When a baby is born the first question is often “are they breathing?”. It’s also often the last question asked about someone who’s dying. Breathing is crucial to sustaining life. So much so that we do it without needing to think about it.
However, that doesn’t mean how we breathe doesn’t matter. It does. There is a right and a wrong way to breathe.
It might seem strange that our body can carry out a subconscious process incorrectly, but it’s important to remember that breathing is both an involuntary (operant) & a voluntary (respondent) learned behaviour (1), meaning we can develop dysfunctional breathing habits without ever being aware of it.
To get philosophical:
Our breath is a reflection of our life and our life is a reflection of our breath.
So, what happens if we are breathing incorrectly, how do we know if we are breathing correctly, and how can we breathe better?
Let’s answer one question at a time…
Hot tip for reading this article: There’s a bit to take in here. I highly recommend reading the article right through on day 1, doing the 5 tests the next day, then tackling each of the 4 letters of the acronym, one per day, then reviewing it all on day 7.
The Impact of Poor Breathing
Dysfunctional breathing is estimated to impact 50-80% of all adults (2), and the figure is even higher in the athlete population, with 91% showing breathing dysfunction (3). Poor breathing has been linked to many common chronic health conditions including:
Anxiety and panic attacks
Depression
Chronic stress
Poor sleep & sleep apnea
Poor cognitive function
ADHD
Diabetes
High blood pressure
Decreased libido
Respiratory illnesses
Musculoskeletal pain
And more
This non-exhaustive list is why I think breathing well is foundational for our health.
What Is Dysfunctional Breathing
Patrick McKeown, author and creator of The Oxygen Advantage identifies the following traits of dysfunctional breathing:
Breathing through the mouth
Audible breathing at rest
Regular sighing
Regular sniffing
Large breaths prior to talking
Yawning with big breaths
Upper chest movement on inhale
Paradoxical breathing (belly moves inward on inhale)
Very noticeable breathing movement at rest
Do I Breathe Correctly
If your breathing is healthy (at rest), it should be smooth, steady and controlled. It should feel easy to breathe, and your breath should be quiet. You should feel your lower torso (your abdomen area and your ribs) expand in 360° with each inhalation and contract with each exhalation… and you should only be using your nose.
If you had no skin, the movement might look something like this…
Not sure if you breathe like that? Take these 3 quick tests.
Is My Mouth Shut Test
Sit upright (not uptight)
Breathe normally
Observe if your mouth is shut on the inhale and exhale
If it’s not, there’s your answer! 😉
You can also repeat this on a slow walk
Hi-Lo Breathing Test
Sit upright (not uptight)
Put one hand on your chest, the other on your belly (just above your belly button)
Breathe normally for 5-10 breaths
Observe which hand moves first (and most)
Repeat lying down (and standing)
Anything other than your belly hand moving outward, away from the spine, on the inhale, may indicate dysfunctional breathing.
Lateral Rib Expansion Test
Sit upright (not uptight)
Form ‘finger pistols’ with your hands and place them on your rib cage (below your lats, above your floating ribs, at t9 and t10) 🔫
Breathe normally
Observe if there is any sideward rib cage expansion
No lateral rib cage expansion on the inhale may indicate dysfunctional breathing.
Additional Tests
While an important part of breathing well is good breathing mechanics (what’s moving, when and how much), it’s also important to look at how your breathing interacts with the rest of your body & mind. It’s why functional breathing covers three areas; biomechanics, biochemistry and psychophysiology.
There are a lot of clinical assessments out there to help paint a broader picture of your breathing (I use a lot for my coaching clients). However, this nifty study combined several of them to create a simple screening for disordered breathing.
Screen your breathing by taking the 2 tests below.
BOLT Test
Note: This is not a maximum breath hold
Take a normal, silent breath IN through your nose.
Allow a normal, silent breath OUT through your nose.
Gently pinch your nose with your fingers
Count the number of seconds until you feel the first involuntary muscle activity triggering your desire to breathe in.
Results:
<25 seconds = B
>25 seconds = A
Questionnaire
In the last 2 weeks…?
Do you notice yourself yawning?
Do you notice breathing through your mouth at night?
Do you feel tense?
Do you feel a cold sensation in your hands or feet?
Scoring:
Never/Not True At All = 0
Occasionally/A Bit True = 1
Frequently/Mostly True = 2
Very Frequently/Very True = 3
Results:
Any 2 or 3 answers = B
Only 0 or 1 answers = A
Interpreting the Results
All A = Likely no breathing dysfunction (89% likelihood)
Any B = Indicates a sensitivity to one area of breathing dysfunction (and further assessment is recommended)
How Can I Improve My Breathing
Every industry I’ve worked in had its own acronyms, and breathwork is no different. Depending on what content you’ve been consuming, you might’ve come across one of the following acronyms teaching you how to breathe better:
LSD - Light, Slow, Deep
NGSE - Nasal, Gentle, Slow, Expansive
LSL - Light, Slow, Low
LESS - Light, Expansive, Slow, Silent
Eagle-eyed readers will notice several common components; use your nose, slow it down and make it light/gentle. Where they differ is how they describe the biomechanical component (deep, low or expansive)… which is quite ironic as biomechanics are in a way the most straightforward.
Let’s unpack each one.
NOSE
Unless you’re completely new to breathwork (if so, hello & welcome 👋), you’ll know just how important it is to use your nose to breathe. Here are my 7 reasons why:
Helps you to stay calm & relaxed
Improves blood flow & oxygen uptake
Improves exercise performance
Fights infections (bacterial, fungal & viral)
Helps maintain body temperature & decrease dehydration
Can help you sleep better
Makes you more attractive (I’m not kidding)
Bonus: Improves cognition
Read the full article on why nose breathing is important
My tip when working on nose breathing is, with your mouth gently closed, keep your jaw relaxed and rest your tongue softly on the roof of your mouth (it can touch your top teeth, but don’t push it into them), because when your tongue is on the roof of your mouth you can’t easily mouth breathe!
SLOW
Breathing slower day-to-day (ideally 10-14 breaths per minute), is not only more relaxing, but also increases heart rate variability (resilience), improves oxygen delivery to the lungs, lowers blood pressure, and increases focus and concentration.
When training to slow your breathing, aim to train below your normal breathing rate, between 3-10 breaths per min (remember, it’s important to slow it down gradually).
Here are some simple breathing tempos to help slow your breathing:
Balanced breath: 4 in, 4 out (7.5 bpm)
Extended exhale: 4 in, 6 out (6 bpm)
Box breath: 4 in, 4 hold, 4 out, 4 hold (3.75 bpm)
LIGHT/GENTLE
“The key to optimum breathing [is] to breathe, but to breathe less.” - James Nestor, author of Breath
Light breathing helps to increase blood flow and oxygen delivery to the cells, make more use of nitric oxide and calm the mind.
Light breathing is not the same as slow breathing. A common mistake when people are learning to slow their breathing is they overcompensate by overbreathing (taking bigger inhales and exhales), or by shallow chest breathing. Both are the opposite of what we want.
Think of light breathing as decreasing the volume of air you breathe in and out. Trying to make it as quiet and soft as possible are helpful cues. Practising this will likely make you feel like you want to breathe more air (‘air hunger’) which is a sign you’re doing it right! This is a good explanation & guided exercise video.
Getting a feel for this requires skill and it’s why it’s the final piece of the puzzle for my clients when helping to improve how they breathe.
Health note: Light breathing is suitable for everyone, except those with a serious health condition or in the first trimester of pregnancy.
DEEP/LOW/EXPANSIVE
Let’s start with why I don’t like using Deep or Low as breathing cues.
If I told 100 people to “take a deep breath”, the majority would either 1) inhale by puffing up their chest 2) take a big inhale via their mouth or 3) do both.
If I told 100 people to “breathe low”, the majority would likely push out their belly outward.
Neither are what we’re looking for.
Instead make your breath expansive. Breathe in 360°, feel your belly move outward and your lower ribs expand to the front, side & back with each breath. Your belly should move out because the diaphragm is moving down.
Expansive breathing increases lung volume, increases air into the lungs & oxygen uptake in the blood and also increases cerebrospinal fluid movement (important for brain health) and lymphatic drainage (waste removal).
Child’s Pose is a great exercise to practise activating your rib cage. With your belly pressed onto your thighs, focus on inhaling into your back, widening your back ribs and lat muscles.
Summary
Regardless of how you scored on the tests, and whether you have dysfunctional breathing or not, I guarantee there is still room for improvement with how you breathe day-to-day. The beautiful thing with breathing is it’s dose dependent… the more work you put in (in the right areas obviously), the more you get out of it.
I also want to leave you with my acronym: NSEL.
It’s definitely not as catchy or memorable (and with a creative mind it’s potentially borderline controversial), but there’s logic to it, as it follows the order I recommend you practise each element in:
Nose
Slow
Expansive
Light
Start at 1), practise Nasal Breathing for 10 mins every day for a week. Then move to 2) Slow Breathing > 3) Expansive Breathing and 4) Light Breathing, and within a month you’ll have completely transformed how you breathe!
Thanks
Thank you to the following legends in the breathwork community who created the acronyms.
LSD - Patrick McKeown, The Oxygen Advantage
NGSE - Martin McPhilimey, Performance Through Health
LESS - Zac Vale, In & Out Breathwork
References
Interested to learn more about the breath or want to learn how to go deeper? Join me at an upcoming workshops or explore my coaching program
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