Can deep breathing be beneficial for people with respiratory conditions such as chronic obstructive pulmonary disease (COPD)? Several studies suggest that it can. But what is deep breathing and what does it entail? And how might deep breathing techniques fit in with conventional treatments for respiratory disorders?
COPD is an often-preventable chronic inflammatory lung disease often referred to as emphysema or chronic bronchitis. Smoking tobacco is a major risk factor for COPD, but non-smokers may develop it too.
A progressive and incurable disease, COPD slowly inflames and thickens lung airways and destroys the tissues where oxygen is exchanged. As one’s air flow becomes constricted, the body has to work harder to function, so COPD is known for causing shortness of breath and severe fatigue. COPD causes serious long-term disability and is the third leading cause of death globally.
In addition to COPD, other causes of poor breathing include asthma; heart problems; anxiety; stress; and infection in the airways from conditions such as croup, bronchitis, pneumonia and colds.
Exploring “Free Diving” Techniques for Problematic Lung Conditions
The conventional treatment for problematic lung conditions is pulmonary rehabilitation, which consists mainly of a physical exercise program along with instruction and a regimen designed to care for the body and lungs.
While length of pulmonary rehabilitation courses can vary widely, the uncomfortable symptoms of COPD can make participation in physical activity unpleasant. So, these rehab programs, while helpful, are prone to significant dropout rates, and it can be difficult to keep patients motivated enough to continue exercising after completion of the program.
A common exercise in pulmonary rehabilitation is pursed lip breathing (PLB). This involves exhalation through tightly pressed lips, followed by inhalation with the mouth closed, which reduces air trapping and reduces the amount of work in breathing.
In diaphragmatic breathing (DB), patients inhale deeply and slowly through the nose for ten seconds, followed by deep and slow exhalation.
See the role of the diaphragm in breathing (left).
What about the breath-holding techniques used by “free divers” who go deep into water for many minutes without scuba gear?
A six-week pilot study (Borg, M et al (2021) conducted by Danish researchers investigated this idea. Nine female patients with moderate to severe COPD were shown breathing techniques tailored for COPD patients by free divers from the Danish national free diving team. The techniques included learning how to inhale to full lung capacity, use PLB to release while performing side bends, and breathe in a rhythm adapted to gait and activity.
The aim was to enable COPD patients to experience shortness of breath in a safe environment while performing moderate exercises and walking. The study found that participants were able to increase the distance walked in six minutes by 48.5 metres (52 yards) and significantly reduce their respiratory rate from 22 to 19 breaths per minute during the recovery period. (The normal adult respiration rate is 12 to 16 breaths per minute).
This small, explorative study suggested that COPD patients could both benefit from—and adhere to—these new breathing techniques in daily life. “We believe the results are promising” and worthy of a large, randomized trial to compare their efficacy to conventional pulmonary rehabilitation, wrote lead researcher Dr. Morten Borg, Department of Respiratory Diseases at Aalborg University Hospital in Aalborg, Denmark.
Stress and Breathing—Helpful Techniques
Under normal circumstances, people do not pay much attention to their breathing—it’s easy and automatic. However, no one is immune to stress, and under certain circumstances, high levels of stress can greatly impact breathing.
Patrick McKeown is an internationally acclaimed breathing coach, speaker, and author of The Breathing Cure: Develop New Habits for a Healthier, Happier and Longer Life.
He notes that stress often prompts the body to take in more oxygen than it actually needs (over-breathing or chronic hyperventilation), thanks to a pattern of fast and shallow breathing. Put another way, taking short breaths of air when stressed is not helpful because the air goes no further than the upper chest, and that can perpetuate more stress while causing less oxygen to reach vital human organs.
McKeown advocates learning to breathe through the nose rather than the mouth. Nose-breathing, he says, improves the quality of the inhaled air before it enters the lungs and provides a line of defense against viruses and bacteria. He claims that nose-breathing results in 10% to 20% better oxygenation of internal organs and cells, and also introduces nitric oxide (NO) into the body—the latter is produced in sinuses around
the nose and sterilizes air during breathing. NO is known to act as an antifungal, antiviral, and antibacterial agent, as well as a bronchodilator in the lungs.
McKeown suggests the use of breathing exercises to resolve stress, reduce anxiety, avoid headaches, and lessen back pain.
Here is one such technique:
Sit in a straight-backed chair
Calm your breathing by taking in a small breath for two seconds through your nose, and then another small breath, this time for three seconds, through your mouth.
Pinch your nose to hold your breath, keeping the mouth closed.
Gently nod your head up and down or sway from side to side until you can’t hold your breath any longer.
Let go of your nose and breathe gently through it. This will make your breathing calmer and more relaxed, and it will remove any blockage in the nose.
Other Deep Breathing Techniques
Studies of Hatha Yoga, which emphasizes deep breathing and the importance of posture, have found various benefits including reduced stress, easing depression and anxiety, and increasing muscle flexibility.
Meanwhile, Dutch “extreme athlete” Wim Hof says certain “conscious” deep-breathing techniques can help people succeed in difficult situations like mountain-climbing, and heighten focus, reduce stress, and build a stronger immune system to fight disease. His method includes two more pillars: intentional exposure to cold weather (which can lead to a build-up of desirable brown adipose tissue and reduction of inflammation), and development of personal will power and commitment.
Among conventional medical practitioners and the American Lung Association, PLB and DM are still the top deep-breathing techniques.
Deep breathing is also often recommended as a means of recovery from COVID-19. However, some precautions are recommended, including avoidance of forced or prolonged expiration. The use of home air purifiers can also aid healthy breathing, but it’s important to choose the right air purifier for particular respiratory conditions.
While many people are able to take breathing for granted, those who develop respiratory conditions may find deep-breathing techniques to be quite beneficial for the relief of constrained airways and stress. Numerous studies support this approach, particularly for patients of COPD. However, it’s important to consult professional practitioners first, so that the techniques involved can be performed properly and efficiently.
*Robin Whitlock is an England-based freelance journalist specializing in environmental issues, climate change, and renewable energy, with a variety of other professional interests including green transportation.