“Breathing may be considered the most important of all the functions of the body, for, indeed, all the other functions depend upon it.” – Ramacharaka: Hindu-Yogi Science of Breath.
Dr Joanna McMillan explains the importance of breathing for optimum health.
Australians living with breathing difficulties
Breathing is an unconscious natural process, as instinctive as swallowing, sneezing, or coughing. You breathe in and out thousands of times over the day and probably never give it a second thought…until something goes wrong. Millions of Australians suffer from lung disease and for them being able to breathe becomes a central focus of their lives.
Asthma alone affects more than 2.2 million Australians and is our country’s most widespread chronic health problem. 1 in 4 children, 1 in 7 adolescents, and 1 in 10 adults are affected. By international standards this is high. Chronic Obstructive Pulmonary Disease (COPD) is the term used for those who have difficulty breathing air out from their lungs and includes asthmatic bronchitis, chronic bronchitis, and emphysema. COPD affects up to one in six Australians over the age of 45 and is the third leading cause of disease burden, after heart disease and stroke. Yet unless you or someone close to you is affected, you probably don’t know much about it. Similarly, lung cancer doesn’t attract the same media attention as say cancer of the breast, yet it is the fourth most common cancer in women and the third most common cancer in men. What’s more, lung cancer is particularly deadly; it is the most common cancer to result in death for men, and is second only to breast cancer in women.
Common causes of breathing problems
What is emphysema?
Emphysema is the result of damage to many of the alveoli, making it increasingly difficult for the body to absorb enough oxygen. In addition, the bronchial tubes become floppy and narrowed, making it hard to breathe in and out. The major symptom is breathlessness. This usually starts during exercise or when walking uphill, but as the lung condition worsens, breathlessness can occur with everyday activities and becomes extremely debilitating.
What is bronchitis?
Bronchitis occurs when the bronchial tubes become inflamed and swollen. Excess mucus is produced as a result and clogs the airways. Sometimes the muscles surrounding the airways also tighten causing bronchospasm and this together with the swollen, narrowed airways makes it difficult to get enough air in and out of the lungs. Symptoms of bronchitis include a persistent cough that brings up mucus, wheezing, and shortness of breath.
The overwhelming number one cause of both bronchitis and emphysema (and lung cancer) is smoking and giving up is the single most important step you can take to both prevent and treat the disease. Frequent chest infections are common so if you suffer from any form of COPD speak to your doctor about a flu vaccination and any other medication that may help. It is also known that emphysema can be hereditary – if you have a family member with the disease you may be susceptible and it is even more important that you avoid smoking and smoky environments since passive smoking can be equally harmful. Dusty environments are also damaging to the lungs so wear a mask when working in such conditions.
Why is optimal breathing so essential to health?
Putting lung disease aside, can how we breathe affect our general state of health? Many Eastern health philosophies and practices have claimed for years that it does. If you have ever practised yoga or meditation, for example, breathing is a central focus. The belief is that breathing incorrectly leads to the poor functioning of practically every body system including digestion, respiration, metabolism, and the immune system. Furthermore, they claim that correct breathing is not a natural process, or has for many reasons been lost into adulthood, but needs to be taught, and once mastered can improve both physical and mental health, increase the ability to concentrate, promote relaxation, and relieve stress. Western medicine has until now largely ignored these ideas, but there is an increasing interest in the use of breathing techniques both to assist those with lung disease to breathe more easily and effectively, as well as being enormously beneficial for all, particularly for relieving stress and anxiety.
Sydney-based physiotherapist Anna-Louise Bouvier says that at least 60 percent of us are poor breathers, and anecdotally (from those she sees in her practice) this figure may be as high as 80 percent. It seems to be a chicken and egg scenario whereby stress, anxiety, and poor posture affect breathing, while poor breathing likewise increases the level of stress and anxiety, and even contributes to poor posture by utilising the wrong muscles and encouraging slumping.
Leon Chaitow, a UK-based holistic health practitioner, lectures and publishes widely on what he terms “breathing pattern disorders” (BPD). He claims that BPDs are extremely common and disturb the blood biochemistry by affecting the balance of oxygen uptake and carbon dioxide elimination, resulting in an altered blood pH. He further claims that this state, produced by incorrect breathing, causes or contributes to a vast range of symptoms ranging from muscular pain and tremors, anxiety and associated muscle tension, fatigue, and sleep disturbances, to gastrointestinal problems and heart palpitations. It certainly seems physiologically plausible that insufficient oxygen and blood pH change could result in such broad-ranging symptoms, but mainstream medical research has yet to concur, stating that there is currently insufficient evidence to support this theory.
How does breathing work?
Our lungs are kind of like giant sponges. When you breathe in, the air is drawn down the windpipe or trachea, which splits into two smaller tubes called the bronchi, and these carry the air down into the lungs. The bronchi then split into increasing numbers of smaller tubes called bronchioles, a bit like the branches of a tree, finally reaching the tiny air sacs called alveoli, of which there are some 300 million in each lung! The walls of the alveoli are so thin that oxygen can pass through them and enter the bloodstream for distribution around the body.
Similarly, carbon dioxide, a waste product of metabolism, can pass from the bloodstream into the alveoli ready to be expired with the next breath. The bronchial tubes secrete mucus to trap dust, dirt, and bacteria and stop them from entering the lungs. Millions of tiny hairs called cilia then sweep back and forth helping to shift the mucus away from the lungs and keep them clean.
Coughing also plays a vital role in this process. Hence the recent advice in the media concerning children and cough mixtures; paediatricians recommend that these medicines are not given to children with a cough as they should be encouraged to cough to help clear the infection. Those with lung diseases such as bronchitis or emphysema are also encouraged to cough to help clear their lungs, particularly first thing in the morning when excess mucus and fluid may have settled in the lungs overnight. It is important to learn how to cough effectively – you ought to be able to clear your lungs in two or three coughs. Your doctor or physiotherapist can teach you how to do this.
What are we doing wrong and how do you breathe effectively?
At the bottom of the chest cavity is the diaphragm. It is a dome-shaped muscle largely responsible for moving air in and out of the lungs. When we breathe in, the diaphragm moves down allowing the lungs to fill with air, and when the diaphragm moves up it helps to force air out of the lungs. If you watch a baby breathing, their belly rises gently with each breath in as the diaphragm contracts downwards, and falls as they breathe out and the diaphragm moves upwards.
Yet somehow, many of us as adults have overridden the instinct to breathe in this way and instead hold our bellies in (possibly because we are all trying to look slimmer!) and breathe lifting our shoulders with each breath. This “shallow breathing” is what correct breathing techniques aim to rectify. There are numerous versions of how to do it and these too have changed over time. Many yoga techniques still teach a form of “belly breathing” – in yoga, they call it the “Complete Breath” or “Dirgha Pranayama” – where the idea is to allow your belly to expand with each inspired breath and contract with each exhalation. This however is not quite correct according to Bouvier. She says this common practice of teaching leads to incorrect muscle use. Instead, lie down and place your hands on your ribcage. As you breathe in you should feel your ribcage expand (think of widening your ribs) allowing your lungs to fill completely, and on the expiration pull your stomach in very softly, almost as if the stomach deflates.
The art of breathing effectively
Think about the speed of your breathing. Do you take lots of shallow short breaths, or slow deep ones? Often when we get anxious the muscles around the chest tighten and we subconsciously start to breathe less effectively, failing to fill the lungs or fully expire “used” air. When you do feel anxious or stressed take a few minutes to stop and concentrate on your breathing. Try counting to three as you breathe in, pausing for a moment, and again counting to three as you breathe out. If possible, do this by breathing through your nose as this helps you to breathe more slowly. The nose also plays an important role in filtering out dust and bacteria, preventing them from entering the lungs. Alternatively, purse your lips as if whistling while breathing out to slow you down and keep breathing under control. Those who practice this type of breathing for 10 minutes or so once or twice a day, or any time they feel stressed, report great improvements in their anxiety levels and are generally more relaxed.
Can breathing correctly help asthmatics?
Asthma is a kind of allergic response where the airways narrow causing wheezing, chest tightness, and difficulty in breathing. Despite popular opinion to the contrary, food and food allergies are not usually linked to asthma. Far more likely triggers are colds and flu, dust mites in bedding, carpets and soft toys, animal fur or feathers, pollen, and moulds often found in damp areas in the kitchen or bathroom.
The good news for asthma sufferers is that breathing therapy may help. The Buteyko Method, developed by a Russian doctor called Professor Konstantin Buteyko over 50 years ago, is a breathing program that claims to dramatically reduce or even eliminate the need for medications in many respiratory diseases, particularly asthma. The method is gaining support from the medical community with the publication of several trials in recent years in Australia, NZ, and the UK – showing improvements in symptoms and reduced need for medications such as inhaled steroids in asthmatics. While Buteyko’s theories of how the method may work have not been confirmed by the research, the fact that such improvements have been found is immensely promising for asthmatics.
Perhaps breathing is not as unconscious and natural an act as we may at first think. We know that we need to breathe to live, but it seems that we also need to learn to breathe correctly if we are to live to our full potential. For those with any disease affecting the lungs, breathing therapies are a must, but indeed the rest of us can benefit. Take 10 minutes now to think about it and see for yourself how it feels.
About Dr Joanna McMillan
Dr Joanna McMillan is one of the best-known nutrition and wellbeing experts in Australia – a nutrition scientist and dietitian, passionate about empowering individuals to lead healthier, more fulfilling lives. She is a popular media spokesperson and has formed key brand partnerships to deliver science-based insights for more than 20 years. Her mission is to bridge the gap in health literacy and make wellness approachable, understandable, and simplified for all walks of life.
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