Dr. Rangan Chatterjee (3:49)

Yeah, I mean, I've noticed all kinds of changes since I moved to more nasal breathing. And there were some really simple and very practical exercises in your book. We'll talk through some of them today. No doubt. I think awareness is really key, right? Because a lot of us, we go through life, we don't even think about our breath. We're just sailing through life. Our breathing's just going on in the background without any thoughts at all. Our breathing is keeping us alive. But how are we living? That's a completely different conversation. I guess this plays into what you said at the start, which is there's many factors in these modern, busy 21st century lives that are affecting something as basic as our breathing apparatus. You mentioned chronic stress. The World Health Organization are calling stress the health epidemic of the 21st century. And stress directly affects our breathing. If you're rushing around, if you've got a work deadline, if you're trying to get all your emails done and you're not aware, almost certainly your breathing will change, right? You're going to be breathing faster, you're going to be breathing more from your chest, your upper chest, than from your diaphragm. And that's going to send signals to your brain on a very primal level that there is danger. In my environment, things aren't going well, which then the brain will send signals back down to your breathing and you'll be in this feed forward cycle where you start to breathe faster and faster and faster. But the beautiful thing about that is you can hack that, for want of a better term, straight away by changing the way you breathe. If you slow it down, if it's more diaphragmatic, well, you're sending calm signals up to the brain and the brain is then sending those calm signals back down. So it's a very simple way for people to understand, breathing is information. The way you breathe is the way you live.

Patrick McKeown (5:35)

And as you said, stress makes people sick. And on the basis that stress makes people sick, relaxation will help to make them better. How can we negate the effects of stress? How do we breathe when we get stressed? We breathe faster, we breathe shallow, we breathe irregular. And this is keeping the body in that state of fight or flight. So what are we doing? I'm saying to people, I need you to breathe through your nose. I need you to gently slow down your breathing, I need you to use your diaphragm, and I need you to adopt a cadence of the breath. Because when we're looking at the breathing, we need to consider that it's not just about diaphragmatic breathing, or it's not just about breathing in through the nose and out through the mouth, or. Or it's not just about take a deep breath when you're stressed. The information take a deep breath when you're stressed is absolute nonsense. It is based on nothing and it helps nobody. Because if we have a belief that it's good to be taking in that huge, big breath, are we really making any positive change in the body? And what I would say to people is starting just gently slowing down your breath, even to the point of a slight air hunger, by just relaxing your breathing, breathing through the nose and, you know, just even concentrate on that. Does it change your body temperature? Does it increase the amount of saliva in the mouth? Do you feel different?

Dr. Rangan Chatterjee (7:07)

It's. I don't know. It's one of those things. Take a deep breath. You're not actually against it, you're just against the way most people interpret that and what they do. So to most people who say, hey, take a deep breath, what do they do? Sort of open the mouth, lift the chest up, you know, breathing from the chest, breathing through the mouth. And you're saying there is another way to take a deep breath, which is using your diaphragm through the nose. Slow, slow and quiet.

Patrick McKeown (7:35)

I'm saying to do the absolute opposite to how you breathe when you are stressed and by gently slowing down your breath. And a lot of the research is centering around six breaths per minute. So when I'm working with a client the first time, what we'll do is we work in the biochemistry of breathing, so we generate air hunger. Then I will spend so much time working on the biomechanics of breathing. Then I will work on the cadence of the breath. And I have the client simply breathe in to 3, 4, and out, 3, 4, 5, 6. And I continue with that. And we are changing the respiratory rate from their normal spontaneous breathing down to six breaths per minute. Why? Because the research shows that you can influence the autonomic nervous system, bodily systems which have been disturbed by stress, especially long term stress. And the research is looking at post traumatic stress disorder, irritable bowel syndrome, anxiety, and also depression has been featured that when you slow down the respiratory rate to six breaths per minute, it's stimulating the vagus nerve, it's increasing heart rate variability, it's increasing the synchronicity between your respiration and the timing of your heartbeat, and it's also exercising or increasing the sensitivity of baroreceptors. Now, I'll just talk about those for just one moment.

Dr. Rangan Chatterjee (9:06)

Yeah, sure.

Patrick McKeown (9:07)

Our body has an innate capability and a need to be able to respond well to the environment. We need to have a balance between the parasympathetic and the sympathetic. If a challenge comes our way, we should be able to adapt to it. Life is always going to throw us a curved ball. How does our body react to it? This is about resilience and people with really good functioning of the autonomic nervous system, they can cope better with what life is throwing at them. Now, in terms of, can you improve that? If you read a paper or an article by Mark Russo, it's called slow breathing, you will see that they have done quite a lot of research looking at the application of slow breathing to general health. When you slow down the breath to six breaths per minute, you stimulate baroreceptors, which are pressure receptors in the major blood vessels in the aorta and in the carotid arteries, and they become more sensitive. So when there's an increase of your blood pressure, the baroreceptors send an immediate message to cause your blood vessels to dilate and your heart rate to slow down so that it brings down your blood pressure. But conversely, if your blood pressure is low, the baroreceptors immediately react by causing your blood vessels to constrict and your heart rate to increase to normalize your blood pressure. But the sensitivity of your baroreceptors are a very good marker of your resilience in life. Now, it's not just about slow breathing. As you pointed out, we do breath holding as well. If you have high blood pressure, don't hold your breath if it's unstable. If you're pregnant, don't do this breath hold exercise. Or if you have any kind of serious medical complaints, don't hold your breath and Just on that topic, never do.

Dr. Rangan Chatterjee (11:00)

Breath holding underwater before swimming or get to the water. Okay? That's really, really important if you're in general good health.

Patrick McKeown (11:10)

We want to stress the body a little bit because we can cause adaptations to happen there like modern life. Now it's all about comfort. But throughout our evolution, we were always exposed to little stressors and I think it's good. Physical exercise is a stress. Going into a cold environment is a stress. We can improve our ability to cope by doing stressors and breath tolling is a stressor. What I would say is don't do extreme breath holding when you're in a state of major stress or anxiety. Start off with small breath holds, the ones that we started off when we were working with your kids. Take a normal breath in and out through the nose, pinch the nose, hold the breath for five seconds, then let go. Breathe in through your nose, breathe normal for 10 seconds and again take a normal breath in and out. Pinch the nose, hold for five seconds, then breathe normal. We've used it with many people with anxiety and stress and the feedback has been very good. And it's also about tapping in incorporating breath hold exercises. Because if I'm giving, to give you an example, if I give a presentation, I used to get a little bit anxious of it before the event, I would go into a separate room and I would really slow down my breathing and take my attention out of the mind onto the breath and bring a quietness to the mind and bring myself into the zone. But then I'm too relaxed. I have focus, but I'm too relaxed. Then I do five strong breath holds because this increases blood flow to the brain. It opens up my nose, it opens up my lungs, it puts me into that state of preparedness.

Dr. Rangan Chatterjee (12:53)

And how do you do those breath holds?

Patrick McKeown (12:55)

I will be in the room, I know I'm about to talk in say five or 10 minutes, I'll take a breath in through my nose, a breath out through my nose. I pinch my nose and I simply walk around holding my breath until I feel a medium to strong air hunger. Then I let go. I breathe through my nose, I calm my breathing, I wait a minute, I do it again, I'll do about five of them. We also have athletes do it pre competition and it's really good for alertness because you want to be going if you're making a presentation, you want to be relaxed and focused, but you don't want to be too relaxed. I want to have absolute stillness of the mind whereby I can focus 100% of my attention on the delivery. I want my attention to move simultaneously with time. I spent 20 years living in my head with all of my attention, pretty much thinking all the time. And you know, this is another topic for conversation because western education, it has gave us a great ability to think. We can decipher, we can break information into tiny pieces, we can reason. We have been trained how to think, but we have not been trained how to stop thinking. We need also to be able to bring a solitude to the mind. How can you create gaps between thoughts?

Dr. Rangan Chatterjee (14:17)

Everything in our society is about getting into our heads, thinking more, reading more online, getting more information and knowledge. I've been absolutely guilty of this and it's just head, head, head. And the big thing I'm really becoming aware of in the last, probably the last three or four years is how to switch that head off and how to come back into your body and how to start trusting your feelings and your intuition. What I found when I do breath holds. Patrick, apart from the benefits, you're talking about your thoughts. Stop. Why? Because when you feel a medium air hunger on that sort of deep primal level, if that continues for another minute or two, that's a threat to life, right? So you start to shut off everything else and you come right into your body. And I guess if people have tried meditation and struggled, right. I would say try some of the breath holds that Patrick's mentioned already or that are in your book and just see what happens. Because it's almost it's default mindfulness. You can't do it without being mindful. So I really enjoy doing those breath holds. And the take home here for people is just incredible. That's to increase performance, right. And reduce stress.

Patrick McKeown (15:29)

Yes.

Dr. Rangan Chatterjee (15:30)

I think many of us are walking around day to day in a certain state of what we consider to be our norm. And we think that's it for us. We don't know how good we could feel.

Patrick McKeown (15:41)

Let's look at how you are breathing now. Are you breathing fast, shallow, and having the mouth open? That's going to impact you in some way. Just make it a concerted effort to bring your attention onto the breath, to slow it down and make that your everyday ritual. And as you pointed out, all of our attention is going outwards and seldom do we bring our attention inwards. And there is an intelligence in the human body. Can you imagine a machine that for 75, 80 years was conducting all of the functions of the human body? There's an intelligence in the human body which is so far going to outweigh anything that mankind can achieve, we can tap into that intelligence. And I'm hoping this is not New Age stuff. You know, I was living in my head for 20 years. I would walk into a beautiful park. I wouldn't see the park because I wasn't there. All of my attention was in my head. Now when I go into the park, yes, of course thoughts come into the mind, but less there's gaps between the thoughts. I can bring my attention into the present moment. I can see, I can listen, I can feel, I can smell and I can taste. And that's how we are relating to life. But you don't relate to life if you're stuck in your head. So you know there's that link between the emotions and the breath and that's what we want to tie into.

Dr. Rangan Chatterjee (17:16)

Hope you enjoyed that Bite Sized clip. Do spread the love by sharing this episode with your friends and family. And if you want more, why not go back and listen to the original full conversation with my guest. If you enjoyed this episode, I think you will really enjoy my My Bite Sized Friday email. It's called the Friday five and each week I share things that I do not share on social media. It contains five short doses of positivity, articles or books that I'm reading, quotes that I'm thinking about, exciting research I've come across, and so much more. I really think you're going to love it. The goal is for it to be a small yet powerful dose of feel goods to get you ready for the weekend. You can sign up for it free of charge@drchatterjee.com Friday 5 Hope you have a wonderful weekend. Make sure you have pressed subscribe and I'll be back next week with my long form conversational Wednesday and the latest episode of Bite Science. Next Friday.