Breath by James Nestor

Breath by James Nestor is one of the best books I’ve read this year, a fascinating look at something we’re doing every second of every day yet hardly ever consciously think about: breathing. It’s jam packed with interesting stories throughout history, of scientists and every day people experimenting with their breath as a way to change their own physiology and health. Many of the tips offered in this book are very simple, like this: Breathing through your nose is beneficial and healthy. Breathing your mouth is bad. Like, really bad if you do it consistently, as they showed in an experiment where they blocked their noses for 2 weeks (every significant biomarker worsened). There are tons of stories from the book I’d love to share (my highlighted notes from Kindle come out to 78 pages and are included at the end), but first I want to go over some of the basic breathing practices and then showcase two of the more out there stories. Whether complex or stupidly easy, what amazes me most about these stories and techniques are how wide ranging the positive effects of breathing properly can be, impacting nearly every area of your health, including sleep, energy, immune system, decreased anxiety and depression, improved focus and cardiovascular health, just to name a few.

BREATHING EXERCISES

The practices below can help you calm down, lower your heartrate, and get to sleep easier. All of these take a few seconds to ten minutes of your day, but the positive effects from breathing properly can affect nearly every area of your health. I’m going to include helpful guided videos rather than text, since I find them easier to follow along with.

Box Breathing
Box breathing is used by Navy Seals to increase focus and relieve stress. This practice and the next are great to do before bed to fall asleep easier.

4-7-8 Breathing
This technique, made famous by Dr. Andrew Weil, places the body into a state of deep relaxation. It’s a little trickier than box breathing but Weil’s guided video is very helpful.

The Wim Hof Method or Tummo Breathing
I started doing the Wim Hof breathing practice consistently after reading this book, despite trying before and not maintaining it. I use this guided practice by the man himself on Youtube. This type of breathing is called Tummo, and there are two types. It has a long history, but Wim Hof has popularized it in recent years. His nickname is the Ice Man because he’s done marathons in snowy mountains in just shorts, and even fought off an infection purposefully injected in him using this breathing technique, while closely observed by doctors. The benefits are many, and while you can push past the beginner stage, I usually just follow it as is and, along with a cold shower in the morning, this lowers my heart rate by 5-10 BPM, which is pretty wild.

Breathhold Walking
“Anders Olsson uses this technique to increase carbon dioxide and, thus, increase circulation in his body. It’s not much fun, but the benefits, Olsson told me, are many. Go to a grassy park, beach, or anywhere else where the ground is soft. Exhale all the breath, then walk slowly, counting each step. Once you feel a powerful sense of air hunger, stop counting and take a few very calm breaths through the nose while still walking. Breathe normally for at least a minute, then repeat the sequence. The more you practice this technique, the higher the count. Olsson’s record is 130 steps; mine is about a third of that.”

Bonus: Double Inhale
This comes from the Stanford neuroscientist Andrew Huberman, who also has a podcast that covers all sorts of health, science, and biology related topics. This is by far the quickest, easiest breath technique to provide instant anxiety relief:
“This is the fastest way that I’m aware of that’s anchored in real known biology to calm oneself down…It’s an inhale through the nose, and then it’s another inhale at the top, and then a long exhale. That’s the fastest way to slow your heart down and calm down.”

NOSE BREATHING

One simple way to improve breathing through your nose if you struggle, is to place a small piece of micropore tape on your lips before bed. Sounds weird, and can be challenging at first, but this has been shown to cure snoring and all the ill effects caused by it. From the book:

“The health benefits of nose breathing are undeniable,” he told me. One of the many benefits is that the sinuses release a huge boost of nitric oxide, a molecule that plays an essential role in increasing circulation and delivering oxygen into cells. Immune function, weight, circulation, mood, and sexual function can all be heavily influenced by the amount of nitric oxide in the body. (The popular erectile dysfunction drug sildenafil, known by the commercial name Viagra, works by releasing nitric oxide into the bloodstream, which opens the capillaries in the genitals and elsewhere.) Nasal breathing alone can boost nitric oxide sixfold, which is one of the reasons we can absorb about 18 percent more oxygen than by just breathing through the mouth.

Mouth taping, Burhenne said, helped a five-year-old patient of his overcome ADHD, a condition directly attributed to breathing difficulties during sleep. It helped Burhenne and his wife cure their own snoring and breathing problems. Hundreds of other patients reported similar benefits. The whole thing seemed a little sketchy until Ann Kearney, a doctor of speech language pathology at the Stanford Voice and Swallowing Center, told me the the same. Kearney helped rehabilitate patients who had swallowing and breathing disorders. She swore by mouth taping.

Kearney herself had spent years as a mouthbreather due to chronic congestion. She visited an ear, nose, and throat specialist and discovered that her nasal cavities were blocked with tissue. The specialist advised that the only way to open her nose was through surgery or medications. She tried mouth taping instead. “The first night, I lasted five minutes before I ripped it off,” she told me. On the second night, she was able to tolerate the tape for ten minutes. A couple of days later, she slept through the night. Within six weeks, her nose opened up. “It’s a classic example of use it or lose it,” Kearney said. To prove her claim, she examined the noses of 50 patients who had undergone laryngectomies, a procedure in which a breathing hole is cut into the throat. Within two months to two years, every patient was suffering from complete nasal obstruction.

Like other parts of the body, the nasal cavity responds to whatever inputs it receives. When the nose is denied regular use, it will atrophy. This is what happened to Kearney and many of her patients, and to so much of the general population. Snoring and sleep apnea often follow. Keeping the nose constantly in use, however, trains the tissues inside the nasal cavity and throat to flex and stay open. Kearney, Burhenne, and so many of their patients healed themselves this way: by breathing from their noses, all day and all night.

ANXIETY AND CARBON DIOXIDE

A more complex and counterintuitive story in the book explains how carbon dioxide is just as important to breathing as oxygen, and could be the key to resolving extreme anxiety in many.

“Those with the worst anxieties consistently suffer from the worst breathing habits. People with anorexia or panic or obsessive-compulsive disorders consistently have low carbon dioxide levels and a much greater fear of holding their breath. To avoid another attack, they breathe far too much and eventually become hypersensitized to carbon dioxide and panic if they sense a rise in this gas. They are anxious because they’re overbreathing, overbreathing because they’re anxious.”

One way to promote proper carbon dioxide levels is to consciously practice breath holding. Techniques like this date back thousands of years to ancient Chinese and Indian texts. Eventually, mixtures of carbon dioxide and oxygen were used to treat all sorts of maladies in the 1900s. But essentially all of that went by the wayside after the 1950’s.

“What’s interesting to me is that nobody disproved it,” says Feinstein of carbon dioxide therapy. “The data, the science, still holds today.” He tells me how he’d stumbled upon some obscure studies by Joseph Wolpe, a renowned psychiatrist who rediscovered carbon dioxide therapy as a treatment for anxiety and had written an influential paper about it in the 1980s. Wolpe’s patients shared stunning and long-lasting improvements after just a few huffs. Donald Klein, another renowned psychiatrist and expert in panic and anxiety, suggested years later that the gas might help reset the chemoreceptors in the brain, allowing patients to breathe normally so they could think normally. Since then, few researchers have studied the treatments. (Feinstein estimates there are about five researching it now.) He just kept wondering if the early researchers were right, if this ancient gas might be remedy to modern ailments.

Feinstein has just been awarded a five-year NIH grant to test the use of inhaled carbon dioxide on patients with panic and anxiety disorders. After his experience administering the gas to S. M. and the German twins with Urbach-Wiethe disease, he’d become convinced carbon dioxide could not only cause panic and anxiety, but that it might also help cure it. He believed that breathing heavy doses of carbon dioxide might elicit the same physical and psychological benefits as the thousand-year-old breathholding techniques. But his therapy didn’t require patients to actually hold their breath or block their throats and count to one hundred with clenched hands like the ancient Chinese. His patients were far too anxious and impatient to practice such an intense technique. Carbon dioxide did all that for them. They’d come in, think about whatever they wanted to think about, take a few inhales of the gas, flex their chemoreceptors back to normal, and be on their way. It was the ancient art of breathholding for those people too anxious to hold their breath.

It’s already showing promising results, and the author even details his own experience under Feinstein’s gas mixture. It’s an unpleasant practice used in extreme cases, and seems counter-intuitive, but it could prove to be a tremendous help to patients who need it, avoiding the need for pharmaceuticals.

Further Notes
Finally, as mentioned, here are the 78 pages of notes I highlighted while reading on my Kindle. The appendix is copied first and is a good primer on what’s covered in the book. If you read my notes and find it useful or interested, I highly recommend reading the whole book.