Evaluating Different Breathing Systems

Have you ever thought about actively working to improve your breathing as part of your daily routine? Some breathing practices were developed for pathologies, such as asthma and chronic obstructive pulmonary disease (COPD), and others for performance enhancement and relaxation. When deciding which system to follow, it’s important to consider how the system might fit your individual needs. Here’s a rundown on the different practices according to their strengths.

The basics of breathing are as simple as inhaling and exhaling gently through the nose. Nasal breathing warms, filters, and slows the influx of air to regulate oxygen and carbon dioxide levels. Mouth breathing disrupts the ratio of these two gasses and can worsen asthmatic symptoms. For more information on the physiology of breathing, read my previous blog post “Breathing Yourself to Better Health.”

Specifically for asthma, Ukrainian physician Dr. Konstantin Buteyko posited that slow and subtle nose breathing and breath holding (after exhaling to build up carbon dioxide) were the best methods to restore the balance of oxygen and carbon dioxide. Mouth breathing results in excessive loss of carbon dioxide that makes the delivery of oxygen less efficient. For more information on the Buteyko method, read my previous blog post “Healing Asthma: Breathing Pattern Disorders.”

With exertion, the temptation exists to breathe through the mouth, and with very vigorous exercise that may be necessary. But with moderate exertion, a half measure is to breathe in through the nose and exhale through the mouth. This is a technique I learned after attending a lecture by respiratory therapist Betsy Thomason, where she described the BreathOutDynamic (BOD) system.

The BOD system is clinically successful in improving quality of life for patients diagnosed with COPD. Even without this condition, the principles of the BOD system can be applied for breathing with activity. Whether at a fast walk or light jog, I can consistently maintain an 8-second exhalation through the mouth and a 4-second nasal inhalation. That’s impressive, given that I would otherwise need to inhale with my mouth at least partially open at that level of exertion.

The mainstay practice of the BOD system is a slow and steady pursed-lip exhale, as if blowing on a pinwheel. That would seem at odds with nose-only breathing practices, but I believe the BOD system is congruent with the Buteyko method. I’ve heard Buteyko’s work distilled to the phrase “breathe less,” and the efficiency of the BOD system allows for maximizing oxygen utilization. With BOD system breathing, you blow off less carbon dioxide and produce an overall balance with oxygen with a slow pursed-lip exhale.

Endurance athletes will be familiar with the dramatic breathing practices of Wim Hof. He is known as the Iceman for his world-record stunts during cold exposure, such as running a marathon in the Arctic wearing nothing more than a pair of shorts and running shoes. Hof has become a global phenomenon, espousing the benefits of cold exposure (also known as cryotherapy) and a peculiar breathing technique that involves hyperventilation.

He doesn’t use the word “hyperventilation” when teaching his breathing practice, but that is the result of taking 30 or more quick deep breaths in and out. Adherents of this practice report increased oxygenation and altering of pH with this practice. The claim of increased oxygenation can be disputed with a pulse oximeter. Although quick deep breaths increase the oxygen level in the body, the relative lack of carbon dioxide blunts the ability of that oxygen to be delivered to cells. Hyperventilation produces lightheadedness as carbon dioxide levels drop and oxygen becomes more tightly bound to the hemoglobin in red blood cells.

I believe the secret sauce of Hof’s technique is the breath hold following the end of a round of 30 or more quick full breaths. Curiously, even a relative novice will experience the ability to hold one’s breath for a minute or longer after a complete exhalation. This occurs because the body is consuming the built-up oxygen, and the impulse to breathe comes from excess carbon dioxide rather than a deficiency of oxygen. Thus, the long breath hold reestablishes a balance of oxygen and carbon dioxide, and the breather receives the benefit of navigating the stress response of both hyperventilation and breath holding. (One is encouraged to hold the breath for as long as possible.)

There may be secondary biochemical benefits to exercising these extremes of respiration, such as the release of erythropoietin that increases red blood cell count. If valid, Hof’s technique would be a natural form of blood doping, simulating training at high elevations. The major benefit it definitely imbues is building stress resilience. Hyperventilation and breath holding are difficult; remaining calm while switching between extremes challenges the breather’s ability to modulate between sympathetic and parasympathetic nervous system activation.

If you’re new to breathing practices, here’s the executive summary: Over the years I have recommended the tried-and-true Buteyko method for asthma patients. Lately I’ve been turning to Patrick McKeown’s work “The Oxygen Advantage” for an updated and more streamlined permutation of the Buteyko method. For COPD patients, I prefer the BOD system and recommend “Just Breathe Out” by Betsy Thomason. For a broad overview of breathing practices, including more about the Wim Hof method, James Nestor’s book “Breath” is the best.

Learn more and practice according to your needs and goals. I don’t have a history of breathing problems, so I personally use a combination of several methods: slow nasal breathing at rest, BOD breathing with activity, and an occasional round or two of Wim Hoff breathing to build stress resilience.