Waiting to Exhale | July 10, 2019

Breath Holding Can be a useful Self Assessment

Buteyko breathing has been all over my IG feed recently.  I do analysis of breathing biomechanics in my practice as an Integrative Movement Therapist, and give breathing exercises to every single client I see.  I talked about this part of my practice last week with an acquaintance. They even asked me “Is it Buteyko?” Nope, but perhaps it will be something I look into studying more deeply.  I do know this much though. Most basically Buteyko breathing addresses the physiological foundations of good breathing habits. And one of those? Don’t breath too much. Huffing and Puffing isn’t just bad news for the three little pigs.

Many systems use the breath hold as a diagnostic

The control pause that Buteyko uses for diagnostics is something that I first learned from Functional Movement Systems — a simple breath hold after exhale performed after a single normal inhale while relaxed and sitting up right. Patrick McKeown calls this the BOLT score in his book The Oxygen Advantage. This stands for Body Oxygen Level Test. This test is timed to the FIRST sign of discomfort or the first urges to breath, and not how long one can forcefully hold the breath. This type of test was first established scientifically in 1975 as a way to study dyspnea or breathlessness.  It tests your body’s tolerance to CO2. This morning at 4:30am my first control pause came to 42 seconds, which is lower than normal for me, but life has been pretty stressful recently. Without any preparations, I could, if I pushed it, hold for 60sec, but this is not really diagnostic.

What does this score mean?

Functional Movement Systems suggested a minimum hold of 25 seconds to establish a baseline of healthy breathing to engage in any other physical correctives. Below this level the recommendation is to focus ONLY on breathing correctives. If you’re control pause is lower than 25 seconds it’s common to have symptoms such as fatigue, insomnia, blocked nose, coughing, breathlessness, and asthma.  Optimal breathing according to physiological standards is 3-4 liters per minute. This capacity results in a control pause of about 60 seconds. At 20 seconds your body is breathing about 3 times this amount. Holds of 15 seconds or less are reason for urgent concern.  With my clients with Asthma I test their ability to hold their breath before and after correctives for the muscular apparatus of breathing. But breathing exercises are always also necessary.

Breathing Exercises

But breathing is good, right? And a big deep inhale is just aewsome, isn’t it? This is a mistake I often have to correct in my students and clients. Deep breathing does not mean taking in more volume than is needed for the activity. Depth refers to shape change in the torso happening all the way into the lower abdomen and pelvic floor. As CO2 is the catalyst for the release of oxygen to tissues and organs, oxygen might be taken into your body during inhale, but it’s released during exhale and during the pauses between breathes. Hard and fast breathing (like ujjayi the way it is often practiced in western power yoga classes) reduces your body’s ability to use oxygen.  Every system of your body benefits from the better delivery of oxygen, and so breath training can have immense and profound results on overall health. Where to start? Learning to breath lightly, and into the right areas of the torso.

References

Thorax. 1975 Jun;30(3):337-43. “Evaluation of breath holding in hypercapnia as a simple clinical test of respiratory chemosensitivity.”
Stanley NN, Cunningham EL, Altose MD, Kelsen SG, Levinson RS, Cherniack NS.