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How To Change The Way You Breathe For More Energy, Better Sleep, Improved Blood Pressure & A Longer Life with James Nestor #644
02:22:53
Listening to this conversation could help you sleep better, quit snoring, and wake refreshed. You’ll learn a simple trick to stop anxiety in its tracks, and find out how to keep asthma and high blood pressure in check.
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- [00:01]
James Nestor
People are locked into these dysfunctional habits that they think are normal, and they don't realize that how they are breathing is directly affecting their health. It's affecting their blood pressure, it's affecting their risk of diabetes and heart disease later on in life. These aren't hypotheses. These are scientific facts. Retraining yourself to have new breathing habits, it takes a little time, takes a little effort, and it will change your life.
- [00:29]
Dr. Rangan Chatterjee
Hey guys, how you doing? Hope you're having a good week so far. My name is Dr. Rangan Chatterjee and this is my podcast, Feel Better, Live More. No matter how well you eat, how much sleep you get, or how much exercise you do, you're not going to be as healthy as you could be if you're not breathing properly. That's the claim from James Nestor, one of the world's foremost experts on breathing and author of the global bestseller the New Science of the Lost Art, which has just been released in a new updated paperback edition. This is James third appearance on my podcast and I'm going to put it out there. I think it's our best episode together yet. Now, you'd be forgiven for thinking, breathing, I'm doing it now. What is there to learn? But here's what makes this a must hear conversation. Many of us are unknowingly breathing in ways that are making us tired, stressed, anxious and unwell. And James makes the case, backed by science and some astounding stories, that something as simple as switching from mouth breathing to nasal breathing could transform your sleep, your energy, your blood pressure, and even your relationship. And the best thing is that it's completely free. You don't need to buy anything, go anywhere, or do anything more than pay attention to something you're already doing 25,000 times a day. We talk about asthma, anxiety, the surprising link between lung size and longevity, and a fascinating Stanford study on how damaging chronic mouth breathing can be. Plus, James reveals a hidden problem with indoor air quality that I really didn't think affected me until he brought his Karma Dioxide monitor into my studio. James also talks about plenty of things that you can start doing immediately to start breathing better, feeling better, and living more. So take a deep breath, relax, and get ready to transform your health one exhalation at a time. I wonder if we could start off by addressing the skeptic, the person who thinks, what's the big deal with breathing and breath work? You know, I'm alive, I'm breathing, why should I care how slow my breathing is, how deep my breathing is? Why will that Help me improve the quality of my life.
- [03:17]
James Nestor
By nature, I am a skeptic. That's what I'm paid to do as a journalist. So I went into this subject not believing anything that I ended up researching and writing about. But what's so easy about breathing is you can feel the effects almost instantly. After a few seconds, you can feel the effects. And if you think what you're feeling is a placebo effect, all you have to do is hook yourself up to a blood pressure cuff or a heart rate variability real time monitor, and you can see in real time how changing your breathing changes your nervous system, changes your oxygenation, changes your heart rate, and so much more. And that's what convinced me was being in a lab and changing my breathing in five different ways and seeing the transformative effect it had on my body and my brain.
- [04:10]
Dr. Rangan Chatterjee
Yeah, and I do understand where skepticism comes from, because we can all breathe, right? If someone's listening to this podcast right now, they're breathing, right? So that's not really up for debate, is it? It's basically, how are you breathing?
- [04:27]
James Nestor
Yeah, well, I think I've heard that a few times of like, we can all breathe. What's the issue? We can all eat, we can all sleep. That doesn't mean you're sleeping well. That doesn't mean you're eating well. So you can eat junk food, ultra processed foods, and that can keep you alive. That allows you enough energy to get by to the next day. You can sleep, hypothetically, three to four hours a night and you will be alive. But that doesn't mean you're doing well and that doesn't mean you're being healthy. And we found the exact same thing happens with breathing. People are locked into these dysfunctional habits that they think are normal and they don't realize that how they are breathing is directly affecting the level of migraines or headaches they get. It's affecting their blood pressure. For some people with sleep apnea and sleep disorder, breathing, it's affecting their risk of diabetes and heart disease later on in life. So we know all this. I'm not making this up. These aren't hypotheses. These are scientific facts.
- [05:29]
Dr. Rangan Chatterjee
Yeah, it's interesting. As a medical doctor, we're not really taught that much about the breath. Certainly the things you write about in your book, we're not really taught about these things. You know, we, we think about oxygen saturations dropping if someone's severely ill, they've got a pneumonia, they're struggling to breathe, they've got emphysema whatever it might be, we're going to look at their oxygen saturations and their respiratory rate at that point. But that, I guess is reflective of where modern medicine is today, right? We sort of are very good at managing disease. I guess we're less good on the creation of health.
- [06:14]
James Nestor
What I've heard from renowned pulmonologists is they're solely interested that you are breathing. They're not looking at how you are breathing. And you know, if you look at what pulmonology does, they're looking at lung cancers that you get in a car accident. They're restoring the lungs so that you can breathe. I asked this pulmonologist, I said, well, when a patient comes in and is breathing dysfunctionally, what do you do? What's your go to technique? And he looked at me like I was crazy. He's like, I don't teach breathwork. That's not something I do. I said, but your discipline is the, the lungs. That's your lane. He said, because I'm just concerned that people are breathing. And if you come to the emergency room or you come to his office and you can't breathe, he can help you. If you come with a mild chronic breathing respiratory condition, it's much harder for them to help you. So I've heard this from sleep medicine as well as pulmonologists that they deal with the walking dead, right? You have to be so bad in order to get their attention and care. And then they're really good at what they do to help someone in a car accident with lung cancer, right? To restore that ability to breathe, not how to breathe.
- [07:31]
Dr. Rangan Chatterjee
It's interesting when we think about how we might utilize breath work in our lives to improve our health, how we feel our energy through a medical lens, people will think about that as prevention, right? They'll say, yeah, if I can improve this aspect of my physiology, that will help me reduce the chances of me getting sick in the future. Which is absolutely true. And we're gonna talk about that. But as you demonstrate in your book, it's not just prevention. You can also treat certain people who have got certain conditions by utilizing the breath. You mentioned high blood pressure before. I think, you know, in the book you talk about asthma, right? I mean, perhaps we could start with asthma because asthma is very, very common. And of course, modern medicine has life saving drugs, you know, because if your airways are tight and you can't breathe, those inhalers that we give you will open up your airways and allow you to get oxygen into your body. So no one's denying that, but I guess the case you're putting forward is that there might be another way or an additional way that we could approach these problems.
- [08:46]
James Nestor
I think that as a filter, as a journalist, my job is to go out into the world and talk to the top researchers and look at the real data. So I didn't know anything about asthma. I had always considered that asthma was an incurable disease, and that's what it's called, an incurable disease. A friend of mine, he's actually my accountant, has a three year old kid, was having a bunch of breathing troubles. They brought him into the doctor and the doctor said, your kid has asthma. These are the drugs. Your kid is going to be an asthmatic the rest of their life and they're gonna get more severe asthma as they age, and then left them there with that. And I think that's really irresponsible because if you look at the data and if you look at the research, so many kids with asthma are mouth breathers, they're over breathing and, and these dysfunctional breathing habits either directly contribute to their symptoms or in some cases, cause the asthma attack. And I have heard this over and over again of people who were basically left to be on their own with asthma their whole lives. Don't leave the house, you know, when it's hot out or there's too many allergens in the air. And yet if you could take control of your breathing, we know this, you can reduce the symptoms and in some cases you can resolve them completely. And this is what Patrick McKeown has spent the past 25 years doing. And people who think that this is some quackery that's been promoted on Instagram should look at the scientific record and talk to these people that have reversed their symptoms.
- [10:21]
Dr. Rangan Chatterjee
There's a real pattern here. James, you spoke about this idea that asthma is often taught to be a chronic, irreversible disease. You could apply the same rationale to type 2 diabetes. It wasn't that long ago where we were taught type 2 diabetes is chronic and irreversible. And, you know, I've been helping people put their type 2 diabetes into remission since probably 2010. But when I first did it on primetime television with a patient back in 2014, it was deemed controversial. People are like, that's not real. I'm like, no, no, we're literally showing you what has happened. You know, the cameras are actually documenting this entire journey. Yes, it's one person. Sure. But the fact that actually this is possible should at Least make us question our assumption that this is irreversible. You can say the same thing with asthma, and I think this nuance often gets lost. You're not saying that inhalers have no role? I think what you're saying is, yes, they do. And why don't we also try and look at the way you breathe and if we can, you know, experiment, get you breathing more from your nose than your mouth, get you using your diaphragm more than your chest, whatever it might be, you may find that you need less inhaler, you may find that your symptoms are better, and you may also find that you don't need inhalers anymore. Is that a fair reflection of what you're trying to say in your book?
- [11:52]
James Nestor
I think for most people, asthma is an incurable disease. I think for most people, type 2 diabetes is an incurable disease because most people do not want to do the work to improve their conditions. I know this seems very nihilistic, but that's what I believe. When you tell someone with type 2 diabetes, like, hey, you need to cut out the carbs, you need to eat more protein and more fat, and doing some intermittent fasting could really help you. The science is there. It's been there for a very long, especially now, right. It's irrefutable. But what I've found is most people don't want to do that. For asthmatics, it's the same thing. You can tell them that your asthma attacks can be directly related to the way in which you breathe, especially when you are over breathing. That tends to increase your chances of having an attack. Or will they then sit and do these breathwork patterns after that? Most won't. Right. So what I try to do in this book, and the message I'm trying to communicate is I want to be here to give people information to help themselves. But you have to first want to help yourself. And if you want to help yourself, there are so many things that you can do to improve your health and your chronic condition, especially asthma. Retraining yourself to have new breathing habits and to take control of an asthma attack through breathing methods. It takes a little time, takes a little effort, and it will change your life.
- [13:25]
Dr. Rangan Chatterjee
It's such an interesting topic, this James, this idea of what does it take for someone to make changes in their life? I'm obsessed with thinking about this. It's been a huge part of my job since I qualified in 2001. Right. How do you encourage, educate, inspire a patient to make changes? And I think there's a Couple of components, I think. I believe passionately that people want to be well, and I believe that the way the message gets communicated to an individual is a huge part of whether they're going to do anything. If. If someone feels as though they've been spoken down to and dismissed, it's unlikely they're gonna do much. If they feel as though someone has listened to them, empathizes with them, is offering them a variety of options, I think that increases your likelihood that they're gonna choose. Well, actually, you know what? If there are a couple of choices, maybe instead of going on Metformin, is it okay, Doc, if I try this diet and exercise thing for a few months first? Right.
- [14:34]
James Nestor
So.
- [14:34]
Dr. Rangan Chatterjee
So I think that plays a role. But one of the things that came to me, James, and I love your take on this. You're making the case in your book that many of us these days are breathing dysfunctionally. We're over breathing, okay? So instead of, let's say, six breaths a minute, many of us are breathing 18 to 20 breaths a minute. And you talk in the book about the physiological changes that ensue when that happens. Now, if we're over breathing, and if we're breathing more through our mouth than our nose, things that we're going to cover in detail shortly, you can argue that much of the population is in a state of sympathetic overdrive. Right? So, you know, the stress system, as you well know, is you can look at in two parts. You know, the sympathetic nervous system when we're stressed, fight or flight versus the parasympathetic. So could it be when you say people don't want to do the work, or in your experience, a lot of people don't want to do the work? Could it also be that because people are stuck in these dysfunctional breathing patterns without knowing they're stuck in a stress state, everything feels more difficult? When they hear information about how they could change their life, it's very hard for them to act on it because of the state of their nervous system. Do you see what I'm getting at?
- [15:59]
James Nestor
Absolutely. I think what you're saying is 100% correct, because we know that the vast majority of these modern chronic diseases are tied to chronic stress. Right, Exactly. We know this. But I think what it ultimately comes down to, it really comes down to that individual. When is the time to make that step to improve your life? Right. What does it take? Do you have to be so sick and pushed against the wall and given that only ch order to improve your health, or do you want to catch it early and do some preventative maintenance. Now everyone's on a different part of that spectrum. Right. And so that's what I've found talking to hundreds, thousands and thousands of people over the past five, six years is I found a lot of people want you to coach them and inspire them and to push them, and yet they still don't manage to take that first step. And I've exerted a lot of time and energy with those people, including people in my family. Right. Who still don't want to take that first step. And I have had to step back and conserve my own energy and say, all I want to give people is information to make educated choices about their health and what you do with it. I'm no longer responsible after that. And this is especially important for me to. To give them informed information and choices about breathing, about how so many of their chronic issues that they're suffering from could be related to the way in which they're breathing. And I expected, in a very naive fashion, that maybe after this book had sold X amount of copies, after I've done so many podcasts, I've spoken at medical colleges all over the place, that there would be some sort of interest in some systemic change to inspire people to start adopting free, easy, simple breathing habits. None of that has happened. I don't see that happening on any level, which is why I think it's best and most effective to communicate this message organically through podcasts like this, to let people empower themselves and take control of their own bodies.
- [18:13]
Dr. Rangan Chatterjee
Yeah, I completely agree. People are ready for change when they're ready for change and not a moment sooner. You said a couple of things there, right. Which I think are worth just pausing on. Free and easy, I think were two words you used. That's what we're really talking about here in a wellness world that many people now will say is expensive and is for the middle classes and the people who've got disposable income. And of course, there's all kinds of neat little toys and tricks. Some of them will probably talk about, say, that people can spend money on in if they want to. But as you say in the conclusion of your book, the most effective is still the simplest. And I'm so passionate about this idea, James, because one thing that comes up a lot in this sort of field of trying to empower people is that people will say it's easier for some people than others if you are growing up in poverty. It's much harder to put these things into practice, which I agree with Totally. And at the same time, I have worked, James, in low socioeconomic areas. And I can tell you one thing I would teach many of my patients back then was breath work practices, and it really helped them. Does it remove the poverty in their life? No, it doesn't. But if I can help them get out of stress state and have simple things that they can use and keep in their back pocket when they need to, I found that they are better able to deal with the stresses in their life and through using breath work practices. Do you know what I mean? So this kind of binary point of view, that it's just for the middle classes, it's like, well, that's not true, because pretty much everything you've written about in this book is free and available to everyone.
- [20:01]
James Nestor
I think you're right about the wellness industry. It's for middle and upper classes. A lot of it. Like some of these devices are thousands and thousands of dollars and thousands and thousands of pounds to just have them. And they work very well. Right. But you have to start with a foundation. So that's why this book, people are like, oh, you know, you're the guy that wrote that book about breathwork. I don't consider this book to be about breathwork. This book is about foundational, healthy breathing and why so many of us are doing it wrong. So before you go into doing all the fancy stuff, I think on any aspect of wellness, before you go and buy the red light sauna, you know, that costs $10,000, get out into the sun for 15 minutes a day, right? So introduce yourself slowly to these things in a way that is free and easy and accessible for everyone. So the foundations of healthy breathing are by far the most important thing that you can do. You do not need to go to retreat, even though those are nice in the tropics, to learn how to breathe, you do not even need to go to a respiratory therapist. You need to take control, do a few simple steps, establish foundational, healthy breathing, and then you'll be able to do all of these other things, but really get the benefits from them.
- [21:19]
Dr. Rangan Chatterjee
Well, let's sort of pick up there, you know, let's sort of go through. And these are things you will have discussed with me in the past. But I don't think you've been on the show for several years now, James, and I don't think these things can be emphasized enough. Right. So what is going on in society? What are the common things that people are perhaps not doing as well as they could do? And then what are some of these simple, easy solutions that people can think about introducing.
- [21:45]
James Nestor
The number one most important thing that people need to do is to become an obligate nasal breather. So around 50% of kids are mouth breathers. For adults, that goes down a little bit at night. Around 60% of adults breathe through their mouths. So you have to turn that around and become a nasal breather, in which in the daytime, most of your breaths are in and out through the nose. I'm breathing through my mouth a bit here. We're having a conversation. Who cares, right? When I'm not talking, when I'm walking around, when I'm working, I'm always breathing out in and out through my nose. And at night, all of your breath should be through your nose. And there's so much science supporting this. All of the benefits from regulating your emotions, from helping you make better decisions, to regulating your nervous system function more and more, nobody is debating those things. And yet you still have a huge percentage of the population that is habitually mouth breathing, and it's causing a ton of damage to your health.
- [22:46]
Dr. Rangan Chatterjee
Okay? So this is the number one problem out there. Of course, it doesn't mean everyone listening suffers from this, because as you said, you know, 50% or whatever, right? And so clearly there'll be people listening who are obligate to nose breathers, but there's a lot of people who are listening who will be obligate mouth breathers. How can they tell or assess if they are an obligate mouth breather?
- [23:10]
James Nestor
So we have. Unfortunately, there's not one easy step to do because so many people suffer from so many different problems, right? But there are a few tricks that you can try out. The first one, take two fingers from both your hands. If you're listening to this, take your hands, take your index finger and your middle finger and place them on the sides of your nostril and spread open your nostrils. If that is significantly easier to breathe, then there is a good chance you are in the 20% of the population that suffers from something called nasal valve collapse, where either your nostrils, the tissue around it is too thin, so when you inhale it flutters, or your nostrils themselves are too small. So if you are one of those people, a good training device are one of those nasal strips. You see sports players using these things. They use them because these strips go over the bridge of the nose and they pull the nostrils up to the way they were supposed to have been, right? And they allow for around 30% more airflow in and out of the nostrils, which is why these are marketed to people who snore, because so many people who snore either have trouble breathing in and out of their nose or they're breathing through their mouth.
- [24:23]
Dr. Rangan Chatterjee
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- [28:35]
James Nestor
It is usually, not always. Some people can snore, make that sound through their nose if their sinuses are really messed up. But most people who are snoring are breathing in and out through the mouth. Yes.
- [28:47]
Dr. Rangan Chatterjee
Yeah. So that's another simple way. If someone, if you know, if you have a partner and if they sleep in the same bedroom as you and say that you were really loud and snoring last night, again, as you say, it's another clue that you might be a mouth breather. Okay.
- [29:02]
James Nestor
Nobody wants to believe their spouse about whether or not you're snoring. So the one thing that you can do is download an app. There's several of them and I'm not affiliated or associated with any of these things. They're free and they're easy. Snore Clock or Snore Lab works pretty well. And what you do is you take your phone, put it on the side of your bed, and it records you throughout the night. And then it provides you with a graph of the severity of your snoring and the sound of you breathing throughout the night and it gives you a score. So if you don't believe the app, you can go back at any time and listen to yourself breathing throughout the night. If you are snoring or if you are struggling to breathe, that is a serious red flag that there is something wrong. This is your body at its time, when it's supposed to be resting and restoring and preparing for the new day. And it is stressed out. So you have to figure that out. And so many people that suffer from snoring are mouth breathers. And when they learn how to become obligate nasal breathers, their snoring either significantly reduces or in some cases resolves entirely. And I've heard this thousands and thousands of times. People send me their sleep data for some reason I never asked for it. And they show the difference between mouth breathing and nasal breathing. I experienced this Myself.
- [30:20]
Dr. Rangan Chatterjee
Do we know what it's like in traditional societies? You know, how many people are mouth breathers versus nose breathers?
- [30:29]
James Nestor
What we do know is that nasal breathing and breathing itself was celebrated as a medicine throughout ancient cultures for thousands and thousands of years. We know that from ancient Hindu traditions of yoga. We know that from ancient Chinese traditions of qigong. We know that from Native American cultures as well. You'll notice something with a few indigenous cultures that are still thriving, right, that have not industrialized. If you were to have them open up their lips and look at their teeth, they'd be perfectly straight. If you were to look at their airways, they'd be broad and enormous. The upper palate would look the opposite of mine. It would be almost flat. Right? How many people in these societies suffers from chronic hypertension, diabetes, even skin cancer? The answer is basically zero. So almost all of these chronic diseases that we are suffering from are what researchers call diseases of civilization. These are diseases that came with us living in an industrial world. And I'm not going to go live in a cave, I'm not going to live in a desert. I'm not going to live in a jungle. I want to live in this world. This is where my friends, my family are. This is where my life is. But how do you get by living in this world and not get sick? And that's the real question. And I think part of that, not the whole picture at all, but part of that is to develop that healthy foundational breathing, especially at night. It's so important at night to get this right. And there is an epidemic, especially among kids, of sleep disorder breathing, of snoring and sleep apnea.
- [32:09]
Dr. Rangan Chatterjee
You mentioned some of the things we can try and use as clues to figure out where do we do the majority of our breathing? Is it through my nose? Is it through my mouth? Would you say another way in which we can look at that ourselves is to go for a 20, 30 minute walk, let's say around your block, right, and see if you can do it with your mouth closed. Or do you need to open it in order to get around? Is that something you'd recommend people take a look at?
- [32:39]
James Nestor
I would start off with getting baseline data. Use one of those apps, whatever app you want to use, and record your breathing at night. And if you are breathing in a dysfunctional way at night, there's a good chance you're breathing dysfunctionally in the day. So once you do that, record it not for one night because your sleep changes, right? Every night. Record it for a week and get A baseline. After that, that's where you can start experimenting with these different hacks. One of them is to use a little piece of tape in the daytime while answering emails or doing dishes or watching tv. Put it on your lips and let it stay there for 20 minutes, right? And ask yourself, as you're breathing, right? This forces you to breathe in and out through your nose. Are you comfortable? Are you relaxed? Are you congested? If you are congested and if you're stressed out, use common sense. Take it off. You're not ready for this yet, but start very slow. This is something I got wrong in this book before, where I told people to experiment with it at night. No, start with it. That's what I did. And it took me a long time, and I had to stick with it. Took weeks for me to acclimate to it. Start slow. Start in the daytime. 20 minutes the first day, 30 minutes the next day, one hour the day after that. Try taking a nap with this little piece of tape. And then once you're good at that, if that is comfortable for you, walk around the block, focusing on keeping your mouth shut, inhaling in and out of your nose. And if that continues to be comfortable, then you can experiment with it at night. But I think low and slow, especially if you are a habitual mouth breather, this is going to be a shock to your system, so don't push it.
- [34:28]
Dr. Rangan Chatterjee
Yeah, you went in hard yourself. And I've told you this before, but after our first conversation together, James, when you mentioned mouth taping, careful how I say this. You mentioned family before. I think I'd mentioned this to my wife prior. Um, but I'm not sure she necessarily wants to hear this stuff from me. Right, so when she heard you say it on our podcast together, I think straight away she started taping her mouth at night, and it was literally like night and day. I'm not kidding you. But her energy and vibrancy, the next day, it was. I was like, what's going on? She's like, I think this mouth taping stuff's working, right? So I think, you know, yes. The kind of, I guess, more responsible advice you could say is to say, hey, go slow, build up. But some people will just go straight in. Some people will be thinking, james, well, is it dangerous for me to take my mouth up at night? You must have been asked this a million times.
- [35:29]
James Nestor
I'm guessing I've been asked this a million times, and it depends. Okay. There is. Sorry, it's very inconvenient. There's not a blanket prescription for everybody to do this stuff. And everybody is different. Their tolerance levels are different. The amount of dysfunctional breathing that they are on that spectrum is totally different depending on the person. Which is why if you go slowly and carefully and go slow, your body will tell you when you're pushing too hard. It will let you know when you've gone over that line. For people with severe sleep apnea, this is probably a really bad idea, right? I would not do it. At the same time, can't believe I'm saying this, but a lot of people with severe sleep apnea have written me and sent me their AHI scores before and after mouth taping and have seen a 50% decrease in the amount of apnea events they have per hour. So I'm not here to tell anyone to do anything. As we said at the beginning of the podcast, I'm giving you information. You can take this information and you can be responsible for, for your own health and do what you want with it. This is a free and easy thing to do for the majority of people with mild snoring and even mild sleep apnea. Certain forms of mild sleep apnea, once they experiment with this, just like your wife, right. It is a completely life transforming thing. A teeny piece of tape can do that much for your energy levels, which to me makes perfect sense because if you are not sleeping properly, if you're not entering those stages of deep restorative sleep every single night, it's going to catch up with you. Once you get that back, you're like, what do I do with all this energy?
- [37:19]
Dr. Rangan Chatterjee
Yeah. There's a couple of things that come to mind, right. First of all, why is it that focusing on the way that you breathe can have such incredible benefits on a variety of different conditions? You know, asthma, energy, high blood pressure. You know, you write in the book about autoimmune disease and how certain things where it can help. And of course, if you think about it logically and look at root causes of physiology in the body, you're led back to the stress response.
- [37:50]
James Nestor
You're led back. That's exactly it.
- [37:52]
Dr. Rangan Chatterjee
But breathing is intimately linked with your stress response. With patients, I would always say breathing is information, right? When you're stressed, you change the way you breathe and that sends signals up to your brain and it almost becomes a vicious cycle where your brain then feels under threat. The opposite is true. When you're calm and your breath is slower and it's deeper and let's say it's quieter and we can talk about these things. Shortly, you're then sending calm signals up to your brain. So it makes complete sense to me that working on your breathing can help a variety of different conditions. The other thing I was thinking about this morning, James, is this idea that if so many of us in society have dysfunctional breathing, as you said at the start, you know, we're able to live, okay? So we're surviving. We may not be thriving, but we're absolutely surviving. We're basically going about our daily lives at like 30 or 40%.
- [38:54]
James Nestor
So what happens is we have evolved to register threats in a certain way. Your heart rate goes up, your respiration goes up. And this is extremely useful. If you're out in the wild and you see a intruder coming into your camp, or you see a lion or you see a bear or whatever, this ramps you up to to fight or to run away, right? And so we've developed this for a reason. Now everything stresses us out. An email from your boss is gonna stress you out. Traffic is gonna stress you out. So what's happening is we stay in this stress response, that breathing quickens, and we tend to keep that breathing throughout the day. So, as you mentioned, not only is the brain controlling our breathing, but our breathing is controlling the brain. It goes the other way. So if you are over breathing and you are breathing into your chest and your mouth is a little open, and you go to any airport, sit on any subway, and you see this all the time, you are sending your brain constant signals that you are stressed out, and you can't break that cycle unless you first take control of your breathing. I don't know of any meditation, any technique that can lower the nervous system overload, right? That can switch you to parasympathetic that does not involve breathing. Slowing down your breathing, taking deeper breaths, breathing in and out of your nose, all of these are foundational to all of those practices.
- [40:33]
Dr. Rangan Chatterjee
And the effects are so far reaching, right? So if you are breathing in a dysfunctional way for the majority of your day, that could be at least one of the reasons why you're reactive with your partner that evening, why you snap at your children, why you feel a need for sugar or alcohol at the end of the day. Because a lot of the time, those things, they're downstream, right? If your stress, if your nervous system is amped up, those things are manifestations of that. So why I believe that we all need our own personal breathwork practice that we can have in our back pocket that we can take around with us should we start feeling anxious or nervous or stressed. Is A, because it's free, B, because it's effective, and C, because the effects are so wide ranging and once you
- [41:28]
James Nestor
check that box, then you can work on all the other stuff.
- [41:30]
Dr. Rangan Chatterjee
Exactly right.
- [41:31]
James Nestor
And so it's not going to fix everything. I would never, ever say that. But it is your first step towards getting control of your asthma attack, of your panic attack, of your emotions, of making a better decision. Right. This is the first step. And it takes a few seconds to do. That's how long it takes to start to turn down the volume in your brain and your body. And then if you do a few dozen of those breaths, if you are extremely stressed out, you will start to turn it down a little more. And for people who don't believe this, that think this is some hippie yoga thing, again, hook yourself up to instruments that are feeding you a constant stream of data. Look what happens to your brain. Look what happens to your blood pressure, your heart rate and more when you take just a few calm and slow breaths.
- [42:33]
Dr. Rangan Chatterjee
Yeah. A lot of people have heard the term white coat hypertension. You know, the high blood pressure you get when you go into your doctor's office. But what you said just there in so many ways explains the physiology of what happens there. Right? So you're nervous, you've just rushed through traffic to get to your doctor's appointment. You couldn't get a parking space, you just, you squeezed one in. You maybe put it on a double. Either line you ran in, and then the doctor's taking your blood pressure. Well, you're stressed out, your nervous system's up. And we know that one of the things that will happen when you're stressed out when you see that line is your blood pressure will go up because we want it to go up, because we want more oxygen going up to your brain. Chronically elevated high blood pressure is such a big problem these days. And of course, usually at your doctor, you'll be offered pharmaceutical medication, which can have value, of course, but it may also be that you don't need it if you start working on your breathing. You know, if you're a mouth breather compared to a nose breather, it may be that that's one of the big contributory factors to your blood pressure being up. And you wouldn't know that until you do the work at trying to change it over to being a nose breather.
- [43:50]
James Nestor
And as you mentioned, these drugs are great. These drugs have saved so many millions and millions of people's lives. Right? And they're a great first step of getting a Severe chronic condition in control. But you have to ask yourself, do you want to be on these drugs the rest of your life? If you do, that's fine, then good for you. And if you don't, if you want to try to take control of it through more natural means, then breathing is one of the options that is available for you. I would like to throw out a little challenge for somebody who has high blood pressure. If you have a high blood pressure, if you have a cuff, you can take your blood pressure before, right? And then you can spend maybe three or four minutes breathing at a rate of around five to six seconds in, five to six seconds out. And on that exhale, you can hum. You can breathe in through the nose, expanding the belly here and on. The exhale doesn't have to be very loud, just. Mm. That's gonna release this profusion of nitric oxide into your bloodstream, which helps dilate those blood vessels. Right. And it helps bring your blood pressure down. I've seen people do this and drop their scores by 20 points within a few minutes. Now, it's temporary unless you adopt better breathing habits. And there are some studies that show this can be very effective for. For the long term. There are no guarantees for anybody with any of this stuff. Hypertension can be multifactorial. Like, there are so many issues if your blood vessels aren't able to expand and constrict, right? If there's calcium coating, there's so many different things. But as a first step to convince yourself this isn't hippie nonsense, I offer that challenge to people who wanna take it up just a few minutes. And if you see a decrease in your blood pressure, if you feel better after a few minutes, what's going to happen after a few days and a few weeks and a few months? Then you can start improving your diet, then you can start improving your exercise regimen, and you can start taking control of your health. And that's what inspires me, is to hear from people who have done this and are able to live more normal, thriving lives.
- [46:14]
Dr. Rangan Chatterjee
Yeah. One of the big things we're talking about here is trying to get people to breathe through their nose more than their mouth. Okay. Some people will no doubt say, yeah, James, I get that, but I've got a blocked nose, right? Or I can't do it. Can you just tackle this? Because I think this is a common thing that comes up, and I think some of those things are quite amenable to change. Some, maybe not so much. But what's your best advice for people
- [46:47]
James Nestor
on that again, I would love to offer you a very simple answer to this question, but there are no simple answers. Some people have structural issues in their sinuses, right? Their turbinates are too plugged up, they have a severely deviated septum. I've broken my nose two, three times, never got it fixed. When I had a scan done of my head, they showed that I was extremely messed up, right? So some people have structural issues. And an ENT can really help you, right? For most people though, and I've heard this from ents, I've heard this from rhinologists and respiratory therapists. For most people it is the tissues and it is inflammation. And a lot of this congestion is tied from the fact that these people are habitual mouth breathers. So their nose literally starts closing up. This is a use it or lose it organ. The more you use it, the more it is going to naturally open up. I was one of those people. Even though I have massive structural issues in my nose, I got through that and I'm able to breathe completely normally through my nose. And the respiratory therapist at Stanford that I talked to about this had the exact same thing. She was slated for surgery. She started nasal breathing, started humming, started using a little piece of tape and everything changed, which is why she prescribes tape to every single one of her patients. So again, we have that spectrum of nasal breathing for people with extreme structural issues. Go get a scan, get checked out. Surgery can be incredibly beneficial. For most of us that are just dealing with bad habits and chronic congestion, there are a lot of things you can do to improve that congestion so that nasal breathing becomes easier.
- [48:32]
Dr. Rangan Chatterjee
It's linked to everything. This idea that our lifestyles can be our best medicine is something I'm so passionate about. That's not anti medicine, it's just saying we can also use food as medicine, exercise as medicine, or as you've just mentioned, breathing as medicine, if we do it in the correct way, right? And this idea that some of us are congested and therefore we think we can't breathe through our noses, you've just addressed that. And of course the chronic mouth breathing could be causing that congestion. So if you can change it over, before you know it, that will start to change. But it could also be because if you're diet, if you're having loads of ultra processed foods, some of them you're perhaps reacting to maybe not a full blown allergy, maybe a little bit of an intolerance that can also cause congestion, intolerances. I know I can be very sensitive to foods and if I eat the wrong foods, for me, I start to feel my nose blocking up dairy. Is one of those just gonna say that?
- [49:32]
James Nestor
Yes.
- [49:33]
Dr. Rangan Chatterjee
And for many kind of Asians and African sort of descent people, dairy is an issue, you know, so all these things are multifactoral. I'm not saying that to confuse people. I'm kind of saying that to empower people to go. I think most people will be able to breathe through their nose, but of course, some people will need to go and see an ENT doctor and they may need some work. If they've had a broken nose, for example.
- [49:57]
James Nestor
The most work you're going to have to do is figure out what is your core issue. Stopping you from nasal breathing, right? That's where the most work and most research after that, applying these different hacks. This is the easy and the fun part, right? So is it structural? Is it just chronic inflammation? Is it just a bad habit? If it is chronic inflammation, what's causing that? Try an elimination diet, right? Remove dairy for a week. We know that snoring and sleep apnea go through the roof in allergy season. Why? Because people get stuffed up. They start mouth breathing and they start snoring. So if we know that's what's causing such a huge percentage of snoring and even mild to moderate sleep apnea, then it makes sense to me. Find a way of clearing your nose. There's some antihistamine drugs that work really well for people who want to clear their nose and be able to get a nice night of sleep, do you think?
- [50:54]
Dr. Rangan Chatterjee
For some people, they've got functional breathing patterns, they're breathing through their nose at night, but then let's say it's allergy season, right? And so for a month, they're struggling with hay fever, they've got a blocked nose. So, you know, because they're not paying attention, they start to mouth breathe more. But could it be that before they know it, they're starting to ingrain a new pattern?
- [51:19]
James Nestor
Yes.
- [51:19]
Dr. Rangan Chatterjee
So allergy season finishes, but actually the pattern that they developed then continues long term.
- [51:26]
James Nestor
This is why so many kids get asthma. Not all of them, but so many kids, they start with a severe respiratory problem, right? The flu or something. They develop mouth breathing over a few weeks, and at night it becomes very, very easy. Through those bad habits, they start getting symptoms of asthma that becomes asthma. Inflammation of the airways, Right? If you have inflammation of the airways, that's the core issue. What do you do? You need to remove that inflammation. And the drugs are great. Bronchodilators work wonderfully. Oral steroids can work great. But as a long term solution, we know now very clearly those are bad news. After a few decades of taking oral steroids, it can lead to a bunch of chronic issues. So it might be a good opportunity when you see that red flag appear with your kid or with yourself, to be like, okay, I don't need to do it tomorrow, I don't need to do it this week, but soon I should consider getting better control of this so that I can live a fuller life without relying on increasing doses of these drugs.
- [52:33]
Dr. Rangan Chatterjee
So going back to where we started, we were talking about asthma and you've just brought up asthma again. We made the case. And look, you've made it at length before when you've been on this show about nasal breathing versus mouth breathing. And people can revisit our earlier episodes if they wanna go deeper into that. If someone's listening to this and they currently have asthma, and you always acknowledge you're not a doctor, right, you're not a physician, you're a journalist who has done the research and is sharing it. So you'll make it clear. I'm making that clear. But what is something that that person can think about doing to start to improve things? Today's episode is sponsored by Vivo Barefoot. Now, one of the simplest ways to improve your whole body health is to start with your feet. Most of us don't realize this, but 95% of us are born with healthy feet. And by adulthood, 77% of us have foot problems. And a big reason is the shoes we wear. Modern shoes are rigid and narrow and over cushioned. They disconnect us from the ground and weaken the very muscles that support our posture, balance and movement. That's why I've been wearing vivobarefoot shoes for well over a decade now. They're the opposite of conventional shoes. Vivos are designed for fit, flex and feel, to let your feet do what human feet have evolved to do. When you free your feet, you free your whole body. And studies have shown that wearing minimalist footwear like Vivos can increase foot strength by up to 60% in just six months, improving balance, natural posture and the way in which you move. If you've never tried barefoot footwear before, Vivo make it really easy to do so. They offer a 100 day money back trial so you can wear them, live in them, move naturally, and if they're not for you, you just send them back, no risk at all. So if you're curious to reconnect with your Natural Movement, in 2026 and give your feet the freedom they're designed for. Try VivoBarefoot and get 15% off your first order by heading to VivoBarefoot.com LiveMore Free your feet and the rest will follow Today's episode is sponsored by AG1, a daily health drink that has been in my own life for over seven years now. This is the time of year when our immune systems are under the most pressure. Between spending more time indoors, travel and seasonal bugs, it's natural to look for extra ways to support our immune defenses. But most people don't want to juggle multiple pills. They want something simple, effective and easy to stick with. AG1 is a daily health drink that provides key immunity, supporting nutrients, vitamin C, vitamin A, zinc and selenium, all of which contribute to the normal function of the immune system. These nutrients are included in highly bioavailable forms, meaning they are much easier for the body to absorb and use. Backed by clinical research, expert formulation and continuous improvement, AG1 has been in my own life for around 7 years now and each batch is independently tested for quality and safety. That's how they guarantee what's in your scoop and what's not. And the best thing, of course, is that all this goodness comes from in one convenient, tasty daily serving. For a limited time only, get a free AG1 flavor sampler and AGZ sampler to try all the flavors. Plus free vitamin D3 and K2 and AG1 welcome kit with your first AG1 subscription order. That's $87 in free gifts for first time subscribers. See all details@drinkag1.com LiveMore.
- [57:08]
James Nestor
The number one thing I would do is to get a very good respiratory therapist who has experience with asthmatics. If you can afford that, if that's available for you, these people can coach you through the entire thing. They are qualified to do this if you are someone who does not want to take that path, who wants to experiment with things on your own. I am not a doctor. You need to be talking to your doctor about this. Do not stop taking any of your drugs, to be clear, but you can start experimenting with healthy, slower, more nourishing breathing habits. There are no negative side effects to breathing better zero. And part of what you can do We've talked about the nasal breathing versus mouth breathing, right? If that's not available to you or you've already established that, the next thing you can do is to learn to take softer, deeper breaths, fewer breaths that are more enriching. And this is how this looks. This does not make for good podcasts, because it's gonna be silent, but you're just taking an inhale through your nose very softly. You're feeling a soft expansion in the abdominal area. And as you exhale, you feel a slight contraction. I shouldn't be able to see your shoulders going up and down. You are not forcing this. If I were watching you breathe from across a sofa, Right. With a coffee table in front, I would not be able to see you breathe. It is so soft and so subtle.
- [58:44]
Dr. Rangan Chatterjee
I think, James, it reminds me, did you not write in the book at some point about many years ago in Japan, a test to join the army? I think was, you have to breathe with a feather under your nose, and if people could see the feather move, you don't get in. Right.
- [59:05]
James Nestor
Good memory.
- [59:06]
Dr. Rangan Chatterjee
Yeah.
- [59:06]
James Nestor
Yeah.
- [59:07]
Dr. Rangan Chatterjee
You wrote this book many years ago now. But do you remember that story?
- [59:09]
James Nestor
I certainly do remember that, and it sticks with me because it's such a visual image. Right. Because that is showing how in control of you, how in control of your body are you? Right. Are you able to control your nervous system? Because if you can't control your nervous system and your breathing in a environment in which you were safe in front of other officers, who could think that you could control yourself when you really need to have your act together in battle? And this is something that could be very effective for asthmatics. If you are able to breathe so soft and so subtly, you think about the amount of inflammation in your airways, you think about what happens during an asthma attack. Asthmatics breathe in, they feel some constriction, Right. And that makes them paranoid. They have to get another breath in, right? Oh, I'm going to lose my breath. I need to breathe some more. Panic attack, asthma attack, they're so similar in so many ways. But if you start to feel that coming on, instead of defaulting to over breathing, which is the single worst thing you can do at that moment, why not default to an even slower, even softer breath? And Patrick McKeown, whom you've had on this show, this is what he has done with thousands and thousands of asthmatics around the world to reduce or resolve their asthma. It is a real thing, and it's not too much of a leap of logic to be like, if over breathing is causing inflammation and causing my airway to close up, well, obviously, if I breathe more slowly and softly, that's going to open things up.
- [61:03]
Dr. Rangan Chatterjee
And I guess the other point to raise there is that, as you mentioned about Patrick McKeown, who's done this with thousands of asthmatics, Asthma is also multifactorial, right? Why not? If you're interested, give this a try. You may find things get fully better. You may find that you need less inhalers. You may be able to get off your steroid inhaler and only use the blusalbutamol inhaler now and again when you get wheezy, you know, or it may make no difference, right? Which is unlikely. It's gonna make no difference. But there's no risk here. You know, there are effects of slow conscious breathing, right? But I wouldn't necessarily call them side effects. They're sort of very desirable effects, aren't they?
- [61:51]
James Nestor
I've never heard of any negative side effect to doing something better, to allowing your body to restore better. And breathing is certainly part of that. I don't know of any negative side effect to learning how to eat better, right? Or learning how to exercise at a normal level. There are no negative side effects of this. I think the difference with breathing is it's available to us all the time. So, you know, unlike exercise, people say, oh, you should meditate for 30 minutes twice a day. That will work. A lot of people can't fit that into their schedules. But this is something that you can be doing as you go about into your world, right? As you sit in your office, as you sit in a car, as you walk around, you can be improving your breathing. And the point of all of this is to develop better habits so that you don't need to think about it months later. And that's really where I like to get people, because they say, oh, man, I gotta pay attention to my mouth. I gotta pay attention to breathing really low and slow. I have to pay attention to my diaphragm. I said, you do for now, but soon you won't even have to think about it. This is your new default, and it can change your life.
- [63:04]
Dr. Rangan Chatterjee
For people who want to start introducing that practice, and they go, okay, I want to look at nasal breathing. I want to do that slow, silent breath, which, you know, the timing, if people want to know, it's all in the book about, you know, five and a half or six seconds in, five and a half or six seconds out. What is the minimum amount of time you think someone really needs to invest in doing that kind of breath to start feeling and getting a difference?
- [63:35]
James Nestor
Some people can change a habit in a few weeks, right? Some people can change a habit in several months. I was able to change my habits permanently in a couple of months. A pretty rigorous. But I get kind of into this stuff.
- [63:48]
Dr. Rangan Chatterjee
Yeah, me too.
- [63:48]
James Nestor
You know, so pretty rigorous exercises of really sticking to the plan because I felt every day what this was doing for my conscious waking hours, my energy levels, my ability to think more clearly, and especially at night, the depth of my sleep, how I was able to sleep so much better. So it inspired me to keep going. But it depends on, again, where you are on that spectrum. You can start with these very, very simple things. Experiment with nasal breathing, experiment with the tape, and next time you're walking around, doesn't matter if you're walking to work, walking in an airport, breathe in and out of your nose and be sure you're doing that breathing in and out of your nose. If it's comfortable for you at one pace, speed it up and see where that limit is. Right. And then just stay just behind that limit to acclimate yourself to it.
- [64:46]
Dr. Rangan Chatterjee
Yeah, once you really start tuning in and become aware, you start to notice it everywhere. You know, you start to notice when you're not doing it. And, you know, I've realized in my own life that, you know, one part of my job is to help host these conversations. So of course, for most of it, well, for a lot of it, you're mouth breathing because that's what you do when you talk. And I think a mutual friend of ours, Brian McKenzie, I've been chatting to Brian a lot about this over the years and I've actually noticed that when I'm doing live events and speaking or I'm doing a lot of podcasting, actually I do notice there's a little bit of fatigue compared to doing other tasks that don't require me to open my mouth because it's a, you know, there's a different physiology going on when you're breathing mostly through your mouth than through your nose. And if people want to really see the difference, they should read the book and look at that 20 day Stanford experiment, which is alarming. Could you just give us the top line of that? So I know it's, it's, there's a lot of color and storytelling around it throughout the book, but just talk, top line. What happened to really show people the differences between mouth breathing and nasal breathing?
- [65:56]
James Nestor
I do wanna mention one thing and I'm happy to do that, give you the bullet points from that, but regarding public speaking and mouth breathing, so I'm in the same boat. So we're in the same line of work, right? We have to do this all day long. And I was talking to a breath worker about this and I said, you know, I really wanna Figure out a way of conserving my energy. Cause I'm just gassed at the end of the day. These long conversations, you know, I'm so excited to do them. But I think it's not just mentally. I think it's physical. And she told me, she said, well, in between every sentence that you say, you just stop and you take a nasal breath in and then you exhale. I'm like, cool. That's not gonna work on a stage with a thousand people doing a podcast. So the answer to that in my mind, is, we live in this world, right? We're going to have to abuse our bodies. I didn't sleep very well last night. I was in a hotel. It's very loud, Right. I'm on a lot of airplanes. I don't always eat that well when I'm on the road. When I'm home, I try to take better, but I choose to live in this world. There are some things you're just going to have to deal with. And one of those things is this level of exhaustion after talking for seven, eight hours a day. Not mental fatigue. But I'm not moving. I'm just sitting down. I'm like, why am I so tired? I talked to a qigong master about this, and he said that this is why in ancient China and currently, people that adhere to qigong practices, no emotions. They're very straight up. Because emotions take energy from you, too. Always breathing in and out of the nose, speaking seldomly. I said, totally cool. If you're living a solitary life in the woods, that does not work for my line of work. Right. So I think we're just kind of hosed as far as that goes. The one thing we can do is when we're done talking, when we're done with this podcast and the taxi back to the airport, I'm going to be humming, I'm going to be breathing in and out of my nose, and I'm going to try to get my respiration locked back in so I can conserve the energy that I have left. Yeah.
- [68:08]
Dr. Rangan Chatterjee
But what the practical take home is for people is just be aware that if you are in a job, let's say you're in sales, and you're constantly on the phone or in meetings and trying to talk to people, or constantly on zoom calls as part of your job and talking, just be aware that that does take a certain toll. And you might notice on days where you're not on those zoom calls or you're not talking as much, you may go, oh, wow, I'm not quite as tired or my, you know, my propensity to want to do things in the evening is different. A lot of people now, of course, if they're driving with Bluetooth technology, they will catch up with mates or family members who are driving. You know, again, there's a road safety issue which I must acknowledge. You know, we're sort of talking about it through the lens of that. I'm not saying don't do it, you know, if it's safe to do so and you want to do it. But just be aware, constantly talking is likely to take some of your energy. Right. And one of the reasons for that is to do with mouth breathing versus nasal breathing. So I think it's again going back to what you said at the start. It's about empowering people, it's about just helping. Someone's going to be listening to that go, oh my God. That's why on Tuesdays and Thursdays I'm knackered after work because I'm talking all day. And it's just these little penny dropping moments that help people become more self aware.
- [69:32]
James Nestor
And we're not saying don't talk exactly. We're not saying put a chalkboard around your neck and write stuff out and say because I'm too fatigued. It's acknowledging it. Your body's flexible, it's meant to be stressed at times. But I've noticed the thing that restores me the most is silence and darkness after events. And if I have that, I get a reboot and so the next day I can do it all over again. So it's just something to recognize. And this does tie into the Stanford experiment in which I had read so many studies, talked to so many experts about the difference of mouth breathing and nasal breathing. All the benefits of nasal breathing, it helps filter allergens, viruses, bacteria, nitric oxide, calms the nervous system, allows more oxygen to pump to the brain. We know all of this and we also knew a lot about the damage of mouth breathing, how it makes you more apt to have respiratory infections, snoring and more. So that was established, but no one had done a study really side to side of having a control of like, what does mouth breathing in the same person look like? And then switching them to nasal breathing, what does that look like? It was 10 days of forced mouth breathing, sounds awful, followed. But you tell people that's what people thought, like, oh, this is some super size me, you know, stunt or whatever. But if you look at the amount of people that are chronically congested, this Is not some crazy thing. This is. We're just putting ourselves into the position of what million tens of millions of people feel like every single day. The difference is we're recording data.
- [71:14]
Dr. Rangan Chatterjee
Okay, so 10 days of mouth breathing. 10 days of breathing. 10 days of breathing. What was the difference?
- [71:18]
James Nestor
The biggest difference was in sleep. This is why I keep going back to sleep. I can talk about the things that we felt.
- [71:25]
Dr. Rangan Chatterjee
The.
- [71:25]
James Nestor
Those aren't as important. Extreme fatigue. Right. Very cloudy in our thoughts. Constantly struggling to stay awake. All of these things, sleepiness. But the things that were really measured more than anything else was sleep. I don't snore. I don't have sleep apnea. In a single night of converting to mouth only breathing, my snoring went up about an hour and a half from zero. And three days later it was at around four to five hours a night. And it stayed there and got worse every single day that that phase of the study continued. The other person in the study, we were allowed a maximum of two people. Only two. I know, it would have been great to have 200. I've been trying to get that study going for a long time. They say, cool, do you have $10 million? I don't. So we had two people in this. The exact same thing happened with them. Anders Ol volunteered to be in the study. Zero snoring, zero sleep apnea when he was breathing normally, as he would, and then full on full snoring throughout the night and sleep apnea. Choking on ourselves simply by changing the pathway through which we breathe air. And then for the other phase where we converted to nasal breathing, wore a little piece of tape. All of the snoring, all of the sleep apnea, all of it, 100% resolved after day two. And I have heard this from so many people. As I mentioned, you talk about your wife who send me their stuff and say, why don't more people know about it now? There's all these products, mouth tape products and all that, because it's irrefutable. People have seen the data and they've also had the experience.
- [73:12]
Dr. Rangan Chatterjee
There are all these products and you can buy them and some of them make it easier. They've got various things where if your mouth wants to open, it can. But you know, I've got this sort of tape just kicking around the house. You know, you're literally talking, aren't you? Just about a tiny bit on your lips. You know, it's not expensive.
- [73:32]
James Nestor
Yeah.
- [73:32]
Dr. Rangan Chatterjee
You know, it's so cheap. And as you just said, it could literally. I mean, I don't think we're overselling it to say, if you're a mouth breather and you train yourself to breathe through your nose at night, it could transform your experience of day to day life.
- [73:47]
James Nestor
Depends who you are. But that's certainly what so many people have been telling me at an event I just did in London. Once again, there were three different people in the crowd that grabbed the microphone and said, you saved my marriage. You keep hearing this over and over and over and there's something to it.
- [74:08]
Dr. Rangan Chatterjee
The same many different topics in Breath. When I was rereading it that I thought would be fun to talk about. One of my favorite chapters was Exhale. And I started to do an exercise yesterday that I've never done before. Right. So in that chapter you talk about this idea that shallow breathing will limit the range of our diaphragms. You know, it's that use it or lose it phenomena you mentioned before. Right. If we're not using our diaphragm to its full ability, we're going to limit its range. And in that chapter on exhale you mentioned, was it this chorister, what was his name, the chorister?
- [74:48]
James Nestor
Karl Stow.
- [74:49]
Dr. Rangan Chatterjee
Yeah, Carl Stow. And there was this exercise you talked about, which I did with my kids last night, which was amazing, where you take a deep breath in. Well, this is my interpretation of it. You can correct me if I've got any of it wrong. And then you just count to 10. You keep counting to 10. Cause you're trying to get a maximum exhale. And it's phenomenal because at the end of it, you really feel your abs. You feel, oh, wow. I very, very rarely exhale to that level. Can you talk a little bit about why exhaling is so important? Why a lot of our problems come from our inability to exhale properly and why that exercise is so useful.
- [75:32]
James Nestor
Carl Staal was a choral conductor. He taught singers how to sing better. He ended up retraining opera singers at the Met Opera. So part of what he was doing was teaching these different people to take a full exhale. So the diaphragm is this parachute shaped muscle that sits underneath the lungs. And when we inhale, it flexes down like that. When we exhale, it relaxes and it pushes air out. So we're supposed to have a lot of movement in this diaphragm. It's supposed to be going all the way down when we inhale. It's supposed to be going up when we exhale. Most of us have very limited movement. Carl Stau Found that we use about 10% of our ability to flex that diaphragm. 10%, most people walking around the street, which means we're just breathing like this. And if we do that, we have to engage other muscles to sort of work with our lungs to push that air in and out. And this is why people tend to put their shoulders up while they tense their necks. So Stau was brought in to the VA hospitals on the east coast to rehabilitate people with emphysema in the 60s. And these are people who were literally left to die. We had no idea what to do with them. So emphysema is under the umbrella of COPD now. So what he found, and what none of the doctors had realized is these people with emphysema, their diaphragms were locked, literally locked, and they were locked on this deep inhale, so they could not exhale air.
- [77:17]
Dr. Rangan Chatterjee
Wow.
- [77:17]
James Nestor
So when they breathed, they just had to go. That's how much they could breathe. So they had to take 30, 40 breaths a minute. We know what that does for stress levels. Also, you're using all of your energy just to breathe in this extremely inefficient way. And this is why they were having so many problems in their lungs, because the air wasn't turning over. That stale air was sitting there. So he realized the problem, and through a series of different massage techniques and breathing techniques, he was able to unlock their diaphragms, allow them to fully exhale. And if you fully exhale, guess what? You're able to fully inhale.
- [78:00]
Dr. Rangan Chatterjee
Yeah.
- [78:01]
James Nestor
And without any drugs, through these breathing techniques, he was able to completely rehabilitate people with emphysema that doctors had never seen anything like this. And he spent a decade in these hospitals working every day of the week to do this. Thousands and thousands of patients. And when he left the hospitals after all that time, all of his techniques were completely forgotten and have not been used since. They were never disproven. Nobody has ever disproven them because they work. They were forgotten, and they just moved on. And emphysemics and people with COPD are basically treated the same way they were in the 50s and 60s right now.
- [78:40]
Dr. Rangan Chatterjee
Yeah. I mean, that was absolutely incredible reading that. And, you know, I think back to my junior doctor days, and, you know, when I was in respiratory and the wards were just full of people with emphysema and they were struggling to breathe, and their lives look really, really, really difficult. And if you think about it on a macro level, from what you've been talking about today, if you're only using 10% of your diaphragm's capacity, if you just think about the moving of air in and out the flow, you know there's going to be a stagnation in the body. Things are not going to properly be moving in and out as they should do. Right. And of course, just learning how to fully exhale, you will fully inhale after a full exhale because that's the only thing that can happen. Right. Was he not the guy who also then started to work with sprinters and athletes? And one of the things I thought I might try at Parkrun this Saturday is, I think he said, on the starting gun, maybe not for sprinters because if it's a 10 second race, you haven't got much time to be messing around. But I think for some of his athletes, say on the starting gun, do a full exhale.
- [79:56]
James Nestor
That's right.
- [79:56]
Dr. Rangan Chatterjee
And I thought, wow, I've never heard that before. What a lovely way to start off your race or your run in a relaxed way, taking a full breath.
- [80:07]
James Nestor
A full exhale and then your first breath, you are breathing in and you are ready to go.
- [80:11]
Dr. Rangan Chatterjee
Yeah.
- [80:12]
James Nestor
So the teams that he coached went on to win more medals at the Olympics than I still to this day, than anybody else. And they were able to do this in Mexico City at a very high elevation where all the other teams were using oxygen. The US Team was not using oxygen, and they busted all these records and won all these medals. And the runners acknowledged, they said we could only do this through the power of exhalation because that power of exhaling, exhaling, allowing that diaphragm to come up allowed you to take that full and rich breath in.
- [80:47]
Dr. Rangan Chatterjee
Do you think some people, you know, we want to keep things free and accessible to as many people as possible. But also sometimes if there's something else out there that could be helpful, we should also say for people who can afford it or do have access, if you've been dysfunctionally breathing for decades, presumably there's all kinds of tightnesses in your, you know, your rib muscles, your intercostals, the fascia. I'm saying this because I've had experience, you know, I've been into breathwork for many years now. And I know certain bodyworkers have been incredibly useful at freeing up certain bits of tightness and tension where, frankly, I thought I was breathing deeply. But because, let's say the right side of my ribs was tight, I wasn't even. I wasn't going there. I was breathing deeply Everywhere else. And it was only like when my friend Christian, who does myofascial release, helped me release that I was like, oh, now I can breathe into my right lower ribs. What's your experience with that? Can that be helpful for people?
- [81:45]
James Nestor
Absolutely. I've had the same experiences, too. I exercise a lot, I surf a lot. I get beat up constantly in the water. And without having that restoration from people who really know fascia. Right. Muscles are important, but are able to manipulate fascia. And this is not. When you think of massages, this is not like, oh, here's your hot stones.
- [82:04]
Dr. Rangan Chatterjee
It's be painful. So painful.
- [82:07]
James Nestor
It's so painful. For an hour I'm sitting there sweating and trying to hold back a scream. But then afterwards, how do you feel? Right?
- [82:15]
Dr. Rangan Chatterjee
Yeah, but it's not just that, James, is it? It's also about going back to this idea of doing the work. Right. So in theory, let's say very simplistic, you had some right lower rib tightness, and you've got a breathing pattern that has developed for a number of years around that. Let's say you can afford to get a good body work. It's in. Who does some work on that. In theory, if that's all you do, and then you don't change anything, it might return because you're going back to the same breathing patterns. So it's much better to also be proactive and go, yeah, get that. If you've got access to it, and then really think about how you're breathing. Are you getting into all parts of your lung? And of course, if you have a practitioner, and the truth is, you know, all yoga classes will have breathing as part of them. All Pilates classes will have breathing as part of them. And many other, you know, martial arts, many other disciplines, because the breath is so fundamental to how you operate in all of them.
- [83:16]
James Nestor
Andrew Weil, the famous integrative doctor, Right. I was having a chat with him. I went out to Arizona, spoke at his foundation. I had a chat with him and he asked me a question. He said, why do people get scoliosis? And I thought about it. I said, oh, it must be genetic. Well, that plays a factor. Oh, must be. This must be that. I said, I don't know why you're the pro here. He said, nobody knows. Nobody knows. All these genetics play some role in it. It's mostly environmental. And what he told me is he believes because he heard this from his mentor, that we develop dysfunctional breathing habits when we're young. We sleep in a certain position. One Side is not opened right the way it should be. We quickly develop. We keep breathing this way. If you were to tilt to your left right now and breathe, so your right lung is going to constantly inflate and deflate, and then your left is not. And if you do this at these stages of quick development, this can change the shape of your spine. So he mentioned that because he believes that these dysfunctional breathing habits could contribute to scoliosis. You could also use healthy, proper biomechanical breathing to restore scoliosis, which is exactly what we've seen.
- [84:48]
Dr. Rangan Chatterjee
And you wrote about with Katherine Schroffer, right, German teenager with scoliosis who breathed herself straight. Now, I need to acknowledge as I'm saying this, that this is not the conventional view. Right. Within medicine.
- [85:02]
James Nestor
No.
- [85:03]
Dr. Rangan Chatterjee
But where I have a real problem sometimes with the way we do science or talk about medicine is research is important, and we absolutely must look at the research and science. But then when you have case studies that disprove something that you thought to be true, that is, oh, that person has actually reversed their type 2 diabetes, maybe, then we can't say that for every single person, type 2 diabetes is chronic and irreversible. You know, it may be that for some people it is, but as soon as you've disproved it with one case, it's like, hold on a minute. Our knowledge is only partial. There must be something out there. Maybe we can study this and figure out, well, what's going on there. And I know many bodywork practitioners. I had Jason Van Bloeck on recently from Human Garrett Marriage. They will tell you that with the practices they do that they have reversed certain scoliosis, right? Now, they've seen that. I've seen that. Right? So it clearly is possible, but it's not mainstream practice. So I feel I have an ethical responsibility as a doctor to share that stuff in this podcast to go, listen, you know, maybe you won't be able to do it. Maybe you don't know someone near you who can help you. But I would just encourage them to read the exile chapter, read Katharina's story, and go, wow, that was because she helped loads of people to do it.
- [86:24]
James Nestor
Hundreds.
- [86:25]
Dr. Rangan Chatterjee
Because she did it herself, Right?
- [86:26]
James Nestor
Hundreds and hundreds. And she was repeatedly, for decades, they tried to ban her from doing this because she was not a doctor. Right. She was a, quote, hobbyist that was doing this. And yet she kept restoring thousands, hundreds and hundreds, thousands and thousands of women restoring. There's scoliosis. And at the end of her life, she lived to be 90 at the end of her life. The German government awarded her an award for medicine for her contributions.
- [86:55]
Dr. Rangan Chatterjee
It also takes someone who's suffering to disprove, because no one's gonna do that if you're well. If you're well, you have no reason. And I wish I knew this. I was reading it thinking, man, I wish I knew this 20 years ago. Cause my mom's had a really bad scoliosis, which just got progressively worse throughout her life. And I remember after my dad died, taking Mum to all these spinal surgeon appointments, and, you know, it was all X rays and, you know, is surgery an option? And again, the doctors were doing their job right, the way they've been trained to do it. But if I knew then what I know now, I might have gone, hey, Mum, you know what? Maybe we should just look at getting you some myofascial release. Say, a breathwork expert, you know, who knows? I don't know that that would have made a difference back then, of course. But it's interesting, isn't it?
- [87:44]
James Nestor
I think those two things. I didn't think that we were gonna bridge the gap between emphysema and scoliosis, but they're so similar in ways that they can be exacerbated and some might even say caused by the same dysfunction in breathing. This inability to engage the diaphragm to fill both of the lungs equally so that you develop a straight spine, so that you continue to take fluid and easy breaths. And I think this combination of myofascial release along with breath training, I mean, you put those two together, and I think it could be very powerful. So all you PTs out there, I'm a journalist. I can't do this. People are going to say, send me more information. But it seems like this is wide open for people to start adopting these methods that have been proven, that have been part of human culture for thousands of years for a reason.
- [88:42]
Dr. Rangan Chatterjee
Let's go about breath holds.
- [88:43]
James Nestor
Okay?
- [88:45]
Dr. Rangan Chatterjee
You talk a lot about breath holds in the book. And of course, a lot of people are aware of a certain type of breathing practice and breath holds. You know, Wim Hof breathing, which I think comes from tummo breathing, from what I understand in your book. But I wanted to take breath hold in a slightly different direction with you, James. We've covered the Wim Hof breathing stuff before when you've been on the show. And I think. I don't think it's for everyone. I think it can be very helpful for some people. And I think the key message you're trying to get across in this conversation is before you go to these fancy breathing techniques, get your foundation sorted, make sure you're nasal breathing. Make sure you can do that slow, quiet breath. In for five or six seconds, out for five or six seconds. The breath hold I want to talk to you about. And it's really. It'll be interesting to get your take on this, especially because you wrote a book on free diving. I think prior to the book on breathing, this idea that it's rising CO2 levels, carbon dioxide levels, that is ultimately our drive to breathe. Okay, now, where I was challenged with that was when I did a breath hold course with Erwin LaCour. I don't know if you know Erwin or not. He's the founder of movenat, a natural movement kind of training organization. He's been teaching people to do natural, primal movements for years. But over the last few years, I think, inspired by free diving, he's been doing what he calls breath hold work, meditation. And I did his online course, and on the very first session, he asked everyone on this zoom call to take a breath in as much as you can and then hold it for as long as you can. And, you know, I had just landed in Sweden. I was rushed to the hotel room. And so there's all kinds of other factors at play here, but I could hold my breath for about a minute before I had to breathe again. Four weeks later, I could do 4 minutes and 20 seconds. Hyperventilation did not play a role at all. Right. So his viewpoint is that I don't wanna speak for Erwin, but he would argue that doing breath holds after you've done hyperventilation is like doing cold plunge with your wetsuit on. Right? So his take on it is that, yeah, sure, you can do that. But of course, as you well know, when you do that hyperventilation, you're blowing off carbon dioxide. So therefore, it's easier to hold your breath because it takes longer for that CO2 to rise, which I get. I understand. What I learned on that course is that when your body is screaming for you to take a breath, literally everything you do, going back to what you said before, your emotions, your thoughts, every part of the more noisy you are, the more that urge to breathe will be there. And he trains us to really quieten and calm our mind. I mean, even as I say it, I find it unbelievable. But I have done this, right? I'm like, oh, my God. Like, at 1 minute 30, when you think you have to breathe, you may well have another two minutes. There you Just don't know. Now, I'm not suggesting anyone does this without supervision, right? I'm absolutely not saying that. That course, James, for me was life changing because it taught me something very, very important. It taught me that actually if I can master the skill of controlling my mind when my body is screaming to take a breath, I'm like, well, most things in life relative to that are gonna be a piece of cake. And I honestly think that that course has helped me. Like, I just feel pretty calm a lot of the time these days. I don't feel that stuff that used to trigger me triggers me as much. And there's many things I've done to help me. But I think that course is one part of the picture. So have you heard of anything like that before? What's your take on it? And also, I guess that challenged my view that it's only carbon dioxide. That is our drive to breathe. I thought, yes, it is. And there's a psychological component as well.
- [93:09]
James Nestor
These practices have been a part of various cultures for a long, long time. Ancient Chinese practices of breath holding are foundational to early versions of qigong. Right? There's one practice in which they want you to inhale and then exhale and hold your breath, counting 1 and 2100 times. That's the initial test, right? They said if you're able to do that 1,000 times, which works out to round a breath hold of eight minutes, depending on how fast you are, then you will be in really enlightened state. Right? Not only physically, but spiritually, mentally. So it doesn't shock me that you had that reaction to it. The course sounds great. I've done a lot of free diving courses. I still free dive. And breathing, of course, is foundational for this. You can't hold your breath unless you're a good breather. Some of those overbreathing techniques can be beneficial. Not for free diving, they can be very dangerous, dangerous near water. But for WIM HOF technique, for Sudarshan Kriya, for holotropic breathwork, for various pranayamas. So those can be very beneficial because what you do is you purposely stress yourself out and then you purposely calm yourself down so you put yourself in control of your nervous system. And what they found with Wim Hof Method, also known as the 2000 year old practice of Tumo, is that this can be very effective for people with autoimmune diseases that in combination with cold exposure. So we know all that and what dictates our need to breathe is that rising level of CO2. I always thought it was oxygen myself. It's not. It's rising levels of CO2. Once you start to understand that. I found it very helpful to wear a monitor on my finger, looking at my blood sats, Right. Because I could hold my breath and after about a minute and a half, I'd be like, there's no way I have oxygen. And sometimes it's unchanged after that amount of time, then minute three, minute four, it will start to go down. But you acclimate yourself to this and you get your body used to it. And cells want to be stressed. Right. It makes them more resilient. And the Chinese considered these breath holds a medicine that can cure a lot of problems. Has that been proven? Not in Western science, it hasn't. But the foundations of that make a lot of sense to me.
- [95:45]
Dr. Rangan Chatterjee
Yeah. It kind of reminds me a little bit about the section in your book about anxiety, where for many years it was believed that the amygdala, that emotional part of our brain, is in many ways the hub of anxiety. And it can be. But as the experiments with CO2 have shown, you know, even if you don't have an amygdala, you can precipitate anxiety in someone by giving them carbon dioxide. Right. So it's kind of like. And I see a similar thing with what I learned on that breath hold course, which is, yeah, rising CO2 levels are the stimulus to breathe. Absolutely true. And there is also a psychological component. So maybe what I did with Irwin over those weeks was use my mind to go a bit further and maybe start training myself to actually tolerate higher levels of CO2 before I needed to breathe.
- [96:43]
James Nestor
So a lot of that is mental, but I think that tolerating more CO2, which is a good thing for a lot of people, having a higher tolerance for CO2. Absolutely good. Especially with people with asthma and anxiety. When I was researching with Dr. Justin Feinstein, this was his main jam was to look at people. He focuses more on panic and anxiety, but he still was experimenting with people with asthma. He found that all of them are over breathing and all of them have a very low tolerance for CO2. That means if you ask an asthmatic or someone with panic to hold their breath, they'll take an inhale and a few seconds later, yeah, about four to five seconds. That's how long they could hold their breath. And he found that the longer they were able to comfortably tolerate that CO2, up to 20 seconds, 30 seconds, eventually 40, 50, their symptoms of asthma and panic and anxiety started to precipitously decrease. And this has been in the literature for actually 50, 60 years. Researchers, renowned researchers have been writing about this. And now he has a hypothesis. I hope he's going to be able to do more research to prove this. That he believes anxiety the main driver to it, the primary driver is breathing.
- [98:07]
Dr. Rangan Chatterjee
Yeah.
- [98:09]
James Nestor
So he had also told me, various psychiatrists and psychologists had told me this as well, that you can never fix anxiety, no matter what retreats you go to, what pills you take, what powders you're taking, unless you first fix that foundational breathing aspect. So if you're breathing dysfunctionally over breathing all the time, very low CO2, doesn't matter what else you do. Not going to say that breathing is going to fix all of those issues, but it starts there and then you move up the ladder.
- [98:45]
Dr. Rangan Chatterjee
There's also something about agency and autonomy that I think comes when you engage in these practices. James so that breath work course I did with Ewin at the end, I thought I felt so empowered, I was like, wow. In the last few weeks, I've literally learned how to control and quieten my mind when my body is screaming to breathe. That self empowerment absolutely bleeds into how you feel about yourself, how you interact in various aspects of your life. That's why I'm such a big fan of people doing things proactively for their health and wellbeing. Because I don't think it's just about the practice. It's about you gaining that knowledge that, oh, I can do stuff that makes a difference. Do you know what I mean? And I think that's what breath work can give people. It's like, oh, wow, I feel stressed. I do three minutes of just slow breathing. Six seconds in, six seconds out. Now I feel calm. Oh, I didn't to buy anything. I need to distract myself on my phone. I didn't need to put something on Netflix. Just me, myself with how I change my breath. It's very, very empowering.
- [99:57]
James Nestor
You're also doing something when you're free diving that is supposed to be impossible. And that's the thing that really blew my mind and inspired me to go on this journey. To learn about breathing over the course of 10 years is, according to so many physicists and so many biologists, the lowest a human was supposed to be able to dive before their lungs would implode was 100fe. They said you can't go lower. What they didn't know is we are imbued with these different reflexes that kick in the deeper we go, that have been lying dormant in us, but are still there. And when they kick in, it allows us to become underwater animals for a little while. And once you start using your natural body, these two scuba tanks called the lungs inside of us, and going down and swimming with dolphins and whales and doing this thing that's supposed to be impossible, and the deeper you go down, you feel these different triggers, these ancient triggers automatically coming on. It just blows my mind.
- [101:05]
Dr. Rangan Chatterjee
One of the funnest things about your book for me is the stories from ancient Indian culture and ancient Chinese culture. And essentially just making the case that a lot of this stuff was known by our ancestors. They may not have had modern scientific data, but it was known, right? And it was funny. I spoke to my mum yesterday. I said, hey, Mum, I'm talking to this guy James tomorrow about breathing. When did you. My mum grew up in India. I said, when did you first learn about the power of breathing? She couldn't quite remember. She said, but I think I was about to seven or eight. And, you know, I think someone in the family taught her a breathing practice. And it makes me think about culture and it's kind of imbued in this subtitle of your book, the New Science of a Lost Art. Right? This stuff has been in so many cultures for so long. Certainly in, you know, my heritage of being in an Indian family, you know, I grew up seeing my Granddad meditate for 20 minutes twice a day, right. I spoke to Henry Shukin about this recently when he was in the podcast, saying, hey, I really didn't need convincing growing up. The meditation was good. It was just surrounding me in my culture that breath work is important, meditation is important. And for me, it's really fun that there's now lots of this modern science that is kind of, you know, validating in some ways what these cultures have known for thousands of years.
- [102:40]
James Nestor
I think that the further we get away from nature, the sicker we get. This is certainly what's happened. We stop moving and we start sitting and we start spending 90% of our time indoors. We start breathing air that isn't healthy. We start eating ultra processed foods. This makes us sicker and sicker. I just think it's so interesting that medicine is now finding once you start peeling away the industrial age from our bodies, something amazing happens. They're able to restore themselves and seek this balance they want to do. This is what we're designed to do. We're designed to be stressed out, but we're also designed to heal. We're healing every moment of our lives. You See that with sleep. You know, the idea of now the biggest thing that people are looking for is just quiet and darkness. This is the most expensive thing, the hardest thing to find in the modern world. Trust me. I keep looking for it in hotels. I never find it.
- [103:49]
Dr. Rangan Chatterjee
Well, funnily enough, I was looking this morning because I'm traveling in a couple of weeks, and I was looking for a hotel. And the hotel I was looking at it is a wellness hotel, right? And I was just looking to see how much it was. But the more expensive rooms, do you know what they're selling? They're saying in this room now, you can have, you know, we've got an air filter, we've got a blackout blind. You know, that is the premium room. Now, it's like you can have a noisy room, or if you want a premium room that we would have had out in nature, you've got to pay for that.
- [104:21]
James Nestor
That's why I find so ironic in this culture is you have to pay more for less. The laundry detergent that doesn't have crap fragrance in it costs twice as much as the detergent that smells like crap. The food that is not processed, that is in its natural state, costs way more than Cheetos down at the local market. And to me, this awareness is a good thing, right? It's that you don't have to spend an incredible amount of money or effort. You just think about the further I go in this direction into industrialization, from the lighting in our houses to the air quality again or whatever, the worse we're going to be. And now if you think of like wellness places, you think about people like 200 years ago, like, where they would want to go is the city. I want to see the bright lights. I want to be around the people. I want to eat the food. I want to see the buildings. Now the exact opposite has happened with the wealthy. I go to my own island where it's all natural lighting. You know, I go to a retreat center that allows me to be encompassed in nature the whole time. And I go to a retreat where
- [105:37]
Dr. Rangan Chatterjee
they take my phone off me when
- [105:38]
James Nestor
I go, I take my phone off.
- [105:40]
Dr. Rangan Chatterjee
You pay a premium.
- [105:41]
James Nestor
For me, food is unprocessed. I eat fruit from trees and vegetables from the ground. And so I think that it's intuitive again. That's one of those things. It doesn't take a huge leap of logic to see how that makes sense. Our body can digest food that's been less ultra processed, right? You know, we can sleep better in the dark when it's quiet. And we can breathe better when we're not surrounded in really tight clothes and sitting in front of a desk all day.
- [106:10]
Dr. Rangan Chatterjee
Yeah. One of the new sections in the paperback is to do with carbon dioxide levels inside. I know you've got this monitor with you because you checked my kitchen, and I was delighted that it was decent. What's going on? What have you learned since the original publication about indoor air quality? And why is it important that we know about it?
- [106:32]
James Nestor
What I've learned is that this is something that I did not know about when I first wrote this book. And luckily I've been able to speak at various conferences, talk to more experts. And they kept telling me, they're like, you have to look at indoor air quality. I said, why? And they said, because there is an epidemic of high carbon dioxide in indoor air. So people say, wait, I thought you just said having higher levels of carbon dioxide in your bloodstream is a good thing. It is. It's all about balance. When you're creating the CO2 within your body, okay, then your body knows what to do with it. It comes on slowly. You can acclimate to it. When you sense high levels of carbon dioxide in the environment, your body views this as a threat.
- [107:16]
Dr. Rangan Chatterjee
It's like breath holding, right? In this in the sense that if you're holding your breath unconsciously because you're looking at your emails. We've not mentioned email apnea yet, but where you hold your breath when you're looking at these emails, right? That's a breath hold of sorts. You're not meaning to do it. The environment is resulting in you doing it. That's very different, isn't it, from when you intentionally decide, you know what? I'm gonna try and now hold my breath for two minutes instead of a minute by calming my mind. Do you know what I mean? It's a similar kind of principle.
- [107:49]
James Nestor
One is conscious and one is acute, right? So you are consciously holding your breath for a short amount of time. You are controlling that. When you are in an environment for hours or days at a time with high CO2 levels, your body has to struggle to keep the blood pH consistent. As you know as a doctor, you have to stay at the same ph. All cells work at a very specific pH, 7.38 to 7.42, right? So you have to be in that range. And if you're not, your body will keep you alive. But it has to do all this extra work, right? Your kidneys have to work harder. It starts pulling minerals from your bones. You have to Release bicarbonate, like, whatever. All of these different things have to happen. So for a short amount of time, it's fine. But chronically, we know that there are so many issues associated with it. When I started doing the deep dive into research, there are governments all over the world that have been doing these studies for 20, 30 years. So, again, it's not controversial. But then you go and start measuring it. We have the science, but the measurements of these indoor environments are an absolute disaster.
- [108:58]
Dr. Rangan Chatterjee
Why is it so bad indoors?
- [108:59]
James Nestor
Shocked. So what happens is, before, back in the day, we used to have these amazing things, this incredible technology called windows. And when it was stuffy in a room, I'm going to open the window. So that window allows fresh air in. So then we had this idea. We're like, let's remove all windows from all hotels and all offices and conference centers, and we're going to pump in air. Okay. We're going to heat that air or cool it down, depending on where we are. We're going to pump it in, then we're going to pump it back out. In theory, that works fine as long as you're pumping that air in and out. And what so many hotels and so many schools too, are doing is pumping in air and out and heating it. So that requires an incredible amount of energy, about 50% of the energy cost. Right. So what they're doing is they're bringing in a small amount of air and they're recycling it throughout the rooms so that they don't have to spend any money cooling it down or heating it up. So you think you're alone in your room, you are breathing the air from the person next door, the person next door to them. So much so that in some hotels, we found that around one in every 20 to 25 breaths you're taking is someone else's exhalation. And if you go to the window to open it up, guess what? It doesn't matter if you're at a wellness hotel. Some of those are the worst, by the way. You can't open the window up. You cannot get fresh air into this room. So right now, in the outdoor environment, there's around 428 parts per million of CO2. Okay. We know that goes up every year in indoor environments once you get to a level of around 1500 parts per million of CO2. So, 3, 3, 4 times the amount that's in the outdoor. Some studies have shown a 50% decrease in cognitive performance.
- [110:59]
Dr. Rangan Chatterjee
Wow.
- [111:00]
James Nestor
Because your body is under stress, if you get to 2,500 parts per million. That's about one in every 25 breaths of someone else's exhalation. That starts increasing precipitously. Headaches, fatigue, even high blood pressure. By the time you get to 3,000 and 4,000, you're at around 1 in 10 to 1 in 12 breaths you're taking is someone else's exhalation. And this is when some very serious problems can occur.
- [111:31]
Dr. Rangan Chatterjee
And just to be really clear, for someone who doesn't understand why that's an issue, why does it matter if 1 in 10 breaths is someone else's exhalation?
- [111:39]
James Nestor
It makes it harder for you to get oxygen. That CO2 is taking up the area that oxygen would otherwise be in. So your body is struggling to get oxygen. And all that CO2 is sending these constant signals to your brain that you are stressed, that there is danger afoot. And for your body to balance that ph again, all of these different functions have to happen in the body. And if it's chronic, it can start pulling minerals out of your body, and it can relate to high blood pressure as well.
- [112:12]
Dr. Rangan Chatterjee
What is the monitor you carry around? Because I'm sure people. I don't know how expensive it is, but I'm sure some people will want to get it and check their own house and office environment.
- [112:21]
James Nestor
So once I was talking with a researcher about this, I went and researched all of the different carbon dioxide meters, and you can buy them on Amazon. And most of them are complete crap, so they're very inaccurate. So I got a professional machine and I tested a bunch. I'm not affiliated with this company. I'm not associate.
- [112:38]
Dr. Rangan Chatterjee
Maybe.
- [112:38]
James Nestor
Maybe I should have been. I don't get any money from this, but I found one that worked really well. So for the past around three years, I've been traveling with this. Every airplane, every hotel, some restaurants. And now I've armed about 20 other people to travel with this one of these monitors, and we're creating a database so that people know what's going on. I have brought this monitor here to this studio.
- [113:04]
Dr. Rangan Chatterjee
Well, let's see what the studio is, shall we?
- [113:07]
James Nestor
I hate to say this.
- [113:08]
Dr. Rangan Chatterjee
No, no, no, no, no, no.
- [113:10]
James Nestor
The worst air quality I've ever seen in a studio. We're gonna fix this. Afterwards, I'm gonna tell you exactly what to do. It's a quick and easy fix. But this means that the air we are breathing right now, one in every about 15 or so breaths is my exhalation, the sound guy's exhalation. That is what you're breathing.
- [113:32]
Dr. Rangan Chatterjee
This is not Good. I'm looking at Gareth. Gareth. We're not in a good situation.
- [113:35]
James Nestor
So if one of us is sick, there is a much higher chance that this is going to be breathed in by the other person.
- [113:45]
Dr. Rangan Chatterjee
This is interesting. Right, so you did my kitchen, which was about 800, which is fantastic. Really good. And let's just sit with the kitchen for a minute. If I wanted to bring that down in the kitchen, if you open the windows and the doors that would just
- [114:02]
James Nestor
naturally come down in a couple of minutes, it would be.
- [114:04]
Dr. Rangan Chatterjee
Cause you say it's 400 outdoors, just being indoors with shut windows and not having that fresh sort of, you know, I guess the staleness of the air, it's gonna rise.
- [114:16]
James Nestor
It's gonna rise.
- [114:18]
Dr. Rangan Chatterjee
Okay. But of course, this studio, which used to be a garage. So I trying to think what it's made of and stuff. So. Okay, yeah, So, I mean, we can fix it, but is there anything you can say about how to fix it? Which would be useful for people listening in case they find in their work environments that, you know, they've got poor air quality?
- [114:37]
James Nestor
Number one, open a window.
- [114:39]
Dr. Rangan Chatterjee
Open a window.
- [114:39]
James Nestor
When you go to a hotel, you call beforehand, do some research. Do they have windows that open? You don't need the window to open all the way. You need this much. You need a few inches. Do they have doors that open? The hotel I stayed at last night, I asked that they had this wonderful door. Even in Manchester in winter, I slept with that door cracked because I know what a difference it makes to my sleep quality and my ability to think more clearly the next day.
- [115:07]
Dr. Rangan Chatterjee
So a lot of the time when we sleep in a hotel room, we'll often say, well, I will at least. But I know many people say, I didn't see it that well. You know, it's in a hotel bed. And it could be different environment. It could be the bed, be the light coming through the door or whatever, all those things. But it could also be the fact that you were sleeping in really, I guess, a high carbon dioxide environment.
- [115:32]
James Nestor
Yes, it is all those things. So next door to me, the guy was watching TV and yelling all night, right? So that kept me off, but at least I was able to remove the air quality. Part of this I have at hotels. I won't name them. Certain wellness hotels that a client put me up at that cost. An incredible amount of money. Gorgeous place, right? They have ferns, they have natural wood, recycled fabrics. The worst air quality I've ever seen in my life. And I woke up that next morning, I didn't Have a thing to drink the night before, went out to a big dinner with a bunch of friends, didn't drink anything. Felt so incredibly hungover. I said, what is going on? I reached in my bag, looked at the monitor and the CO2 levels were just absolutely off the hook.
- [116:16]
Dr. Rangan Chatterjee
I mean, going back to ancient wisdom and bringing up my mum again. My mum has always, always, always slept with a window open.
- [116:25]
James Nestor
Yep.
- [116:26]
Dr. Rangan Chatterjee
Even when it was, you know, December and cold and the heating's on, she would always say, no, I can't sleep unless the window's open. So she'd always keep it open. And it's quite interesting now to think, well, maybe she just intuitively knew that or, you know, that I feel better when I've got airflow in my room. Which kind of makes sense, doesn't it?
- [116:44]
James Nestor
Of course you feel better. Why wouldn't you feel better? I mean, that's what this is. Another thing, it's so simple. The good news about this though is it's a very fixable problem. This isn't some systemic thing that's going to require all of this changing of infrastructure. Once these hotels start to get outed, the one thing that really speaks is money. When people start saying, don't stay at this hotel, it's $600 a night and the air quality is crap. You are going to see them improve their H vac so quickly and it's not going to cost them that much. If they really cared about the health of their guests, they'd be pumping in at minimum. Allow us a breath of fresh air. One thing I noticed in Vegas, I've done a lot of speaking gigs in Vegas. The air quality in Vegas rooms, even with windows that do not open was superb. Every single hotel room in Vegas was around 600 to 500 parts per minute.
- [117:48]
Dr. Rangan Chatterjee
Oh, my God. These guys don't mess around.
- [117:50]
James Nestor
They do not mess around. The best air quality I've ever seen in a hotel and you wake up and you're like, even though I'm jet lagged, I did have a few glasses of wine the night before. I feel pretty good. I'm ready to take on the day. I'm ready to go see a show.
- [118:08]
Dr. Rangan Chatterjee
The business case is there, the business case is there.
- [118:11]
James Nestor
That's why I think you can shame people for. That's unethical. That doesn't move things. I think that you can show them. You're gonna lose money, people are gonna stop going to your hotel and you're lying to guests saying this is a wellness hotel and you won't Even allow us a fresh breath of air.
- [118:29]
Dr. Rangan Chatterjee
Yeah, I'm definitely getting one of these.
- [118:30]
James Nestor
The make of this is an Aeronet 4, right. So I do not work for Aeronet. I put this sticker on it because I, I noticed I was promoting this product all over the place. These are. Right now there's a bunch of other companies coming out with these. These are the best. And I've tested this. If you were to open your door, if you had a little fan, in about 10 minutes, we'd see this drop to a thousand parts per million, which is good. Which is really good.
- [118:57]
Dr. Rangan Chatterjee
What have you seen on planes?
- [118:59]
James Nestor
It depends at you wonder why you go on a plane and people are stressed, right. When they get on a plane and then you're like, why is everybody asleep after five minutes? It doesn't have to do with their stress levels. Has to do with there's so much CO2 that the body just goes and completely crashes. And I think they use this to pacify us. Some airlines have much better air quality than others. Which shows you again, this is a choice that these companies are making. Right. They want to conserve a little money on oxygen on filtering air. So some are much better than others. I want to get more data before we come out with all of this. We're going to share all of this information for free for everyone. So you can see some when the airline is. Before it takes off. Right. The reason why it gets so hot in there is the engines aren't running right and so the air isn't flowing. I've seen 3,500 parts per million right before it takes off, once it gets going. A bunch of engineers, the Council of Engineers, suggested anything above 1000 parts per million is bad news. It feels like stuffy air. I have never been on a flight anywhere that wasn't well north of that, ever. And this includes a flight that's 14 hours long.
- [120:18]
Dr. Rangan Chatterjee
You know, when you think about something like jet lag, for example, and you know, we've conventionally put that down to circadian rhythms, which of course is huge. Right. But what I've learned over the past few years. There's a guy again, I have no affiliation with this company, but I was recommended this app called FlyKit F L Y K I T T. I used to struggle badly with jet lag. This thing has pretty much eliminated it for me. It is phenomenal. The guy who created it has worked with Navy SEALs for years and he said, yes, circadian biology is part of it, but flying particularly long flights is pro inflammatory. So there's a whole protocol around reducing inflammation through supplements, through compression sorts, through meals, at the right times, all kind of stuff. But that opened my mind to thinking, okay, I struggled if I ever went to America from here, like to the west coast, eight hour time difference, oh man, you know, I would really, really struggle with the time difference. The last couple of times I went and I followed the Flykit protocol to the letter, I was about 90% of the way there. You know, it was game changing. And one of the things the founder told me when I contacted him and spoke to him about this, he goes, the other thing you want to think about again, I don't really fly that much, so for a regular flyer this might be more important. He said, you can look at the, and I can't remember the models, but you can just Google this. But some of the newer models said they put their cabin pressure to the equivalent of 4 to 6,000ft, whereas the older planes, it's more 6 to 8,000ft. And I'm like, oh, wow. So I've actually started for this trip I've got in a couple of weeks. I don't think I've flown for ages. I'm actually looking at, oh, I can go in the morning or I can go in the afternoon. Oh, the afternoon flight is on a newer plane where they're only pressuring to 4,5000ft. And again, to some people this is going to be obsessive. But I'm thinking, well, if I'm going to be on a plane for 12 hours to LA, actually, I'm sure it'll make a massive difference. So I'd be interested, James, as part of your research. Maybe it's too complex, but it would be interesting to see if you notice a difference on the newer planes versus the older planes.
- [122:38]
James Nestor
I've been on every single Florida plane. I am constantly traveling. You know, maybe some years it'd be 100 days a year. Like, I'm on the road all the time. And what I've seen is it is consistently bad. Some are much worse than others, but it's consistently bad. And what we hope to do with this information isn't to shame people, isn't to point fingers. It's to say, we're watching you and if you improve your air quality, we'll also announce that too. And if we announce that more people are going to know about this, more people are going to take your flight over the competing flight. I think if airlines start to have more oxygen in the cabin to start treating the air a little better, it's going to make a massive difference to how you feel when you show up at that destination and will make you want to choose that airline more consistently.
- [123:34]
Dr. Rangan Chatterjee
As someone who probably doesn't want this label but is considered around the world now an expert in breathing and the breath, I'm interested that you travel so much and I'm really interested as to are there some things now that you never travel without based upon what you've
- [123:54]
James Nestor
learned and experienced through trial and error, I become one of those weirdos that has my little. I'm sorry. It's true. I never thought this would happen. I would mock these people endlessly, and now I'm one of them. So I have specific lights that I travel with. Right when I get into the hotel room, I switch off the bulbs and I have red lights or amber lights. So that's the number one thing. I travel either with neti pot if I know I'm going to have a source of distilled water, or with nasal spray, natural nasal sprays.
- [124:31]
Dr. Rangan Chatterjee
Is that in case you get sick on the road?
- [124:33]
James Nestor
No, it's preventative maintenance. So you think about, you're in an airplane. We know the air quality is not very good. People say, oh, I only fly business or first class because the air quality is so much better up there. I'm here, I have proof it is the exact same. So you can use another excuse to do that and that's fine, but don't say it's air quality. So if you use a nasal spray, you think of all the stuff you're exposed to on the airplane. I can't get sick when I'm on the road. I'm speaking at events, I'm doing research. If I get sick, it's a disaster. So I spray out my nose when.
- [125:08]
Dr. Rangan Chatterjee
When you land or when you get on the plane.
- [125:11]
James Nestor
I do it when I land. Sometimes if it's a long flight, 14 hour flight, I will go in the bathroom halfway through, spray it out a little bit. I also have another spray bottle with a diluted version of iodine. In there. If I feel a cold coming on, then there's been some good research into that. And that was especially effective for Covid. They found this is very, very effective.
- [125:35]
Dr. Rangan Chatterjee
Mouth tape on the plane?
- [125:36]
James Nestor
Never. I've seen people do it and I, you know.
- [125:39]
Dr. Rangan Chatterjee
Do you travel with mouth tape?
- [125:41]
James Nestor
I use it every single night, but wherever I am.
- [125:43]
Dr. Rangan Chatterjee
Okay, so you travel with it, you use it in the hotel, but why do you not use it on the plane?
- [125:48]
James Nestor
I just can't go that far. Okay. I'd love to give you another reason that's scientific, but I just can't. And I've noticed. I have noticed cause I pay attention to this. If I'm sleeping like this up in a chair, I tend to have my mouth closed. It's when I put my head on a pillow.
- [126:11]
Dr. Rangan Chatterjee
Wow.
- [126:12]
James Nestor
That I'll do that. But I've seen an increasing number of people rocking the mouth with their little hoodie and the eye thing, you know, and that's great.
- [126:20]
Dr. Rangan Chatterjee
Have you seen people mouth tape on a plane before? Yeah, yeah, yeah.
- [126:25]
James Nestor
Oh yeah, yeah. For four.
- [126:27]
Dr. Rangan Chatterjee
So they know it was you. So they're like, he's snacking.
- [126:28]
James Nestor
No, no, nobody knows it's me. Nobody cares.
- [126:31]
Dr. Rangan Chatterjee
They're giving you a secret sign like you got me inside.
- [126:33]
James Nestor
So everyone's jet lagged, you know, everyone's tired. You just go on and get, get the stuff done. So I think lights, a nasal spray, those breathing techniques you have in your back pocket when you're waiting in line at immigration. It's taking forever and you're tired and you sense your nervous system getting stressed out. Let's breathe into a count of around five or six. Let's breathe out. Let's do some humming. As I'm. When I'm at airports, if I'm early, I'm walking. And I just make this a habit. Even if that means an hour and a half, I'm walking. And if I'm walking, I'm for four steps in, four steps out. That's how I'm walking. When I am breathing and walking and humming and I'm just. As I'm talking about this, I'm just realizing what an absolute freak I have become. But it's kept me healthy.
- [127:25]
Dr. Rangan Chatterjee
It's got you healthy. You look well, you travel so much, you get sick very rarely. And I think it's easy to judge people and go, oh, they're doing this or they're doing that. But everyone's got their own reasons, haven't they? And you've obviously found over the years that actually, I'm sure writing breath has also massively influenced you. But you've probably just discovered that when you do it this way, you're well and you perform better. And that's your job. That's what you get paid to do.
- [127:50]
James Nestor
That's the reality. When I didn't do it this way, I was exhausted. I was getting sick before I would have to do a big. I was getting congested all the time. And I really felt the pain of travel. I still feel the pain, but it's less so. And. And all these things all together, you know, they just fit into a small little bag. It's not like I carry an extra suitcase filled with this stuff. It's just small, little stuff. And I can make my cozy little home in these hotel rooms, and I'm fine with that.
- [128:25]
Dr. Rangan Chatterjee
One thing we've not mentioned, I just want to quickly touch on, James, is this correlation between lung size and longevity. I think people who listen to my show and have them for a number of years will be very familiar with the idea that as you get older, you lose muscle mass. And really, as you get older, you want to make sure that you're doing something about it. Resistance training or whatever else it is you might do. You want to try and minimize how much you lose to be. Well, as you get older, lung size seems to follow a similar trajectory in the sense that as you get older, I think in your book, you write that between the ages of 30 and 50, you lose 12% of your lung capacity. And at 80 years old, 30% less air is coming in than it was, I think, when you were younger.
- [129:15]
James Nestor
That's right.
- [129:16]
Dr. Rangan Chatterjee
Right. So just give us a quick overview of lung size and longevity, if you will.
- [129:21]
James Nestor
So if you have a smaller gas tank, you have to fill up more often, Right? We know that. And every time you fill up, that's going to require you to exert more energy. You know, you have to stop. You have to fill up. So why would you want to do that? What you want to do is have a larger gas tank so you don't have to fill up that often. You can conserve that energy, and your body can use that energy to help restore itself. We know this is absolutely true with athletic performance, but it's also true with just in life. Taking fewer, deeper breaths is deeply restorative to the body. So at a time when we need as much energy as possible, when we are growing older, why would we want to take away our ability to breathe? These slower, deeper breaths that allow us to reserve more energy to repair our aging and ailing bodies. But the opposite happens, right? Our lungs start shrinking up, we lose flexibility in the musculature around here. That's why you see a lot of older people that are hunched over like this. If you are hunched over and your shoulders are like this, you can only breathe up into the chest. You see this all the time. And they're breathing through the mouth. Just so. Yoga was based on this premise. Early yoga was done seated, so it was done seated. It's sitting down, and Breathing and stretching and qigong. What is qigong? It's learning how to take qi from the air, expanding the lungs and keeping that flexibility. The good news is that you can change this at any time. Just like muscle mass, muscle mass actually takes a lot more effort and dedication to maintain and increase when you get older. But expanding your lungs and keeping flexibility here, this is relatively easy compared to that. And it will make a huge difference because again, taking fewer, deeper, softer breaths allows you more energy and less effort, less wear and tear on the body.
- [131:29]
Dr. Rangan Chatterjee
I think I've heard you say, James, or maybe you wrote about it, that lung size is maybe the metric that's correlated the most with longevity. Is it more than VO2 max and muscle mass?
- [131:42]
James Nestor
That's when this study was released in the 80s, the Framingham did, which was a 70 year longitudinal study, they found the number one most significant marker of lifespan was lung size and lung function. What that means is the quicker your lungs shrink, the quicker they become disease, the sooner you are going to die.
- [132:06]
Dr. Rangan Chatterjee
It makes me wonder is one of the reasons why movement and exercise is so good for our longevity is because generally when you're moving, and of course it depends whether you're walking or running or the intensity, but you know you are sort of working out your lungs, aren't you? They're getting moved and worked out. Whereas if you just sat watching television, hunched over on the sofa, those lungs are not really doing much, 100%. So it must be at least one of the factors.
- [132:36]
James Nestor
It's one of the exercise has so many benefits for the brain, for muscle mass, for the body. Of course it does. But that, that one part of lung capacity doesn't seem to be mentioned too much, not mentioned as much as it should. But just maintaining moderate exercise regimens allows you to increase especially smaller lungs, about 15% more lung capacity.
- [133:02]
Dr. Rangan Chatterjee
James, on my Instagram, when I mentioned yesterday that you were coming on, there was quite a lot of excitement and a few questions have come in. So I so new thing I'm trying is to see these sort of quick fire questions at the end. Are you good if I just go through a few of them? Let's do it firstly around children. Okay. Alex Miller says how can we encourage our children to have good breathing habits?
- [133:25]
James Nestor
Children don't care about being healthy. What they do care about is how they look. So I've spoken at a lot of different schools and I tell them about the benefits of nasal breathing, they're rolling their eyes, whatever, and then you show them a picture of their face if they are a chronic mouth breather and how it's gonna change their profile to have this retrognathic profile and crooked teeth and all that. And it scares the hell out of them. So I would suggest if you have teenagers, don't start with a health angle. Find a picture of a kid with adenoid face, that's the official term, or retrognathic facial growth, and show that to your kids. And they're gonna say, oh, my God, I want my face to grow differently than that. I'm gonna shut my mouth and become an obligate nasal breather.
- [134:13]
Dr. Rangan Chatterjee
Okay. Love it. Ali says, why do you think, James, that we're not taught about breath in school so we can appreciate it from a much earlier age?
- [134:22]
James Nestor
Why aren't we taught about nutrition in schools or exercise in schools? Hopefully that will change. But don't rely on these institutions or governments to do it. This is why shows like this are so important. Now you have the information, you can take this and develop your own program for yourself and your kids.
- [134:40]
Dr. Rangan Chatterjee
Another ally says, what's the one way of breathing you'd recommend to teenagers with anxiety?
- [134:48]
James Nestor
Unfortunately, this is gonna be a longer answer than you would hope it would be. The number one thing I would highly suggest you do is have your kid, if they suffer from anxiety, especially if they suffer from symptoms of adhd, to look at their sleep. There is more and more data coming out showing that the likely cause, not the effect, because of many cases of ADHD are directly tied to sleep disordered breathing. A kid is choking on themselves. A kid is snoring all night long. They wake up tired, they can't focus, they get cranky, it stunts their growth, they get sick all the time. So something like around 70 to 80% of kids with ADHD have sleep disordered breathing. Start with the breath, as I mentioned. Get that phone. Record your kid at night. If they are snoring or have sleep apnea, you have to fix that first. Then I can introduce a bunch of different breathing techniques that can bring the anxiety down. But start with the foundation.
- [135:54]
Dr. Rangan Chatterjee
Yeah, I love that, James. And I just wanna highlight something you said there. You said many cases of adhd, right? Because I know this is such a controversial area. You're not saying all cases?
- [136:04]
James Nestor
Absolutely not.
- [136:05]
Dr. Rangan Chatterjee
It could be a contributory factor at the very least. So let's look at it. But you're going beyond that. You're saying for some people it's actually causing it.
- [136:14]
James Nestor
But I will say, given that you're 100% right about that, given that you can do all these Other therapies. If your kid is snoring or suffering from sleep apnea or any sleep disorder, just having trouble breathing, it doesn't matter what other therapies you do. You have to fix that first.
- [136:33]
Dr. Rangan Chatterjee
Yeah. It also reminds me of something about a year ago, or not quite a year, Dr. Bryce Applebaum said to me, he's a phenomenal functional optometrist. And I went and done his five day intensive course near Baltimore, and it's phenomenal. And he says, let's say adhd, for example. And again, I don't want to misspeak for Bryce, but he says some version of. Until we've ruled out functional vision problems, I don't think a diagnosis of HGHD can be made, I. E. The principle being that is a collection of symptoms that we give a label. And what he's saying. And what you're saying is, look, there may be reasons for that that can be changed. He would argue that if you've got a functional vision problem and you can work on that and get it better, and the brain's working better, some of those symptoms will go. You're saying that it may be that your child has got sleep disorder breathing. Well, what happens if you correct that? Maybe it'll get better, maybe it'll get fully better. Maybe there'll be no symptoms, maybe there'll be less symptoms. It's just trying to look at these things in a slightly different way without getting triggered, just going, well, maybe there's something I can do that might help.
- [137:49]
James Nestor
I heard this. This is so creepy. I heard this exact same thing two weeks ago when I was talking to an optomet. He said, look at the amount of kids who have learning disabilities, and then look at the amount of kids who have vision problems. And those two diagrams almost completely overlap. And his thinking was, you have to first restore the vision problem, and then you can address these other things. And he has hundreds and hundreds of case studies showing that when these kids were able to. To have improved vision, the majority of their learning problems went away.
- [138:24]
Dr. Rangan Chatterjee
Yeah, same with Bryce. He's got those. And again, vision is not the same as eyesight. And if you want to go deeper on that, check out my podcast with Bryce where we go into all those differences. Okay. Jana said, what would be the one ultimate breathing exercise that one should do every day?
- [138:45]
James Nestor
You know, a lot of people ask me this. They think that I'm gonna whisper to them some mystical knowledge that I learned in some cave somewhere. But the exercises breathe through your nose. That's it. That's all. It doesn't have to be more complicated than that.
- [139:02]
Dr. Rangan Chatterjee
I'll finish up with this one from Jules. She says, what is your own go to breathing technique, James, for in the moment stress.
- [139:12]
James Nestor
In the moment stress. This is what I do. I relax my shoulders, I relax my tongue, I take an inhale, hold my breath. I take an inhale, hold my breath, take another inhale, all the way up, let it calmly out very slowly. Then I do it again. I take an inhale, hold, inhale, hold, inhale. And we're going to do it one more time, letting it out completely. We're going to inhale in, hold, inhale, hold, inhale, all the way up, let it out very calmly. That tends to reset me.
- [139:55]
Dr. Rangan Chatterjee
Yeah, love it. This is not a question, it's just a comment from Jackie who said, rangan, please tell James that his book was life changing for her. I know you hear that all the time from people all over the world. James. Honestly, I, as I said at the start, having you on for the third time was fantastic. Yes, because I've enjoyed this conversation. But over the last few days, it's given me another reason to dip back into breath. Obviously it's out now and I say, obviously, people may not know there's a newer version of it, the paperback, with some, you know, a new introduction, some new sections. It really is a phenomenal book. I can see why it's had such a. An amazing impact all over the world. To finish off, I'm just really interested. The book's almost been out for six years. Why is it, do you think that six years on from releasing this book, people are still wanting to talk to you about the topic of breath?
- [141:03]
James Nestor
I think that even though I am working on other projects, I've been working on a new book which is coming out next year. I keep getting pulled back into breathing and I think it has to do with a level of anger that parents have that other people have, that they had to learn about all of these fundamental abilities that we should be doing that are available for us for free, that anyone can do. They had to learn about it from a journalist in a book and not from their doctors, which they've been seeing for decades. And so the reason why I still enjoy doing these conversations is because these people are still angry and, and I want to make them less angry by giving them information. And they can take that information and choose to do with whatever they want with it. But I've found that that's become a side role for me, is trying to disseminate information to allow people to empower themselves.
- [142:17]
Dr. Rangan Chatterjee
Yeah. Well, James, I think you've done incredible work. Thank you for releasing the new edition. Thank you for continuously doing these interviews. Because with every single interview you do, there is at least gonna be one person who hears it who goes, oh my God. That might be why my child is, you know, abc. That might be why I struggle with my energy or whatever. It might be that may be why even though my diet and my exercise is dialed in, maybe the reason I'm exhausted all the time is cause I'm not breathing properly. So I want to thank you. I think it's a gift to the world this book. I've enjoyed getting to know you over the past few years and thanks for coming into the studio. Really appreciate it.
- [143:02]
James Nestor
Thanks very much for having me.
- [143:08]
Dr. Rangan Chatterjee
Really hope you enjoyed that conversation. Do think about one thing that you can take away from and apply into your own life and also have a think about one thing from this conversation that you can teach to somebody else. Remember, when you teach someone, it not only helps them, it also helps you learn and retain the information. Now, before you go, just wanted to let you know about Friday 5. It's my free weekly email containing five simple ideas to improve your health and happiness. In that email I share exclusive insights that I do not share anywhere else, including health advice, how to manage your time better, interesting articles or videos that I've been consuming, and quotes that have caused me to stop and reflect. And I have to say, in a world of endless emails, it really is delightful that many of you tell me it is one of the only weekly emails that you actively look forward to receiving. So if they if that sounds like something you would like to receive each and every Friday, you can sign up for free@drchatterjee.com Friday 5 Now if you are new to my podcast, you may be interested to know that I have written five books that have been bestsellers all over the world covering all kinds of different topics. Happiness, food, stress, sleep, behavior change and movement, weight loss, and so much more. So please do take a moment to check them out. They are all available as paperbacks, ebooks, and as audiobooks which I am narrating. If you enjoyed today's episode, it is always appreciated if you can take a moment to share the podcast with your friends and family or leave a review on Apple Podcasts. Thank you so much for listening. Have a wonderful week. And please note that if you want to listen to this show without any adverts at all, that option is now available for a small monthly fee on Apple and on Android. All you have to do is click the link in the episode notes in your podcast app. And always remember, you are the architect of your own health. Making lifestyle change is always worth it because when you feel better, you live more.
- [145:23]
James Nestor
Sam.