• Distraction
• Whether the breath hold follows an inhalation or exhalation
• Whether the athlete hyperventilates before the breath hold
Holding the breath following an inhalation results in a longer breath-hold time since carbon dioxide is diluted in a larger volume of air, meaning the brain’s receptors to carbon dioxide are not activated as quickly.
Breath-hold time increases if you take a number of big breaths immediately prior to holding your breath, but this effect is especially dangerous when practiced by swimmers. Taking big breaths immediately before a swim will significantly reduce carbon dioxide in the blood but has little effect on increasing oxygen stores. Because the brain’s signal to resume breathing is depleted by this technique, oxygen levels can drop to very low levels before the swimmer feels the need to breathe. This situation can result in the swimmer losing consciousness underwater and in worst-case scenarios can cause death by drowning. The U.S. Navy Seals website warns against this dangerous practice:
Important Alert: It has come to our attention that many men preparing for Special Operations Forces training are practicing breath holding underwater, and there have been several cases of drowning and near drowning recently. Please do not practice breath holding (under water) without professional supervision.
Notes
1. The Oxygen Paradox
22 When levels of carbon dioxide: Cheung S. Advanced Environmental Exercise Physiology. Champaign, IL: Human Kinetics; 2009.
26 “The carbon dioxide pressure”: Bohr C, Hasselbalch K, Krogh A. Concerning a biologically important relationship—the influence of the carbon dioxide content of blood on its oxygen binding. Skand Arch Physiol 1904;16:401–12; www .udel.edu/chem/white/C342/Bohr%281904%29.html (accessed August 2012).
26 “an exercising muscle is hot”: West JB. Respiratory Physiology: The Essentials. Philadelphia: Lippincott Williams & Wilkins; 1995.
27 In general, blood flow: Magarian GJ, Middaugh DA, Linz DH. Hyperventilation syndrome: A diagnosis begging for recognition. West J Med. 1983 May; 138(5):733–36.
27 A study by Dr. Daniel M. Gibbs: Gibbs DM. Hyperventilation-induced cerebral ischemia in panic disorder and effects of nimodipine. Am J Psychiatry. 1992 Nov;149(11):1589–91.
27 It is well documented that habitual mouth breathing: Kim EJ, Choi JH, Kim KW, et al. The impacts of open-mouth breathing on upper airway space in obstructive sleep apnea: 3-D MDCT analysis. Eur Arch Otorhinolaryngol. 2011 Apr;268(4):533–9. Kreivi HR, Virkkula P, Lehto J, Brander P. Frequency of upper airway symptoms before and during continuous positive airway pressure treatment in patients with obstructive sleep apnea syndrome. Respiration. 2010;80(6):488–94. Ohki M, Usui N, Kanazawa H, Hara I, Kawano K. Relationship between oral breathing and nasal obstruction in patients with obstructive sleep apnea. Acta Otolaryngol Suppl. 1996;523:228–30. Lee SH, Choi JH, Shin C, Lee HM, Kwon SY, Lee SH. How does open-mouth breathing influence upper airway anatomy? Laryngoscope. 2007 Jun;117(6):1102–6. Scharf MB, Cohen AP. Diagnostic and treatment implications of nasal obstruction in snoring and obstructive sleep apnea. Ann Allergy Asthma Immunol. 1998 Oct;81(4):279–87; quiz 287–90. Wasilewska J, Kaczmarski M. Obstructive sleep apnea-hypopnea syndrome in children. Wiad Lek. 2010;63(3):201–12. Rappai M, Collop N, Kemp S, deShazo R. The nose and sleep-disordered breathing: What we know and what we do not know. Chest. 2003 Dec;124(6):2309–23.
28 However, an increase of carbon dioxide opens: A study by Dr. van den Elshout from the department of pulmonary diseases at the University of Nijmegen in the Netherlands explored the effect on airway resistance when there is an increase of carbon dioxide (hypercapnia) or a decrease (hypocapnia). Altogether, fifteen healthy people and thirty with asthma were involved. The study found that an increase of carbon dioxide resulted in a “significant fall” in airway resistance in both normal and asthmatic subjects. This simply means that the increase of carbon dioxide opened the airways to allow a better oxygen transfer to take place. Interestingly, individuals without asthma also experienced better breathing. Van den Elshout FJ, van Herwaarden CL, Folgering HT. Effects of hypercapnia and hypocapnia on respiratory resistance in normal and asthmatic subjects. Thorax. 1991;46(1):28–32.
28 Maintaining normal blood pH: Casiday R, Frey R. Blood, Sweat, and Buffers: pH Regulation During Exercise. Acid-Base Equilibria Experiment. www.chem istry.wustl.edu/~edudev/LabTutorials/Buffer/Buffer.html (accessed August 20, 2012).
31 As the late chest physician Claude Lum: Lum LC. Hyperventilation: The tip and the iceberg. J Psychosom Res. 1975;19(5–6):375–83.
2. How Fit Are You Really? The Body Oxygen Level Test (BOLT)
32 In fact, studies have shown: A study by Japanese researchers Miharu Miyamura and colleagues from Nagoya University, of ten marathon runners and fourteen untrained individuals found that athletes had a significantly greater tolerance to carbon dioxide at rest when compared with untrained individuals. The study found that for the same amount of exercise, athletes experienced 50 to 60 percent less breathlessness than that of untrained individuals. Miyamura M, Yamashina T, Honda Y. Ventilatory responses to CO2 rebreathing at rest and during exercise in untrained subjects and athletes. Jpn J Physiol. 1976;26(3):245–54.
34 Oxidative stress occurs when: Finaud J, Lac G, Filaire E. Oxidative stress: Relationship with exercise and training. Sports Med. 2006;36(4):327–58.
34 It has been said that one: One difference between endurance athletes and nonathletes is decreased ventilatory responsiveness to hypoxia (low oxygen) and hypercapnia (higher carbon dioxide). Scoggin CH, Doekel RD, Kryger MH, Zwillich CW, Weil JV. Familial aspects of decreased hypoxic drive in endurance athletes. J Appl Physiol. 1978 Mar;44(3):464–8.
In a paper entitled “Low exercise ventilation in endurance athletes” that was published in Medicine and Science in Sports, the authors found that nonathletes breathe far heavier and faster to changes in oxygen and carbon dioxide when compared with endurance athletes at equal workloads. The authors observed that the lighter breathing of the athlete group may explain the link between “low ventilatory chemosensitivity and outstanding endurance athletic performance.” Martin BJ, Sparks KE, Zwillich CW, Weil JV. Low exercise ventilation in endurance athletes. Med Sci Sports. 1979 Summer;11(2):181–5.
35 Studies have shown that athletic ability: In a study published in the Journal of Applied Physiology that compared thirteen athletes and ten nonathletes, the athletes’ response to increased carbon dioxide was 47 percent of that recorded by the nonathlete controls. The authors noted that athletic ability to perform during lower oxygen pressure and higher carbon dioxide pressure corresponded to maximal oxygen uptake or VO2 max. Byrne-Quinn E, Weil JV, Sodal IE, Filley GF, Grover RF. Ventilatory control in the athlete. J Appl Physiol. 1971 Jan;30(1):91–8. In another study conducted at the Research Centre of Health, Physical Fitness and Sports at Nagoya University in Japan, researchers evaluated nine initially untrained college students. Five out of the nine students took up physical training for three hours a day, three times a week for four years. The researchers found that VO2 max increased after training and the response of breathing to increased arterial carbon dioxide decreased significantly during each training period. Moreover, CO2 responsiveness was found to correlate negatively with maximum oxygen uptake in four out of the five trained subjects. Similarly to the previous study, subjects with reduced sensitivity to CO2 experienced increased delivery of oxygen to working muscles. Miyamura M, Hiruta S, Sakurai S, Ishida K, Saito M. Effects of prolonged physical training on ventilatory response to hypercapnia. Tohoku J Exp Med. 1988 Dec;156 Suppl:125–35.
35 There is a strong association: Saunders PU, Pyne DB, Telford RD, Hawley JA. Factors affecting running economy in trained distance runners. Sports Med. 2004;34(7):465–85.
36 Researchers investigating reduced breathing found that running economy: Scientists investigated whether controlling the number of breaths during swimming could improve both swimming performance and running econo
my. A paper published in the Scandinavian Journal of Medicine and Science in Sports involved eighteen swimmers, ten men and eight women, who were assigned to two groups. The first group was required to take only 2 breaths per length and the second group 7 breaths. As swimming is one of the few sports that naturally limits breath intake, it is often of interest to scientists since reducing the amount of air consumed during training adds an additional challenge to the body and may lead to improvements in respiratory muscle strength. Interestingly, the researchers found that running economy improved by 6 percent in the group that performed reduced breathing during swimming. Lavin KM, Guenette JA, Smoliga JM, Zavorsky GS. Controlled-frequency breath swimming improves swimming performance and running economy. Scand J Med Sci Sports. 2015 Feb;25(1):16–24.
37 As far back as 1975: Stanley NN, Cunningham EL, Altose MD, Kelsen SG, Levinson RS, Cherniack NS. Evaluation of breath holding in hypercapnia as a simple clinical test of respiratory chemosensitivity. Thorax. 1975 Jun;30 (3):337–43.
Japanese researcher Nishino acknowledged breath holding as one of the most powerful methods to induce the sensation of breathlessness, and that the breath hold test “gives us much information on the onset and endurance of dyspnea (breathlessness).” The paper noted two different breath-hold tests as providing useful feedback on breathlessness. According to Nishino, because holding of the breath until the first definite desire to breathe is not influenced by training effect or behavioral characteristics, it can be deduced to be a more objective measurement of breathlessness. Nishino T. Pathophysiology of dyspnea evaluated by breath-holding test: Studies of furosemide treatment. Respir Physiol Neurobiol. 2009 May 30;167(1):20–5.
39 Since carbon dioxide is the primary: Stanley et al. 1975, 337–43.
40 “If a person breath holds after a normal exhalation”: McArdle W, Katch F, Katch V. Exercise Physiology: Energy, Nutrition, and Human Performance. 7th ed. Philadelphia: Lippincott Williams & Wilkins; 2010:289.
40 Breath-hold measurements have also been used: The department of physiotherapy at the University of Szeged, Hungary, conducted a study that investigated the relationship between breath-hold time and physical performance in patients with cystic fibrosis. Eighteen patients with varying stages of cystic fibrosis were studied to determine the value of the breath-hold time as an index of exercise tolerance. The breath-hold times of all patients were measured. Oxygen uptake (VO2) and carbon dioxide elimination were measured breath by breath as the patients exercised. The researchers found a significant correlation between breath-hold time and VO2 (oxygen uptake), concluding “that the voluntary breath-hold time might be a useful index for prediction of the exercise tolerance of CF patients.” Taking this one step further, increasing the BOLT of patients with CF corresponds to greater oxygen uptake and reduced breathlessness during physical exercise. Barnai M, Laki I, Gyurkovits K, Angyan L, Horvath G. Relationship between breath-hold time and physical performance in patients with cystic fibrosis. Eur J Appl Physiol. 2005 Oct;95(2–3):172–8. Results from a study of thirteen patients with acute asthma concluded that the magnitude of breathlessness, breathing frequency, and breath-hold time was correlated with severity of airflow obstruction and, secondly, that breath-hold time varies inversely with the magnitude of breathlessness when it is present at rest. In simple terms, the lower the breath-hold time of asthmatics, the greater the breathing volume and breathlessness. Pérez-Padilla R, Cervantes D, Chapela R, Selman M. Rating of breathlessness at rest during acute asthma: Correlation with spirometry and usefulness of breath-holding time. Rev Invest Clin. 1989 Jul–Sep;41(3):209–13.
3. Noses Are for Breathing, Mouths Are for Eating
52 Mouth breathing activates the upper chest: Swift AC, Campbell IT, McKown TM. Oronasal obstruction, lung volumes, and arterial oxygenation. Lancet. 1988 Jan;1(8577):73–75.
52 Dentists and orthodontists have also: Harari D, Redlich M, Miri S, Hamud T, Gross M. The effect of mouth breathing versus nasal breathing on dentofacial and craniofacial development in orthodontic patients. Laryngoscope. 2010 Oct;120(10):2089–93. D’Ascanio L, Lancione C, Pompa G, Rebuffini E, Mansi N, Manzini M. Craniofacial growth in children with nasal septum deviation: A cephalometric comparative study. Int J Pediatr Otorhinolaryngol. 2010 Oct;74(10):1180–83. Baumann I, Plinkert PK. Effect of breathing mode and nose ventilation on growth of the facial bones. HNO. 1996 May;44(5):229–34. Tourne LP. The long face syndrome and impairment of the nasopharyngeal airway. Angle Orthod. 1990 Fall;60(3):167–76.
52 One of his observations: Price W (ed.). Nutrition and Physical Degeneration. 8th ed. La Mesa, CA: Price-Pottenger Nutrition Foundation; 2008:55.
53 In comparison, Catlin: Catlin G (ed.). Letters and Notes on the Manners, Customs, and Condition of the North American Indians. New York: Wiley & Putnam; 1842.
53 Most high-performance cars cannot: Sutcliffe S. Bugatti Veyron online review (2005). www.autocar.co.uk/car-review/bugatti/veyron/first-drives/bugatti-veyron (accessed September 2, 2014).
54 With such incredible efficiency: Burton M, Burton R. (eds.). The International Wildlife Encyclopedia. 3rd ed. New York: Marshall Cavendish Corp.; 2002:403.
54 The same is true: Morgan E. Aquatic Ape Theory. Primitivism. www.primitiv ism.com/aquatic-ape.htm (accessed September 2, 2014).
54 Charles Darwin was: Ibid.
54 Birds, for example: Pelecaniformes. Wikipedia. en.wikipedia.org/wiki/Pelecani formes (accessed September 2, 2014).
54 Guinea pigs and rabbits: Nixon JM. Breathing pattern in the guinea-pig. Lab Anim. 1974;8:71–7. Hernandez-Divers SJ. The rabbit respiratory system: Anatomy, physiology, and pathology. Proceedings of the Association of Exotic Mammal Veterinarians Scientific Program. Providence, RI; 2007:61–8.
55 Experience tells the: Jackson PGG, Cockcroft PD (eds.). Clinical Examination of Farm Animals. Oxford, UK, and Malden MA: Blackwell Science; 2002:70.
55 The late Dr. Maurice Cottle: Timmons BH, Ley R (eds.). Behavioral and Psychological Approaches to Breathing Disorders. New York: Springer; 1994.
56 In the yoga: Ramacharaka Y (ed.). Nostril vs. mouth breathing. In: The Hindu-Yogi Science of Breath. Waiheke Island, New Zealand: Floating Press; 1903.
56 Nose breathing imposes: Timmons, Ley (eds.), Behavioral and Psychological Approaches.
56 Nasal breathing warms: Fried R (ed.). Hyperventilation Syndrome: Research and Clinical Treatment (Johns Hopkins Series in Contemporary Medicine and Public Health). Baltimore, MD: Johns Hopkins University Press; 1987.
57 Nasal breathing removes: Ibid.
57 Nasal breathing during physical: Morton AR, King K, Papalia S, Goodman C, Turley KR, Wilmore JH. Comparison of maximal oxygen consumption with oral and nasal breathing. Aust J Sci Med Sport. 1995 Sep;27(3):51–5.
57 As discussed in the next section: Vural C, Güngör A. Nitric oxide and the upper airways: Recent discoveries. Tidsskr Nor Laegeforen. 1999 Nov 10;119(27): 4070–2. Doctors Maria Belvisi and Peter Barnes and colleagues from the National Heart and Lung Institute in the United Kingdom demonstrated that one of the roles of nitric oxide includes dilation of the smooth muscles surrounding the airways. Belvisi MG, Stretton CD, Yacoub M, Barnes PJ. Nitric oxide is the endogenous neurotransmitter of bronchodilator nerves in humans. Eur J Pharmacol. 1992 Jan 14;210(2):221–2. Djupesland PG, Chatkin JM, Qian W, Haight JS. Nitric oxide in the nasal airway: A new dimension in otorhinolaryngology. Am J Otolaryngol. 2001 Jan–Feb; 22(1):19–32. Lundberg JO. Nitric oxide and the paranasal sinuses. Anat Rec (Hoboken). 2008 Nov;291(11):1479–84. Vural C, Güngör A. Nitric oxide and the upper airways: Recent discoveries. Kulak Burun Bogaz Ihtis Derg. 2003 Jan;10(1):39–44.
57 Mouth-breathing children are at greater risk: Okuro RT, Morcillo AM, Ribeiro M, Sakano E, Conti PB, Ribeiro JD. Mouth breathing and forward head posture: Effects on respiratory biomechanics and exercise capacity in children. J Bras Pneumol. 2011 Jul–Aug;37(4):471–9. Conti PB, Sakano E, Ribeiro MA, Schivinski CI, Ribeiro JD. Assessment of the body posture of mouth-breathing children an
d adolescents. J Pediatr (Rio J). 2011 Jul–Aug;87(4):357–63.
57 A dry mouth also increases acidification: Orthodontists online community. Mouth Breathing. orthofree.com/fr/default.asp?contentID=2401 (accessed January 7, 2015).
57 Mouth breathing causes: Ibid.
57 Breathing through the mouth: Kim et al. 2010, 533–9. Kreivi et al. 2010, 488–94. Ohki et al. 1996, 228–30. Lee et al. 2007 Jun, 1102–6. Scharf, Cohen 1998 Oct, 279–87; quiz 287–90.
58 When the first article appeared discussing: Chang, HR (ed.). Nitric Oxide, the Mighty Molecule: Its Benefits for Your Health and Well-Being. Jacksonville, FL: Mind Society; 2011.
58 And although nitric oxide: Ibid.
58 In 1992, nitric oxide: Culotta E, Koshland DE Jr. NO news is good news. Science. 1992 Dec 18;258(5090):1862–5.
58 In 1998, Robert F. Furchgott: Raju, TN. The Nobel chronicles. 1998: Robert Francis Furchgott (b 1911), Louis J Ignarro (b 1941), and Ferid Murad (b 1936). Lancet. 2000 Jul 22;356(9226):346. Rabelink, AJ. Nobel prize in medicine and physiology 1998 for the discovery of the role of nitric oxide as a signalling molecule. Ned Tijdschr Geneeskd. 1998 Dec 26;142(52):2828–30.
58 When I first began: Ignarro L. NO More Heart Disease: How Nitric Oxide Can Prevent—Even Reverse—Heart Disease and Strokes. Rprt. New York: St. Martin’s Press; 2006. Cartledge J, Minhas S, Eardley I. The role of nitric oxide in penile erection. Expert Opin Pharmacother. 2001 Jan;2(1):95–107. Toda N, Ayajiki K, Okamura T. Nitric oxide and penile erectile function. Pharmacol Ther. 2005 May;106(2):233–66. Chang, Nitric Oxide, the Mighty Molecule; 2012.
58 Nitric oxide is produced: Lundberg JO, Weitzberg E. Nasal nitric oxide in man. Thorax. 1999;(54):947–52. Chang, Nitric Oxide, the Mighty Molecule; 2012. Lundberg JO. Airborne nitric oxide: Inflammatory marker and aerocrine messenger in man. Acta Physiol Scand Suppl. 1996;633:1–27.
The Oxygen Advantage: The Simple, Scientifically Proven Breathing Techniques for a Healthier, Slimmer, Faster, and Fitter You Page 27