that nature plays a significant part in our athletic abilities.
There is one area in particular where a combination of genetics and behavior has considerable influence on athletic performance, and that is the way the face and jaws develop during childhood. For example, take a look at the structure of the face and jaws of past Olympic gold medal winners including Usain Bolt, Sanya Richards-Ross, Steve Hooker, and Roger Federer. What is strikingly apparent for this group, and for the vast majority of top-class athletes, is the forward growth of the face and width of the jaws. Athletic success depends on having good airways, which in turn is dependent on normal facial structure. Spend a lot of time with your mouth hanging open or sucking your thumb during childhood and the face grows differently from how nature intended.
In fact, Michael Phelps, the most decorated Olympian of all time, is one of the very few top-class athletes who does not exhibit forward growth of the jaws and a wide facial structure. Based on his facial profile, there is a high likelihood that he was a mouth breather during childhood, possibly requiring orthodontic treatment in his early teens. It is also possible that Phelps chose swimming, either consciously or unconsciously, as it was the one sport that he could excel in. The very act of swimming restricts breathing to help offset any negative effects that have developed from mouth breathing or an inefficient breathing pattern.
Although the natural order of things is to breathe through the nose, many children—especially those with asthma or nasal congestion—habitually breathe through the mouth. Brazilian researchers investigating the prevalence of mouth breathing in children aged 3 to 9 found that 55 percent of a random selection of 370 subjects were mouth breathers. Children who regularly breathe through their mouth tend to develop negative alterations to their face, jaws, and the alignment of their teeth. Mouth breathing affects the shape of the face in two ways. First, there is a tendency for the face to grow long and narrow. Secondly, the jaws do not fully develop and are set back from their ideal position, thus reducing airway size. If the jaws are not positioned forward enough on the face, they will encroach on the airways. See for yourself: Close your mouth, jut out your chin, and take a breath in and out through your nose, noting the way air travels down behind the jaws. Now do the same but pull your chin inward as far as you can—you will probably feel as if your throat is closed up as you try to breathe. This is exactly the effect poorly developed facial structure has on your airway size. It is no wonder that those with restricted airways tend to favor mouth breathing.
The forces exerted by the lips and the tongue primarily influence the growth of a child’s face. The lips and cheeks exert an inward pressure on the face, with the tongue providing a counteracting force. When the mouth is closed, the tongue rests against the roof of the mouth, exerting light forces that shape the top jaw. Because the tongue is wide and U-shaped, it follows that the shape of the top jaw should be wide and U-shaped also. In other words, the shape of the top jaw reflects the shape of the tongue. A wide U-shaped top jaw is optimal for housing all our teeth.
However, during mouth breathing, it is very unlikely that the tongue will rest in the roof of the mouth. 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. Since the top jaw is not then shaped by the normal pressures of the tongue, the end result is the development of a narrow V-shaped top jaw. Aesthetically, this contributes to a narrowing of the facial structure, crooked teeth, and orthodontic problems. It has been well documented that mouth-breathing children grow longer faces.
The second way facial structure is affected by the way we breathe during childhood is the position of the jaws. The way the jaws develop has a direct influence on the width of the upper airways. Our upper airways comprise the nose, nasal cavity, sinuses, and throat. Strong athletic performance requires large upper airways that enable air to flow freely to and from the lungs. Although a high BOLT score and effective breathing technique are crucial for high levels of performance, having airways that function with little resistance is also very advantageous. For example, a marathon runner who has efficient breathing but airways that are the width of a narrow straw is not going to get too far.
The normal growth of the face is forward. Since a mouth-breathing child does not rest his or her tongue in the roof of the mouth, the jaws are unable to be properly shaped by the tongue, and the natural forward growth of the jaws is impeded. This results in jaws that are set back from their ideal position, compromising airflow. For the correct development of the lower half of the face and airways, it is imperative that a child habitually breathes through his or her nose. Breathing through the nose with the tongue resting in the roof of the mouth helps to establish the ideal conditions for the normal development of the face.
I switch
ed from mouth to nose breathing during the late 1990s, when I was in my early twenties, but it was only after I met with myofunctional therapists Joy Moeller, Barbara Greene, and Karen Samuel in 2006 that I learned the correct position of the tongue. Until then, I hadn’t given it a moment’s consideration, and most likely my tongue had been flopping about without a home for the previous thirty-two years. Between them, Joy, Barbara, and Karen have devoted almost a hundred years to reeducating people on the placement of the tongue and facial muscles in order to address a variety of detrimental issues that affect the development of the jaws and teeth. Spending thousands of dollars on orthodontic treatment can be in vain if poor habits such as mouth breathing, tongue thrusting, and incorrect swallowing are not addressed. And you may be able to avoid orthodontic treatment altogether if these habits are not permitted to develop in the first place.
In the correct resting position, three-quarters of the tongue should press gently against the roof of the mouth with the tip of the tongue placed just behind the top front teeth—the same place we put the tongue to make the N sound “nuh.” Just like nasal breathing, optimal resting tongue posture is not a recent discovery; for thousands of years it formed an important part of Eastern yoga and the religion of Buddhism. Yogi Bhajan, who introduced Kundalini yoga to the United States in 1968, accredited the upper palate and the tip of the tongue as the two most important parts of the body. The ancient Buddhist scriptures of the Pali Canon contain passages describing how the Buddha pressed his tongue against the roof of the mouth for the purposes of controlling hunger and the mind.
The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You Page 22