Patrick McKeown: How Optimal Breathing Can Change Your Life [Podcast Ep. #8]

Transcribed from the episode audio by AI, so it may contain mistakes.

Ravi0:00Welcome to the Motivated Life podcast. I'm Ravi Raman. In today's episode, I'll be speaking with Patrick McKeown. Patrick is the author of a book called The Oxygen Advantage. And there's an interesting story behind how I came to know about Patrick's work. I believe it's important because his work is all about breathing. And if you were to go to any bookstore or one of the few remaining bookstores and look at the aisles of books in the health and fitness section, you'll see most relating to how to build stronger muscles, how to lose weight, new fitness routines, workout routines, those sorts of things.

But what you're not going to see is a lot of books about breathing. There's a certain irony to that because, well, we can go for weeks without food and a few days without water, but we can't go much more than a few minutes without breathing. It really is vitally important. And if you're a yogi as I am, you understand the importance of breath. But in our society, we don't hear about breath being a fundamental and important thing for health. It intuitively makes sense, but most of us don't actually know what proper breathing is and what impact it can have on our life.

Now, I first stumbled upon Patrick because I've been fascinated with the topic of breathing for a long, long time. Ever since I was a little kid, I struggled with not asthma, but allergies so that six months out of the year, my nose was mostly blocked. And so I stumbled into learning with different ways of improving my breathing. And then as I got more and more into yoga, I realized how important breathing really is. Now that said, it's easy to fall back into bad habits. And I've noticed the past couple years my breathing has not been as good as it could be.

And I stumbled upon Patrick's new book. Now, I had written a blog post many years ago back in 2009 that was, and still is my most commented blog post ever. It's on increasing your endurance through breathing through your nose. Now, what's interesting is Patrick had actually replied and commented on that blog post back in 2009. Now, here we are many years later, and I stumbled upon his book a few weeks ago and reached out. and he was kind enough to offer an interview. So it's interesting how things sort of come full circle.

In this interview, we're going to talk about a whole lot of stuff. And we talk for just under an hour. We probably could have spoken for days. Much of what we talk about were just hitting the surface level on. His book has a lot more depth, the chemistry behind what happens when we breathe properly, the biochemistry behind what happens. happens in our bodies when that happens, how our breathing is linked to performance in sport, to stress and anxiety at work, to focus in concentration, and even to how our skull develops, particularly in childhood.

Now, we didn't go into the weight lost aspects, though there is plenty of, at least superficial evidence so far to show that when we get our breathing under control. We can get our weight under control. And so I think it's a very important topic and something that not enough people are talking about. So I'm proud to be able to bring you this interview. And with that, I guess I'll stop talking now. And we'll go ahead and get going with this interview with Patrick McKeown, author of The Oxygen Advantage.

Enjoy. Patrick, welcome to the podcast. How you doing? Good.

Patrick4:38Thanks very much, Ravi. It's great to be here.

Ravi4:41So where are you calling in from?

Patrick4:43So I'm calling in from the west of Ireland. I live outside of town called Galway, and I'm out in Connemara, so I'm out in the countryside. But I've got nice views and cold weather. It's a perfect place for good breathing.

Ravi4:56Yeah, it definitely sounds like it. So I just want to dive right in and ask you a question point blank. Can shutting your mouth really change your life? Yeah,

Patrick5:06Totally, especially if you're a mouth breather. You know, if somebody has been already nose breathing, both during wakefulness and sleep, they don't get so much out of it because obviously they're doing it anyway. But if somebody has been mouth breathing, there's no question the detrimental effects of mouth breathing. They're immense, you know, in terms of I had my mouth open for 20 years. I had rhinitis, so my nose was constantly stuffed. I had asthma and generally the two will go together. And because I had rhinitis my sleep was affected, because if your nose is blocked you're more likely to have a light sleep.

I was waking up tired and because I was mouth breathing, I was breathing faster, so I tend to be more stressed. So, in a nutshell, what mouth breathing did for me is it affected my sleep, so my concentration during the day was poor, so my ability to study academically was reduced and it affected my stress level. So little things that would normally, you know, people would cope quite well with them. I would get more stress, so I'd higher perceived stress than other individuals. My asthma is really badly affected and often required, increased medical intervention, etc.

And my nose was constantly stuffed. So I've craniofacial changes too because I had my mouth open from a child all the way through. My jaws aren't developed the way they should be. I'd crooked teeth. My jaws are set back in the face. My nose is crooked. Now, still, I got away with it to some extent. But even still, your breathing through the nose is probably the most least talked about thing, that habit of a human being. We all talk about diet. We talk about physical exercise, you know, which are all great.

But let's talk about breathing. Let's talk about the benefits of breathing the way our ancestors used to breathe. Breathing the way we breathed when we were born. and countering that the negative effects of mouth breathing is is key.

Ravi7:08Well, let's talk about that because here's the thing. If nose breathing is so natural, why does it seem like when I go out walking down the street, it seems like everyone has their mouth hanging open, even me, I'm a yogi, I'm a meditator, I practice breathing techniques, and I still find myself mouth breathing all the time. If this is how we're meant to be, why is it that? everyone has their mouth hanging open, sucking an air through their mouth.

Patrick7:37I think it's just a habit. It seems to have corresponded with modern life. The first documented cases of mouth breathing would have been back in the 1600s. Now, if the thing that we've evolved over hundreds of thousands of years and all that time we had our mouths closed, our ancestors were nasal breathers, How did they know that? And they know by unearting the skulls of our ancestors that they had a wide facial structure and there was plenty of room for airway and basically, as the child was growing up, throughout her evolution, the child had the lips together, the mouth was closed, lips together and tongue resting in the roof of the mouth, because the tongue is wide, shaped, it's a wide use shaped and that develops the palate.

So it was very clear that when anthropologists were unerting skulls from graves of upper middle class individuals and these people had had passed on the 1600s they noticed narrow palettes and gothic-shaped jaws, V-shaped jaws, overcrowding of teat. And this was the first documented case of overcrowding of teat. And basically it's not because the teat were too big, It was because the jaws were too small. And the jaws were too small because the tongue wasn't in the roof of them out. And the tongue wasn't in the roof of them out because the individual was mouth breathing.

You can't have your tongue resting in the roof of them out if you're breathing through your mouth. So by breathing through your nose, your tongue is resting there, which is the correct resting position of the tongue, and I don't just mean the tip of the tongue, I mean three quarters of your tongue resting and the roof them out. But in order to mouth read if the nose was stuffy or, you know, if there was any anatomical issue going on the nose you have to have your mouth open.

So you're breathing through your mouth, but in order to breathe through your mouth, you can't have your tongue resting there. And why did it all happen? Well, upper middle class people had access to sugar, they had access to more kind of modernized foods, even back. In the 1600s. Sugar has been around for a long time in europe. It's been around since the 11th century. So sugar um seems to be some factor in contributing to open mouth breathing. It's a way of life now.

Ravi9:47what is the link between sugar and mouth breathing what do you what

Patrick9:52are it's very difficult to know precisely but it just seems to be know a suggestion that when we change our diets, our breathing also changed. And it may be simply because the metabolism, there's extra work involved in terms of sugar, that it seems to be contributing to inflammation of the airways and inflammation of the nasal cavity, inflammation of the lungs, and that there's some link there. It's difficult to quantify it. But back in the 1930s, a dentist called Dr. Weston Price, he wrote a book called Nutrition and Physical.

Degeneration and his work involved traveling from different from country to country and he looked at the traditional people in these countries and you noticed they had tremendous facial structures, they'd wide faces and they'd no overcrowding of teeth. They had really wide, you-shaped jaws, good airways etc. And he noticed that within one generation that when these individuals started eating processed foods, that children became mouth breathers. So he documented that back in 1932 I think it might be in 1938 that one generation of processed foods causes individuals to switch from those to mouth breathing.

And, you know, his European settlers in the United States, there was an American painter called George Catlin. And he taught the traditions of the Native American Indians were dying out. So he went and lived with them for one year. And he wrote a book, this is going back, 1800s, 1870, or thereabouts. And he said that the native Indian mother, every time that they put the child asleep, the child went to bed, the mother would go over to the child and gently pressed the lips together. And he said this was tremendous.

This was a tremendous, you know, act for a mother to do for a growing baby. And then he spoke about the European settlers and their mouths wide open, they're lying in their backs and their mouths wide open. And he said they were gasping into the multitude. So he wrote a book, called Shut Your Mouth and Save Your Life. And that's going back. So this is going back a long time. There's been another book's written, yogi books of 1903. I think it's called The Science of Brett.

And it says one of the most common habits. This is back in 1903, mouth breathing. And that man is subject to many diseases as a result of it. And you could say, well, that's a bit of an over-exaggeration. But let's look at even some of the changes that happen as a result of mouth breathing. Number one is you're not taking condition. air into the lungs. We often think the skin is the organ of the body that's in most contact with the atmosphere. So your skin, the area of your skin is about two meters squared.

And people are aware of the benefits. So you have to put on suntan lotion or sunscreen or whatever. You know, you want to protect your skin against the elements. But the real organ that's in contact with atmosphere is the lungs. Your lungs are 75 to 100 meters squared. If you were to open up the area of contact with the small air sacks, you know, there's 300 million of them per lung. There's about 500 million for the two lungs. And the area of contact of the small air sacs with the atmosphere is 75 meters to 100 meter square.

That's 50, up to 50 times more extensive the area than I'm in contact with the skin. And if you breathe through an open mouth, that atmosphere, that atmospheric air is going directly straight into the lungs. So in terms of people would ask more people with bronchic constriction. It causes cooling of the airways. It causes drying out of the airways. It causes moisture literally to be sucked out of the airways. And this in turn causes inflammation of the airways. And if there's inflammation in the lungs that travels up to the nose, and if there's inflammation of the nose that travels down to the lungs.

So since about 2013, doctors now have recognized a unified airway model Because, before that, an E&T ear, nose and throat spasias they looked specifically after the nose nose and a pulmonologist would look after the lungs when, actual fact, whatever's happening in one will tend to happen to the other. So unified airway model is very important and the recognition of it, because if your nose is blocked and your mouth breathing, your sleep is affected and people with rhinitis or allergic rhinitis would be hay fever, for example, and that affects about 30% of the western population.

Ravi14:16yeah you're talking to a suffer a severe allergy suffer that causes much of my mouth breathing though I'm now trying to actively stay in nose breathing and

Patrick14:26Well ravi you're, you're going to know the connection down with sleep, because if you've got allergic rhinitis and you're twice as likely to have sleep problems, right, so then we wake up tired and if you wake up tired, our concentration is affected. Um mouth breathing, in terms of dental health, dries out the mouth because saliva is an anti-plac agent. Saliva is very good for for good gum health, you know, because it's helping to neutralise bacteria in the mouth, and the mouth harbors a lot of bacteria.

But if you're breathing through the mouth, the mouth is dry. Bacteria is more rampant. Gums are affected. The upper airways are pretty much traumatized by taking that cold, dry air into the lungs, through them out, and we're more prone to dental cavities and gum disease. And bad breath. Bad breath also is a factor of mouth breathing. So that's dental health and sleep is affected. And the lower airways, the lungs are affected for those with asthma. Stress levels. So Stanford Medical School, they located a pacemaker in the brain in March of this year.

They said that this pacemaker is spying on your breathing. And if you breathe fast, the pacemaker relays signals of agitation throughout the brain. But if you breathe really slow, the pacemaker, which is spying on your breathing, relays signal of calm. So it's not just that stress causes our breathing to be fast, but fast breathing causes our mind to be agitated. Now, if you have an open mouth, you're going to breathe fast because your nose imposes 50% restriction to your breathing than your mouth during the day.

Ravi16:03So what you're saying is, for those of us that aren't, we'll talk about the athletic application here, because for me, that's the one that seems very counterintuitive, but it makes sense when I apply it. We'll talk about that in a second. Sure. But for those who are not professional or even amateur athletes, they're professional office workers. Let's talk about why this really matters. Why should they shut their mouth, learn to breathe through their nose if they're looking for focus, concentration, lower stress, higher performance at work?

Yeah,

Patrick16:34well, first to sleep, as I spoke about, if you have your mouth open during sleep, you're far more to snore, far more likely to snore, you're far more likely to have obstructive sleep apnea. it increases the risk of that. You have a lighter sleep, so they've done experiments with men, and they've blocked their noses on one night to force them to mouth breathe, and then they block their mouths in another night to force them to nose breed, and then they subjectively and objectively measured their sleep quality.

During mouth breathing, every parameter was reduced. They found that the individual spent more time in light sleep, less time in deep sleep, and the number of apnea, hypopony index, basically the restriction to breathing had significantly increased. So sleep disturbances is greatly increased as a result of open-map breathing.

Ravi17:24What is, and the mechanism for that, what do you think is going on that causes disruptive sleep? Because you're still getting air in.

Patrick17:33You're getting air in, but the

Ravi17:35key is, how

Patrick17:36much resistance to it is there? You know, breathing through the nose during the day imposes resistance. your breathing, but in actual fact, the opposite happens during your sleep. So you're two and a half times more likely to have sleep disorders, breathing through an open mouth versus breathing through the nose. I think it's the architecture of the airways. When the mouth is hanging open, the volume of the diameter of the airway, which is including the throat down into the trachea, that's significantly reduced. So there's a greater resistance to your breathing.

And with a resistance to your breathing, the sleep quality is affected. And also, breathing through the nose will tend to involve a full or deeper breath, because it's the nose breathing that activates the diaphragm, but it's mouth breathing that activates the chest. Now, if you breathe through your nose, you'll tend to use your diaphragm. And if you're using your diaphragm, the muscles that are keeping the airways open in the throat are more likely to stay open. So there's a communication feedback between the muscles of the diaphragm and the muscles of the throat.

And there's another thing going on that if you breathe with an open mouth, you dry out the upper airways and they're more likely to be sticky. So if they collapse during sleep, they're more likely to stay collapsed for a longer period of time. So the severity of the sleep apnea increases. Another factor is nitric oxide. If you breathe through your nose, you pick up nitric oxide and you carry this nitric oxide into your lungs. But nitric oxide is a signaling molecule. And that sends a message to the airways, sorry, it's in the muscles of the throat.

to stay open. So your airway is functioning far better by breathing through your nose. It's almost as if man and woman was designed to breathe through the nose, not through them out. And even in terms of, you know, they looked at studies swift back in 1988, individuals who had jaw surgery and their jaws were wired shut. And they found that individuals who were forced to breathe through the nose, the oxygen uptake in the blood was 10 to 15% greater. Now, breathing through the nose also increases N tidal CO2.

So N tidal CO2 is basically the amount of CO2 in the lungs, which equals the amount of CO2 in the blood. And carbon dioxide is very important because in order for oxygen transfer to take place from the blood to the cells, you need CO2. But if you're breathing hard, and if you're breathing with an open mouth, you've lower N tidal CO2. And as a result, the oxygen isn't released so readily from the rest. red blood cells to the cell. So mouth breathers, Google it. You know, you put in mouth breather into Google.

What do you think it comes up with? The first thing that comes up is it's a stupid person. So a mouth breather is a stupid person And they usually equate that It's the most derogatory term. I was watching a film there. It's called a family man. I was flying from Australia to to Ireland there but two days ago And they were given out. There was this sales guy, this family guy, and he's a head hunter and he's talking about his group of mouth breathers and it's the most derogatory term that they could use was called somebody a mouth breather and that's how society looks at it and you could say, yeah, well, generally the term is used because if you're not conscious enough of breathing through your nose, you're pretty stupid, like that's kind of dead, the inference on it.

But mouth breathing does reduce oxygen delivery to the brain. Mouth breathing is affecting sleep. So mouth breathers.

Ravi21:03it's so counterintuitive but yeah but you know in your book you lay out the science behind why that's actually

Patrick21:09Happening? Yeah, I know it's. This science is not new. The science is going back to 1904, the bore effect. Uh, danish physiologist christian bore. He said the the partial pressure of carbon dioxide in the blood is very important because it determines the affinity of hemoglobin for oxygen. So basically we have, when oxygen passes into the lungs and it passes from the lungs into the blood, it's carried two ways. In the blood oxygen is carried two ways. In the blood most of it is carried by hemoglobin, and hemoglobin is a protein that carries four units of oxygen, and hemoglobin allows 70 times more oxygen to be carried than otherwise would be.

So hemoglobin is the big carrier of oxygen. And the second way that oxygen is carried in the blood is directly dissolved in it. Now it's a very small amount. It's three millilitres of oxygen for one liter of blood. So the vast majority of oxygen is carried in the blood by red blood cells by hemoglobin. So you can imagine this hemoglobin is the carrier of oxygen. And the condition that allows the red blood cell or the hemoglobin to release oxygen is an increase of body temperature or an increase of what's called this phosphoglycerate or carbon dioxide.

Carbon dioxide here is very important because your breathing will directly influence the amount of carbon dioxide in the lungs, and the amount of carbon dioxide in the lungs will equal the amount of carbon dioxide in the blood. So how you breathe directly influences the carbon dioxide partial pressure for CO2 in the blood. If you breathe hard and you get rid of too much CO2, the hemoglobin holds on to oxygen. And basically that's the bore effect. The bore effect states if there's an increase of carbon dioxide, there's a reduction of blood pH.

And with that, the red blood cells releases oxygen more readily. Now, conversely, if we're breathing harder or breathing more than what we should be, hemoglobin holds onto oxygen. So here's the interesting thing. The harder we breed, the less oxygen gets delivered. The lighter we breed, the more oxygen gets delivered. And in terms of stress is probably the easiest way to think of this.

Ravi23:25Right, because I'm, what I'm, what I'm, so in, the workplace, you know, what I'm hearing you say is that when you breathe properly, you have the proper pH, the hemoglobin is able to release the oxygen. You can actually oxygenate your body more with a lower volume of breath through the nose than with gasping through the mouth. And from a worker perspective, if I want to have energy all day long and I want to get oxygen to my cells, then this can really, really help. And not only in sleep, but also during.

during the work day. Now, one question for you is during the work day, so I'm a coach and I work with leaders and tech companies helping them with their performance. And stress and anxiety oftentimes come up. People working against deadlines. And it seems to me that a body that's more oxygenated can better deal with stress. And in my own life, I've noticed that when I'm nose breathing, I'm able to deal with stress or I just don't get stressed at all. really i mean i'm just able to recover very quickly what have you discovered in terms of the impact of stress and anxiety with the breath

Patrick24:38I think there's um. I think we really need to look at blood flow to the brain, and it's not that we're asking people to underbreed, but it's that we're recognizing that modern society is literally causing us to breathe too much. And if you think of your office worker, they could be on the phone all day. And if you're, if you're talking all day in the phone, or even talking, you know, in media, meetings, et cetera, your breathing volume increases And as your breathing volume increases, it's causing a disturbance to blood gases.

So blood vessels constrict and less oxygen gets delivered. And one organ is going to receive less oxygen is the brain. So the crowded arteries, which are feeding the brain with oxygen. And the crowded arteries can constrict by up to 50% from over breathing. And McGarion is a researcher who wrote a paper called Hyperventilation Syndrome, a diagnosis begging for recognition. He said for every one millimeter decrease of CO2, blood flow to the brain reduced by 2%. It's also been known in the rash that carbon dioxide is a very calming effect and the paper is saying that basically the brain by regulating breathing regulates its own excitability.

And another factor is in 2016 paper they looked at the effect of mouth breathing and basically when you breathe through an open mouth the brain, the oxygen demand by the brain increases, but the oxygen delivery to the brain reduces. So the brain needs more oxygen, but gets less. They're saying that this is contributing to central fatigue. So we can influence by focusing on the breadth and by slowing down our breathing, and by slowing down our breathing, we're almost resetting the breathing center in the brain towards a better breathing volume.

It's not the exercise that's the key. I want to change everyday breathing. I want people breathing through their nose and breathing lightly. And the only way you know you're doing that is with a higher bold score. So as bold score increases and breadth of all time, which is pretty much the bolt score, that's an indirect measurement of your CO2. So by giving you an indirect measurement of your CO2, you then have some feedback of, you know, in terms of the oxyhemoglobin dissociation curve or the amount of oxygen that's delivered to the brain.

the brain needs more oxygen so we'd want to breathe that way to feed it

Ravi27:03So maybe we can talk about two things now. One, I'd love it if you can just describe how you would describe the optimal breath, to sort of give us a paint that picture. And the second, let's talk about the bolt score, what it is, why it's important and maybe how people can, can go measure, and of course I'll include references to your book where you go into all the details. But if we can talk about those two things, so maybe if you can paint the picture of the perfect breath and what the bullet score is,

Patrick27:36So the perfect breath is light, it's quiet, it's gentle. If you were to look at somebody breathing, it's very difficult to detect our breathing. It's through the nose and it's driven by the diaphragm and there's a gentle pause on the exhale. So say that again, it's light, it's quiet, it's gentle, It's through the nose, in and out of the nose, not just in through the nose and out of the mouth, but both in and out of the nose. It's driven by the diaphragm. So the primary breathing during rest is driven by the diaphragm.

And as soon as you exhale, there's a gentle pause before you feel the need to breathe in again, And that's good breathing. Conversely, unhealthy breathing is through the mouth, using the chest, irregular breathing, effortful breathing, fast breathing, and it's not that you're having a panic attack, but it's just that your breathing volume is faster than what it should be, and it's typically the breathing associated with stress. So it's no coincidence that how we breathe during stress are also the same elements that are involved in breathing pattern disorders.

Now, taking into consideration boat, boat is a very good score in terms of, as your bold score increases, you're more likely to breathe you using your diaphragm. If you have a low bolt score, you're more likely to breed using your chest. If you've got a low bolt score, you're more likely to have a faster respiratory rate and reduce lung function. Um, and both score basically is

Ravi29:10You take, we get into the bolt score. I have a clarifying question maybe you can talk about because when you say the optimal breath is light, you know there's a misnomer um that a proper breath is you know a deep big inhale and a deep big exhale. And maybe if you can talk to really how light a breath should be? I know it was surprising to me to learn really how light and optimal breath is, so

Patrick29:41in terms of quantifying it if you look at somebody's breathing it should be difficult to see their breath there's a book in Taoist yoga was written in 1980 and it said that the perfect man no sorry they said your breathing should be so smooth that the fine hairs within the nostrils do not move. Now, can you imagine breathing so lightly that the fine hairs within the nostrils do not move? And then Lao Su, Chinese philosopher, so from 500 BC, he said that the perfect person breeds as if they do not breathe.

Trouther. You know, if we're looking at turning towards Eastern medicine and Eastern martial arts, it was all about taking light breathing. There was a Tai Chi master grandmaster, her name was Master Jennifer Lee, and I met her in London about 10 years ago and I looked at her breathing and her breathing was absolutely perfect. It was regular, it was so light, the amplitude of the breadth was so gentle, it was difficult to see and it was perfect. And her bowl score was 40 seconds. And I asked her, I said how come you so good breathing?

And she said well, this has been passed down from generation to generation. And she said during Tai Chi, if the judges, if they see a competitor, breathe, points are deducted. So the whole emphasis there was light breathing. And if you go to the ancient sutras in yoga, it's not about taking big breaths. It's not about breathing hard. And actual fact, hard breathing is to be avoided. It's all about subtle breaths. So they use the word subtle.

Ravi31:22Subtle right and you know, as a as a yoga teacher myself, it's amazing how many people, including I, used to teach this way, um instruct their students to take a big deep breath in, yes, and a big deep breath out, and and even encourage sighing. I remember even in classes, sometimes I'd say, okay, now let out a sigh because it feels good.

Patrick31:42It does. It does because it stretches everything and relaxes it. Um, but a sigh is is a regular breathing, and it's only an individual who's really stressed or somebody with breathing pattern disorders who tends to sigh a lot, because our breathing should be regular throughout today. You know, Ravi, I think the best way to determine the truth in breathing is is to have your listeners sit back, put one hand on chest, one hand on tummy, one hand on chest, one hand above their navel, and just to tune into their breath with their lips closed, breathing gently in and out of the nose, and just for them to start softening the breathing.

The feeling the slightly colder air coming into the nose and the slightly warmer air leaving the nose and to start gently softening and slowing down the breath. And to slow down their breathing to the point that they feel air hunger and then to breathe really lightly and really gently to maintain that feeling of air hunger. And the feeling of air hunger just signifies that carbon dioxide is increased in the blood. So the lighter you breathe, carbon dioxide increases in the blood. And look at the physiological responses, feel the physiological responses of what happens when you make your breathing really light, check your body temperature, check the amount of watery saliva in the mouth, check your mental alertness.

Normally what happens is that the vast majority of people, when they really slow down their breathing, and I mean slowing it down to the point of air hunger, because air hunger is the key, their body temperature increases, they get warmer. They've got increased watery sliving them out, which is activation of the parasympathetic response, the body's relaxation response, and they get drowsy. So we can bring somebody from a state of sympathetic, from a state of stress into relaxation in three to four minutes. But that's not by taking the big breath.

That's by taking a light breath. And the other thing is, like, what does the word deep mean? If you were to look in a dictionary, the word deep means far from the top. So in terms of the lungs, deep means using your diaphragm, Well, the only way you can breathe deeply is breathing through your nose. Like if you, as you sit there or as your listener sit there, if they look down at their chest and they take a breath through their mouth, they'll see that mouth breathing activates the upper chest.

Mouth breathing is a shallow breath. So we're all about deep breathing, but light breathing. Right.

Ravi34:09Now, let's talk about the Bolt Score because you've mentioned it. And what I'd love to talk about is the Bolt Score. You mentioned a couple numbers, 40 seconds, for example, in the case of the Tai Chi individual. But let's talk about what it is, why it matters, and how one would figure out their own bolt score. And then I do want to make sure we talk a bit about how all of this applies to people who are, let's say, marathon runners or triathletes and how it can help them.

Yeah.

Patrick34:40The bold score Brett. Whole time has been investigated for many years. 1919, there was a colonel in either the US or the British Army. His name was Colonel Flack And it was published in the Lancet Medical Journal. But basically he used breath toll time As a measurement of stress in pilots And on one occasion he sent up A pilot, was sent up but had a low breath toll time And that pilot came down and crashed and died And as a result They introduced breadth toll time as a measurement of stress in pilots And the breadth toll time that you had to espouse to with 30 seconds.

Now, bold score is you take a normal breath in, normal breath out, and you pinch your nose. And you count how many seconds it takes until you feel the first distinct reaction of the body to breed. And then you let go, and your breath at the end should be pretty normal. So it's not a test of how long you can hold your breath for. It's only a test until you feel the first physiological reaction of your body to take a breath.

Ravi35:42So what would that physiological reaction be? Is it like a little feeling of a little desire to breathe in? Or is it just discomfort? How would you describe it?

Patrick35:51It can depend on the person. Some people feel it their diaphragm contracts. Like if you think of it this way, if you hold your breath, there's going to be some point that your brain is going to say, breathe. So you may feel your diaphragm from contracting the body. Because literally what happens is you're holding your breath, carbon dioxide increase in the blood, blood pH is decreasing. and the respiratory centre is reacting to that, it's going to send a stimulus to breathe. So some individuals will feel like diaphragm moving downwards.

You may feel the throat muscles, it's kind of like a feeling like a swallow, or just maybe the first stress to breathe, the first stress with the body to breathe, and the breath at the end should be normal. So it measures, it's an indirect measurement of N-Taddle CO2, as I said, and it measures the onset and endurance of breathlessness. So it measures how soon do you get breastless? breathless, both during rest and also during physical exercise, and how breathless are you across a given level of physical exercise?

So it's a very good test, I think, for athletes, because if you've got a low bolt score, it means that your breathing is going to be hard.

Ravi36:57And low would be less than what?

Patrick36:59Less than 20 is to cut off, you know, anybody less than 20 seconds, it's an indicator of breathing pattern disorders, or it's an indicator that your breathing could be substantially improved. That would be

Ravi37:09me. My bolt this morning I did a couple tests. So just for the listeners out there, I've been recommitting to practicing the Oxygen Advantage techniques in the book for the past seven days. My first bolt score was 11 seconds, seven days ago. And every morning I do several tests. And this morning I had three tests and one was 21 seconds and then the next two were 18. So that's sort of where I fit. Now, that's only been a week, and I've seen. But that's

Patrick37:40a good, that's a good improvement in a week. That really good improvement, yeah. In terms of the measurement itself, you know, if we've got an individual with a bolt score of 10 seconds, they get very breathless very quickly. They go do physical exercise, and they're going to run out of air. So it's a measurement of how much air do you need for a given level of exercise? Now, there's a benefit to having a higher bolt score. Because, first of all, you're going to have less feeling of breathlessness.

Another aspect of it is that your breathing muscles, they consume oxygen. And the harder you breathe, the more oxygen that's consumed. So during normal breathing, there's about 2 to 3% of your oxygen intake that goes just directly to support the respiratory muscles. Now, if you're doing fairly intense physical exercise, 10% of your oxygen intake is supporting your breathing muscles. If you do really intense physical exercise, it increases to 15%. So the harder you breathe, the more oxygen that's going just to support the breathing muscles. But the other aspect is, the lower your boat score, the more you are breathing too much.

And if you're breathing too much, you're getting rid of too much CO2. And as a result, there's less oxygen getting delivered to the tissues, and then you'll go anaerobically quicker. So your V-O-2 max reduces. So running economy, V-O-2 max, basically it's a measure of how much oxygen is delivered to yourselves. An indirect measurement, like it'll give you some feedback on that. And from that aspect, I think it's a very useful, like you said, your bowl score was 11 seconds. I've measured the Olympic athletes and their bowl score was 11 seconds.

And you'd wonder how on earth are they competing. And this wasn't a year after the event. I'm talking about a month before an event. And it would really, there's no question, it would dramatically hold them back.

Ravi39:43So if a bolt of less than 10 is compromised and less than 20 is suboptimal, what do you think is a good bolt score for people who just want to live their lives and not be constrained by their breathing?

Patrick39:59It has to be above 25. Okay. Yeah, it has to be above 25. Like the absolute goal is 40, not everybody achieves it. It takes a lot of work. If individuals are talking a lot during their day, after stressed, you know, the boat score is going to be reduced. However, having a higher bolt will enable you to talk and enable you to be able to cope with stress a lot better. Because in order to improve your bowl score, you have to have attention on your breath.

And when you have attention on your breath, you're taking attention out of the mind, So you're restructuring. You know, a number of different parts of the brain there's up to eight different regions of the brain that alter in response to following the breath, and the one thing that I'll say is you know, in terms of meditation, meditation is absolutely wonderful, um, but we often find that when we're having people follow their breath and focus on their breathing, when the goal is to achieve an air hunger, the mind tends to be more anchored to the breath, so there's less likely for the mind to wander.

And then, when the mind is forced to pay attention exclusively to the breath for a period of time, you're training the brain, so the distracted mind is reducing and at the same time, you're opening up blood flow, so your blood vessels dilation, the amount of oxygen delivery to the brain is increasing and that's got a calming effect. So we're helping a number of ways in terms of stress. One is get a better night's sleep. Breathe through your nose, don't wake up at a dry mat in the morning.

If you have a dry mat in the morning tells you straight away that your mouth, breathing, your sleep is lighter. Number two in your everyday practice follow your breathing. It's very, very, very good for honing attention, for improving concentration, because what's concentration other than your ability to hold your attention or something for a period of time without distraction? And distraction is now endemic. You know modern technology is is a distraction. How many times does your mobile phone phone send you an alert? You've got emails there.

You've got text messaging. You're bouncing from an email to a text message to another email. You're on your job, but you close off the job and you check your emails, you check your text, you're checking your phones, 40, 50 more times, you know, in a small, short period of time. The mind is very distracted. Microsoft did a study back in 2000 and they measured the average attention span of 3,000 people from Canada. And they found at the time it was 12 seconds. That's back in the year 2000.

Ravi42:36It's probably gotten a lot worse.

Patrick42:38Yeah, well, they repeated the same study in 2012. And they found that the attention span had reduced to eight seconds. And they said, this is a problem. They said because a goldfish has an attention span of nine seconds. So if you Google Microsoft goldfish study, you'll see the results of that. Now, this is a problem because if the attention span, tension span is reducing. It means their mind is more distracted. It also contributes to stress. It contributes to anxiety. But then Matthew Gillingworth, they were Harvard researchers.

They tracked 250,000 data points. I think it was 5,000 individuals. And they asked them the question. They did it by an app called track your happiness dot org. And they asked individuals a question, are you thinking about something other than what you're doing at this time? And And the conclusion that they reached was that the human being, unlike other animals, the human being's mind wanders a lot. And oftentimes we're doing something, but our attention isn't on what we're doing. So we could be reading a page, but our attention isn't on the page.

Our attention is stuck in our head. In other words, we're going around living in our head, And they found that. They found that the more distracted the mind, the less happy we are. So they are saying that there's a direct relationship between increased thought activity, increased wandering minds and even if the wandering mind was a positive thought, it didn't matter. Thinking is thinking. If you haven't got the ability to control the mind, you're going to be less happy. And you know, if we think about people often talk about the millennials.

I was in Sydney, there, just waiting at the airport, and I switched off my phone and I bought a smartphone about seven years ago and I still have the second grade Samsung. I'm very proud to admit it and that it's on grade eight or whatever it's on. And within about three days I rang a phone the phone who's a mobile carrier, and I said take me off this 3G or take me off whatever I said. I don't want mobile, I don't want internet, I don't want emails, I don't want any of this stuff.

I want a phone. A phone is. My phone and I was sitting on Sydney airport and I had time just to wait for a flight and I looked around, everybody stuck in their mobile phones, everybody, young, old, male, female, didn't matter. And you know, and I said I was just saying, is there an exception to this? Yeah, some people weren't stuck in their mobile phones or stuck in their laptops, which was pretty much the equivalent of it. And that's where our attention is going. You know, every waking moment it's almost that we're bored.

If we have nothing to do, that we have to use our phone and the mind is constantly distracted. Well, a distracted mind is no use, that's.

Ravi45:23right and what what I've witnessed and I what I'm hearing you say is that by bringing attention back to our breath, it actually provides us a built-in tool to not have to be able to live in a world with distraction, engage in a world with distraction, but not be as distracted. Yeah, totally. And that's, I mean, something the yogis have been talking about for a long, long time. Yes. The mind follows the breath. And it's something that you're really bringing back, bringing back to the public awareness, which is really fantastic.

Now, there's a couple points I want to talk about very quickly in our final few minutes. One is, you know, there will be people listening who will wonder, okay, this is all fine if I'm sitting at work, if I'm going for a walk. But I'm training for the Boston Marathon. I'm training for Iron Man Canada. I'm a long-distance hiker climbing mountains. Should I, this doesn't apply to me, right? They're going to think this doesn't apply to them. But what you're really saying is no, breathe through the nose all the time, and it will help.

Is that really what you're saying? The

Patrick46:33key message, like I put it in the book because if you're an elite athlete, you want to spend some of your time breathing through the nose during physical exercise and some of the time breathing through your mouth, because you won't attain 100% work rate by nasal breathing exclusively, but you will attain 85 to 90%. So for a recreational athlete, the importance of nose breathing is huge. Nose breathing, better gas exchange, better oxygen uptake, it's easier on the airways, it's a more quality of breathing. It's a quality of fitness and also improve recovery.

So your quality of your workout is much better by breathing through the nose. But you mightn't be able to attain 100% work rate that you would have ordinarily. Now, as your both score increases, your ability to attain a higher. work rate also improves. So if you're an elite athlete, I always, with elite athletes, I let, you know, we spend 50, say 50% of the time training with the mouth closed. This adds an extra load onto the breathing muscles. This allows deeper breathing. And because in actual fact, most concentration of blood is in the lower lobes of the lungs.

So the lower parts of the lungs have the greatest concentration of blood. But if you're breathing through your mouth, you're taking more air into the upper part, so it's inefficient in terms of a gas exchange. So elite athletes is to spend, yeah, about 50% of their time breathing through their nose exclusively and to alternate with mouth breathing whenever they need to do an all-out effort. And that's in order to prevent muscle deconditioning. So nose breathing is also huge for an elite athlete and nose breathing during sleep.

And for that, we actually use a paper tape. Because it's the one way to guarantee it. Now, you could say, well, is it just all about nose breathing? No, it's not. If you breathe effectively, you'll get a higher bolt score. We're all about changing everyday breathing patterns. And you change your everyday breathing patterns by actively slowing down the breath, focusing on the breadth. And it's almost that you're resetting the breathing center in the brain towards a higher tolerance of CO2. And when you've got a higher tolerance of CO2, well, it means that when you're doing physical exercise and as your cells begin to produce more and more CO2, that your ventilation doesn't have to increase to as much as it would ordinarily.

Now another aspect of that is we do breadth-halling. So we do simulation of altitude training. During a sprint normally, your oxygen levels, well, you know, they won't drop by all that much, but they'll drop during a sprint down to about 93%, say from a norm of 95 to 99%. And your carbon dioxide will stay pretty much constant. because your ventilation will increase sufficiently, you know, in order to keep carbon dioxide the same. So we do breath-tholding to greatly disturb the blood acid base balance. So we have an individual, breathe in through their nose, breathe out through their nose, pinch their nose, and I'd have them walk.

And as the air hunger gets a little bit stronger, I have them jog, and as it gets stronger again, I have them sprint. And then I have them let go and breathe through the nose and get their breathing back towards normal. We use a little pulse oxymeter as well to measure our blood oxygen saturation. It's a little finger-held device that you just put it on your finger. And basically, it's got an infrared light there to detect if hemoglobin is saturated with oxygen. Now, we drop SPO2 generally to about 85%.

That's simulation, simulating an altitude of about 5,000 meters. We also greatly increased carbon dioxide, most certainly from 40 to 50 millimeter of mercury. So we're disturbing the blood acid-based balance. We're stimulating anaerobic lycosis. We're pushing the body into such an oxygen debt and a high-carbon dioxide that the body then is forced to adopt to that. And what happens then is the buffering capacity increases. So there's two aspects. You know, we change everyday breathing so we can improve bold, but we can also push the athlete to the extremes because the breathing muscles don't get trained during physical training.

Swimming is probably the only acceptance to it, because you're breathing against resistance and in order to develop a muscle you have to add an extra load onto it. When you do breath holding, you'll feel your breathing muscles contracting. As you hold your breath, your breathing muscles will contract more and more and more you'll feed them. You know kind of involuntary movement of the breathing muscles in response to the breath hold. Well, you're giving your breathing muscles a workout. So you're breathing, giving your breathing muscles workout to improve respiratory muscle strength.

You're also changing blood gases. You're improving buffering capacity. There's other aspects of it. You generate EPO, a ritual poitian. If you do a strong breath hold... Legally, yes. Yeah. Yeah, it's a very, it's a, it's a, it's a, it's really put on the map now since the Tour de France and all that carry on is going there. You know, that kind of shows the degree is to which these athletes will do. The margin in terms of performance between top athletes is a half a percent. So if you can get a half a percent to one percent in terms of improvement, that's all an elite athlete

Ravi51:53needs. Yeah. Yeah. You know, there's, I feel like we can, we could probably talk for days. And in fact, you do lead workshops and train people in this over days. Yes, we do. But I'm, I'm wondering in this in the last maybe minute, if, if you can leave the listeners with a couple things they can do starting today. Now, imagine someone who's been a habitual mouth breather, they might have allergies, but they're, they're interested in getting started. What would you recommend?

Patrick52:23Sure. The first thing I'd say is sit down, measure your bolt score. The lower your bolt, the more improvement for breathing. The second thing is, if you have allergies, is hold your breath to free up your nose. Breath holding and physical exercise has been known since 1923 to open up your nose. Now, if a female is pregnant, if you've any If you have any serious medical complaints, don't do any breath holding. And

Ravi52:46you're saying hold it until the initial urge to breathe. No, hold it until you turn it in the face. Well, no.

Patrick52:53With the bowl score, all right, hold it until the initial urge. But in order to unblock your nose, you have to hold your breath for quite a while. So you want to hold your breath until a fairly strong air hunger. But at the end, make sure you breathe through your nose. Wait a minute and do it again. And do it at five times. Now, the exercise for unblocking the nose is simple. it's like this. Take a normal breath into your nose, normal breath out to your nose, pinch your nose, hold your nose and start walking and keep walking until you feel a pretty strong air hunger.

Then let go and breathe into your nose and calm your breathing. Wait a minute and do it again. So all it is is breathe into your nose, breathe out to your nose, pinch your nose, hold your nose and start walking. Keep walking until the air hunger gets pretty strong. Then let go, breathe through your nose and calm your breathing, do that five times, your nose will be opened. If your nose isn't open, then you have a structural issue. The more you breathe through your nose, the more the nose stays open.

So that's another thing. Even if you've been mouth breathing for the last 20 years, there's no way you are performing to the best of your ability by going around with your mouth open. And also think about, there's no, you know, there's a reason that mouth breathers have been called mouth breathers in derogatory terms in terms of dental health, bad bread, you know, gum disease, drying out the upper airways, it affects your sleep, it affects just so many aspects that are affected by just simply

Ravi54:17mouth breeding. Not to mention the snoring. Your partner will thank you or whoever's in your house will

Patrick54:23thank you. No, you can still snore through your nose. I'll kind of give you a definition of it, Ravi. If you snore with your mouth, it sounds like this. So there's a vibration of the soft tissue at the back of the throat. But if you sort of snort to your nose, it sounds like this. So it's, there's a difference. However, we can, we can have a dress boat. You can simply, we use a small paper tape to get the mouth closed and that works wonderfully well.

And that stops from out snoring straight away. But nose snoring, that's when we change breathing volume, And so when you change breathing volume and breathing is lighter and the nose is easier to breathe through, it makes such a difference. Now we do use a nasal dial as well mute snoring. So if an individual has really kind of compromised nasal airways, or if they've been mouth breathing for a long time, they can. They can lose muscle tone. So there's there's muscles in the nose which are designed to keep the nasal valves open and if you've been mouth breathing for a long time, those muscles lose patency.

So we use a small nasal dilator called mute just to open up the nose. Is

Ravi55:29that just like a breathe right strip

Patrick55:30Yeah, pretty much. We find that the breed right strips don't stick so well and also then you know they don't last, you know you put them on next day. But breed right strips they serve the purpose and it's based on the, the cotal maneuver. But uh, the the mute is a small plastic device that you just insert up into the nose and that keeps the nose open. And to determine that you can, what you can do is put one finger one side of your nostril and the under finger the other side of your nostril and just gently prize your nostrils apart and you'll feel it's easier to breathe.

So Cotler was an E&T back in the 70s, he discovered that. Yeah, that's what the device does. So back to, yeah, so I'm saying measure your bolt, do the nose and blocking exercise, and then practice slowing down your breathing and slow down your breathing to the point that you get our hunger and check the effect it has in your body. Do you feel warmer? Is there any changing the amount of sliving them out? Do you feel drowsy? And then you know you're on the right try

Ravi56:30Yeah, I definitely feel. When I practice the exercises. I I feel a warmth, like a deep warmth, um, tons of saliva in the mouth and I feel an incredible sense of focus and uh, all those, all those seem like really good byproducts and I just want to say thank you for doing what you do. You know, there are a thousand and one books out there teaching, telling people how to lose weight and get fit and do all kinds of, but there are very few talking about breathing.

But really it seems like the breath underlies everything and can make life better, work better, exercise better. In your book, you talk about weight loss. We didn't even touch that. You talk about how it can help kids grow up and grow their facial structures better. Yeah.

Patrick57:16And Ravi, you know, just when you talk about children, sorry to go across you. Sure. A philanthropist contacts us about a month ago. And he said, we want to make your course out free to all children. regardless of financial circumstances. So our complete DVD course, the online DVD, it used to be $50 is now free. Oh,

Ravi57:37wow. Where can people find that?

Patrick57:38So you go to buetaco Clinic.com and just go to DVD sets and scroll down to the children's course. And just click on that link then. And then if you scroll down a little bit, you'll see click here to access free online course. And that's the entire Buetecco method. And so there's six exercise. Everything about Butteco for children, the importance of it. I'm teaching three young kids. One is four years of age, and the other two kids are about eight or nine. And they go through the exercise with them.

So it's free for any kid, anywhere in the world.

Ravi58:11Right. And Butteco was your mentor.

Patrick58:13Boutteco originally, yeah, because I had chronic health issues. You know, I'd asthma, it had blocked the nose, it stressed, all that. And I was in the corporate world, but it wasn't working for me. I was so stressed and I didn't have the productivity. I'd driven myself to true university. I was very driven, you know, so I got there. But the amount of work that it took was too much because if you don't have concentration, you're putting in the hours, but you're not putting in the quality.

And I remember a friend of mine I studied three months for an exam And it was a friend of mine came to be 20 minutes before the exam And he says do you have any notes there? Because he didn't have time to study it. He was setting up a business at the time this was back in 1996 or whatever and I handed him my notes and I watched him for 20 minutes. He had 100% of his attention on my notes and I remember thinking here I was only a 20 year old and I was thinking there's no way I could do that.

And I know he wasn't just looking at them, he was focused. So the two of us went off, we did our exam and the results come out. He got the same result that I got. It took me three months, it took him 20 minutes. Now the same guy his name is Terry Clune. He set up a business called Taxbackcom. He's got offices throughout the world. He's you know, he's got a thousand employees. He's made tremendous inroads in terms of the financial services sector. A genius brain, but he had concentration.

Naturally I didn't have it, but I had to develop it. I developed it and it's made an immense amount of difference. We never look at concentration, Yeah.

Ravi59:54Well, you've given people some tools to help bolster their concentration. Yes, absolutely. That's really fantastic. You know, I hope we get to do this again. Hopefully I'll get a chance to meet you perhaps at one of your trainings if you come stateside. Yeah, of

Patrick1:00:10course. Yeah. No, I'm state side again next month. And we've got to always get a number of trainings going on, you know, either Oxygen Advantage or Buteyko. So it's always

Ravi1:00:21there. Wonderful. Wonderful. Well, Patrick, thanks again, and hope to see you soon.

Patrick1:00:26Great. Thanks very much, Ravi.

Ravi1:00:29Thanks for tuning in. You can get further details about everything we've discussed on the website. Just visit RaviRaman.com forward slash podcast, where I have show notes as well as a full archive of all previous episodes. And if you're so inclined, leaving a rating and a review about the podcast helps other people to discover it. So if you're enjoying what I'm talking about, please take a moment and leave a quick rating and review. And that's all I've got for today. I'll see you in the next episode.