Date: 02/08/2008
What needs to happens to fall asleep? We fall asleep at night when we are relaxed, when our blood CO2 levels increase, and when our brain waves change toward an increase in the production of Alpha and Theta brain waves. In Stage 1 sleep the levels of Alpha decrease as levels of Theta brain waves increase. For those who understand EEGs, there will be bursts of activity at 14hz . This is a sensory motor rhythm. If if does not occur then sleep onset is usually difficult.
In EEG terms, if you don?t generate 15-18 hz or sufficient Beta brainwave and stage V sleep, you may have trouble staying asleep. This person goes through stages I, II, III and then hangs out in Delta, never getting into restorative REM (rapid eye movement) sleep. In stage IV sleep (REM), Theta, Alpha and Beta are all produced with little Delta. This is restorative sleep. Stage III is Delta sleep and is not restorative.
STAGE 1: In this stage the modulatory neurons become less active. On the EEG one will see declining levels of Alpha as Theta levels begin to increase. Awareness drifts and word based thinking ceases. Image based thinking may increase.
STAGE 2: NonREM sleep deepens in state two. The sensory motor rhythm (14hz) is required to move into this stage.
(People who have difficulty falling asleep need training in SMR or sensory rhythm production or perhaps 21hz.
Without the production of SMR these individuals will toss and turn, engage in mind chatter, have a racing mind and not be able to fall asleep.)
STAGE 3: Onset of REM sleep. Norepinephrine and serotonin are essentially shut down, while acetylcholine neurons are fully active. There is a drop down into Delta. Unless they can continue on into REM sleep they will not feel rested, restored, and instead, will wake feeling tired, groggy, and grumpy. They might just begin dreaming and then wake up into stage-one sleep, only slightly remembering their dreams.
STAGE 4 or REM sleep: This is dreaming sleep, when we are without muscle tone, paralyzed, and EEG is fast and eyes are moving back and forth (REM). When we are learning new things we spend more time in REM sleep. If interrupted, we remember less the next day. Acetylcholine during sleep seems to be the agent of remembering. On the EEG one will see high levels of Alpha, Theta and Beta, but not much Delta. Those who don?t make Beta will have difficulty waking and will feel drugged and need their ?caffeine?.
Sleep drugs usually have a two week cycle before one becomes sensitized and needs more. Effectiveness of these drugs is usually based on sleep improvement. Questions to ask yourself about sleep are:
Do you fall asleep easily?
How long does it take to fall asleep?
Do you wake frequently and are you able or unable to fall back to sleep?
Do you dream?
Do you remember your dreams?
Do you feel rested after a night?s sleep?
Do you feel fatigued and feel like you have to drag yourself out of bed?
Waking frequently in a dream indicates a return to beta during dreaming. This is usually the mother who hears her baby crying, the ?light-sleeper? who reports waking to the slightest noise, movement, provocation, etc. While sometimes necessary, getting out of this habit once beyond the need for it may require some training to break the habit. What is probably taking place here is the lack of periodicity or normal 90 minute cycling through the 4-6 sleep periods during the night. This interferes with the normal restorative process of sleep. Using earplugs, white noise, ocean waves, a fan, air-conditioner can help to break this pattern. One clue to identifying this pattern is a report that they ?always wake-up? at such and such a time?.
One of the most important aspects about falling asleep is blood CO2 level. As we rest and relax and arterial CO2 increases, we get sleepy and that is when we fall asleep.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
An elevation in blood CO2 level is important for falling asleep, staying asleep and sleeping well. CO2 is important for relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing.
http://www.theMangoTreeSpa.com
Friday, September 11, 2009
WHAT IS SLEEP?
Date: 02/08/2008
What is sleep? Most of our information on sleep has come from EEG?s. On the average we spend one-third of our lives sleeping or 8 hours each night. While the amount of sleep required by individuals actually varies considerably, the figure of 8 hours may have come from Sir Thomas Mores Utopia. In a classic bell curve of sleep the range is from 4.5 to 10.5 hours. The length of sleep does not seem to correlate with intelligence or personality. Thomas Edison and Napoleon slept only a few hours, Einstein slept for long periods and Michael Angelo took 15-minute catnaps every hour. Up until age ten, we sleep 25 percent more than the rest of our lives. This is also when most learning takes place. In total we sleep one third of our lives.
Sleep is necessary for learning and consolidation of information. While not fully explained, sleep is thought to be related to brain restoration and consolidation of new learning. The hippocampus seems to be involved in this process and receives increased levels of acetylcholine during sleep. We spend more time in REM sleep when we are learning new things. Interrupted REM sleep causes us to remember less well the next day. There is much controversy on whether we learn as we are falling off to sleep. Apparently, information needs to already be in the system.
What is REM sleep? This is a stage of desynchronized sleep when all muscle tone is lost, where the EEG is firing in a fast manner (much as in wakefulness), rapid eye movement occurs (REM), and sleepers are difficult to wake.
When does dreaming occur? Dreaming occurs during REM sleep. The sleeper is very much in a paralyzed state. If awakened during REM sleep, dream recall is 80 to 95 percent. Those who awake at other times dont recall their dreams.
Normal sleepers go through regular cycles of REM sleep alternating with four levels of non-REM sleep.
The important thing about sleep is regulation. How much may not be as much the issue as regular and enough for us as individuals as being more important an issue. Sleep deprivation studies have shown that without sleep, death will occur within 4-6 weeks. Body weight and temperature are seriously dis-regulated by lack of sleep. Without sleep our thermoregulation goes haywire. Sleep is also an energy and heat conserving response of our being. Studies by J. Kiecolt-Glasser have shown a decreased ability to resist infection with improper, lack-of, or stressful sleep. Sleep is a dramatic condition during which memories are consolidated, restorative hormones released, and neuronal excitability modulated. Regulated sleep is important.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
An elevation in blood CO2 level is important for falling asleep, staying asleep and sleeping well. C02 is important for relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing. http://www.theMangoTreeSpa.com
What is sleep? Most of our information on sleep has come from EEG?s. On the average we spend one-third of our lives sleeping or 8 hours each night. While the amount of sleep required by individuals actually varies considerably, the figure of 8 hours may have come from Sir Thomas Mores Utopia. In a classic bell curve of sleep the range is from 4.5 to 10.5 hours. The length of sleep does not seem to correlate with intelligence or personality. Thomas Edison and Napoleon slept only a few hours, Einstein slept for long periods and Michael Angelo took 15-minute catnaps every hour. Up until age ten, we sleep 25 percent more than the rest of our lives. This is also when most learning takes place. In total we sleep one third of our lives.
Sleep is necessary for learning and consolidation of information. While not fully explained, sleep is thought to be related to brain restoration and consolidation of new learning. The hippocampus seems to be involved in this process and receives increased levels of acetylcholine during sleep. We spend more time in REM sleep when we are learning new things. Interrupted REM sleep causes us to remember less well the next day. There is much controversy on whether we learn as we are falling off to sleep. Apparently, information needs to already be in the system.
What is REM sleep? This is a stage of desynchronized sleep when all muscle tone is lost, where the EEG is firing in a fast manner (much as in wakefulness), rapid eye movement occurs (REM), and sleepers are difficult to wake.
When does dreaming occur? Dreaming occurs during REM sleep. The sleeper is very much in a paralyzed state. If awakened during REM sleep, dream recall is 80 to 95 percent. Those who awake at other times dont recall their dreams.
Normal sleepers go through regular cycles of REM sleep alternating with four levels of non-REM sleep.
The important thing about sleep is regulation. How much may not be as much the issue as regular and enough for us as individuals as being more important an issue. Sleep deprivation studies have shown that without sleep, death will occur within 4-6 weeks. Body weight and temperature are seriously dis-regulated by lack of sleep. Without sleep our thermoregulation goes haywire. Sleep is also an energy and heat conserving response of our being. Studies by J. Kiecolt-Glasser have shown a decreased ability to resist infection with improper, lack-of, or stressful sleep. Sleep is a dramatic condition during which memories are consolidated, restorative hormones released, and neuronal excitability modulated. Regulated sleep is important.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
An elevation in blood CO2 level is important for falling asleep, staying asleep and sleeping well. C02 is important for relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing. http://www.theMangoTreeSpa.com
CO2 AND FALLING ASLEEP: THE STAGES OF SLEEP AND WHAT THEY LOOK LIKE ON A PET SCAN
Date: 02/08/2008
Normal sleepers go through regular cycles of REM sleep alternating with four levels of nonREM sleep.
WAKEFULLNESS:? The brain is bathed in constant levels of neurotransmitters, norepinephrine and serotonin with spikes of acetylcholine under novel conditions.
SLEEP:
STAGE 1: In this stage the modulatory neurons become less active. On the EEG one will see declining levels of Alpha as Theta levels begin to increase. Awareness drifts and word based thinking ceases.? Image based thinking may increase.
STAGE 2:? NonREM sleep deepens in state two. The sensory motor rhythm (14hz) is required to move into this stage.
(People who have difficulty falling asleep need training in SMR or perhaps 21hz.
Without the production of SMR these individuals will toss and turn, engage in mind chatter, have a racing mind and not be able to fall asleep.)
STAGE 3:Onset of REM sleep. Norepinephrine and serotonin are essentially shut down, while acetylcholine neurons are fully active. There is a drop down into Delta. Unless they can continue on into REM sleep they will not feel rested, restored, and instead, will wake feeling tired, groggy, and grumpy. They might just begin dreaming and then wake up into stage-one sleep, only slightly remembering their dreams.
STAGE 4 or REM sleep: This is dreaming sleep, when we are without muscle tone, paralyzed, and EEG is fast and eyes are moving back and forth (REM). When we are learning new things we spend more time in REM sleep.If interrupted, we remember less the next day.? Acetylcholine during sleep seems to be the agent of remembering. On the EEG one will see high levels of Alpha, Theta and Beta, but not much Delta. Those who dont make Beta will have difficulty waking and will feel drugged and need their caffeine.
In a typical 8-hour sleep period, 20-25 percent will be spent in REM sleep and the rest in nonREM sleep.? Normals cycle the above stages 4-6 times throughout the night. REM begins in the first round about 60-80 minutes after falling asleep. The stages repeat after about 10 minutes of REM. With each cycling the REM periods increase and nonREM decreases. This is why most dreams occur in the early morning hours. The average 70 year old has spent 6 years dreaming.
WAKEFULLNESS STAGE 1 STAGE 11 STAGE 111 STAGE 1V
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
An elevation in blood CO2 level is important for falling asleep, staying asleep and sleeping well. C02 is important for relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing.
http://www.theMangoTreeSpa.com
Normal sleepers go through regular cycles of REM sleep alternating with four levels of nonREM sleep.
WAKEFULLNESS:? The brain is bathed in constant levels of neurotransmitters, norepinephrine and serotonin with spikes of acetylcholine under novel conditions.
SLEEP:
STAGE 1: In this stage the modulatory neurons become less active. On the EEG one will see declining levels of Alpha as Theta levels begin to increase. Awareness drifts and word based thinking ceases.? Image based thinking may increase.
STAGE 2:? NonREM sleep deepens in state two. The sensory motor rhythm (14hz) is required to move into this stage.
(People who have difficulty falling asleep need training in SMR or perhaps 21hz.
Without the production of SMR these individuals will toss and turn, engage in mind chatter, have a racing mind and not be able to fall asleep.)
STAGE 3:Onset of REM sleep. Norepinephrine and serotonin are essentially shut down, while acetylcholine neurons are fully active. There is a drop down into Delta. Unless they can continue on into REM sleep they will not feel rested, restored, and instead, will wake feeling tired, groggy, and grumpy. They might just begin dreaming and then wake up into stage-one sleep, only slightly remembering their dreams.
STAGE 4 or REM sleep: This is dreaming sleep, when we are without muscle tone, paralyzed, and EEG is fast and eyes are moving back and forth (REM). When we are learning new things we spend more time in REM sleep.If interrupted, we remember less the next day.? Acetylcholine during sleep seems to be the agent of remembering. On the EEG one will see high levels of Alpha, Theta and Beta, but not much Delta. Those who dont make Beta will have difficulty waking and will feel drugged and need their caffeine.
In a typical 8-hour sleep period, 20-25 percent will be spent in REM sleep and the rest in nonREM sleep.? Normals cycle the above stages 4-6 times throughout the night. REM begins in the first round about 60-80 minutes after falling asleep. The stages repeat after about 10 minutes of REM. With each cycling the REM periods increase and nonREM decreases. This is why most dreams occur in the early morning hours. The average 70 year old has spent 6 years dreaming.
WAKEFULLNESS STAGE 1 STAGE 11 STAGE 111 STAGE 1V
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
An elevation in blood CO2 level is important for falling asleep, staying asleep and sleeping well. C02 is important for relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing.
http://www.theMangoTreeSpa.com
CAPNOTRAINER
Capno Trainer
For observing, evaluating, and learning breathing behavior
A break-through product! The ultimate in breathing education!
Did you know that allocation of carbon dioxide, through breathing, directly regulates body pH, electrolyte balance, blood distribution, hemoglobin chemistry, and kidney function?
A MUST FOR ALL THOSE WHO DO BREATHING TRAINING!
capno trainer $3000.00
Detect bad breathing and learn good breathing with the CapnoTrainer ®.
Learned overbreathing behavior leads to exhaling too much CO2,
resulting in extracellular alkalinity. Shifts in pH may account for “unexplained” symptoms, psychological changes, effects of stress, and performance deficits.
PRACTICAL APPLICATIONS
Use the CapnoTrainer® for detecting bad breathing behavior and leaming good breathing behavior.
*Pinpoint optimal breathing mechanics for acid-base balance.
*Discover the tríggers for good and bad breathing pattems.
*See how thoughts, moods, and emottons are changed by breathing.
*Learn how mental and physical performance is alterad by breathing.
*Evalúate the effects of breathing on leaming, memory, and attention.
*See how breathing behavior and defensiveness may be reiated.
*Examine how pain, injury, discomfort, and breathing may be linked.
*Discover how breathing may be mediating unexplained symptoms.
*A Test for anaerobia threshold during fitness training by monitoring CO2.
*Use breathing as a way of exploring awareness and consciousness.
*Lean what good and bad breathing behaviors feel like.
*Help people overcome their fears about breathing.
*Teach embracement through breathing and heart varíability training.
*Learn to breathe intuitively, inside-out, rather than prescríptively, outside-in.
If you are an educator, trainer, coach, or therapist, the CapnoTrainer® serves as an important adjunctive tool.
peak performance training, relaxation training, attention training, alertness training, meditation, patient educatíon, stress management, childbirth training, motivational training, public speaking, leaming enhancement, anxiety management (e.g., testing), anger management, mastering performance challenges (e.g., in aviation), athletic training, and breathing training of all kinds.
Overbreathing (CO2 deficit) can cause, trigger, or exacerbate physical symptoms, performance deficits, and psychological complaints.
shortness of breath, breathlessness, chest tightness/pressure, chest pain, feelings of suffocation, sweaty palms, cold hands, tingling of the skin, numbness, heart palpitations, irregular heart beat, anxiety, apprehension, emotional outbursts, stress, tenseness, fatigue, weakness, exhaustion, dry mouth, nausea, light-headedness, dizziness, fainting, black-out, blurred visión, confusión, disorientatbn, attention deficit, poor thinking, poor memory, poor concentration, impaired judgment, problem solving deficit, reduced pain threshold, headache, trembling, twitching, shivering, muscle tension, spasm, stiffness, abdominal cramps, and bloatedness.
In predlsposed individuals, overbreathing (CO2 deficit) can trigger or exacerbate acute and chronic conditions:
phobias (e.g., public speaking), migraine phenomena, hypertension, attentíon disorder, asthma attacks, angina attacks, heart attacks, panic attacks, hypoglycemia, ischemia (e.g., tissue hypoxia), depression, epileptic seizures, sexual dysfunction, sleep disturbances, allergy, irritable bowel syndrome, repetitive strain injury, and chronic fatigue.
RESTRICTED USE:
The CapnoTrainer is an educational instrument designed for enhancing performance through leaming and teaching good breathing behavior. It is not intended for medical diagnosis or treatment.
SOFTWARE APPLICATIONS
The software runs on PC computers and operates within Windows 98 (second edition), Millennium, 2000, NT, XP, and Vista environments.
Observe the following physiology:
CO2 waveform, in mmHg: airflow pattern Breathing rhythmicity: breath holding, gasping, End-tidal C02(ETC02), in mmHg: overbreathing, Coordinating breath: rate and depth, Breathing rate averages, in breaths per minute
Heart Rate, beat to beat calculations: heart rate variability, Breathing Heart Wave (BHW): parasympathetic tone, BHW amplitude, in beats per minute: degree of relaxation, Heart Rate (HR) averages (traditional measurement)
Advanced Optlon for HRV training:
Multiple heart wave frequencies (HF/LFA/LF) Frequency analysis of heart rate variability (HRV DFT) Differential autonomic nervous system measurements
SOFTWARE FEATURES
*Signals displayed alone and in multiple combinations, Signals displayed in multiple graphic formats
*Live history screens, showing whole or part of session Evaluation, training, and observational screens
*Multi-graph and multi-signal data review screens
*Zoom function, select graph & signal, Gain & Auto-gain, Signal offset & Auto-center *Screen sweep time, slower/faster, Freeze screen immediately, Pause screen, end of sweep *Refresh screen, Signal hiding, Averaging function
*Set signal threshold & auto-threshold
*Audio feedback for signal changes (options menu), Event marker, draws line and records note
*Select predefined task periods, e.g., baseline
*Data recording on/off, pause, and erase
*Print screen opttons, Uve or recorded data screens
*Save "screen feature" adjustments to trainee name
*Save sessions to "trainee" files/names
*Setect from among easy to use graphical data reports
*Review recorded data in "tape recorder" fashion
*Review, formal, and save graphical reports as desired
*Digital cursor for numerícal readout on graphs
*Generate automatic Quick reports and Excel reports
*Select predefined evaluation and training schedules
*Define your own automated task schedules
*Use built-in breathing questionnaire form
*View HELP Windows for education and teaching
*Read detailed INFO HELP screens for each screen display
Please contact us if you would like more information or would like to purchase this machine. 506 2786 5300 info@themangotreespa.com
For observing, evaluating, and learning breathing behavior
A break-through product! The ultimate in breathing education!
Did you know that allocation of carbon dioxide, through breathing, directly regulates body pH, electrolyte balance, blood distribution, hemoglobin chemistry, and kidney function?
A MUST FOR ALL THOSE WHO DO BREATHING TRAINING!
capno trainer $3000.00
Detect bad breathing and learn good breathing with the CapnoTrainer ®.
Learned overbreathing behavior leads to exhaling too much CO2,
resulting in extracellular alkalinity. Shifts in pH may account for “unexplained” symptoms, psychological changes, effects of stress, and performance deficits.
PRACTICAL APPLICATIONS
Use the CapnoTrainer® for detecting bad breathing behavior and leaming good breathing behavior.
*Pinpoint optimal breathing mechanics for acid-base balance.
*Discover the tríggers for good and bad breathing pattems.
*See how thoughts, moods, and emottons are changed by breathing.
*Learn how mental and physical performance is alterad by breathing.
*Evalúate the effects of breathing on leaming, memory, and attention.
*See how breathing behavior and defensiveness may be reiated.
*Examine how pain, injury, discomfort, and breathing may be linked.
*Discover how breathing may be mediating unexplained symptoms.
*A Test for anaerobia threshold during fitness training by monitoring CO2.
*Use breathing as a way of exploring awareness and consciousness.
*Lean what good and bad breathing behaviors feel like.
*Help people overcome their fears about breathing.
*Teach embracement through breathing and heart varíability training.
*Learn to breathe intuitively, inside-out, rather than prescríptively, outside-in.
If you are an educator, trainer, coach, or therapist, the CapnoTrainer® serves as an important adjunctive tool.
peak performance training, relaxation training, attention training, alertness training, meditation, patient educatíon, stress management, childbirth training, motivational training, public speaking, leaming enhancement, anxiety management (e.g., testing), anger management, mastering performance challenges (e.g., in aviation), athletic training, and breathing training of all kinds.
Overbreathing (CO2 deficit) can cause, trigger, or exacerbate physical symptoms, performance deficits, and psychological complaints.
shortness of breath, breathlessness, chest tightness/pressure, chest pain, feelings of suffocation, sweaty palms, cold hands, tingling of the skin, numbness, heart palpitations, irregular heart beat, anxiety, apprehension, emotional outbursts, stress, tenseness, fatigue, weakness, exhaustion, dry mouth, nausea, light-headedness, dizziness, fainting, black-out, blurred visión, confusión, disorientatbn, attention deficit, poor thinking, poor memory, poor concentration, impaired judgment, problem solving deficit, reduced pain threshold, headache, trembling, twitching, shivering, muscle tension, spasm, stiffness, abdominal cramps, and bloatedness.
In predlsposed individuals, overbreathing (CO2 deficit) can trigger or exacerbate acute and chronic conditions:
phobias (e.g., public speaking), migraine phenomena, hypertension, attentíon disorder, asthma attacks, angina attacks, heart attacks, panic attacks, hypoglycemia, ischemia (e.g., tissue hypoxia), depression, epileptic seizures, sexual dysfunction, sleep disturbances, allergy, irritable bowel syndrome, repetitive strain injury, and chronic fatigue.
RESTRICTED USE:
The CapnoTrainer is an educational instrument designed for enhancing performance through leaming and teaching good breathing behavior. It is not intended for medical diagnosis or treatment.
SOFTWARE APPLICATIONS
The software runs on PC computers and operates within Windows 98 (second edition), Millennium, 2000, NT, XP, and Vista environments.
Observe the following physiology:
CO2 waveform, in mmHg: airflow pattern Breathing rhythmicity: breath holding, gasping, End-tidal C02(ETC02), in mmHg: overbreathing, Coordinating breath: rate and depth, Breathing rate averages, in breaths per minute
Heart Rate, beat to beat calculations: heart rate variability, Breathing Heart Wave (BHW): parasympathetic tone, BHW amplitude, in beats per minute: degree of relaxation, Heart Rate (HR) averages (traditional measurement)
Advanced Optlon for HRV training:
Multiple heart wave frequencies (HF/LFA/LF) Frequency analysis of heart rate variability (HRV DFT) Differential autonomic nervous system measurements
SOFTWARE FEATURES
*Signals displayed alone and in multiple combinations, Signals displayed in multiple graphic formats
*Live history screens, showing whole or part of session Evaluation, training, and observational screens
*Multi-graph and multi-signal data review screens
*Zoom function, select graph & signal, Gain & Auto-gain, Signal offset & Auto-center *Screen sweep time, slower/faster, Freeze screen immediately, Pause screen, end of sweep *Refresh screen, Signal hiding, Averaging function
*Set signal threshold & auto-threshold
*Audio feedback for signal changes (options menu), Event marker, draws line and records note
*Select predefined task periods, e.g., baseline
*Data recording on/off, pause, and erase
*Print screen opttons, Uve or recorded data screens
*Save "screen feature" adjustments to trainee name
*Save sessions to "trainee" files/names
*Setect from among easy to use graphical data reports
*Review recorded data in "tape recorder" fashion
*Review, formal, and save graphical reports as desired
*Digital cursor for numerícal readout on graphs
*Generate automatic Quick reports and Excel reports
*Select predefined evaluation and training schedules
*Define your own automated task schedules
*Use built-in breathing questionnaire form
*View HELP Windows for education and teaching
*Read detailed INFO HELP screens for each screen display
Please contact us if you would like more information or would like to purchase this machine. 506 2786 5300 info@themangotreespa.com
UNDERSTANDING THE ROLES OF OXYGEN AND CARBON DIOXIDE
UNDERSTANDING THE ROLES OF OXYGEN AND CARBON DIOXIDE
Date: 02/08/2008
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
The presence of sufficient carbon dioxide in the body helps oxygen get released into the cells. Let me explain. When you breathe in air, oxygen enters your lungs where it attaches itself to iron forming the molecule hemoglobin. As hemoglobin, oxygen gets transported through your body. Now, oxygen is strongly attached to hemoglobin. If you were ever an anxiety (blood level of C02 around 25-30mmHg) or panic patient (blood level of C02 between 20-30mmHg) perhaps your doctor told you to breathe into a brown paper bag. What would you be breathing? You would be re-breathing your Carbon Dioxide that you had breathed out. So, you would be breathing mostly Carbon Dioxide. Why do this? Your blood level is saturated with Oxygen from over-breathing, and your arterial carbon dioxide level is too low. When you breathe a bag full of carbon dioxide you will raise your blood level of C02 to a higher level (40mmHg is normal) and now the Oxygen that is attached to the hemoglobin molecule can be EXCHNGED for C02.
Carbon Dioxide and Oxygen are symbiotic, co-dependent gases upon which our lives intimately depend. If oxygen level goes up as in over-breathing, Carbon Dioxide goes down by means of exhalation, oxygen will remain attached to iron as hemoglobin and be unavailable to the tissues. If C02 goes up through retention or slowed exhalation, then more oxygen will unload off hemoglobin and be available to your tissues in your arterial blood.
How can we know this? Can it be measured? Can we consciously learn to adjust this equation if need be? The answer to all three is, yes, we can become aware, we can measure it and we can consciously adjust the equation.
The only way to absolutely know if you are over-breathing or not is to measure your blood gases. There are two machines that can be used: an oximeter that measures oxygen level and a capnograph that measures Carbon Dioxide levels breath by breath. Using an oximeter by itself can be somewhat misleading unless you understand the ratios of Oxygen to Carbon Dioxide. Hospitals are now using Oximeters to know about someone`s breathing and unfortunately, very few have the background to interpret a correct reading. Many think an Oxygen saturation reading of 99% is good. Instead it means you are hyperventilating.
The correct machine to measure and infer information from is a capnograph. This machine is not as easy to build as the oximeter as it requires very delicate parts. A Dr. Peter Litchfield in Colorado has had a machine built for the lay person to use on their computer. This machine is very user friendly, the accompanying material is very informative, and Dr. Litchfield has developed classes for breathing certification as well. His approach is innovative and puts a very different slant on the whole subject of breathing awareness. The important thing is you can hook yourself up while sitting or lying or performing stationary exercises and monitor your breathing for any length of time. This is much like a 24 hour blood pressure monitor for really discovering if you have blood pressure. Most important, the capno-trainer averages CO2 level, rate of breathing, Heart Rate Variability and includes several programs for monitoring and guiding your breathing for training purposes.
When this machine was first introduced I was thrilled to discover it. I had researched many medical companies looking for a capnograph that could give feedback on C02 level breath by breath. I had taken two groups to climb to 20,000 feet in the Mt. Everest area doing breathing research and could not find such a machine. When the capno-trainer was introduced I made a most interesting discovery. I was shocked at how many "normal looking" individuals who showed no signs of respiratory distress were over-breathing. Yoga teachers were some of the worst breathers as most learn to "even-breathe".
As the issue of being able to consciously intervene to change your breathing I will for the purposes of this short paper on C02 and 02 tell you to deep breathe into the diaphragm and slow your exhale. There is much more to the learning of these practices. On my web site I have a two hour teaching session on "How to Teach Proper Breathing" that goes into this subject in detail.
Please visit my website for many more articles on the subject of breathing and other issues and for information on the Capno-trainer and how you can get one.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
Date: 02/08/2008
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
The presence of sufficient carbon dioxide in the body helps oxygen get released into the cells. Let me explain. When you breathe in air, oxygen enters your lungs where it attaches itself to iron forming the molecule hemoglobin. As hemoglobin, oxygen gets transported through your body. Now, oxygen is strongly attached to hemoglobin. If you were ever an anxiety (blood level of C02 around 25-30mmHg) or panic patient (blood level of C02 between 20-30mmHg) perhaps your doctor told you to breathe into a brown paper bag. What would you be breathing? You would be re-breathing your Carbon Dioxide that you had breathed out. So, you would be breathing mostly Carbon Dioxide. Why do this? Your blood level is saturated with Oxygen from over-breathing, and your arterial carbon dioxide level is too low. When you breathe a bag full of carbon dioxide you will raise your blood level of C02 to a higher level (40mmHg is normal) and now the Oxygen that is attached to the hemoglobin molecule can be EXCHNGED for C02.
Carbon Dioxide and Oxygen are symbiotic, co-dependent gases upon which our lives intimately depend. If oxygen level goes up as in over-breathing, Carbon Dioxide goes down by means of exhalation, oxygen will remain attached to iron as hemoglobin and be unavailable to the tissues. If C02 goes up through retention or slowed exhalation, then more oxygen will unload off hemoglobin and be available to your tissues in your arterial blood.
How can we know this? Can it be measured? Can we consciously learn to adjust this equation if need be? The answer to all three is, yes, we can become aware, we can measure it and we can consciously adjust the equation.
The only way to absolutely know if you are over-breathing or not is to measure your blood gases. There are two machines that can be used: an oximeter that measures oxygen level and a capnograph that measures Carbon Dioxide levels breath by breath. Using an oximeter by itself can be somewhat misleading unless you understand the ratios of Oxygen to Carbon Dioxide. Hospitals are now using Oximeters to know about someone`s breathing and unfortunately, very few have the background to interpret a correct reading. Many think an Oxygen saturation reading of 99% is good. Instead it means you are hyperventilating.
The correct machine to measure and infer information from is a capnograph. This machine is not as easy to build as the oximeter as it requires very delicate parts. A Dr. Peter Litchfield in Colorado has had a machine built for the lay person to use on their computer. This machine is very user friendly, the accompanying material is very informative, and Dr. Litchfield has developed classes for breathing certification as well. His approach is innovative and puts a very different slant on the whole subject of breathing awareness. The important thing is you can hook yourself up while sitting or lying or performing stationary exercises and monitor your breathing for any length of time. This is much like a 24 hour blood pressure monitor for really discovering if you have blood pressure. Most important, the capno-trainer averages CO2 level, rate of breathing, Heart Rate Variability and includes several programs for monitoring and guiding your breathing for training purposes.
When this machine was first introduced I was thrilled to discover it. I had researched many medical companies looking for a capnograph that could give feedback on C02 level breath by breath. I had taken two groups to climb to 20,000 feet in the Mt. Everest area doing breathing research and could not find such a machine. When the capno-trainer was introduced I made a most interesting discovery. I was shocked at how many "normal looking" individuals who showed no signs of respiratory distress were over-breathing. Yoga teachers were some of the worst breathers as most learn to "even-breathe".
As the issue of being able to consciously intervene to change your breathing I will for the purposes of this short paper on C02 and 02 tell you to deep breathe into the diaphragm and slow your exhale. There is much more to the learning of these practices. On my web site I have a two hour teaching session on "How to Teach Proper Breathing" that goes into this subject in detail.
Please visit my website for many more articles on the subject of breathing and other issues and for information on the Capno-trainer and how you can get one.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
LEARNING 2:1 BREATHING as A FUNCTION OF PROPER BREATHING
Date: 02/08/2008
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
What is "proper breathing" and how do I do it? Proper breathing is both deep diaphragmatic breathing which promotes a relaxed, parasympathetic state, and also involves a slower rate of exhalation. For example, think of breathing in to a count of 3 and exhaling to a count of 6.
Maybe we should be breathing this way most of the time, not just when we are practicing relaxation. This is slow, deep breathing.
To begin learning this 2:1 ratio of breathing in to breathing out, practice this rate when you are focused and are essentially at rest. You can`t worry about it at other times. Changing a very basic learned habit such as breathing rate may well be a life-time occupation. You will never learn it and not ever regress. Over-breathing has its purpose as well.
The body will adjust the rate during other activities. At first, exaggerate the exercise and really try to breathe very slowly and consciously during practice. This will carry over into a more comfortable rate during autonomic breathing.
First to learn to diaphragmatically breathe. Imagine you have a large balloon in your stomach below the diaphragm. Inhale into that balloon, allowing your stomach to move outward, downward or even sideways. Once full, exhale slowly through pursed lips. Pretend you are exhaling through a straw and very slowly let the air out as the stomach deflates. You can even use the stomach muscles to draw the stomach in. This is actually a better exercise to strengthen the stomach muscles than holding your stomach in all the time. Getting in touch with those stomach muscles can be difficult for many. We usually breathe in in exactly the opposite manner, inhaling and drawing our stomach in and when exhaling letting our stomach out. This is "backward breathing".
At first. for learning purposes, you can only be attentive to this when you are focused, resting and practicing. Your practice time has to be devoted to this one issue. If not, and not practiced many times a day, you probably won`t learn it. Remember, what you do enough becomes learned. Some say it takes a year to break an old habit. Physical therapists say you have to exercise an injured, unexercised muscle every hour and a half to have it gain the awareness of the new behavior you wish it to learn. I am hoping with dedication and practice you will learn it. You have to practice the change in behavior very frequently if you expect it to become natural and even then you have to stay on top of it and your reaction to events, people and things. Practicing once a day will not equal learning.
To jump start the process, I recommend you use a timer or watch that you can set to remind you every 15 minutes to tune into your breathing and practice for a few minutes. You could put a pop up reminder on your computer as well if you spend much time there.
When one begins to breathe this way, many body changes begin to take place. Heart rate drops, blood pressure drops, muscle tension decreases. In fact, deep abdominal breathing and muscle tension are incompatible. Think of the tense posture of someone sitting in a dental chair, "breath-holding" while gripping the arms of the dental chair with their tense, blanched hands and knuckles. You can"t do that with deep abdominal breathing. They just don`t go together.
When you breathe deeply and exhale slowly, GI (gastrointestinal) function tends to normalize. If someone is pretty tense and uptight and carries their stomach drawn in, then breathing this way causes a nice calm increase in stomach wall movement and this stimulates a gentle peristalsis. This tends to work for the person who is constipated. For the individual who experiences diarrhea frequently, this breathing technique is very effective. Take for instance the "anxious stomach-responder" to stress. Let`s say this person is having to give a presentation and is having a case of stage freight. Because the person is perceiving the audience as a threat (sympathetic arousal), the brain sends an autonomic message to the gut (in gut responders to stress) to increase peristalsis. The gut accommodates by increasing peristalsis causing increased evacuation, all to the biological end of allowing the organism to survive by being better able to run or fight better. We can ultimately run or fight better with an empty stomach and gastrointestinal tract.
Finally, if done properly, with this slow, deep breathing, we will experience an increase in hand temperature up in the range of 94-96 degrees. Biologically, we can afford to have warm hands if we are safe. If not safe, and we are subject to a threat attack, we would put our hands and or feet out in front of us to protect our selves. If we were assaulted and wounded, we might bleed to death. Again, because biology dictates our survival, under stress or perceived stress, our brain sends a message to our periphery (hands and feet) and tells the blood vessels to constrict. Our hands and feet get cold. Warm hands and deep breathing go together. Cold hands and chest breathing also go together. Biologically, by virtue of breathing deeply we are cueing our brain to know that we are safe, we can relax, and let blood flow to the periphery.
Practice, Practice, Practice!
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
http://www.theMangoTreeSpa.com
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
What is "proper breathing" and how do I do it? Proper breathing is both deep diaphragmatic breathing which promotes a relaxed, parasympathetic state, and also involves a slower rate of exhalation. For example, think of breathing in to a count of 3 and exhaling to a count of 6.
Maybe we should be breathing this way most of the time, not just when we are practicing relaxation. This is slow, deep breathing.
To begin learning this 2:1 ratio of breathing in to breathing out, practice this rate when you are focused and are essentially at rest. You can`t worry about it at other times. Changing a very basic learned habit such as breathing rate may well be a life-time occupation. You will never learn it and not ever regress. Over-breathing has its purpose as well.
The body will adjust the rate during other activities. At first, exaggerate the exercise and really try to breathe very slowly and consciously during practice. This will carry over into a more comfortable rate during autonomic breathing.
First to learn to diaphragmatically breathe. Imagine you have a large balloon in your stomach below the diaphragm. Inhale into that balloon, allowing your stomach to move outward, downward or even sideways. Once full, exhale slowly through pursed lips. Pretend you are exhaling through a straw and very slowly let the air out as the stomach deflates. You can even use the stomach muscles to draw the stomach in. This is actually a better exercise to strengthen the stomach muscles than holding your stomach in all the time. Getting in touch with those stomach muscles can be difficult for many. We usually breathe in in exactly the opposite manner, inhaling and drawing our stomach in and when exhaling letting our stomach out. This is "backward breathing".
At first. for learning purposes, you can only be attentive to this when you are focused, resting and practicing. Your practice time has to be devoted to this one issue. If not, and not practiced many times a day, you probably won`t learn it. Remember, what you do enough becomes learned. Some say it takes a year to break an old habit. Physical therapists say you have to exercise an injured, unexercised muscle every hour and a half to have it gain the awareness of the new behavior you wish it to learn. I am hoping with dedication and practice you will learn it. You have to practice the change in behavior very frequently if you expect it to become natural and even then you have to stay on top of it and your reaction to events, people and things. Practicing once a day will not equal learning.
To jump start the process, I recommend you use a timer or watch that you can set to remind you every 15 minutes to tune into your breathing and practice for a few minutes. You could put a pop up reminder on your computer as well if you spend much time there.
When one begins to breathe this way, many body changes begin to take place. Heart rate drops, blood pressure drops, muscle tension decreases. In fact, deep abdominal breathing and muscle tension are incompatible. Think of the tense posture of someone sitting in a dental chair, "breath-holding" while gripping the arms of the dental chair with their tense, blanched hands and knuckles. You can"t do that with deep abdominal breathing. They just don`t go together.
When you breathe deeply and exhale slowly, GI (gastrointestinal) function tends to normalize. If someone is pretty tense and uptight and carries their stomach drawn in, then breathing this way causes a nice calm increase in stomach wall movement and this stimulates a gentle peristalsis. This tends to work for the person who is constipated. For the individual who experiences diarrhea frequently, this breathing technique is very effective. Take for instance the "anxious stomach-responder" to stress. Let`s say this person is having to give a presentation and is having a case of stage freight. Because the person is perceiving the audience as a threat (sympathetic arousal), the brain sends an autonomic message to the gut (in gut responders to stress) to increase peristalsis. The gut accommodates by increasing peristalsis causing increased evacuation, all to the biological end of allowing the organism to survive by being better able to run or fight better. We can ultimately run or fight better with an empty stomach and gastrointestinal tract.
Finally, if done properly, with this slow, deep breathing, we will experience an increase in hand temperature up in the range of 94-96 degrees. Biologically, we can afford to have warm hands if we are safe. If not safe, and we are subject to a threat attack, we would put our hands and or feet out in front of us to protect our selves. If we were assaulted and wounded, we might bleed to death. Again, because biology dictates our survival, under stress or perceived stress, our brain sends a message to our periphery (hands and feet) and tells the blood vessels to constrict. Our hands and feet get cold. Warm hands and deep breathing go together. Cold hands and chest breathing also go together. Biologically, by virtue of breathing deeply we are cueing our brain to know that we are safe, we can relax, and let blood flow to the periphery.
Practice, Practice, Practice!
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
http://www.theMangoTreeSpa.com
BOOST YOUR IMMUNE SYSTEM WITH PROPER BREATHING
Date: 02/08/2008
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attach themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
Our first line of defense against infections, bacterial or viral is our immune system, namely our white blood cells. We are always talking about boosting our immune system and taking supplements to achieve this. Well, what if we did this the natural way by charging up our white blood cells. Perhaps a couple of hours of proper breathing with slow exhalation at the first sign of an infection might do more for us than all the chicken soup we could eat.
Carbon Dioxide, according to much scientific research, will do more to speed up the white blood cells, to make them attack with greater force and to better recognize the enemy.
the job of the white blood cells is to scout out the infection and then to destroy it. The second line of defense is to create antibodies against that infection so it won`t return. Acting like a relay team the antibodies inform other white blood cells of the enemy.
Antibodies with a sugar amine attached lack the drive and ability to do a fast and efficient job. What should takes hours may now take days. With sufficient Carbon Dioxide in your body, these antibodies can often destroy an infection before you even know you have it.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attach themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
Our first line of defense against infections, bacterial or viral is our immune system, namely our white blood cells. We are always talking about boosting our immune system and taking supplements to achieve this. Well, what if we did this the natural way by charging up our white blood cells. Perhaps a couple of hours of proper breathing with slow exhalation at the first sign of an infection might do more for us than all the chicken soup we could eat.
Carbon Dioxide, according to much scientific research, will do more to speed up the white blood cells, to make them attack with greater force and to better recognize the enemy.
the job of the white blood cells is to scout out the infection and then to destroy it. The second line of defense is to create antibodies against that infection so it won`t return. Acting like a relay team the antibodies inform other white blood cells of the enemy.
Antibodies with a sugar amine attached lack the drive and ability to do a fast and efficient job. What should takes hours may now take days. With sufficient Carbon Dioxide in your body, these antibodies can often destroy an infection before you even know you have it.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
THE BREATHING CONNECTION TO HORMONES LIKE INSULIN
THE BREATHING CONNECTION TO HORMONES LIKE INSULIN
Date: 02/08/2008
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attach themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
What IS the role of hormones. These proteins help the body communicate with itself. Take insulin and its effect on Diabetes as an example. Insulin is a hormone made by the pancreas and its job is to tell the cells of the body to open to let glucose in so they can make energy. If the insulin hormone proteins have sugars attached instead of Carbon Dioxide, insulin can`t work as designed. The result of this is, cells don?t then get the fuel or energy they need, the pancreas makes more insulin, and the liver releases more sugar into the blood stream. The result is more insulin with sugar attached, cells that are starving and losing energy, and the final result if this continues is diabetes.
Instead, breathe deep into the diaphragm or belly, blow out your air more slowly all to increase your arterial level of CO2. Most people, over 66% are over-breathing. Please visit my website to learn more about the subject of breathing.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
Date: 02/08/2008
Rapid breathing, sighing, rapid exhalation causes you to loose too much Carbon Dioxide and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attach themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
What IS the role of hormones. These proteins help the body communicate with itself. Take insulin and its effect on Diabetes as an example. Insulin is a hormone made by the pancreas and its job is to tell the cells of the body to open to let glucose in so they can make energy. If the insulin hormone proteins have sugars attached instead of Carbon Dioxide, insulin can`t work as designed. The result of this is, cells don?t then get the fuel or energy they need, the pancreas makes more insulin, and the liver releases more sugar into the blood stream. The result is more insulin with sugar attached, cells that are starving and losing energy, and the final result if this continues is diabetes.
Instead, breathe deep into the diaphragm or belly, blow out your air more slowly all to increase your arterial level of CO2. Most people, over 66% are over-breathing. Please visit my website to learn more about the subject of breathing.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
http://www.theMangoTreeSpa.com
DRY AGING SUN-SPOT SKIN --- WHY DOES OUR SKIN AGE?
DRY AGING SUN-SPOT SKIN --- WHY DOES OUR SKIN AGE?
Date: 02/08/2008
Rapid breathing, sighing and rapid exhalation causes you to loose too much Carbon Dioxide, and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attached themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
We can look at skin as an example. As a teen we produce new skin cells very quickly. These rise to the surface and are exfoliated in around 7 days. With aging, at around 50, this same process may take 7 weeks, leaving those cells to dehydrate and degenerate. Without enough C02 on board at all times we lack the structural proteins necessary to repair and regenerate new skin cells on an on-going basis. Instead of making vibrant, healthy new skin cells, the aging, dehydrating scenario occurs.
In addition, the skin gets filled with toxic protein-sugar complexes. Age spots are an example of these protein-sugar complexes. These spots are also called liver spots and unknown to most, what you see on the outside is also happening throughout the body. If they are showing up on your skin they are also within.
Could over breathing be a huge factor in aging skin? People have always said smokers wrinkle more than non-smokers. Could breathing explain this? The average over-breather breathes between 20,000 and 28,000 times a day. The significance of this rate may well be the fuel and essence of our being and our beauty. How we perform this on-going fuel injection-ejection task is critical. How fast we exhale and where we breathe are of major importance to our health and well-being.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Where you breathe in your body is important. It is the difference between stress and relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing.
http://www.theMangoTreeSpa.com
Date: 02/08/2008
Rapid breathing, sighing and rapid exhalation causes you to loose too much Carbon Dioxide, and it is this loss that can make you ill. Carbon dioxide is a cohort of oxygen and without enough you will end up being oxygen deficient as well.
C02 is a regulator of proteins. Every protein in the body has attached to it a group called an amine. Amines are sticky and attached themselves to Carbon dioxide. If there is not enough Carbon Dioxide in the body these amines will instead attach to sugars in the blood stream.
A protein with a sugar attached is toxic and becomes a waste product that needs to be removed from the body.
What is the role of proteins in the body? Each of the thousands of proteins in our body has a different role; they may be hormones, neurotransmitters, enzymes or antibodies. The above are considered structural proteins that build our bodies and keep us healthy.
We can look at skin as an example. As a teen we produce new skin cells very quickly. These rise to the surface and are exfoliated in around 7 days. With aging, at around 50, this same process may take 7 weeks, leaving those cells to dehydrate and degenerate. Without enough C02 on board at all times we lack the structural proteins necessary to repair and regenerate new skin cells on an on-going basis. Instead of making vibrant, healthy new skin cells, the aging, dehydrating scenario occurs.
In addition, the skin gets filled with toxic protein-sugar complexes. Age spots are an example of these protein-sugar complexes. These spots are also called liver spots and unknown to most, what you see on the outside is also happening throughout the body. If they are showing up on your skin they are also within.
Could over breathing be a huge factor in aging skin? People have always said smokers wrinkle more than non-smokers. Could breathing explain this? The average over-breather breathes between 20,000 and 28,000 times a day. The significance of this rate may well be the fuel and essence of our being and our beauty. How we perform this on-going fuel injection-ejection task is critical. How fast we exhale and where we breathe are of major importance to our health and well-being.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
Where you breathe in your body is important. It is the difference between stress and relaxation. Visit my website at the link below to learn more about proper breathing and about the capnotrainer to measure and use to train proper breathing.
http://www.theMangoTreeSpa.com
PROSTATE CANCER, STRESS AND PROPER BREATHING
Date: 02/08/2008
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
I know what Doctors say about Prostate Cancer and Prostitis, but consider this possibility. Have you ever thought that Prostate Cancer might be an oxygen deprivation disease? Scientific research has validated through many experiments that cancer cells grow more quickly in an oxygen deprived environment and more slowly in an oxygen rich environment. Now, what is the number one male cancer? We know it is Prostate for men.
Did you know that there was a precipitous increase in the incidence of prostrate cancer following the "Calvin Klein tight-jeans" era? Men were told at that time to "loosen up" and wear boxer shorts instead of tight jockey shorts as the tight pants were cutting off circulation.
Did you know that prostate cancer often times metastasizes to other organs: the liver, pancreas, brain, bones, etc. but never to the penis (right next door), the heart (though we have systemic cancer) or rarely to the muscles, all blood-rich (more oxygen) organs. The heart does not get cancer or it is extremely rare. You`ve heard of systemic cancer and that means through blood carrying, the cancer has spread throughout the system, but not to the heart. Again, the heart is oxygen rich and may be the last place to exhibit Cancer.
Muscle cancer is not very common. In each separate case there may be a reason, such as inactivity, diabetes, blood clot, injury, etc. You almost never hear of penal cancer. Why not? Again, because this is another blood rich organ that gets much exercise.
The penis is right next to the prostate gland and yet prostate is the most common male cancer. What is going here? Why would this happen. Let`s look at the behavior of the male in our species, the male animal as well. It is known in the stress circles that the FIRST place the male animal tightens under stress is the perineal area (between the testicles and the anus). The organs of reproduction are drawn up as far inside as possible so the animal or man can run or fight to protect itself from death and non-survival of the species. Imagine in our very stressful life that this happens over and over, maybe hundreds of times a day.
In that stressful life-pattern breathing patterns change to a hyperventilatory-stress breathing pattern (chest breathing, rapid exhaling) and the perineal stress response becomes an ongoing learned pattern of existence. In stress versus relaxation terms this would mean poor blood flow and oxygen to an area that is already tight, tense and compromised?.a perfect set-up for the development of cancer cells or mutation from lack of oxygen, or at the very least, prostitis.
How can you prevent or reverse this situation? Obviously, stress management may be necessary to learn how to cope with life?s dealings. Learn how to breathe properly all the time. Learn deep diaphragmatic breathing and how to breathe out more slowly and extend your exhalation. Please visit my website for many articles on this subject.
There are other examples of this oxygen deprivation connection and I welcome you to add your input and your story.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
http://www.theMangoTreeSpa.com
Until you know your C02 level you will not know if you are breathing correctly. Most people are hyperventilating or over-breathing and don?t know it. You have to measure your C02 in your exhalation to know if you are over-breathing. There is no other way to know. Oxygen and C02 are true partners in the game of breathing.
I know what Doctors say about Prostate Cancer and Prostitis, but consider this possibility. Have you ever thought that Prostate Cancer might be an oxygen deprivation disease? Scientific research has validated through many experiments that cancer cells grow more quickly in an oxygen deprived environment and more slowly in an oxygen rich environment. Now, what is the number one male cancer? We know it is Prostate for men.
Did you know that there was a precipitous increase in the incidence of prostrate cancer following the "Calvin Klein tight-jeans" era? Men were told at that time to "loosen up" and wear boxer shorts instead of tight jockey shorts as the tight pants were cutting off circulation.
Did you know that prostate cancer often times metastasizes to other organs: the liver, pancreas, brain, bones, etc. but never to the penis (right next door), the heart (though we have systemic cancer) or rarely to the muscles, all blood-rich (more oxygen) organs. The heart does not get cancer or it is extremely rare. You`ve heard of systemic cancer and that means through blood carrying, the cancer has spread throughout the system, but not to the heart. Again, the heart is oxygen rich and may be the last place to exhibit Cancer.
Muscle cancer is not very common. In each separate case there may be a reason, such as inactivity, diabetes, blood clot, injury, etc. You almost never hear of penal cancer. Why not? Again, because this is another blood rich organ that gets much exercise.
The penis is right next to the prostate gland and yet prostate is the most common male cancer. What is going here? Why would this happen. Let`s look at the behavior of the male in our species, the male animal as well. It is known in the stress circles that the FIRST place the male animal tightens under stress is the perineal area (between the testicles and the anus). The organs of reproduction are drawn up as far inside as possible so the animal or man can run or fight to protect itself from death and non-survival of the species. Imagine in our very stressful life that this happens over and over, maybe hundreds of times a day.
In that stressful life-pattern breathing patterns change to a hyperventilatory-stress breathing pattern (chest breathing, rapid exhaling) and the perineal stress response becomes an ongoing learned pattern of existence. In stress versus relaxation terms this would mean poor blood flow and oxygen to an area that is already tight, tense and compromised?.a perfect set-up for the development of cancer cells or mutation from lack of oxygen, or at the very least, prostitis.
How can you prevent or reverse this situation? Obviously, stress management may be necessary to learn how to cope with life?s dealings. Learn how to breathe properly all the time. Learn deep diaphragmatic breathing and how to breathe out more slowly and extend your exhalation. Please visit my website for many articles on this subject.
There are other examples of this oxygen deprivation connection and I welcome you to add your input and your story.
By Rosemary MacGregor RN, MS info@themangotreespa
506 2786 5300
http://www.theMangoTreeSpa.com
BREATHING REFERENCES
Date: 02/08/2008
The Sports Health Handbook, Harris, Norman, Lovesey, John, Orom, Chris, World?s Work Ltd. (Great Britian) 1982
Every Breath You Take (Breathing Tips for Better Running), Plunket, Bob, The Runner, March 1986
Abdominal-thoracic respiratory movements and levels of arousal, Beverly Timmons, Joseph Salamy, Joe Kamiya and Dexter Girton, Psychon.Sci,. 1972. Vol. 27 (3)
The Nature of Respriatory Changes Associated with Sleep Onset, Karen H. Naifeh and Joe Kamiy, Sleep, 4 (1):49-59, 1981
Biofeedback of Alveolar Carbon Dioxide Tension and Levels of Arousal, K. Naifeh, J. Kamiya, D. Monroe Sweet, Biofeedback and Self-Regulation, Vol 7, No. 3 1982, 283-299
*Breathe Away Your Chains of Pain, Prevention, December, 1989, 58-64
Take a Deep Breath, Dr. James E. Loehr and Dr. Jeffery A. Migdow, Villard books, New York 1986
Body Sides Switch Dominance Every 2-3 Hours, Brain Mind Bulletin, June 16, 1986, Vol 11, No 11
*Breathing Cycle Linked To Hemispheric Dominance, Brain Mind Bulletin, Jan 3, 1983, Vol 8, No 3
*Breath Technique Selectively Activates Hemishpheres, Brain Mind Bulletin, Jan 1988, Vol 13, No4
Selective hemisphereic stimulation by unilateral forced nostril breathing, D.A. Werntz, R.G> Bickford, D. Shannahoff-Khalsa, Human Neurobiology, Nov. 1986
Rhythms of the Mind and Breath, (Our breathing patterns parallel our patterns of brain activity), David s. Shannohoff-Khalsa, Advances, Vol.6, No.2 51-55
Respiration, Stress, and Cardiovascular Function, Paul Grossman, Psychophysiology, vol.20. No 3, 1983
End-tidal Carbon Dioxide Concentration During Cardiopulmonary Resusitation, (editorial comments about ETCO2 monitoring to provide quantitative measurement of blood flow during CPR), NEJM, Vol. 319, No. 9, 579-580
Yoga and Chemoreflex response to hypoxia and hypercapnia (finding of how slow breathing substantially reduced chemosensitivity while long-term yoga practice equaled a generalized reduction in chemoreflex), Lucia Spicuzza, Alessandra Gabutti, Cesare Porta, Nicola Montano, Luciano Bernardi, Lancet, Vol 356, October 28, 2000, 1495-1496
*Slow Down, you Breathe too Fast (Doctors suspect chronic hyperventilation is behind many ?phychological? ailments), American Health, June 1992, 71-75
High-Altitude Cerebral Edema Evaluated With Magnetic Resonance Imaging, P. Hackett, PR Yarnell, R. Hill, K. Reynard, J. Heit, J. McCormick (With HACE edema occurs in the white matter of the brain) JAMA. Dec 9. 1998-vol 280, No 22, 1920-1925
Respiratory Alkalosis and Hypocarbia, (The role of carbon dioxide in the body economy) L,C, Lum, The Chest, Heart and Stroke Journal, winter 78/79. Vol 3, #4 London, 31-34
Hyperventilation and Pseudo-Allergic Reactions, L.C. Lum, Involvment of Drugs and Chemicals, vol. 4, pp. 106-119 (Karger, Basel 1985)
Hyperventilation Leading to Hallucinations, T.E. Allen, Bertrand Agus, American Psychiat., 125: 5, Nov 1968
Hyperventilation syndromes in medicine and psychiatry: a review, L. C. Lum, Journal of the Royal Society of Medicine, Vol 80, April 1987. 229-231
The Syndrome of Habitual Chronic Hyperventilation, L.C. Lum, Modern Trends in psychosomatic medicine-3, London, Butterworths, 1976, 196-230
Hyperventilation: the Tip and the Iceberg, L.C. Lum, Journal of Psychosomatic Research, Vol. 19, 1975, 375-383
Physiological Considerations in the Treatment of Hypeventilation Syndromes, L.C. Lum, Journal of Drug Research, 1983, 1867-1872
Breathing Exercises in the Treatment of Emphasema, Diana Innocenti, Physiotherapy, Dec 1966 437-441
Respiratory and Vascular Responses to Simple Visual Stimuli in Autistics, Retardates and Normals, Angela James, Robert J. Barry, Psychophysiology, Vol 17, 4, 541-547
*Breathing For the Brain, American Health, Nov 1986 16-17
The Science of Breath, Swami Rama, R. Ballentine, Alan Hymes, The Himalayan Institute, 1979
Brain Breathing, Diana Ingber (Changing the way we breathe can change the way our brain works` and give us conscious control over our blood pressure, immune system and mental health) Science Digest, June 1981 72-111
*Hyperventilation and the body C. Gilbert, Journal of Bodywork and Movement Therapies, (1998) 2(3), 184-191
Breathing and the Cardiovascular System, Journal of Bodywork and Movement Therapies, October 1998
*Breath, the Way of Balance, Phil Nuernberger, Dawn, Vol. 2, No.2. 1982
Healing with Ki-Kou: The Secrets of Ancient Chinese Breathing Techniques Li Xiuling, Agora Health Books (800-851-7100) 1993
Oriental Breathing Therapy, Takashi Nakamura, Japan Publications, Inc. 1981
Breath by Breath, Larry Rosenberg, Shambala, Boston 1999
Respiratory Physiology, N. Balfour Slonim, L.H. Hamilton, Mosby Co., 1987
Exercise Manual for J. H. Schultz?s Standard Autogenic Training and Special Formulas, Beata Jenks, Salt Lake City, 1973
Pranayama, Swami Kuvalayananda, Kirloskar Press, 1966
The Hyperventilation Syndrome, Robert Fried, John Hopkins Press, 1987
The Breath Connection, Robert Fried, Insight Books, 1990
The Premordial Breath, Vol 1, (An ancient Chinese way of prolonging life through breath control), translated by Jane Huang, Original books, 1987
The Breathing Book, Donna Farhi, Henry Holt and Co., 1996
Relaxation with Biofeedback-Assisted Guided Imagery: the Importance of Breathing Rate as an index of Hypoarousal, Robert Fried, Hunter College and the Institute for Rational Emotive Therapy, N. Y.
Pursed Lips Breathing Training Using Ear Oximetry, B. Tiep, M. Burns, D. Kao, R. Madison, J. Herrera, Chest, 90, 2, August, 1986
Breathing Awareness as a Relaxation Method in Cardiac Rehabilitation, Jan Van Dixhoorn, Hugo J. Duivenvoorden, Proceedings of Third International Conference on Stress Management, Edinburgh 1988, Plenum, N.Y.
Panic Attacks During Sleep: A Hyperventilation-Probability Model, Ron Ley, J. Behavior, Therapy and Experimental Psychiatry, Vol. 19, No. 3. Pp. 181-192, 1988
EEG apha-biofeedback training: an experimental technique for the management of anxiety, J.F. Hare, B.H.Timmons, J.R. Roberts, A.S. Burman, Journal of Medical Engineering and Technology, Vol 6, No. 1, Jan & Feb, 1982, 19-24
The Effects of Emotions on Short-term Power Spectrum Analysis of Heart Rate Variability, R. MaCraty, M. Atkinson, W. Tiller, Glen Rein, A. Watkins, The Journal of American Cardiology, Vol 76, no. 14, Nov 15, 1089-1093
The Role of Oscillations In Self-Regulation: Their Contribution to Homeostasis, N. Giardino, P. Lehrer, J. Feldman, In Diana Kenny and F. J. mcGuigans (Eds): Stress and Health: Research and clinical applications, 1-33
Cardiac Vagal Tone: A Physiological Index of Stress, S. Porges, NeuroSciences and Behavioral Reviews, Vol. 19, No. 2, 225-233
Heart Rate Variability, Special Report, Circulation, Vol. 93, No 5, March 1, 1996, 1043-1065
Heart Rate Variability in Health and Disease, E.Kristal-Boneh, M. Raifel, P. Froom, J. Ribak, Scandinavian J Work Environ Health, 1995, 21: 85-95
Breathing and the Cardiovascular System, C. Gilbert, Journal of Bodywork and Movement Therapies, Octiber 1999
The Sports Health Handbook, Harris, Norman, Lovesey, John, Orom, Chris, World?s Work Ltd. (Great Britian) 1982
Every Breath You Take (Breathing Tips for Better Running), Plunket, Bob, The Runner, March 1986
Abdominal-thoracic respiratory movements and levels of arousal, Beverly Timmons, Joseph Salamy, Joe Kamiya and Dexter Girton, Psychon.Sci,. 1972. Vol. 27 (3)
The Nature of Respriatory Changes Associated with Sleep Onset, Karen H. Naifeh and Joe Kamiy, Sleep, 4 (1):49-59, 1981
Biofeedback of Alveolar Carbon Dioxide Tension and Levels of Arousal, K. Naifeh, J. Kamiya, D. Monroe Sweet, Biofeedback and Self-Regulation, Vol 7, No. 3 1982, 283-299
*Breathe Away Your Chains of Pain, Prevention, December, 1989, 58-64
Take a Deep Breath, Dr. James E. Loehr and Dr. Jeffery A. Migdow, Villard books, New York 1986
Body Sides Switch Dominance Every 2-3 Hours, Brain Mind Bulletin, June 16, 1986, Vol 11, No 11
*Breathing Cycle Linked To Hemispheric Dominance, Brain Mind Bulletin, Jan 3, 1983, Vol 8, No 3
*Breath Technique Selectively Activates Hemishpheres, Brain Mind Bulletin, Jan 1988, Vol 13, No4
Selective hemisphereic stimulation by unilateral forced nostril breathing, D.A. Werntz, R.G> Bickford, D. Shannahoff-Khalsa, Human Neurobiology, Nov. 1986
Rhythms of the Mind and Breath, (Our breathing patterns parallel our patterns of brain activity), David s. Shannohoff-Khalsa, Advances, Vol.6, No.2 51-55
Respiration, Stress, and Cardiovascular Function, Paul Grossman, Psychophysiology, vol.20. No 3, 1983
End-tidal Carbon Dioxide Concentration During Cardiopulmonary Resusitation, (editorial comments about ETCO2 monitoring to provide quantitative measurement of blood flow during CPR), NEJM, Vol. 319, No. 9, 579-580
Yoga and Chemoreflex response to hypoxia and hypercapnia (finding of how slow breathing substantially reduced chemosensitivity while long-term yoga practice equaled a generalized reduction in chemoreflex), Lucia Spicuzza, Alessandra Gabutti, Cesare Porta, Nicola Montano, Luciano Bernardi, Lancet, Vol 356, October 28, 2000, 1495-1496
*Slow Down, you Breathe too Fast (Doctors suspect chronic hyperventilation is behind many ?phychological? ailments), American Health, June 1992, 71-75
High-Altitude Cerebral Edema Evaluated With Magnetic Resonance Imaging, P. Hackett, PR Yarnell, R. Hill, K. Reynard, J. Heit, J. McCormick (With HACE edema occurs in the white matter of the brain) JAMA. Dec 9. 1998-vol 280, No 22, 1920-1925
Respiratory Alkalosis and Hypocarbia, (The role of carbon dioxide in the body economy) L,C, Lum, The Chest, Heart and Stroke Journal, winter 78/79. Vol 3, #4 London, 31-34
Hyperventilation and Pseudo-Allergic Reactions, L.C. Lum, Involvment of Drugs and Chemicals, vol. 4, pp. 106-119 (Karger, Basel 1985)
Hyperventilation Leading to Hallucinations, T.E. Allen, Bertrand Agus, American Psychiat., 125: 5, Nov 1968
Hyperventilation syndromes in medicine and psychiatry: a review, L. C. Lum, Journal of the Royal Society of Medicine, Vol 80, April 1987. 229-231
The Syndrome of Habitual Chronic Hyperventilation, L.C. Lum, Modern Trends in psychosomatic medicine-3, London, Butterworths, 1976, 196-230
Hyperventilation: the Tip and the Iceberg, L.C. Lum, Journal of Psychosomatic Research, Vol. 19, 1975, 375-383
Physiological Considerations in the Treatment of Hypeventilation Syndromes, L.C. Lum, Journal of Drug Research, 1983, 1867-1872
Breathing Exercises in the Treatment of Emphasema, Diana Innocenti, Physiotherapy, Dec 1966 437-441
Respiratory and Vascular Responses to Simple Visual Stimuli in Autistics, Retardates and Normals, Angela James, Robert J. Barry, Psychophysiology, Vol 17, 4, 541-547
*Breathing For the Brain, American Health, Nov 1986 16-17
The Science of Breath, Swami Rama, R. Ballentine, Alan Hymes, The Himalayan Institute, 1979
Brain Breathing, Diana Ingber (Changing the way we breathe can change the way our brain works` and give us conscious control over our blood pressure, immune system and mental health) Science Digest, June 1981 72-111
*Hyperventilation and the body C. Gilbert, Journal of Bodywork and Movement Therapies, (1998) 2(3), 184-191
Breathing and the Cardiovascular System, Journal of Bodywork and Movement Therapies, October 1998
*Breath, the Way of Balance, Phil Nuernberger, Dawn, Vol. 2, No.2. 1982
Healing with Ki-Kou: The Secrets of Ancient Chinese Breathing Techniques Li Xiuling, Agora Health Books (800-851-7100) 1993
Oriental Breathing Therapy, Takashi Nakamura, Japan Publications, Inc. 1981
Breath by Breath, Larry Rosenberg, Shambala, Boston 1999
Respiratory Physiology, N. Balfour Slonim, L.H. Hamilton, Mosby Co., 1987
Exercise Manual for J. H. Schultz?s Standard Autogenic Training and Special Formulas, Beata Jenks, Salt Lake City, 1973
Pranayama, Swami Kuvalayananda, Kirloskar Press, 1966
The Hyperventilation Syndrome, Robert Fried, John Hopkins Press, 1987
The Breath Connection, Robert Fried, Insight Books, 1990
The Premordial Breath, Vol 1, (An ancient Chinese way of prolonging life through breath control), translated by Jane Huang, Original books, 1987
The Breathing Book, Donna Farhi, Henry Holt and Co., 1996
Relaxation with Biofeedback-Assisted Guided Imagery: the Importance of Breathing Rate as an index of Hypoarousal, Robert Fried, Hunter College and the Institute for Rational Emotive Therapy, N. Y.
Pursed Lips Breathing Training Using Ear Oximetry, B. Tiep, M. Burns, D. Kao, R. Madison, J. Herrera, Chest, 90, 2, August, 1986
Breathing Awareness as a Relaxation Method in Cardiac Rehabilitation, Jan Van Dixhoorn, Hugo J. Duivenvoorden, Proceedings of Third International Conference on Stress Management, Edinburgh 1988, Plenum, N.Y.
Panic Attacks During Sleep: A Hyperventilation-Probability Model, Ron Ley, J. Behavior, Therapy and Experimental Psychiatry, Vol. 19, No. 3. Pp. 181-192, 1988
EEG apha-biofeedback training: an experimental technique for the management of anxiety, J.F. Hare, B.H.Timmons, J.R. Roberts, A.S. Burman, Journal of Medical Engineering and Technology, Vol 6, No. 1, Jan & Feb, 1982, 19-24
The Effects of Emotions on Short-term Power Spectrum Analysis of Heart Rate Variability, R. MaCraty, M. Atkinson, W. Tiller, Glen Rein, A. Watkins, The Journal of American Cardiology, Vol 76, no. 14, Nov 15, 1089-1093
The Role of Oscillations In Self-Regulation: Their Contribution to Homeostasis, N. Giardino, P. Lehrer, J. Feldman, In Diana Kenny and F. J. mcGuigans (Eds): Stress and Health: Research and clinical applications, 1-33
Cardiac Vagal Tone: A Physiological Index of Stress, S. Porges, NeuroSciences and Behavioral Reviews, Vol. 19, No. 2, 225-233
Heart Rate Variability, Special Report, Circulation, Vol. 93, No 5, March 1, 1996, 1043-1065
Heart Rate Variability in Health and Disease, E.Kristal-Boneh, M. Raifel, P. Froom, J. Ribak, Scandinavian J Work Environ Health, 1995, 21: 85-95
Breathing and the Cardiovascular System, C. Gilbert, Journal of Bodywork and Movement Therapies, Octiber 1999
A BRIEF OVERVIEW OF THE CHEMISTRY OF RESPIRATION AND THE BREATHING HEART WAVE
Title: A BRIEF OVERVIEW OF THE CHEMISTRY OF RESPIRATION
Date: 02/08/2008
A BRIEF OVERVIEW OF THE CHEMISTRY OF RESPIRATION
AND THE BREATHING HEART WAVE
Peter M. Litchfield, Ph.D. in California Biofeedback. Vol. 19, No. 1 (Spring 2003)
Respiration: Chemistry and Mechanics
“Respiration” is behavioral-physiologic homeostasis, a form of self-regulatory behavior, which constitutes a
transport system for customized delivery of atmospheric oxygen to each and every tissue based on their specific
metabolic requirements, including the transport of metabolic carbon dioxide from the cells to outside air. The
“mechanics” of respiration constitute “breathing,” the use of the lungs for moving oxygen, carbon dioxide, and other
gases to and/or from the blood. The “chemistry” of respiration constitutes the physiology of moving oxygen from
the lungs to the cells, and carbon dioxide from the cells to the lungs. Optimizing respiration means good “chemistry
through good “mechanics.”
In this overview, “breathing mechanics” have reference to breathing rhythmicity (holding, gasping, sighing),
breathing rate, breathing depth (volume), locus of breathing (chest and diaphragm), breathing resistance (nose and
mouth), and collateral muscle activity for breathing regulation (muscles other than the diaphragm). “Breathing
chemistry” has reference to the ventilation of carbon dioxide through these breathing mechanics in the service of
establishing adaptive respiratory chemistry. Respiratory chemistry can be monitored by measuring changes in
exhaled carbon dioxide, to be discussed later, so as to ensure that the learning of breathing mechanics is truly in the
service of respiration.
Good breathing “mechanics” rather than good respiratory physiology, has unfortunately become almost the
exclusive focus of breathing training and learning, often along with insistence on tying it to “relaxation” training
regimens in the context of specific philosophical and/or professional agenda. As a result, it is not surprising then,
that at least 50 percent of therapists and trainers who teach breathing actually deregulate respiratory chemistry by
inducing “overbreathing” with their instructions to trainees, not realizing that they are inducing system-wide
physiological crisis through the establishment of hypocapnia, i.e., carbon dioxide deficit. Unfortunately, based on
this kind of thinking, myths and misunderstandings about “good” breathing often constitute the “working
knowledge” of professionals and lay audiences alike. Here are some of them:
Good breathing means relaxation.
No. Good breathing is important in all circumstances, whether relaxed or not.
Learning good breathing requires relaxation.
No. This would mean that during most life circumstances, breathing is maladaptive.
Diaphragmatic breathing is synonymous with good breathing.
No. In many instances one may begin to overbreathe as a result of switching from chest to diaphragm.
Good respiration is all about the mechanics of breathing.
No. Good breathing means ventilating in accordance with metabolic requirements.
Diaphragmatic, deep, slow breathing means better distribution of oxygen.
No. Mechanics may look letter perfect, but oxygen distribution may be poor.
Underbreathing, with the result of oxygen deficit, is common.
No. To the contrary, overbreathing is common.
Good breathing translates into optimizing respiratory physiology, and contrary to popular thinking, learning to
breathe well does not simply mean deep, slow, diaphragmatic breathing in the context of learning how to relax.
Adaptive breathing means regulating blood chemistry, through proper ventilation of carbon dioxide, in accordance
with metabolic and other physiologic requirements associated with all life activities and circumstances: relaxation or
stress, rest or challenge, fatigue or excitement, attention or open-focus, playing or working. Deregulated breathing
chemistry, i.e., hypocapnia (CO2 deficiency) as a result of overbreathing, means serious physiological crisis
involving system-wide compromises that involve physical and mental consequences of all kinds, to be examined
later in this overview. Evaluating, establishing, maintaining, and promoting good respiratory chemistry are
fundamental to virtually any professional practice involving breathing training. Good breathing chemistry
establishes a system-wide context conducive to optimizing health and maximizing performance.
2
Breathing training is invariably included as an important component of relaxation training, but surely does not in
and of itself constitute relaxation. Breathing may be fully optimized, and hopefully is, during times of stress and
challenge where relaxation is neither possible nor adaptive. Once good breathing chemistry and breathing
mechanics are in place, relaxation training may then also include the establishment of stable high-amplitude
breathing heart waves, i.e., parasympathetic (nervous system) tone, otherwise known as the respiratory sinus
arrhythmia (RSA) and as one of the frequency ranges (HF) of what is known as heart rate variability (HRV).
Respiratory Chemistry: The Role of Carbon Dioxide in Oxygen Distribution
Blood is circulated with great precision to specific body sites based on their local and immediate metabolic
requirements. Higher metabolism in more active tissues and cells generates higher levels of CO2 resulting in
immediate local vasodilation (relaxation of smooth muscles with the result of increasing the diameter of the vessels),
thus setting the stage for supplying the required oxygen and glucose to the associated tissues, such as to specific
regions of the brain while thinking.
Higher levels of CO2 also lead to an immediate drop in blood and extracellular fluid pH levels through the
formation of carbonic acid, thus obliging the hemoglobin to more readily distribute its oxygen to meet local
metabolic requirements. Lower levels of CO2, as a result of lower metabolism, lead to blood vessel constriction
(e.g., reduction in the diameter of the coronaries) and to higher levels of blood and extracellular fluid pH (less
carbonic acid), thus permitting oxygen and glucose to go elsewhere where metabolic requirements are greater. In
the simplest of terms, this is the biochemistry of healthy respiration.
Deregulated Respiration: Effects of Carbon Dioxide Deficit on Physiology
The most serious form of breathing deregulation is overbreathing, an all too common and serious state of
behavioral-physiologic affairs. Overbreathing is undoubtedly one of the most insidious and dangerous
behaviors/responses to environmental, task, emotional, cognitive, and relationship challenges in our daily lives.
Overbreathing can be a dangerous behavior immediately triggering and/or exacerbating a wide variety of serious
physical and mental symptoms, complaints, and deficits in health and human performance.
Overbreathing* means bringing about carbon dioxide (CO2) deficit in the blood (i.e., hypocapnia) through excessive
ventilation (increased “minute volume”) during rapid, deep, and dysrhythmic breathing, a condition that may result
in debilitating short-term and long-term physical and psychological complaints and symptoms. The slight shifts in
CO2 chemistry associated with overbreathing may cause physiological changes such as hypoxia (oxygen deficit),
cerebral vasoconstriction (brain), coronary constriction (heart), blood and extracellular alkalosis (increased pH),
cerebral glucose deficit, ischemia (localized anemia), buffer depletion (bicarbonates), bronchial constriction, gut
constriction, calcium imbalance, magnesium deficiency, and muscle fatigue, spasm (tetany), and pain.
*Note: “Overbreathing” is a behavior leading to the physiological condition known as hypocapnia, i.e., carbon dioxide deficit.
“Hyperventilation,” although nomenclature synonymous with hypocapnia in physiological terms, is often used as a clinical term to describe a
controversial psychophysiologic “syndrome” implicated in panic disorder and other clinical complaints.
Effects of Overbreathing on Cerebral O2:
Vasoconstrictive effects
Reduction of O2 Availability by 40 Percent
(Red = most O2, dark blue = least O2)
In this image, oxygen availability in the brain is reduced by 40% as a
result of about a minute of overbreathing (hyperventilation). Not only is
oxygen availability reduced, but glucose critical to brain functioning is
also markedly reduced as a result of cerebral vasoconstriction.
3
Blood is distributed based on metabolic requirement. Overbreathing is excessive ventilation of carbon dioxide,
excessive because CO2 levels in the blood no longer accurately reflect metabolic level; the ratio of metabolic CO2
to expired CO2 has shifted in favor of exhaled CO2. The consequence is a miscalculation of local metabolic
requirements that leads to less than the required amount of vasodilation, or to vasoconstriction, and thus to
potentially serious deficits of oxygen (hypoxia) and glucose (hypoglycemia) as well as of other required nutrients
for the optimal functioning of a wide variety of tissues and physiological systems (e.g., brain, heart, and lungs).
This misinformation about metabolism also triggers constriction of other smooth muscles, e.g., in the bronchioles
and the gut, thus potentially exacerbating both asthma and irritable bowel syndrome.
Carbon dioxide deficit means a reduction in carbonic acid and a corresponding shift of blood and extracellular fluid
pH in the alkaline direction, i.e., above the normal range of 7.38 – 7.40; alkalosis is an immediate consequence of
hypocapnia. Paradoxically, this results in an increase in oxygen saturation in the blood, because hemoglobin does
not encounter pH levels that accurately reflect current metabolic requirements and is thus less inclined than it would
otherwise be to release its oxygen; the pH level does not properly reflect metabolic requirements. Thus, although
oxygen saturation is maximized, oxygen distribution is withheld where in fact metabolic needs significantly exceed
those reflected by the reduced CO2 levels resulting from overbreathing.
The coupling of vasoconstriction and "disinclined" hemoglobin (because of higher pH levels) means significant
compounding of oxygen distribution problems where oxygen deficits (hypoxia) are considerably greater than those
brought about by vasoconstriction alone, e.g., deficits, in effect, that may exceed 50 percent in the brain. Combining
these effects with glucose deficit in the brain, in the heart, and in other physiological systems can precipitate,
exacerbate, and even originate serious consequences, including physiological and psychological complaints,
symptoms, and syndromes of numerous kinds (see below).
Alkalosis, i.e., increased pH due to reduced levels of CO2, leads to yet further compromises. Extracellular fluid
alkalosis increases cellular excitability and contractility (e.g., neuronal excitability in the brain) and thus actually
increases oxygen demand, anaerobic metabolism, and antioxidant depletion (caused by excitatory amino acids).
And, in fact, yet further worsening matters, alkalosis inhibits the negative feedback normally associated with lower
pH levels that limit the production of metabolic acids themselves (e.g., lactate), and hence yet further compromises
performance. Blood alkalosis leads to migration of calcium ions into muscle tissue, including both smooth (e.g.,
coronary, vasocerebral, bronchial, gut) and skeletal tissue, resulting in increased likelihood of muscle spasm
(tetany), fatigue, and pain. And, platelet aggregation is increased, thus elevating the likelihood of blood clotting.
Overbreathing is an insidious and unconscious habit, one that is not readily detectable. Overbreathing may be
precipitated at stressful times of the day, during times of defensiveness and emotionality, during information
overload, or upon the commencement of ordinary tasks through self-initiation or instructions from authority. Some
individuals overbreathe with little provocation and may do so chronically, all day without knowing it. And,
unfortunately overbreathing is even induced (often) and reinforced by professionals who teach breathing mechanics
(e.g., diaphragmatic training) in the name of relaxation, improved health, and better performance. Good chemistry
is fundamental to optimal behavioral-physiologic homeostasis, basic to optimizing health and performance.
Chronic Deregulation: Compensatory Behavioral-Physiologic Activity and its Price
Bicarbonates are required for controlling acidosis (when blood becomes less alkaline than normal, less than 7.38),
i.e., neutralizing acids, brought about through physical activity (e.g., lactic acid) as well as through other physiologic
activities (e.g., ketoacidosis as a result of diabetes). Chronic hypocapnia resulting from overbreathing ultimately
leads to compensatory renal unloading of bicarbonates (inhibition of bicarbonate reabsorption in the kidneys), which
lowers blood and intracellular pH toward normal levels, but in the end neither completely renormalizing nor
stabilizing pH levels. Unfortunately, chronic compensatory behavior may ultimately seriously compromise
buffering capabilities, resulting in reduced physical endurance and greater susceptibility to fatigue.
In addition to the loss of bicarbonates, there is also significant loss of magnesium (and phosphates) a deficiency that
may ultimately lead to an imbalanced magnesium-calcium ratio critical to muscle functioning, resulting in increased
likelihood of muscle fatigue, weakness, and spasm.
4
Although the blood pH, i.e. alkalosis, is reduced as a result of this compensatory behavior, and hemoglobin
distributes its oxygen more consistently with metabolic requirements, smooth muscle constriction and its
consequences remain a chronic condition (e.g., cerebral vasoconstriction, coronary constriction, bronchial
constriction, and gut constriction).
Note: Individuals suffering with diabetes may overbreathe as a means to controlling ketoacidosis, i.e., reducing levels of carbonic acid. This is
why biofeedback for “relaxation training,” for example, was contraindicated for such individuals. Normalizing CO2 levels implicit in relaxation
training, without proper attention to matter of chemistry, might well result in acidosis. The “price” for compensatory overbreathing behavior,
however, is high and nevertheless needs to be seriously addressed.
Overbreathing: Effects on Health
Overbreathing, based on the chemistry of breathing described above, can trigger or exacerbate physical and
psychological complaints such as: shortness of breath, breathlessness, chest tightness and pressure, chest pain,
feelings of suffocation, sweaty palms, cold hands, tingling of the skin, numbness, heart palpitations, irregular heart
beat, anxiety, apprehension, emotional outbursts, stress, tenseness, fatigue, weakness, exhaustion, dry mouth,
nausea, lightheadedness, dizziness, fainting, black-out, blurred vision, confusion, disorientation, attention deficit,
poor thinking, poor memory, poor concentration, impaired judgment, problem solving deficit, reduced pain
threshold, headache, trembling, twitching, shivering, muscle tension, muscle spasms, stiffness, abdominal cramps
and bloatedness. It is little wonder, then, why surveys have found that up to 60 percent of all ambulance calls in
major US cities are the result of overbreathing!
The significance of the effects of this little known but thoroughly documented physiology can be put into
perspective knowing that surveys suggest that 10 to 25 percent of the US population suffers from chronic
overbreathing, and that over half of us overbreathe on frequent occasion! The following is a quotation from a book
chapter written by Dr. Herbert Fensterheim (Chapter 9, Behavioral and Psychological Approaches to Breathing
Disorders, 1994), a highly respected and internationally prominent author and psychotherapist, and it points to the
fundamental importance of evaluating respiratory chemistry, i.e., overbreathing, in the mental health professions,
regardless of a practitioner’s school of thought or treatment paradigm:
“Given the high frequency of incorrect breathing patterns in the adult population, attention to the symptoms of
hyperventilation [overbreathing] should be a routine part of every psychological evaluation, regardless of the specific
presenting complaints. Faulty breathing patterns affect patients differently. They may be the central problem,
directly bringing on the pathological symptoms; they may magnify, exacerbate, or maintain symptoms brought on by
other causes; or they may be involved in peripheral problems that must be ameliorated before psychotherapeutic
access is gained to the core treatment targets. Their manifestations may be direct and obvious, as when overbreathing
leads to a panic attack, or they may initiate or maintain subtle symptoms that perpetuate an entire personality
disorder. Diagnosis of hyperventilatory [overbreathing] conditions is crucial.”
Chronic vasoconstriction, magnesium-calcium imbalance, buffer depletion, and alkalosis (higher levels of blood and
extracellular pH levels) as a result of overbreathing may in predisposed individuals trigger or exacerbate: phobias,
migraine phenomena, hypertension, attention disorder, asthma attacks, angina attacks, heart attacks, cardiac
arrhythmias, thrombosis (blood clotting) panic attacks, hypoglycemia, epileptic seizures, altitude sickness, muscle
weakness and spasm, sexual dysfunction, sleep disturbances (apnea), allergy, irritable bowel syndrome (IBS),
repetitive strain injury (RSI), and chronic fatigue.
In an important recent review article on the subject of hypocapnia (CO2 deficit) in the New England Journal of
Medicine (J. Laffey and B. Kavanagh, 4 July 2002), the authors say:
“…extensive data from a spectrum of physiological systems indicate that hypocapnia has the potential to propagate or
initiate pathological processes. As a common aspect of many acute disorders, hypocapnia may have a pathogenic role in the
development of systemic diseases” (pages 44 and 46). And, they go on to say, “Increasing evidence suggests that
hypocapnia appears to induce substantial adverse physiological and medical effects” (page 51).
Long-term vasoconstriction may also lead to ischemia in the brain and the heart (anemia in cells not adequately
supplied with oxygen), result in reduced neurotransmitter synthesis that contributes to the onset of depression and
other psychological syndromes, and chronically lower the threshold for most of the complaints listed above, e.g.,
chronic vasoconstriction and increased systemic vascular resistance may reduce the threshold for elevated blood
pressure or precipitate angina attack in predisposed individuals.
5
It is estimated that the primary complaint of one third of all patients in general medical practice is fatigue, a
condition that may actually be brought on and/or exacerbated by buffer depletion resulting from overbreathing, and
a condition (fatigue) in and of itself that can be assessed through CO2 measurement (capnometry) to be described
later in this overview. On this basis alone, some prominent physicians in both Europe and America assert that
capnometers, like blood pressure devices, should be on the desktop of every general and family practitioner.
It is estimated that more than a third of all those who suffer with asthma overbreathe, a condition potentially leading
to immediate bronchial constriction and asthma attack. The “struggle” to breathe and fear of “not getting enough
air” can easily lead to “panicky” breathing where vicious circle overbreathing may result in a progressive worsening
of hypocapnia-induced bronchial constriction and increased airway resistance. Teaching good breathing mechanics
to people with asthma through diaphragmatic breathing can very significantly improve breathing efficiency by
increasing volume, reducing rate, establishing rhythmicity, and eliminating collateral muscle movement not required
for good breathing. In effect, it reduces the “struggle” to breathe by introducing an effortlessness form of breathing
that also provides for a sense of mastery over the debilitating effects of the condition. This training, however, can
itself easily result in overbreathing through a combination of the “success” of the method itself (increased efficiency,
volume) and the continued motivation “to get enough air,” and where neither the therapist nor the patient are
familiar with overbreathing and its effects.
Documented medical savings of 45 percent over a five year period in heart attack patients following only six
breathing training sessions, led to legislation in Holland that all cardiac rehabilitation centers offer breathing training
to patients. Unfortunately, this little known research and its highly practical implications remain relatively unknown
to most professionals working in American cardiac rehabilitation centers, where the importance of behavioral
respiratory physiology has simply not been introduced. The importance of breathing training in cardiovascular
health is yet further supported by the article in the New England Journal of Medicine (page 50), where the authors
point out that “hypocapnia has been clearly linked to the development of arrhythmias, both in critically ill patients
and in patients with panic disorder.”
How can “simple” breathing training significantly influence the outcome of cardiovascular rehabilitation in patients
who overbreathe? Consider the following: A survey of studies on overbreathing and coronary constriction show a
reduction of blood volume by about 50 percent (a 23 percent reduction in coronary diameter), a significant reduction
in compromised individuals; and, extreme coronary constriction as a result of overbreathing has also been identified
in a subpopulation of patients. Increased platelet aggregation brought about by hypocapnia may precipitate blood
clotting, i.e., thrombosis. Buffer depletion resulting from long-term overbreathing, as described earlier, may also
significantly contribute to the onset of arrhythmias and other cardiovascular abnormalities. Increased vascular
resistance as a result of vasoconstriction and alkalosis brought about through chronic overbreathing may trigger
hypertension in predisposed individuals. Hypocapnia leads to cellular excitability and to increased contractility of
the heart, increasing oxygen demand while oxygen availability is sharply decreased. And, the upward pH shift
brings on calcium migration into muscle tissue, increasing the likelihood of arterial (coronary) spasm. Normalizing
breathing chemistry reverses these effects.
The New England Journal of Medicine article goes on to point out that clinically significant overbreathing in
pregnant women is commonplace, and that during childbirth, “…further lowering of the partial pressure of arterial
CO2 - even for a short duration - such as during anesthesia for cesarean section - may have serious adverse effects
on the fetus.” The implications of this statement are staggering when considering that some child-birthing
techniques used by many thousands of women (western) worldwide actually engaged women in the practice of
extreme forms of overbreathing during childbirth.
Overbreathing during wakefulness is seriously implicated as an important variable in the origin and in the onset of
sleep apnea. “Hypocapnia is a common finding in patients with sleep apnea and may be pathogenic,” according to
the same article in New England Journal of Medicine.
The seriousness of the effects of hypocapnia are made absolutely clear in the New England Journal of Medicine
review article, written for the express purpose of warning physicians about their use of hypocapnia as a means to
controlling symptoms and conditions resulting from injury and disease, as well as its widespread use in general
anesthesia. In fact, the impact of hypocapnia on cerebral blood flow and blood volume is so dramatic, according the
article, that almost 50 percent of emergency physicians and 36 percent of neurosurgeons actually induce hypocapnia
to control of life-threatening intracranial swelling resulting from head trauma or brain injury.
6
Overbreathing: Effects on Cognition
Cognitive and perceptual deficits are perhaps most clearly understood by newcomers to this physiology by
examining the effects of hypoxia on the behavior of pilots. Every pilot knows about the cognitive and perceptual
deficits resulting from the effects of hypoxia in high altitude chambers, including impaired decision-making,
perceptual motor skills, information processing, problem solving, task completion, memory, thinking, and
communication effectiveness. Serious cerebral hypoxia means that even the easiest of tasks become significant
mental challenges, e.g., simple navigational calculations during an engine-out procedure. In fact, overbreathing is
routinely monitored in fighter pilots while in flight. Particularly noteworthy, as is often emphasized by on-looking
observers, is the fact that these performance decrements go completely undetected by those actually suffering from
the hypoxia. Overbreathing at sea level and the resulting hypoxia produce precisely these same effects!
The potent impact of overbreathing on cerebral functioning is made clear in the recent article in the New England
Journal of Medicine in the description of the use of hypocapnia for controlling intracranial swelling in otherwise
life-threatening brain trauma circumstances: “Hypocapnic alkalosis decreases cerebral blood flow by means of
potent cerebral vasoconstriction, thereby lowering intracranial pressure.” The dramatic impact of overbreathing on
cognitive function is put into further perspective, when the authors describe the widespread and deliberate induction
of hypocapnia during general anesthesia (e.g., for reducing the need for sedatives), as follows:
“The causative role of hypocapnia in postoperative cognitive dysfunction is underscored by the finding that exposure to an
elevated partial pressure of arterial carbon dioxide [i.e., normalizing CO2 levels] during anesthesia appears to enhance
postoperative neuropsychologic performance.”
Cognitive, perceptual, and motor skill deficits, brought about by hypoxia (oxygen deficit) are yet further exacerbated
by cerebral hypoglycemia (glucose deficit, as a result of vasoconstriction) that may compromise brain functioning to
a yet greater degree. The potentially debilitating combination of cerebral oxygen and glucose deficits resulting
directly from overbreathing may seriously compromise and/or disrupt ability to attend, focus, concentrate, imagine,
rehearse the details of an action (e.g., golf swing), initiate performance, play a musical instrument, sing, engage in
public speaking, and perform all kinds of other complex tasks.
There is a fine line between vigilance and stress. In the transition from vigilance to stress, i.e., from positive
attentiveness to guarded defensiveness (fight-flight behavioral patterns), overbreathing may be immediately instated
with its debilitating effects occurring within less than a minute. This same kind of transition may occur when taskdemand
exceeds a certain level of complexity or when relationship challenge exceeds a certain level of emotionality:
overbreathing as a component of defensive posturing takes over. Task-induced overbreathing for example can
insidiously and unsuspectingly contribute to the degradation of human performance, insidious because the performer
is neither likely to be aware that overbreathing is taking place, nor have any idea whatsoever as to its effects.
Performers who are task-induced “overbreathers” are good candidates for breathing chemistry training.
The implications of overbreathing and its regulation for working with children and adults suffering with attention
deficits are significant. Low cerebral CO2 as a result of overbreathing shifts the EEG power spectrum downwards
and elevates the presence of theta EEG activity, the frequency domain of principal interest to neurofeedback
practitioners who seek to reduce theta activity in clients who suffer attention deficit disorder. Before beginning such
work it truly behooves practitioners to normalize the chemistry of breathing, a fundamental system-wide
physiological consideration, before beginning neurofeedback or other forms of behavioral-physiologic training.
Overbreathing: its Effects on Emotion
Cerebral hypoxia and cerebral hypoglycemia not only have profound effects on cognition and perception but also on
emotionality: apprehension, anxiety, anger, frustration, fear, panic, stress, vulnerability, and feelings of low selfesteem.
Cerebral (brain) oxygen and glucose deficits may trigger “disinhibition” of emotional states, i.e., release of
emotions otherwise held “in check.” Loss of emotional control, intensification of emotional states, and exacerbation
of debilitating stressful states of consciousness may result from overbreathing in challenging and adverse
circumstances, e.g., flying phobias and debilitating public speaking anxiety. Emotional discharge in challenging
environments itself may, of course, further exacerbate cognitive and other performance deficits.
7
Failure to understand the source of physical sensations resulting from overbreathing, e.g., light-headedness, tingling
of the skin, tightness of the chest, sweaty hands, and breathlessness, typically leads to a false interpretation of their
meaning. The incorrect, and usually negative, self assessment that may result, e.g., “I am losing control,” is likely to
elicit secondary emotional responses (e.g., fear) and further exacerbate the ones directly resulting from cerebral
oxygen and glucose deficits. And indeed, practitioners and trainers themselves, not familiar with the effects of
overbreathing, may unfortunately also misinterpret these secondary effects, taking them as evidence supporting their
own biases about the significance of the kinds of complaints reported by the client, e.g., “relaxation moves you
closer to yourself, and this makes you uncomfortable. Overworking is your way of protecting yourself.”
Sometimes overbreathing is deliberately induced for the very reason that it can trigger emotional memories and
states, e.g., rebirthing. Stanislav Grof’s Holotropic Breathwork, widely known for its use in triggering emotional
and memory release, is an excellent example of how overbreathing lowers the threshold for emotional expression.
Some breathing inductions used in natural child birth, for example, involve extreme forms of overbreathing, based
on the premise that disorientation reduces capacity to focus on pain; from a respiratory chemistry perspective,
however, this amounts to induction of system-wide crisis with potentially adverse effects on the infant.
Overbreathing: Effects on Performance
Compromising the blood buffering system (i.e., reduced capacity to regulate acidosis) means reduced physical
capacity and endurance, ranging from limiting athletes in their pursuit of achieving peak levels of physical
performance, to contributing to the incapacitation of individuals with fatigue and unable to perform the simplest of
tasks without exhausting their supply of buffers.
Incrementally increasing the workload on an exercise bike or treadmill increases metabolism, and hence the output
of carbon dioxide. Normal ventilation means that the CO2 exhaled is consistent with level of metabolism; there is
no overbreathing. Eventually, however, when buffers become depleted and can no longer neutralize lactic and other
acid byproducts, overbreathing becomes a short-term solution to the resulting acidosis, i.e., carbonic acid is reduced,
thus offsetting the build up of other acids. Monitoring CO2 levels during exercise on an exercise bike or treadmill
permits an observer to take note of this critical point, the point at which overbreathing is itself a compensatory
response to buffer depletion, the point at which physical exhaustion can be identified. And, as described previously,
chronic overbreathing itself may lead to buffer depletion, thus ultimately reducing physical capacity and endurance
to a point where simple exercise becomes equivalent to the maximum endurance effort of an athlete.
Buffer depletion physiology has very significant implications for performance and health. Running out of buffers
with exercise equivalent to walking to work, crossing a few streets to lunch, or preparing dinner for the family
means “physical” exhaustion doing the simple physical chores that define the daily routine of life. Overbreathing
may not only lead to buffer depletion but may then also become its own short-term solution to the resulting acidosis,
i.e., a vicious circle syndrome. This state of affairs can be observed by exercising on an exercise bike or treadmill
and noting the point at which there is a drop in carbon dioxide level, the point at which overbreathing is engaged.
Professional and lay audiences both ponder the ways in which “stress” ultimately has its effects on health and
performance. What are the mediating variables that lead to behavior-physiologic deregulation? One important
contributing factor may be the way in which one encounters challenge: bracing or embracing, defensive-posturing or
life-engaging? The defensive or bracing mode often includes overbreathing (part of the “fight-flight” behavioral
configuration) that may lead to the fatigue symptoms and complaints associated with the effects of buffer depletion
and magnesium deficiency, along with the wide range of physical and psychological effects previously described.
The “fatigue” associated with overbreathing may be misidentified as “depression.” Exercise may be “prescribed”
when rest is in order, where exercise will actually exacerbate the problem and is contraindicated. Buffer depletion,
resulting from exercise and associated compensatory overbreathing, may in fact precipitate cardiac arrhythmias even
in otherwise healthy individuals. Rest will permit build-up of the buffers, but upon returning to a challenging
environment without breathing and other forms of self-management training, overbreathing is likely to be reinstated,
once again resulting in buffer depletion and a relapse of fatigue and associated effects of “stress.” Deregulated
respiratory chemistry constitutes a behavioral-physiologic mechanism that may directly account for some of the
effects of “stress” on homeostasis and self-regulation.
8
Respiratory Training: General Considerations
Fritjof Capra, famed physicist and systems theorist, states his position on the mindbody dichotomy so well when he
says, “the organizing activity of living systems, at all levels of life, is mental activity” (The Web of Life, 1996). In
other words, there simply is no dichotomy, that all of life is itself inherently “mindful.” Thus, in this thesis there is
no distinction between physiological or psychological crisis; defensive posturing or bracing and life-engaging or
embracing are “mindful” frames of physiological reference, comprising what might be described as “life” postures.
These “life” postures are fundamental operating-definition culture-based concepts as can be seen in Western
psychology where there is emphasis on defensiveness, and in Eastern philosophy and practice (e.g., meditation),
where there is emphasis on embracement of chi, i.e., life or breath. Both of these postures are profoundly reflected
in the chemistry and in the mechanics of respiration.
Breathing evaluation and training bring together differing western schools of thought and tradition, including
physiology, psychology, healthcare, and human performance with the promise of weaving them together with
Eastern thinking, traditions, and practice into an active, personal, and mindful participation in behavioralphysiologic
self-regulation for health and performance.
Seeing “physiology as mindful” carries with it an important implication: it is the “ego” part of the mind that
identifies itself as “separate” from the “body,” giving rise to the mind-body dichotomy through its indignant claim
on ownership of all of the mind, wherein the mind necessarily came to be viewed as “our” unconscious, rather than
as a property of the fundamental essence of life itself and in all of its forms. Accessing the body, then, for the
“mindful physiology” oriented practitioner, means accessing the mind: intuitions, images, feelings, archetypes, and
meaning itself. Accessing the mind through body sensitivity training is fundamental to what has come to be known
as biofeedback and is the basis for breathing evaluation and training. It is little wonder that breathing is a point of
physio-spiritual connection in Eastern philosophical thinking.
As Capra points out in his book, The Web of Life, the whole is not simply greater than its parts but actually provides
for the definition, the very identity, of the parts themselves. Overbreathing sets the stage for crisis, even for trauma,
and for a consciousness of defensive posturing and bracing. It engages state-dependent behaviors, even statedependent
personalities, which are protective in nature offering the prospect of safety in a threatening world;
overbreathing becomes a doorway into a different consciousness where one may disconnect, isolate, or flee, but pay
the price of behavioral physiologic deregulation. Changing consciousness, means changing the definition of
constituent physiological dynamics: rapid heart rate is a sign of stress in the context of defensiveness, whereas it is a
sign of joy in the context of embracement. Good respiratory chemistry and mechanics set the stage for
“embracement,” rather than defensiveness, as a “life” posture. Wellness is ultimately about embracing, about the
heart, about bringing together the mindfulness of physiology with the personal consciousness. Health is about
seeking, presence, and availability, not about ego and defensiveness. When naked, don’t overbreathe, be there.
Learning about the behavioral physiology of respiration offers the prospect of bringing easy to understand, highly
practical, and easy to implement educational applications of “mindful-physiology” to healthcare and human
performance practitioners everywhere. Everyone acknowledges some measure or responsibility for breathing, as is
evidenced by everyone’s use of the pronoun “I.” Breathing training is an ideal context in which to teach people
about the mindful nature of physiology, where self-regulation training for health and performance can make a
powerful impact on the practical thinking of large audiences within a short time. The theme is: “The whole body is
the organ of the mind, not just the brain. Our minds are the music that our bodies play to the universe.”
Respiratory Training: Specific Considerations
Breathing chemistry training does NOT replace breathing mechanics training; the two together comprise true
respiratory training (i.e., getting O2 to the cells and CO2 back to the lungs). There is NO specific breathing
protocol, technique, or program that constitutes the “right one,” however, keeping respiratory chemistry in the
adaptive window is a critical consideration in most any kind of breathing training. There are numerous approaches
to teaching the mechanics of adaptive breathing that permit practitioners to integrate breathing evaluation and
training into their work based on professional background, expertise, experience. Unfortunately, however, in very
few cases is the chemistry of breathing included as a component of the training.
9
Breathing is a complex behavior. It is voluntary and involuntary. It is greatly influenced by emotion. It is
synchronized with complex speech behavior. Basic neurophysiological control of breathing originates in the
respiratory centers located in the brain stem, the pons and medulla, where breathing rate and volume are regulated
based on CO2 levels. While in a coma, breathing mechanics (rate and volume) track CO2 levels precisely. There
are other breathing centers throughout the brain including the limbic system (emotion), the speech areas of the brain,
and the frontal cortex (voluntary control). These other regulatory centers may interfere with adaptive breathing,
resulting in deregulated breathing, overbreathing that is often associated with breath holding, gasping, sighing, chest
breathing, rapid breathing, reverse breathing (contracting the diaphragm while breathing out), and so on. Training
for adaptive breathing chemistry, in most instances, means restoring regulated breathing through reinstatement of
the basic brain stem breathing reflex.
How is overbreathing identified? Without monitoring CO2 levels, there is simply no way of knowing. Use of the
capnometer is the only practical and technically reliable method for detecting it with certainty. Arterial carbon
dioxide (PaCO2) can be measured directly through invasive monitoring, or indirectly by means of measurement of
CO2 content in exhaled air. Measurement of CO2 at the end of exhalation, or at the “end” of the “tide” of the air
breathed out, is known as “end-tidal carbon dioxide,” or ETCO2, and is under normal circumstances highly
correlated with invasive arterial measurement. Capnometry is used in virtually every surgery room and critical care
unit in America, and is based on textbook physiology and highly reliable technology.*
The objective of breathing training while “at rest” is to restore proper breathing chemistry (CO2 levels), establish
breathing rhythmicity (reduction of holding, gasping, sighing), lower breathing rate, increase breathing depth, shift
the locus of breathing from chest to diaphragm, encourage nasal breathing, relax musculature during exhalation,
reduce collateral muscle activity, and establish a stable presence of high amplitude breathing heart wave activity
(parasympathetic tone, RSA). Training for good breathing chemistry involves learning how to:
(1) evaluate breathing both at rest and in the context of multiple kinds of challenge;
(2) teach the physiology and psychology of respiration;
(3) identify the sensations of overbreathing, and reinstate the basic brain stem breathing reflex;
(4) interpret physiological experience, e.g., deregulated vs. regulated breathing;
(5) train breathing mechanics: rhythmicity, volume, rate, resistance, and locus of control;
(6) instate prophylactic (deliberate) techniques for consciously disengaging or preventing overbreathing;
(7) configure new patterns of behavioral-physiologic defensive posturing, without overbreathing;
(8) establish “embracement physiology” where overbreathing is not a “mindful” component; and
(9) generalize new patterns of breathing that normalize chemistry in diverse life circumstances.
In summary, training involves: (1) education, (2) learning prophylactic techniques, (3) reinstating the basic
respiratory reflex mechanism, (4) learning new patterns of defensive posturing, and (5) learning to engage
“embracement” physiology by establishing new chemistry and its associated “physiologic mindfulness.”
Breathing evaluation and training may be useful for behavioral physiologic applications by healthcare providers and
patients, performance trainers and athletes/artists, corporate trainers and trainees, behavioral health professionals and
clients, human service providers and clients, consultants and self-improvement trainees, educators and students, and
academicians and researchers. Examples of performance training applications include: improving memory,
enhancing thinking and problem solving skills, improving concentration (playing an instrument), attention training
(e.g., attention deficit), reducing anxiety (e.g., public speaking, test taking), managing stress, managing anger,
decreasing fatigue, increasing alertness and readiness, reducing muscle tension, diminishing physical pain,
facilitating relaxation, facilitating disciplines of inner directedness (e.g., meditation), maximizing performance
training (e.g., flight training), natural child birth preparation, peak performance training (e.g., athletes and coaches),
and evaluating and improving physical condition.
*Measurement of End-Tidal CO2:
The presence of a “gas” is measured in terms of its pressure, and more specifically in terms of its relative pressure contribution to total
atmospheric pressure, i.e., its partial pressure. Total atmospheric pressure on a standard day at sea level is 760 millimeters of mercury (mmHg),
and is comprised of the partial pressures
Date: 02/08/2008
A BRIEF OVERVIEW OF THE CHEMISTRY OF RESPIRATION
AND THE BREATHING HEART WAVE
Peter M. Litchfield, Ph.D. in California Biofeedback. Vol. 19, No. 1 (Spring 2003)
Respiration: Chemistry and Mechanics
“Respiration” is behavioral-physiologic homeostasis, a form of self-regulatory behavior, which constitutes a
transport system for customized delivery of atmospheric oxygen to each and every tissue based on their specific
metabolic requirements, including the transport of metabolic carbon dioxide from the cells to outside air. The
“mechanics” of respiration constitute “breathing,” the use of the lungs for moving oxygen, carbon dioxide, and other
gases to and/or from the blood. The “chemistry” of respiration constitutes the physiology of moving oxygen from
the lungs to the cells, and carbon dioxide from the cells to the lungs. Optimizing respiration means good “chemistry
through good “mechanics.”
In this overview, “breathing mechanics” have reference to breathing rhythmicity (holding, gasping, sighing),
breathing rate, breathing depth (volume), locus of breathing (chest and diaphragm), breathing resistance (nose and
mouth), and collateral muscle activity for breathing regulation (muscles other than the diaphragm). “Breathing
chemistry” has reference to the ventilation of carbon dioxide through these breathing mechanics in the service of
establishing adaptive respiratory chemistry. Respiratory chemistry can be monitored by measuring changes in
exhaled carbon dioxide, to be discussed later, so as to ensure that the learning of breathing mechanics is truly in the
service of respiration.
Good breathing “mechanics” rather than good respiratory physiology, has unfortunately become almost the
exclusive focus of breathing training and learning, often along with insistence on tying it to “relaxation” training
regimens in the context of specific philosophical and/or professional agenda. As a result, it is not surprising then,
that at least 50 percent of therapists and trainers who teach breathing actually deregulate respiratory chemistry by
inducing “overbreathing” with their instructions to trainees, not realizing that they are inducing system-wide
physiological crisis through the establishment of hypocapnia, i.e., carbon dioxide deficit. Unfortunately, based on
this kind of thinking, myths and misunderstandings about “good” breathing often constitute the “working
knowledge” of professionals and lay audiences alike. Here are some of them:
Good breathing means relaxation.
No. Good breathing is important in all circumstances, whether relaxed or not.
Learning good breathing requires relaxation.
No. This would mean that during most life circumstances, breathing is maladaptive.
Diaphragmatic breathing is synonymous with good breathing.
No. In many instances one may begin to overbreathe as a result of switching from chest to diaphragm.
Good respiration is all about the mechanics of breathing.
No. Good breathing means ventilating in accordance with metabolic requirements.
Diaphragmatic, deep, slow breathing means better distribution of oxygen.
No. Mechanics may look letter perfect, but oxygen distribution may be poor.
Underbreathing, with the result of oxygen deficit, is common.
No. To the contrary, overbreathing is common.
Good breathing translates into optimizing respiratory physiology, and contrary to popular thinking, learning to
breathe well does not simply mean deep, slow, diaphragmatic breathing in the context of learning how to relax.
Adaptive breathing means regulating blood chemistry, through proper ventilation of carbon dioxide, in accordance
with metabolic and other physiologic requirements associated with all life activities and circumstances: relaxation or
stress, rest or challenge, fatigue or excitement, attention or open-focus, playing or working. Deregulated breathing
chemistry, i.e., hypocapnia (CO2 deficiency) as a result of overbreathing, means serious physiological crisis
involving system-wide compromises that involve physical and mental consequences of all kinds, to be examined
later in this overview. Evaluating, establishing, maintaining, and promoting good respiratory chemistry are
fundamental to virtually any professional practice involving breathing training. Good breathing chemistry
establishes a system-wide context conducive to optimizing health and maximizing performance.
2
Breathing training is invariably included as an important component of relaxation training, but surely does not in
and of itself constitute relaxation. Breathing may be fully optimized, and hopefully is, during times of stress and
challenge where relaxation is neither possible nor adaptive. Once good breathing chemistry and breathing
mechanics are in place, relaxation training may then also include the establishment of stable high-amplitude
breathing heart waves, i.e., parasympathetic (nervous system) tone, otherwise known as the respiratory sinus
arrhythmia (RSA) and as one of the frequency ranges (HF) of what is known as heart rate variability (HRV).
Respiratory Chemistry: The Role of Carbon Dioxide in Oxygen Distribution
Blood is circulated with great precision to specific body sites based on their local and immediate metabolic
requirements. Higher metabolism in more active tissues and cells generates higher levels of CO2 resulting in
immediate local vasodilation (relaxation of smooth muscles with the result of increasing the diameter of the vessels),
thus setting the stage for supplying the required oxygen and glucose to the associated tissues, such as to specific
regions of the brain while thinking.
Higher levels of CO2 also lead to an immediate drop in blood and extracellular fluid pH levels through the
formation of carbonic acid, thus obliging the hemoglobin to more readily distribute its oxygen to meet local
metabolic requirements. Lower levels of CO2, as a result of lower metabolism, lead to blood vessel constriction
(e.g., reduction in the diameter of the coronaries) and to higher levels of blood and extracellular fluid pH (less
carbonic acid), thus permitting oxygen and glucose to go elsewhere where metabolic requirements are greater. In
the simplest of terms, this is the biochemistry of healthy respiration.
Deregulated Respiration: Effects of Carbon Dioxide Deficit on Physiology
The most serious form of breathing deregulation is overbreathing, an all too common and serious state of
behavioral-physiologic affairs. Overbreathing is undoubtedly one of the most insidious and dangerous
behaviors/responses to environmental, task, emotional, cognitive, and relationship challenges in our daily lives.
Overbreathing can be a dangerous behavior immediately triggering and/or exacerbating a wide variety of serious
physical and mental symptoms, complaints, and deficits in health and human performance.
Overbreathing* means bringing about carbon dioxide (CO2) deficit in the blood (i.e., hypocapnia) through excessive
ventilation (increased “minute volume”) during rapid, deep, and dysrhythmic breathing, a condition that may result
in debilitating short-term and long-term physical and psychological complaints and symptoms. The slight shifts in
CO2 chemistry associated with overbreathing may cause physiological changes such as hypoxia (oxygen deficit),
cerebral vasoconstriction (brain), coronary constriction (heart), blood and extracellular alkalosis (increased pH),
cerebral glucose deficit, ischemia (localized anemia), buffer depletion (bicarbonates), bronchial constriction, gut
constriction, calcium imbalance, magnesium deficiency, and muscle fatigue, spasm (tetany), and pain.
*Note: “Overbreathing” is a behavior leading to the physiological condition known as hypocapnia, i.e., carbon dioxide deficit.
“Hyperventilation,” although nomenclature synonymous with hypocapnia in physiological terms, is often used as a clinical term to describe a
controversial psychophysiologic “syndrome” implicated in panic disorder and other clinical complaints.
Effects of Overbreathing on Cerebral O2:
Vasoconstrictive effects
Reduction of O2 Availability by 40 Percent
(Red = most O2, dark blue = least O2)
In this image, oxygen availability in the brain is reduced by 40% as a
result of about a minute of overbreathing (hyperventilation). Not only is
oxygen availability reduced, but glucose critical to brain functioning is
also markedly reduced as a result of cerebral vasoconstriction.
3
Blood is distributed based on metabolic requirement. Overbreathing is excessive ventilation of carbon dioxide,
excessive because CO2 levels in the blood no longer accurately reflect metabolic level; the ratio of metabolic CO2
to expired CO2 has shifted in favor of exhaled CO2. The consequence is a miscalculation of local metabolic
requirements that leads to less than the required amount of vasodilation, or to vasoconstriction, and thus to
potentially serious deficits of oxygen (hypoxia) and glucose (hypoglycemia) as well as of other required nutrients
for the optimal functioning of a wide variety of tissues and physiological systems (e.g., brain, heart, and lungs).
This misinformation about metabolism also triggers constriction of other smooth muscles, e.g., in the bronchioles
and the gut, thus potentially exacerbating both asthma and irritable bowel syndrome.
Carbon dioxide deficit means a reduction in carbonic acid and a corresponding shift of blood and extracellular fluid
pH in the alkaline direction, i.e., above the normal range of 7.38 – 7.40; alkalosis is an immediate consequence of
hypocapnia. Paradoxically, this results in an increase in oxygen saturation in the blood, because hemoglobin does
not encounter pH levels that accurately reflect current metabolic requirements and is thus less inclined than it would
otherwise be to release its oxygen; the pH level does not properly reflect metabolic requirements. Thus, although
oxygen saturation is maximized, oxygen distribution is withheld where in fact metabolic needs significantly exceed
those reflected by the reduced CO2 levels resulting from overbreathing.
The coupling of vasoconstriction and "disinclined" hemoglobin (because of higher pH levels) means significant
compounding of oxygen distribution problems where oxygen deficits (hypoxia) are considerably greater than those
brought about by vasoconstriction alone, e.g., deficits, in effect, that may exceed 50 percent in the brain. Combining
these effects with glucose deficit in the brain, in the heart, and in other physiological systems can precipitate,
exacerbate, and even originate serious consequences, including physiological and psychological complaints,
symptoms, and syndromes of numerous kinds (see below).
Alkalosis, i.e., increased pH due to reduced levels of CO2, leads to yet further compromises. Extracellular fluid
alkalosis increases cellular excitability and contractility (e.g., neuronal excitability in the brain) and thus actually
increases oxygen demand, anaerobic metabolism, and antioxidant depletion (caused by excitatory amino acids).
And, in fact, yet further worsening matters, alkalosis inhibits the negative feedback normally associated with lower
pH levels that limit the production of metabolic acids themselves (e.g., lactate), and hence yet further compromises
performance. Blood alkalosis leads to migration of calcium ions into muscle tissue, including both smooth (e.g.,
coronary, vasocerebral, bronchial, gut) and skeletal tissue, resulting in increased likelihood of muscle spasm
(tetany), fatigue, and pain. And, platelet aggregation is increased, thus elevating the likelihood of blood clotting.
Overbreathing is an insidious and unconscious habit, one that is not readily detectable. Overbreathing may be
precipitated at stressful times of the day, during times of defensiveness and emotionality, during information
overload, or upon the commencement of ordinary tasks through self-initiation or instructions from authority. Some
individuals overbreathe with little provocation and may do so chronically, all day without knowing it. And,
unfortunately overbreathing is even induced (often) and reinforced by professionals who teach breathing mechanics
(e.g., diaphragmatic training) in the name of relaxation, improved health, and better performance. Good chemistry
is fundamental to optimal behavioral-physiologic homeostasis, basic to optimizing health and performance.
Chronic Deregulation: Compensatory Behavioral-Physiologic Activity and its Price
Bicarbonates are required for controlling acidosis (when blood becomes less alkaline than normal, less than 7.38),
i.e., neutralizing acids, brought about through physical activity (e.g., lactic acid) as well as through other physiologic
activities (e.g., ketoacidosis as a result of diabetes). Chronic hypocapnia resulting from overbreathing ultimately
leads to compensatory renal unloading of bicarbonates (inhibition of bicarbonate reabsorption in the kidneys), which
lowers blood and intracellular pH toward normal levels, but in the end neither completely renormalizing nor
stabilizing pH levels. Unfortunately, chronic compensatory behavior may ultimately seriously compromise
buffering capabilities, resulting in reduced physical endurance and greater susceptibility to fatigue.
In addition to the loss of bicarbonates, there is also significant loss of magnesium (and phosphates) a deficiency that
may ultimately lead to an imbalanced magnesium-calcium ratio critical to muscle functioning, resulting in increased
likelihood of muscle fatigue, weakness, and spasm.
4
Although the blood pH, i.e. alkalosis, is reduced as a result of this compensatory behavior, and hemoglobin
distributes its oxygen more consistently with metabolic requirements, smooth muscle constriction and its
consequences remain a chronic condition (e.g., cerebral vasoconstriction, coronary constriction, bronchial
constriction, and gut constriction).
Note: Individuals suffering with diabetes may overbreathe as a means to controlling ketoacidosis, i.e., reducing levels of carbonic acid. This is
why biofeedback for “relaxation training,” for example, was contraindicated for such individuals. Normalizing CO2 levels implicit in relaxation
training, without proper attention to matter of chemistry, might well result in acidosis. The “price” for compensatory overbreathing behavior,
however, is high and nevertheless needs to be seriously addressed.
Overbreathing: Effects on Health
Overbreathing, based on the chemistry of breathing described above, can trigger or exacerbate physical and
psychological complaints such as: shortness of breath, breathlessness, chest tightness and pressure, chest pain,
feelings of suffocation, sweaty palms, cold hands, tingling of the skin, numbness, heart palpitations, irregular heart
beat, anxiety, apprehension, emotional outbursts, stress, tenseness, fatigue, weakness, exhaustion, dry mouth,
nausea, lightheadedness, dizziness, fainting, black-out, blurred vision, confusion, disorientation, attention deficit,
poor thinking, poor memory, poor concentration, impaired judgment, problem solving deficit, reduced pain
threshold, headache, trembling, twitching, shivering, muscle tension, muscle spasms, stiffness, abdominal cramps
and bloatedness. It is little wonder, then, why surveys have found that up to 60 percent of all ambulance calls in
major US cities are the result of overbreathing!
The significance of the effects of this little known but thoroughly documented physiology can be put into
perspective knowing that surveys suggest that 10 to 25 percent of the US population suffers from chronic
overbreathing, and that over half of us overbreathe on frequent occasion! The following is a quotation from a book
chapter written by Dr. Herbert Fensterheim (Chapter 9, Behavioral and Psychological Approaches to Breathing
Disorders, 1994), a highly respected and internationally prominent author and psychotherapist, and it points to the
fundamental importance of evaluating respiratory chemistry, i.e., overbreathing, in the mental health professions,
regardless of a practitioner’s school of thought or treatment paradigm:
“Given the high frequency of incorrect breathing patterns in the adult population, attention to the symptoms of
hyperventilation [overbreathing] should be a routine part of every psychological evaluation, regardless of the specific
presenting complaints. Faulty breathing patterns affect patients differently. They may be the central problem,
directly bringing on the pathological symptoms; they may magnify, exacerbate, or maintain symptoms brought on by
other causes; or they may be involved in peripheral problems that must be ameliorated before psychotherapeutic
access is gained to the core treatment targets. Their manifestations may be direct and obvious, as when overbreathing
leads to a panic attack, or they may initiate or maintain subtle symptoms that perpetuate an entire personality
disorder. Diagnosis of hyperventilatory [overbreathing] conditions is crucial.”
Chronic vasoconstriction, magnesium-calcium imbalance, buffer depletion, and alkalosis (higher levels of blood and
extracellular pH levels) as a result of overbreathing may in predisposed individuals trigger or exacerbate: phobias,
migraine phenomena, hypertension, attention disorder, asthma attacks, angina attacks, heart attacks, cardiac
arrhythmias, thrombosis (blood clotting) panic attacks, hypoglycemia, epileptic seizures, altitude sickness, muscle
weakness and spasm, sexual dysfunction, sleep disturbances (apnea), allergy, irritable bowel syndrome (IBS),
repetitive strain injury (RSI), and chronic fatigue.
In an important recent review article on the subject of hypocapnia (CO2 deficit) in the New England Journal of
Medicine (J. Laffey and B. Kavanagh, 4 July 2002), the authors say:
“…extensive data from a spectrum of physiological systems indicate that hypocapnia has the potential to propagate or
initiate pathological processes. As a common aspect of many acute disorders, hypocapnia may have a pathogenic role in the
development of systemic diseases” (pages 44 and 46). And, they go on to say, “Increasing evidence suggests that
hypocapnia appears to induce substantial adverse physiological and medical effects” (page 51).
Long-term vasoconstriction may also lead to ischemia in the brain and the heart (anemia in cells not adequately
supplied with oxygen), result in reduced neurotransmitter synthesis that contributes to the onset of depression and
other psychological syndromes, and chronically lower the threshold for most of the complaints listed above, e.g.,
chronic vasoconstriction and increased systemic vascular resistance may reduce the threshold for elevated blood
pressure or precipitate angina attack in predisposed individuals.
5
It is estimated that the primary complaint of one third of all patients in general medical practice is fatigue, a
condition that may actually be brought on and/or exacerbated by buffer depletion resulting from overbreathing, and
a condition (fatigue) in and of itself that can be assessed through CO2 measurement (capnometry) to be described
later in this overview. On this basis alone, some prominent physicians in both Europe and America assert that
capnometers, like blood pressure devices, should be on the desktop of every general and family practitioner.
It is estimated that more than a third of all those who suffer with asthma overbreathe, a condition potentially leading
to immediate bronchial constriction and asthma attack. The “struggle” to breathe and fear of “not getting enough
air” can easily lead to “panicky” breathing where vicious circle overbreathing may result in a progressive worsening
of hypocapnia-induced bronchial constriction and increased airway resistance. Teaching good breathing mechanics
to people with asthma through diaphragmatic breathing can very significantly improve breathing efficiency by
increasing volume, reducing rate, establishing rhythmicity, and eliminating collateral muscle movement not required
for good breathing. In effect, it reduces the “struggle” to breathe by introducing an effortlessness form of breathing
that also provides for a sense of mastery over the debilitating effects of the condition. This training, however, can
itself easily result in overbreathing through a combination of the “success” of the method itself (increased efficiency,
volume) and the continued motivation “to get enough air,” and where neither the therapist nor the patient are
familiar with overbreathing and its effects.
Documented medical savings of 45 percent over a five year period in heart attack patients following only six
breathing training sessions, led to legislation in Holland that all cardiac rehabilitation centers offer breathing training
to patients. Unfortunately, this little known research and its highly practical implications remain relatively unknown
to most professionals working in American cardiac rehabilitation centers, where the importance of behavioral
respiratory physiology has simply not been introduced. The importance of breathing training in cardiovascular
health is yet further supported by the article in the New England Journal of Medicine (page 50), where the authors
point out that “hypocapnia has been clearly linked to the development of arrhythmias, both in critically ill patients
and in patients with panic disorder.”
How can “simple” breathing training significantly influence the outcome of cardiovascular rehabilitation in patients
who overbreathe? Consider the following: A survey of studies on overbreathing and coronary constriction show a
reduction of blood volume by about 50 percent (a 23 percent reduction in coronary diameter), a significant reduction
in compromised individuals; and, extreme coronary constriction as a result of overbreathing has also been identified
in a subpopulation of patients. Increased platelet aggregation brought about by hypocapnia may precipitate blood
clotting, i.e., thrombosis. Buffer depletion resulting from long-term overbreathing, as described earlier, may also
significantly contribute to the onset of arrhythmias and other cardiovascular abnormalities. Increased vascular
resistance as a result of vasoconstriction and alkalosis brought about through chronic overbreathing may trigger
hypertension in predisposed individuals. Hypocapnia leads to cellular excitability and to increased contractility of
the heart, increasing oxygen demand while oxygen availability is sharply decreased. And, the upward pH shift
brings on calcium migration into muscle tissue, increasing the likelihood of arterial (coronary) spasm. Normalizing
breathing chemistry reverses these effects.
The New England Journal of Medicine article goes on to point out that clinically significant overbreathing in
pregnant women is commonplace, and that during childbirth, “…further lowering of the partial pressure of arterial
CO2 - even for a short duration - such as during anesthesia for cesarean section - may have serious adverse effects
on the fetus.” The implications of this statement are staggering when considering that some child-birthing
techniques used by many thousands of women (western) worldwide actually engaged women in the practice of
extreme forms of overbreathing during childbirth.
Overbreathing during wakefulness is seriously implicated as an important variable in the origin and in the onset of
sleep apnea. “Hypocapnia is a common finding in patients with sleep apnea and may be pathogenic,” according to
the same article in New England Journal of Medicine.
The seriousness of the effects of hypocapnia are made absolutely clear in the New England Journal of Medicine
review article, written for the express purpose of warning physicians about their use of hypocapnia as a means to
controlling symptoms and conditions resulting from injury and disease, as well as its widespread use in general
anesthesia. In fact, the impact of hypocapnia on cerebral blood flow and blood volume is so dramatic, according the
article, that almost 50 percent of emergency physicians and 36 percent of neurosurgeons actually induce hypocapnia
to control of life-threatening intracranial swelling resulting from head trauma or brain injury.
6
Overbreathing: Effects on Cognition
Cognitive and perceptual deficits are perhaps most clearly understood by newcomers to this physiology by
examining the effects of hypoxia on the behavior of pilots. Every pilot knows about the cognitive and perceptual
deficits resulting from the effects of hypoxia in high altitude chambers, including impaired decision-making,
perceptual motor skills, information processing, problem solving, task completion, memory, thinking, and
communication effectiveness. Serious cerebral hypoxia means that even the easiest of tasks become significant
mental challenges, e.g., simple navigational calculations during an engine-out procedure. In fact, overbreathing is
routinely monitored in fighter pilots while in flight. Particularly noteworthy, as is often emphasized by on-looking
observers, is the fact that these performance decrements go completely undetected by those actually suffering from
the hypoxia. Overbreathing at sea level and the resulting hypoxia produce precisely these same effects!
The potent impact of overbreathing on cerebral functioning is made clear in the recent article in the New England
Journal of Medicine in the description of the use of hypocapnia for controlling intracranial swelling in otherwise
life-threatening brain trauma circumstances: “Hypocapnic alkalosis decreases cerebral blood flow by means of
potent cerebral vasoconstriction, thereby lowering intracranial pressure.” The dramatic impact of overbreathing on
cognitive function is put into further perspective, when the authors describe the widespread and deliberate induction
of hypocapnia during general anesthesia (e.g., for reducing the need for sedatives), as follows:
“The causative role of hypocapnia in postoperative cognitive dysfunction is underscored by the finding that exposure to an
elevated partial pressure of arterial carbon dioxide [i.e., normalizing CO2 levels] during anesthesia appears to enhance
postoperative neuropsychologic performance.”
Cognitive, perceptual, and motor skill deficits, brought about by hypoxia (oxygen deficit) are yet further exacerbated
by cerebral hypoglycemia (glucose deficit, as a result of vasoconstriction) that may compromise brain functioning to
a yet greater degree. The potentially debilitating combination of cerebral oxygen and glucose deficits resulting
directly from overbreathing may seriously compromise and/or disrupt ability to attend, focus, concentrate, imagine,
rehearse the details of an action (e.g., golf swing), initiate performance, play a musical instrument, sing, engage in
public speaking, and perform all kinds of other complex tasks.
There is a fine line between vigilance and stress. In the transition from vigilance to stress, i.e., from positive
attentiveness to guarded defensiveness (fight-flight behavioral patterns), overbreathing may be immediately instated
with its debilitating effects occurring within less than a minute. This same kind of transition may occur when taskdemand
exceeds a certain level of complexity or when relationship challenge exceeds a certain level of emotionality:
overbreathing as a component of defensive posturing takes over. Task-induced overbreathing for example can
insidiously and unsuspectingly contribute to the degradation of human performance, insidious because the performer
is neither likely to be aware that overbreathing is taking place, nor have any idea whatsoever as to its effects.
Performers who are task-induced “overbreathers” are good candidates for breathing chemistry training.
The implications of overbreathing and its regulation for working with children and adults suffering with attention
deficits are significant. Low cerebral CO2 as a result of overbreathing shifts the EEG power spectrum downwards
and elevates the presence of theta EEG activity, the frequency domain of principal interest to neurofeedback
practitioners who seek to reduce theta activity in clients who suffer attention deficit disorder. Before beginning such
work it truly behooves practitioners to normalize the chemistry of breathing, a fundamental system-wide
physiological consideration, before beginning neurofeedback or other forms of behavioral-physiologic training.
Overbreathing: its Effects on Emotion
Cerebral hypoxia and cerebral hypoglycemia not only have profound effects on cognition and perception but also on
emotionality: apprehension, anxiety, anger, frustration, fear, panic, stress, vulnerability, and feelings of low selfesteem.
Cerebral (brain) oxygen and glucose deficits may trigger “disinhibition” of emotional states, i.e., release of
emotions otherwise held “in check.” Loss of emotional control, intensification of emotional states, and exacerbation
of debilitating stressful states of consciousness may result from overbreathing in challenging and adverse
circumstances, e.g., flying phobias and debilitating public speaking anxiety. Emotional discharge in challenging
environments itself may, of course, further exacerbate cognitive and other performance deficits.
7
Failure to understand the source of physical sensations resulting from overbreathing, e.g., light-headedness, tingling
of the skin, tightness of the chest, sweaty hands, and breathlessness, typically leads to a false interpretation of their
meaning. The incorrect, and usually negative, self assessment that may result, e.g., “I am losing control,” is likely to
elicit secondary emotional responses (e.g., fear) and further exacerbate the ones directly resulting from cerebral
oxygen and glucose deficits. And indeed, practitioners and trainers themselves, not familiar with the effects of
overbreathing, may unfortunately also misinterpret these secondary effects, taking them as evidence supporting their
own biases about the significance of the kinds of complaints reported by the client, e.g., “relaxation moves you
closer to yourself, and this makes you uncomfortable. Overworking is your way of protecting yourself.”
Sometimes overbreathing is deliberately induced for the very reason that it can trigger emotional memories and
states, e.g., rebirthing. Stanislav Grof’s Holotropic Breathwork, widely known for its use in triggering emotional
and memory release, is an excellent example of how overbreathing lowers the threshold for emotional expression.
Some breathing inductions used in natural child birth, for example, involve extreme forms of overbreathing, based
on the premise that disorientation reduces capacity to focus on pain; from a respiratory chemistry perspective,
however, this amounts to induction of system-wide crisis with potentially adverse effects on the infant.
Overbreathing: Effects on Performance
Compromising the blood buffering system (i.e., reduced capacity to regulate acidosis) means reduced physical
capacity and endurance, ranging from limiting athletes in their pursuit of achieving peak levels of physical
performance, to contributing to the incapacitation of individuals with fatigue and unable to perform the simplest of
tasks without exhausting their supply of buffers.
Incrementally increasing the workload on an exercise bike or treadmill increases metabolism, and hence the output
of carbon dioxide. Normal ventilation means that the CO2 exhaled is consistent with level of metabolism; there is
no overbreathing. Eventually, however, when buffers become depleted and can no longer neutralize lactic and other
acid byproducts, overbreathing becomes a short-term solution to the resulting acidosis, i.e., carbonic acid is reduced,
thus offsetting the build up of other acids. Monitoring CO2 levels during exercise on an exercise bike or treadmill
permits an observer to take note of this critical point, the point at which overbreathing is itself a compensatory
response to buffer depletion, the point at which physical exhaustion can be identified. And, as described previously,
chronic overbreathing itself may lead to buffer depletion, thus ultimately reducing physical capacity and endurance
to a point where simple exercise becomes equivalent to the maximum endurance effort of an athlete.
Buffer depletion physiology has very significant implications for performance and health. Running out of buffers
with exercise equivalent to walking to work, crossing a few streets to lunch, or preparing dinner for the family
means “physical” exhaustion doing the simple physical chores that define the daily routine of life. Overbreathing
may not only lead to buffer depletion but may then also become its own short-term solution to the resulting acidosis,
i.e., a vicious circle syndrome. This state of affairs can be observed by exercising on an exercise bike or treadmill
and noting the point at which there is a drop in carbon dioxide level, the point at which overbreathing is engaged.
Professional and lay audiences both ponder the ways in which “stress” ultimately has its effects on health and
performance. What are the mediating variables that lead to behavior-physiologic deregulation? One important
contributing factor may be the way in which one encounters challenge: bracing or embracing, defensive-posturing or
life-engaging? The defensive or bracing mode often includes overbreathing (part of the “fight-flight” behavioral
configuration) that may lead to the fatigue symptoms and complaints associated with the effects of buffer depletion
and magnesium deficiency, along with the wide range of physical and psychological effects previously described.
The “fatigue” associated with overbreathing may be misidentified as “depression.” Exercise may be “prescribed”
when rest is in order, where exercise will actually exacerbate the problem and is contraindicated. Buffer depletion,
resulting from exercise and associated compensatory overbreathing, may in fact precipitate cardiac arrhythmias even
in otherwise healthy individuals. Rest will permit build-up of the buffers, but upon returning to a challenging
environment without breathing and other forms of self-management training, overbreathing is likely to be reinstated,
once again resulting in buffer depletion and a relapse of fatigue and associated effects of “stress.” Deregulated
respiratory chemistry constitutes a behavioral-physiologic mechanism that may directly account for some of the
effects of “stress” on homeostasis and self-regulation.
8
Respiratory Training: General Considerations
Fritjof Capra, famed physicist and systems theorist, states his position on the mindbody dichotomy so well when he
says, “the organizing activity of living systems, at all levels of life, is mental activity” (The Web of Life, 1996). In
other words, there simply is no dichotomy, that all of life is itself inherently “mindful.” Thus, in this thesis there is
no distinction between physiological or psychological crisis; defensive posturing or bracing and life-engaging or
embracing are “mindful” frames of physiological reference, comprising what might be described as “life” postures.
These “life” postures are fundamental operating-definition culture-based concepts as can be seen in Western
psychology where there is emphasis on defensiveness, and in Eastern philosophy and practice (e.g., meditation),
where there is emphasis on embracement of chi, i.e., life or breath. Both of these postures are profoundly reflected
in the chemistry and in the mechanics of respiration.
Breathing evaluation and training bring together differing western schools of thought and tradition, including
physiology, psychology, healthcare, and human performance with the promise of weaving them together with
Eastern thinking, traditions, and practice into an active, personal, and mindful participation in behavioralphysiologic
self-regulation for health and performance.
Seeing “physiology as mindful” carries with it an important implication: it is the “ego” part of the mind that
identifies itself as “separate” from the “body,” giving rise to the mind-body dichotomy through its indignant claim
on ownership of all of the mind, wherein the mind necessarily came to be viewed as “our” unconscious, rather than
as a property of the fundamental essence of life itself and in all of its forms. Accessing the body, then, for the
“mindful physiology” oriented practitioner, means accessing the mind: intuitions, images, feelings, archetypes, and
meaning itself. Accessing the mind through body sensitivity training is fundamental to what has come to be known
as biofeedback and is the basis for breathing evaluation and training. It is little wonder that breathing is a point of
physio-spiritual connection in Eastern philosophical thinking.
As Capra points out in his book, The Web of Life, the whole is not simply greater than its parts but actually provides
for the definition, the very identity, of the parts themselves. Overbreathing sets the stage for crisis, even for trauma,
and for a consciousness of defensive posturing and bracing. It engages state-dependent behaviors, even statedependent
personalities, which are protective in nature offering the prospect of safety in a threatening world;
overbreathing becomes a doorway into a different consciousness where one may disconnect, isolate, or flee, but pay
the price of behavioral physiologic deregulation. Changing consciousness, means changing the definition of
constituent physiological dynamics: rapid heart rate is a sign of stress in the context of defensiveness, whereas it is a
sign of joy in the context of embracement. Good respiratory chemistry and mechanics set the stage for
“embracement,” rather than defensiveness, as a “life” posture. Wellness is ultimately about embracing, about the
heart, about bringing together the mindfulness of physiology with the personal consciousness. Health is about
seeking, presence, and availability, not about ego and defensiveness. When naked, don’t overbreathe, be there.
Learning about the behavioral physiology of respiration offers the prospect of bringing easy to understand, highly
practical, and easy to implement educational applications of “mindful-physiology” to healthcare and human
performance practitioners everywhere. Everyone acknowledges some measure or responsibility for breathing, as is
evidenced by everyone’s use of the pronoun “I.” Breathing training is an ideal context in which to teach people
about the mindful nature of physiology, where self-regulation training for health and performance can make a
powerful impact on the practical thinking of large audiences within a short time. The theme is: “The whole body is
the organ of the mind, not just the brain. Our minds are the music that our bodies play to the universe.”
Respiratory Training: Specific Considerations
Breathing chemistry training does NOT replace breathing mechanics training; the two together comprise true
respiratory training (i.e., getting O2 to the cells and CO2 back to the lungs). There is NO specific breathing
protocol, technique, or program that constitutes the “right one,” however, keeping respiratory chemistry in the
adaptive window is a critical consideration in most any kind of breathing training. There are numerous approaches
to teaching the mechanics of adaptive breathing that permit practitioners to integrate breathing evaluation and
training into their work based on professional background, expertise, experience. Unfortunately, however, in very
few cases is the chemistry of breathing included as a component of the training.
9
Breathing is a complex behavior. It is voluntary and involuntary. It is greatly influenced by emotion. It is
synchronized with complex speech behavior. Basic neurophysiological control of breathing originates in the
respiratory centers located in the brain stem, the pons and medulla, where breathing rate and volume are regulated
based on CO2 levels. While in a coma, breathing mechanics (rate and volume) track CO2 levels precisely. There
are other breathing centers throughout the brain including the limbic system (emotion), the speech areas of the brain,
and the frontal cortex (voluntary control). These other regulatory centers may interfere with adaptive breathing,
resulting in deregulated breathing, overbreathing that is often associated with breath holding, gasping, sighing, chest
breathing, rapid breathing, reverse breathing (contracting the diaphragm while breathing out), and so on. Training
for adaptive breathing chemistry, in most instances, means restoring regulated breathing through reinstatement of
the basic brain stem breathing reflex.
How is overbreathing identified? Without monitoring CO2 levels, there is simply no way of knowing. Use of the
capnometer is the only practical and technically reliable method for detecting it with certainty. Arterial carbon
dioxide (PaCO2) can be measured directly through invasive monitoring, or indirectly by means of measurement of
CO2 content in exhaled air. Measurement of CO2 at the end of exhalation, or at the “end” of the “tide” of the air
breathed out, is known as “end-tidal carbon dioxide,” or ETCO2, and is under normal circumstances highly
correlated with invasive arterial measurement. Capnometry is used in virtually every surgery room and critical care
unit in America, and is based on textbook physiology and highly reliable technology.*
The objective of breathing training while “at rest” is to restore proper breathing chemistry (CO2 levels), establish
breathing rhythmicity (reduction of holding, gasping, sighing), lower breathing rate, increase breathing depth, shift
the locus of breathing from chest to diaphragm, encourage nasal breathing, relax musculature during exhalation,
reduce collateral muscle activity, and establish a stable presence of high amplitude breathing heart wave activity
(parasympathetic tone, RSA). Training for good breathing chemistry involves learning how to:
(1) evaluate breathing both at rest and in the context of multiple kinds of challenge;
(2) teach the physiology and psychology of respiration;
(3) identify the sensations of overbreathing, and reinstate the basic brain stem breathing reflex;
(4) interpret physiological experience, e.g., deregulated vs. regulated breathing;
(5) train breathing mechanics: rhythmicity, volume, rate, resistance, and locus of control;
(6) instate prophylactic (deliberate) techniques for consciously disengaging or preventing overbreathing;
(7) configure new patterns of behavioral-physiologic defensive posturing, without overbreathing;
(8) establish “embracement physiology” where overbreathing is not a “mindful” component; and
(9) generalize new patterns of breathing that normalize chemistry in diverse life circumstances.
In summary, training involves: (1) education, (2) learning prophylactic techniques, (3) reinstating the basic
respiratory reflex mechanism, (4) learning new patterns of defensive posturing, and (5) learning to engage
“embracement” physiology by establishing new chemistry and its associated “physiologic mindfulness.”
Breathing evaluation and training may be useful for behavioral physiologic applications by healthcare providers and
patients, performance trainers and athletes/artists, corporate trainers and trainees, behavioral health professionals and
clients, human service providers and clients, consultants and self-improvement trainees, educators and students, and
academicians and researchers. Examples of performance training applications include: improving memory,
enhancing thinking and problem solving skills, improving concentration (playing an instrument), attention training
(e.g., attention deficit), reducing anxiety (e.g., public speaking, test taking), managing stress, managing anger,
decreasing fatigue, increasing alertness and readiness, reducing muscle tension, diminishing physical pain,
facilitating relaxation, facilitating disciplines of inner directedness (e.g., meditation), maximizing performance
training (e.g., flight training), natural child birth preparation, peak performance training (e.g., athletes and coaches),
and evaluating and improving physical condition.
*Measurement of End-Tidal CO2:
The presence of a “gas” is measured in terms of its pressure, and more specifically in terms of its relative pressure contribution to total
atmospheric pressure, i.e., its partial pressure. Total atmospheric pressure on a standard day at sea level is 760 millimeters of mercury (mmHg),
and is comprised of the partial pressures
CAPNOBREATH TRAINING
Log In
articles
Title: CapnoBreath Training
Date: 02/08/2008
CapnoBreath Training
Peter M. Litchfield, Ph.D. in California Biofeedback. Vol. 21, No. 3 (Fall 2005)
Good respiration requires neither relaxation nor a specific mechanical prescription, save one:
“The varied melodies of breathing mechanics must ultimately play the music of balanced chemistry.”
Although nearly everyone agrees that good respiration is basic to healthy physiology and psychology, only a
very few people who do breathing training know much about respiration and how its chemistry regulates
fundamental physiology critical to good health and optimal performance. Deregulated respiratory chemistry
is commonplace, and may have profound immediate and long-term effects that trigger, exacerbate, and/or
cause a wide variety of serious emotional, perceptual, cognitive, attention, behavioral, and physical deficits in
health and performance. Breathing evaluation and training, without regard to chemistry, leave out perhaps
the most fundamental, practical, and profound factors that account for (1) the far-reaching effects of
deregulated breathing, as well as for (2) the surprising benefits of proper breathing re-education.
Breathing is a behavior, and as a behavior it meets multiple objectives, including, among others:
respiration
acid-base balance
prophylactic intervention
communication
relaxation
performance enhancement
psychological access
flight-fight preparation
consciousness exploration
meditation.
The fundamental of these, however, are acid-base balance and respiration (also itself, regulated by shifts in
acid-base balance). CapnoBreath Training is about serving these two inextricably associated objectives,
while setting the stage for the others.
THE HENDERSON AND HENDERSON-HASSELBACH EQUATIONS
Breathing chemistry is about carbon dioxide (CO2) regulation. Carbon dioxide plays a critical role in acidbase
physiology, where contained therein are the principles of oxygen transport and distribution. The
Henderson equation, known to virtually everyone who has studied acid-base, renal, and pulmonary
physiology, tells us that hydrogen ion concentration, [H+], in extracellular fluids (plasma, cerebrospinal,
lymph, and interstitial) is regulated by the relationship between partial pressure arterial carbon dioxide,
PaCO2, regulated by breath, and bicarbonate concentration, [HCO3
?], regulated by the kidneys: [H+] = K x
PaCO2 ? [HCO3
?], where K is the dissociative constant of carbonic acid (H2CO3). In other words, acid-base
physiology is regulated by changes in the relative contributions of pulmonary and renal physiologies: [H+] =
lungs ? kidneys. These contributions shift so as to maintain healthy fluid pH levels, e.g., 7.4 in plasma.
Changing the numerator of the Henderson equation may result in respiratory acidosis/alkalosis, whereas
changing the denominator may result in metabolic acidosis/alkalosis. When either the numerator or
denominator changes, there is a corresponding compensatory change in the other, although this
compensation is always incomplete, and can result in serious side effects unrecognized by practitioners
everywhere. The Henderson-Hasselbach equation, which was developed later, states the same relationship
in terms of pH, which is the negative logarithm of [H+],: pH = pK + log [HCO3
?], where pK is the negative
logarithm of the dissociation constant (for H2CO3), or in essence pH = kidneys ? lungs
The clinical physiology literature describes how disease, dysfunction, and deficit impact the Henderson
equation, along with the consequences of disturbed acid-base balance and the price for its partial
compensation. The origins of acid-base disturbances in this literature are addressed exclusively from a
medical perspective, where only minimal lip service, at best, is paid to the behavioral contributions which
continuously, immediately, and significantly regulate the numerator of the Henderson acid-base balance
equation.
Breathing is behavior, and like any other behavior, it is regulated in varying degrees by learning, and thus by
motivation, emotion, cognition, perception, and memory. Integrating learning with this physiology means that
the Henderson equation can be expressed in yet another way: [H+] = breathing behavior ? kidney physiology,
OR interestingly perhaps, acid-base regulation = psychology ? physiology. Changes in acid-base physiology
regulate not only our physiology, but also our psychology, e.g., emotions, cognition, and even personality.
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Breathing mediated neurophysiological pH regulation, for example, suggests that breathing may play an
important role in the titration of subtle shifts in states of consciousness that mediate changes in cognitive,
emotional, and behavioral patterns and hierarchies. It is surely an understatement to say that this profound
relationship between behavior and physiology has been overlooked by both medical science and behavioral
science practitioners. Even biofeedback and neurofeedback practitioners, who are trained in applied
psychophysiology, are rarely familiar with this physiology and its far-reaching implications, e.g., how
breathing mediates symptoms, deficits, and homeostatic deregulation resulting from stress.
HYPOCAPNIA AND ITS EFFECTS
Although CO2 is, of course, excreted in the exhale, a significant portion of it is retained in the blood where it
regulates pH levels vital to the distribution of oxygen and glucose to tissues such as the brain. In fact, while
at rest, only about 12 to 14 percent of the CO2 that travels in blood through the capillary bed of the lungs is
actually excreted. In a healthy person, arterial CO2 is precisely maintained (40 mmHg), even during exercise
when CO2 production may increase by tenfold.
Deregulated CO2 chemistry results from either underbreathing or overbreathing. Underbreathing behavior,
contrary to popular opinion, is rare in healthy people; it results in respiratory acidosis, which precipitates
obvious, immediate, and uncomfortable sensations which in most cases are easily overcome by more rapid
and/or deeper breathing. Overbreathing behavior, on the other hand, is common; it precipitates respiratory
alkalosis (increased pH) brought about by a deficiency in extracellular fluid carbon dioxide (e.g., blood
plasma), a physiological condition known as hypocapnia (CO2 deficit). The effects can be insidious and
dramatic.
Hypocapnia leads to physiological changes such as hypoxia (oxygen deficit), hemoglobin alterations
(effecting release of oxygen and nitric oxide), cerebral vasoconstriction, coronary constriction, cerebral
glucose deficit, ischemia (localized anemia), buffer depletion (bicarbonates and phosphates), bronchial
constriction, gut constriction, neuronal excitability (sodium shifts), magnesium-calcium imbalance,
hypokalemia (plasma potassium deficit), hyponatremia (plasma sodium deficiency), antioxidant depletion,
platelet aggregation, and muscle fatigue, spasm (tetany), weakness, and pain.
These disturbances in physiology can trigger and exacerbate health-related complaints of all kinds, as well
as deficits in physical performance (e.g., sports), including: phobias, migraine phenomena, hypertension,
attention disorder, asthma attacks, angina attacks, heart attacks, cardiac arrhythmias, thrombosis (blood
clotting) panic attacks, hypoglycemia, epileptic seizures, altitude sickness, sexual dysfunction, sleep
disturbances (apnea), allergy, irritable bowel syndrome (IBS), repetitive strain injury (RSI), and chronic
fatigue. The symptoms precipitated by overbreathing are dependent upon individual differences, including
physiological propensities, physical compromise, health status, and psychological history. Overbreathing
may also, of course, constitute a compensatory response to metabolic acidosis, e.g., ketoacidosis, by
increasing pH.
The potentially debilitating combination of cerebral hypoxia and cerebral hypoglycemia, along with
hemoglobin that is disinclined to give up its oxygen and the nitric oxide required for vasodilation, can result in
profound psychological and behavioral changes: (1) deficits in ability to attend, focus, concentrate, imagine,
rehearse the details of an action, engage in complex tasks, perform perceptual motor-skills (e.g., piloting
vehicles), parallel-process information, problem solve, access relevant memory (e.g., test performance),
think, and communicate effectively (e.g., public speaking); (2) emotional reactivity (e.g., marital conflict) that
may trigger or exacerbate debilitating stressful states of consciousness, including, apprehension, anxiety,
anger, frustration, fear, panic, vulnerability, and low self-esteem; and (3) personality shifts or dissociative
states that result in social disconnectedness, emotional withdrawal, defensive posturing, emotional
numbness, and inability to be present. How many neurofeedback practitioners consider the effects of
hypocapnia?
Overbreathing is undoubtedly an insidious and debilitating response to everyday challenges, insidious
because its presence goes unrecognized and its effects unidentified. In fact, surveys suggest that 10
percent or more of the US population suffers from chronic overbreathing and that 60 percent of all
ambulance calls in major US cities are the result of overbreathing (Fried 1999)! For every person who shows
up in emergency, how many more show up in physician’s offices with unexplained symptoms? For every
person who goes to see a physician, how many more simply go to work? And for everyone who reports a
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“medical symptom” how many more suffer with performance deficits? Overbreathing is a behavior that
precipitates changes in chemistry that can mediate these “unexplained symptoms,” misunderstood
performance deficits, and acute and chronic “effects of stress.” The resulting effects of hypocapnia are
profound and deserve full attention by virtually anyone doing breathing training.
THE IMPORTANCE OF GETTING THE PHYSIOLOGY “RIGHT”
Faulty assumptions and understandings about respiratory physiology are implicit in breathing training
practices everywhere, which unfortunately, in many cases, may actually lead to counterproductive practice.
Teaching good respiration through insistence on the mechanics associated with relaxation, for example, may
create a problem rather than offer a solution; good respiration should not depend on being relaxed. And,
teaching deep breathing for relaxation can, as a result of CO2 deficit, trigger emotions, cognitive deficits, and
misinterpreted physical effects. Breathing objectives, such as relaxation, must be ultimately subordinated to
good respiration, and not the reverse as some would have it. Evaluating, monitoring, and teaching good
chemistry through breathing deserve serious attention by virtually anyone, layperson or professional,
involved in learning and/or teaching breathing. How many biofeedback practitioners are doing so?
Breathing training should not simply statistically favor good respiration, where the mechanisms responsible
for positive outcomes are (1) only implicit in the training methodology, (2) unknown by both practitioner and
client, and (3) often dismissed as not important in the name of “what we do works and that’s what counts.”
Emphasis on slow breathing rather than on deregulated chemistry, for example, may statistically favor
improvement of respiration, however it is easy to overbreathe while breathing slowly and does not by itself
constitute better chemistry. It is important to know the underlying physiology that accounts for the positive
outcomes of one’s educational and therapeutic efforts, to make the implicit explicit, wherein relevant
mechanisms are addressed directly rather than incidentally. And, in fact, as described earlier, some of these
mechanisms are well documented in the fields of pulmonary and acid-base physiology, where focusing
directly on chemistry and the basic mechanics that serve it, point the way to far greater efficacy, not to
mention credibility.
Making the implicit explicit provides for direct focus on the variables that count, the ones that provide for the
efficacy, including the kinds of clients that can be helped, the degree to which clients are helped, and the
speed and cost of doing so. It also means (1) helping practitioners to evolve their interventions based on
facts, rather than on tradition or professional rumors, (2) avoiding mixing effective factors with irrelevant
ones, that take time, cost money, and side-track progress, (3) avoiding unwitting introduction of
counterproductive elements of training, such as deep breathing, (4) avoiding faulty assumptions and
misconceptions about what is required for healthy breathing, such as the suppositions by many that
relaxation and slow breathing are necessarily prerequisite to good respiration, and (5) providing high impact
patient education, where both the perceived efficacy and credibility of breathing self-regulation are
enhanced.
GOOD CHEMISTRY TRAINING IS IMPLICITLY EMBEDDED
The relevance of breathing and acid-base physiology is illustrated below, as an example of how CO2 and its
regulation is implicitly embedded in breathing training traditions everywhere, in this case diaphragmatic
breathing training for people who suffer with asthma.
(1) Fact: Increasing airway resistance, reducing lung compliance, and increasing bronchial constriction make
it more difficult to breathe.
(2) Fact: Increasing airway resistance, reducing lung compliance, and increasing bronchial constriction
increase the likelihood of asthma symptoms and attack.
(3) Fact: Lowering CO2 levels in airways (local hypocapnia), through overbreathing, increases airway
resistance, reduces lung compliance, and the likelihood of bronchial constriction.
(4) Fact: Making it more difficult to breathe, increases the effortfulness of breathing, and may introduce a
sense of not being able to get one’s breath, worry about breathing, and intentional efforts to get more air.
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(5) Fact: Effortful breathing, “trying to get one’s breath,” increases the likelihood of overbreathing, which
lowers CO2 levels and results in increased airway resistance, reduced lung compliance, and increased
bronchial constriction. These effects, as stated above, may then lead to greater difficulty in breathing and an
increased likelihood of an asthma symptoms and attack.
(6) Fact: These factors described above, taken together, provide the ideal circumstances for vicious circle
learning described in classical learning theory, involving both Pavlovian (emotional responses) and operant
conditioning (breathing behavior) principles.
The vicious circle might go as follows:
(a) Anticipation of difficulty in breathing leads to fear of not getting enough air.
(b) Fear leads to reaching for more air.
(c) Reaching for air leads to overbreathing.
(d) Overbreathing leads to airway (local) hypocapnia.
(e) Airway hypocapnia increases the difficulty in breathing and likelihood of symptoms.
(f) Increased difficulty in breathing increases apprehension, worry, and fear.
(g) Cerebral hypocapnia exacerbates emotionality, and triggers fear, disorientation, and symptoms.
(h) Cerebral hypocapnia results in dissociation, e.g., emergence of defensive (asthma) personality.
(i) Emotionality and defensiveness result in “trying harder,” failure, and sense of helplessness.
(j) Overbreathing sets the stage for the development of learned helplessness.
(k) Secondary gain for overbreathing sets the stage for learning dysfunctional breathing.
(l) Overbreathing generalizes as a coping style and becomes embedded in defensive personality.
(7) Fact: It has been clearly demonstrated that reducing breathing effortfulness through learning good
diaphragmatic breathing helps people with asthma. This is the based on which “incentive spirometry” is
implemented as a behavioral intervention worldwide to help reduce the likelihood of asthma attacks.
Why can incentive spirometers be so helpful? What is the physiology that explains these results?
It is hypothesized by many that the following considerations taken together make asthma
symptoms and attacks less likely:
(1) Diaphragmatic breathing means much more air per breath.
(2) Diaphragmatic breathing means fewer breaths per minute for greater volumes of air.
(3) Diaphragmatic breathing by itself is less effortful than multi accessory muscle (chest) breathing.
(4) Greater use of the diaphragm eliminates the need for using accessory muscles.
(5) Effortless breathing reduces the physical “struggle” associated with “getting one’s breath.”
(6) Effortless breathing reduces fear, anxiety, and worry about breath.
(7) Diaphragmatic breathing results in slower breathing.
(8) Diaphragmatic breathing translates into relaxation, relief, a sense of confidence in breathing.
AND, teaching effortless diaphragmatic breathing may lead to:
(1) self-management of underbreathing,
(2) reduction of autonomic arousal, and
(3) a sense of self-empowerment.
Clearly, in the case of pulmonary pathology, good diaphragmatic breathing may very significantly improve
tidal volume, and be absolutely essential to matching ventilation with perfusion, i.e., to ensuring adequate
ventilation. This is the physiological basis for the benefits of learning through incentive spirometry. Although
this is a significant self-management tool for increasing tidal volume, it says little, if anything, about factors
that set the stage for bronchial constriction, increased airway resistance, reduced lung compliance, and the
onset of asthma symptoms. In accounting for these physical changes, many practitioners point to the
importance of emotional triggers and concomitant autonomic changes as the key factors, and hence to the
importance of learning effortless breathing, relaxation, positive self talk, and physical confidence building.
Simply pointing to autonomic correlates, however, does not directly account for the physiological changes
and symptoms associated with asthma. For example, how does autonomic arousal increase airway
resistance, when, in fact, sympathetic activity actually decreases, not increases, airway resistance? And,
how do slower breathing, decreased fear, and effortless breathing actually reduce the likelihood of asthma
symptoms and attacks? Some of the physiology accounting for these considerations is likely to include: (1)
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reduced airway (local) hypocapnia and its effects on airway resistance, lung compliance, and bronchial
activity, and (2) reduced systemic hypocapnia (e.g., cerebral) and its effects on emotional reactivity and
physical symptoms.
Diaphragmatic breathing is regulated by the brain stem medullary dorsal respiratory group (DRG) in
accordance with the Henderson and Henderson-Hasselbach equations, which includes changes in pH or
[H+], HCO3
? (bicarbonates), and PaCO2 (and other fluid PCO2). Using other breathing accessory muscles,
such as during so-called “chest breathing,” may quickly result in deregulation of this basic brain stem reflex,
and increase the likelihood of deregulated chemistry; in fact, the onset of its effects, overlooked by most,
may even be falsely attributed to both asthma and autonomic arousal. And, of course, breathing training
which decreases the likelihood of hypocapnia, reduces the probability of deregulation. Here is a partial
accounting of such variables:
Factors that trigger hypocapnia Factors leading to hypocapnia prevention
Worry about breathing Breathing self-confidence, trust
Using accessory muscles Diaphragmatic control
Intentional breathing Allowing breathing to happen
Deep breathing Quiet effortless breathing
Rapid breathing Allowing for exhale and its transition
Fear and anxiety Relaxation
Defensiveness Embracement
Negative self-talk Self-affirmations
Misinformation about breathing Education
Secondary responses to physical symptoms Counterconditioning
Variables that decrease the likelihood of hypocapnia are implicitly embedded in effective breathing training
protocols, e.g., incentive spirometry training. Unfortunately, however, behaviors which increase the
likelihood of hypocapnia are also often encouraged by trainers, who unfortunately don’t know about the basic
biochemistry involved. Emphasis on deep diaphragmatic breathing during incentive spirometry training may
result in the self-defeating effects of hypocapnia, whereas emphasis on quiet effortless diaphragmatic
breathing is likely to normalize PCO2 levels.
OVERBREATHING BEHAVIOR
Optimal respiration means regulating chemistry, through proper ventilation of CO2, relaxed or not, such as
during the acrobatics of talking, emotional encounters, and professional challenges. Good breathing
chemistry establishes a system-wide context conducive to optimizing physical and psychological
competence, where chemistry needs to be balanced regardless of what we are doing, thinking, or feeling.
Nevertheless, overbreathing behavior, like any other maladaptive behavior can be quickly and easily learned,
and unfortunately, like so many habits, are often challenging to disengage, manage, modify, or eliminate; the
learning principles, are the same.
Overbreathing can be learned as a defensive response to specific challenges (e.g., performing before an
audience, or confronting a distressed partner), or it can mediate shifts in consciousness that set the stage for
learning constellations of defensive behaviors that serve to protect against trauma, including people, things,
and oneself. The desire or need for “control” is a metaphor frequently embedded in deregulated breathing
behavioral patterns. These defensive behaviors, like many vicious circle behaviors, may come at a high
cost, as described above: physical symptoms, emotional reactivity, cognitive deficits, and performance
decrements with immediate, long-term, and profound effects. Herbert Fensterheim (Timmons & Lay, 1994),
an internationally prominent psychotherapist, points to these considerations in addressing mental health
professionals when he says:
“Given the high frequency of incorrect breathing patterns in the adult population, attention to the symptoms of
hyperventilation [overbreathing] should be a routine part of every psychological evaluation, regardless of the
specific presenting complaints. Faulty breathing patterns affect patients differently. They may be the central
problem, directly bringing on the pathological symptoms; they may magnify, exacerbate, or maintain symptoms
brought on by other causes; or they may be involved in peripheral problems that must be ameliorated before
psychotherapeutic access is gained to the core treatment targets. Their manifestations may be direct and
obvious, as when overbreathing leads to a panic attack, or they may initiate or maintain subtle symptoms that
perpetuate an entire personality disorder. Diagnosis of hyperventilatory [overbreathing] conditions is crucial.”
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Although breathing is subject to the same learning principles as any other behavior, it is a unique behavior in
a number of significant ways, ways which makes its deregulation of very special
concern to practitioners interested in teaching self-regulation for health and performance:
(1) It is a “perpetual” behavior. It does not emerge only at specific times and places. It takes place
virtually all of the time, and when briefly it does not, its absence is still relevant.
(2) It is a behavior that is necessarily woven into virtually every mindful-physiology tapestry. It is an
inevitable part of every behavioral topography. It transitions from one topography into the next, and may
carry with it behaviors, emotions, memories, thoughts, symptoms, senses of self,
personality styles, and physical reactions from the previous topography.
(3) It is serves as a gateway wherein it set stages, creates backdrops of meaning, establishes contexts, and
changes states for management of the mindfulness of physiology.
(4) It is controlled centrally from diverse neurophysiological sites as well as locally by cells and
tissues. Throughout the day it is voluntary and involuntary, conscious and unconscious.
(5) It is critical to basic human functions, including not only acid-base physiology and the delivery
of oxygen and glucose, but is vital to social behaviors such as verbal communication.
(6) Its basic nature is reflexive. Intentional practice can be difficult because you can’t do it for a while, take a
break, and then continue again when you feel more confident. It will happen anyway. You can’t avoid it. It’s
always there. You can’t put it aside if you don’t like it.
CAPNOBREATH TRAINING
CapnoBreath Training (where “capno” means CO2) is about learning and teaching adaptive respiratory
chemistry within a wide range of breathing mechanics. It means precision coordinating of breathing rate and
depth through reflex control of the diaphragm, a brain stem coordinated reflex mechanism which can be
easily deregulated, consciously or unconsciously. CapnoBreath training is about reinstating this reflex
mechanism. It means integrating knowledge of respiratory chemistry with the mechanics of breathing, where
emphasis is on the relationship dynamics of breathing mechanics for achieving good chemistry, rather than
on specific “mechanics” prescriptions (e.g., a specific breathing rate), where the effects of breathing
chemistry are neither accounted for during initial evaluation nor included as a part of self-regulation learning.
Good respiration requires neither relaxation nor a specific mechanical prescription, save one: the varied
melodies of breathing mechanics must ultimately play the music of balanced chemistry.
CapnoBreath training includes exploration, education, play, and training as follows:
(1) exploration: originating and sustaining factors and circumstances;
(2) identification: dysfunctional breathing patterns, when and where;
(3) phenomenology: feelings, memories, thoughts, and sense of self;
(4) knowledge-learning: understanding basic breathing concepts;
(5) sign-learning: recognizing physical, psychological, and behavioral symptoms;
(6) mechanics-learning: play for diaphragmatic, rate, & depth awareness;
(7) visceral-learning: developing an internalized sense of chemistry; and
(8) state-learning: developing a sense of chemistry for consciousness (e.g., emotions).
CapnoBreath training, in the larger context, is about learning “to embrace” (or to engage) a challenge rather
than to “defend from” a challenge. Embracing means “being present,” connecting, and learning, where
defending (or bracing) means armoring, isolating, and disconnecting. Healthy breathing should not be state
or context specific, e.g. during meditation, relaxation, or prophylactic intervention. CapnoBreath training is
about learning to breathe with the whole body; every cell breathes, not just the lungs. Learning good
respiration is learning about what breathing “feels like,” and is ultimately not about what breathing “looks
like.” CapnoBreath training is about learning to breathe inside-out, rather than outside-in.
THE EFFICACY OF CAPNOBREATH TRAINING
Clinicians and researchers everywhere substantiate the “efficacy” of their techniques, protocols,
interventions, training methods, and educational programs based on how they “stack up” based on whether
or not, and to what degree they impact, for example, hypertension. But, what about the efficacy of reducing
hypertension itself on heart attack or stroke? Does reducing hypertension through biofeedback, for example,
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actually reduce the likelihood of a heart attack, or is this just an assumption based on statistics about
hypertension? Few of us ask these questions. We simply assume that biofeedback regulated blood
pressure is synonymous with reducing the likelihood of heart attack or stroke: the link is simply a leap of
faith, not science.
Curiously, on the other hand, although the clinical research literature very clearly, without controversy, and
with exceptionally well documented science, points to the profound effects of hypocapnia, no one talks about
substantiating the efficacy of their interventions, e.g., biofeedback, based on changes in PaCO2 which lie at
the very heart of acid-base physiology and its effects on health and performance! Additionally, and important
to point out, is the fact that breathing regulation is under our immediate and direct control (in healthy people),
and unlike methods contributing to changes in blood pressure physiology, shifts in breathing are not indirect
and do not require life style changes.
Although the importance, relevance, and efficacy of breathing training is indisputably acclaimed and widely
practiced in professional and lay circles worldwide, it is curious, indeed, that the practical relevance and
efficacy of breathing chemistry (CapnoBreath) training, which rests on the firm ground of a vast empirical
science, is so frequently challenged and questioned by these very same practitioners. It is this chemistry
which, in fact, offers up perhaps the most fundamental reason for the efficacy of breathing learning and
training so widely embraced by all.
Making the case for (1) the clinical and educational relevance of the management of hypocapnia, and (2) the
potential effectiveness of clinical and educational interventions for its amelioration, far exceeds making the
case for blood pressure reduction, or most any other behavioral intervention that involves physiological selfregulation
learning. Why is training for good chemistry not widely recognized and practiced by practitioners
everywhere? The answer is simple: this fundamental, highly-documented, non-controversial practical
science has not been adequately and effectively brought to their attention. Now is the time.
Note: When perfusion is greater than ventilation, some of the blood that passes through the pulmonary capillary network
is not ventilated. This means that some of the CO2, which would otherwise diffuse into the alveoli, is returned to the
arterial system. This blood mixes with the blood that has been partially or fully ventilated, with the result that the arterial
PaCO2 is higher than it would be otherwise. This is known as “CO2 retention,” a phenomenon identified with people who
suffer with asthma and other pulmonary disorders. There is, of course, immediate compensation for “CO2 retention,” as
a result of increased ventilatory drive, which restores normal PaCO2 (arterial) levels.
Although PaCO2 levels may be normalized (eucapnia), ETCO2 levels (end-tidal CO2) will be lower, giving the uniformed
observer the false impression of overbreathing and hypocapnia. The readings are lower because of (1) the mixture of
alveolar gases containing different partial pressures of CO2, and (2) the diffusion of proportionately greater amounts of
CO2 in alveoli which are fully ventilated. Thus, although alveolar and end-tidal CO2 are low, PaCO2 may be normal. This
is often the explanation as to why people with asthma “overbreathe:” they have “CO2 retention.” If this is true, of course,
they aren’t really overbreathing: there is no (systemic) hypocapnia. Unfortunately, this “organic variable,” leads many to
precluding further behavioral considerations, when in fact its very presence establishes the basis for learning
dysfunctional breathing: the resulting local airway hypocapnia may produce asthma symptoms, leading to the vicious
circle learning pattern described above, with the consequence of systemic hypocapnia (low PaCO2) and its effects on
emotionality and physical symptoms. Mismatch of ventilation and perfusion does not preclude overbreathing behavior in
people with asthma, but rather serves to set the stage for its acquisition.
REFERENCES
Fried, R. (1999). Breathe well, be well. New York: John Wiley & Sons.
HealthCare Professional Guides (1998). Anatomy and Physiology. Springhouse: Springhouse Corporation.
Laffey, J.G., & Kavanagh, B.P. (2002). Hypocapnia. New England Journal of Medicine, 347(1) 43-53.
Levitzky, M. G., (2003). Pulmonary Physiology. New York: McGraw Hill.
Thomson, W. S. T., Adams, J. F., & Cowan, R. A. (1997) Clinical Acid-Base Balance.
New York: Oxford University Press.
Timmons, B. H., & Ley, R. (editors, 1994). Behavioral and psychological approaches to breathing disorders.
New York: Plenum Press.
articles
Title: CapnoBreath Training
Date: 02/08/2008
CapnoBreath Training
Peter M. Litchfield, Ph.D. in California Biofeedback. Vol. 21, No. 3 (Fall 2005)
Good respiration requires neither relaxation nor a specific mechanical prescription, save one:
“The varied melodies of breathing mechanics must ultimately play the music of balanced chemistry.”
Although nearly everyone agrees that good respiration is basic to healthy physiology and psychology, only a
very few people who do breathing training know much about respiration and how its chemistry regulates
fundamental physiology critical to good health and optimal performance. Deregulated respiratory chemistry
is commonplace, and may have profound immediate and long-term effects that trigger, exacerbate, and/or
cause a wide variety of serious emotional, perceptual, cognitive, attention, behavioral, and physical deficits in
health and performance. Breathing evaluation and training, without regard to chemistry, leave out perhaps
the most fundamental, practical, and profound factors that account for (1) the far-reaching effects of
deregulated breathing, as well as for (2) the surprising benefits of proper breathing re-education.
Breathing is a behavior, and as a behavior it meets multiple objectives, including, among others:
respiration
acid-base balance
prophylactic intervention
communication
relaxation
performance enhancement
psychological access
flight-fight preparation
consciousness exploration
meditation.
The fundamental of these, however, are acid-base balance and respiration (also itself, regulated by shifts in
acid-base balance). CapnoBreath Training is about serving these two inextricably associated objectives,
while setting the stage for the others.
THE HENDERSON AND HENDERSON-HASSELBACH EQUATIONS
Breathing chemistry is about carbon dioxide (CO2) regulation. Carbon dioxide plays a critical role in acidbase
physiology, where contained therein are the principles of oxygen transport and distribution. The
Henderson equation, known to virtually everyone who has studied acid-base, renal, and pulmonary
physiology, tells us that hydrogen ion concentration, [H+], in extracellular fluids (plasma, cerebrospinal,
lymph, and interstitial) is regulated by the relationship between partial pressure arterial carbon dioxide,
PaCO2, regulated by breath, and bicarbonate concentration, [HCO3
?], regulated by the kidneys: [H+] = K x
PaCO2 ? [HCO3
?], where K is the dissociative constant of carbonic acid (H2CO3). In other words, acid-base
physiology is regulated by changes in the relative contributions of pulmonary and renal physiologies: [H+] =
lungs ? kidneys. These contributions shift so as to maintain healthy fluid pH levels, e.g., 7.4 in plasma.
Changing the numerator of the Henderson equation may result in respiratory acidosis/alkalosis, whereas
changing the denominator may result in metabolic acidosis/alkalosis. When either the numerator or
denominator changes, there is a corresponding compensatory change in the other, although this
compensation is always incomplete, and can result in serious side effects unrecognized by practitioners
everywhere. The Henderson-Hasselbach equation, which was developed later, states the same relationship
in terms of pH, which is the negative logarithm of [H+],: pH = pK + log [HCO3
?], where pK is the negative
logarithm of the dissociation constant (for H2CO3), or in essence pH = kidneys ? lungs
The clinical physiology literature describes how disease, dysfunction, and deficit impact the Henderson
equation, along with the consequences of disturbed acid-base balance and the price for its partial
compensation. The origins of acid-base disturbances in this literature are addressed exclusively from a
medical perspective, where only minimal lip service, at best, is paid to the behavioral contributions which
continuously, immediately, and significantly regulate the numerator of the Henderson acid-base balance
equation.
Breathing is behavior, and like any other behavior, it is regulated in varying degrees by learning, and thus by
motivation, emotion, cognition, perception, and memory. Integrating learning with this physiology means that
the Henderson equation can be expressed in yet another way: [H+] = breathing behavior ? kidney physiology,
OR interestingly perhaps, acid-base regulation = psychology ? physiology. Changes in acid-base physiology
regulate not only our physiology, but also our psychology, e.g., emotions, cognition, and even personality.
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Breathing mediated neurophysiological pH regulation, for example, suggests that breathing may play an
important role in the titration of subtle shifts in states of consciousness that mediate changes in cognitive,
emotional, and behavioral patterns and hierarchies. It is surely an understatement to say that this profound
relationship between behavior and physiology has been overlooked by both medical science and behavioral
science practitioners. Even biofeedback and neurofeedback practitioners, who are trained in applied
psychophysiology, are rarely familiar with this physiology and its far-reaching implications, e.g., how
breathing mediates symptoms, deficits, and homeostatic deregulation resulting from stress.
HYPOCAPNIA AND ITS EFFECTS
Although CO2 is, of course, excreted in the exhale, a significant portion of it is retained in the blood where it
regulates pH levels vital to the distribution of oxygen and glucose to tissues such as the brain. In fact, while
at rest, only about 12 to 14 percent of the CO2 that travels in blood through the capillary bed of the lungs is
actually excreted. In a healthy person, arterial CO2 is precisely maintained (40 mmHg), even during exercise
when CO2 production may increase by tenfold.
Deregulated CO2 chemistry results from either underbreathing or overbreathing. Underbreathing behavior,
contrary to popular opinion, is rare in healthy people; it results in respiratory acidosis, which precipitates
obvious, immediate, and uncomfortable sensations which in most cases are easily overcome by more rapid
and/or deeper breathing. Overbreathing behavior, on the other hand, is common; it precipitates respiratory
alkalosis (increased pH) brought about by a deficiency in extracellular fluid carbon dioxide (e.g., blood
plasma), a physiological condition known as hypocapnia (CO2 deficit). The effects can be insidious and
dramatic.
Hypocapnia leads to physiological changes such as hypoxia (oxygen deficit), hemoglobin alterations
(effecting release of oxygen and nitric oxide), cerebral vasoconstriction, coronary constriction, cerebral
glucose deficit, ischemia (localized anemia), buffer depletion (bicarbonates and phosphates), bronchial
constriction, gut constriction, neuronal excitability (sodium shifts), magnesium-calcium imbalance,
hypokalemia (plasma potassium deficit), hyponatremia (plasma sodium deficiency), antioxidant depletion,
platelet aggregation, and muscle fatigue, spasm (tetany), weakness, and pain.
These disturbances in physiology can trigger and exacerbate health-related complaints of all kinds, as well
as deficits in physical performance (e.g., sports), including: phobias, migraine phenomena, hypertension,
attention disorder, asthma attacks, angina attacks, heart attacks, cardiac arrhythmias, thrombosis (blood
clotting) panic attacks, hypoglycemia, epileptic seizures, altitude sickness, sexual dysfunction, sleep
disturbances (apnea), allergy, irritable bowel syndrome (IBS), repetitive strain injury (RSI), and chronic
fatigue. The symptoms precipitated by overbreathing are dependent upon individual differences, including
physiological propensities, physical compromise, health status, and psychological history. Overbreathing
may also, of course, constitute a compensatory response to metabolic acidosis, e.g., ketoacidosis, by
increasing pH.
The potentially debilitating combination of cerebral hypoxia and cerebral hypoglycemia, along with
hemoglobin that is disinclined to give up its oxygen and the nitric oxide required for vasodilation, can result in
profound psychological and behavioral changes: (1) deficits in ability to attend, focus, concentrate, imagine,
rehearse the details of an action, engage in complex tasks, perform perceptual motor-skills (e.g., piloting
vehicles), parallel-process information, problem solve, access relevant memory (e.g., test performance),
think, and communicate effectively (e.g., public speaking); (2) emotional reactivity (e.g., marital conflict) that
may trigger or exacerbate debilitating stressful states of consciousness, including, apprehension, anxiety,
anger, frustration, fear, panic, vulnerability, and low self-esteem; and (3) personality shifts or dissociative
states that result in social disconnectedness, emotional withdrawal, defensive posturing, emotional
numbness, and inability to be present. How many neurofeedback practitioners consider the effects of
hypocapnia?
Overbreathing is undoubtedly an insidious and debilitating response to everyday challenges, insidious
because its presence goes unrecognized and its effects unidentified. In fact, surveys suggest that 10
percent or more of the US population suffers from chronic overbreathing and that 60 percent of all
ambulance calls in major US cities are the result of overbreathing (Fried 1999)! For every person who shows
up in emergency, how many more show up in physician’s offices with unexplained symptoms? For every
person who goes to see a physician, how many more simply go to work? And for everyone who reports a
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“medical symptom” how many more suffer with performance deficits? Overbreathing is a behavior that
precipitates changes in chemistry that can mediate these “unexplained symptoms,” misunderstood
performance deficits, and acute and chronic “effects of stress.” The resulting effects of hypocapnia are
profound and deserve full attention by virtually anyone doing breathing training.
THE IMPORTANCE OF GETTING THE PHYSIOLOGY “RIGHT”
Faulty assumptions and understandings about respiratory physiology are implicit in breathing training
practices everywhere, which unfortunately, in many cases, may actually lead to counterproductive practice.
Teaching good respiration through insistence on the mechanics associated with relaxation, for example, may
create a problem rather than offer a solution; good respiration should not depend on being relaxed. And,
teaching deep breathing for relaxation can, as a result of CO2 deficit, trigger emotions, cognitive deficits, and
misinterpreted physical effects. Breathing objectives, such as relaxation, must be ultimately subordinated to
good respiration, and not the reverse as some would have it. Evaluating, monitoring, and teaching good
chemistry through breathing deserve serious attention by virtually anyone, layperson or professional,
involved in learning and/or teaching breathing. How many biofeedback practitioners are doing so?
Breathing training should not simply statistically favor good respiration, where the mechanisms responsible
for positive outcomes are (1) only implicit in the training methodology, (2) unknown by both practitioner and
client, and (3) often dismissed as not important in the name of “what we do works and that’s what counts.”
Emphasis on slow breathing rather than on deregulated chemistry, for example, may statistically favor
improvement of respiration, however it is easy to overbreathe while breathing slowly and does not by itself
constitute better chemistry. It is important to know the underlying physiology that accounts for the positive
outcomes of one’s educational and therapeutic efforts, to make the implicit explicit, wherein relevant
mechanisms are addressed directly rather than incidentally. And, in fact, as described earlier, some of these
mechanisms are well documented in the fields of pulmonary and acid-base physiology, where focusing
directly on chemistry and the basic mechanics that serve it, point the way to far greater efficacy, not to
mention credibility.
Making the implicit explicit provides for direct focus on the variables that count, the ones that provide for the
efficacy, including the kinds of clients that can be helped, the degree to which clients are helped, and the
speed and cost of doing so. It also means (1) helping practitioners to evolve their interventions based on
facts, rather than on tradition or professional rumors, (2) avoiding mixing effective factors with irrelevant
ones, that take time, cost money, and side-track progress, (3) avoiding unwitting introduction of
counterproductive elements of training, such as deep breathing, (4) avoiding faulty assumptions and
misconceptions about what is required for healthy breathing, such as the suppositions by many that
relaxation and slow breathing are necessarily prerequisite to good respiration, and (5) providing high impact
patient education, where both the perceived efficacy and credibility of breathing self-regulation are
enhanced.
GOOD CHEMISTRY TRAINING IS IMPLICITLY EMBEDDED
The relevance of breathing and acid-base physiology is illustrated below, as an example of how CO2 and its
regulation is implicitly embedded in breathing training traditions everywhere, in this case diaphragmatic
breathing training for people who suffer with asthma.
(1) Fact: Increasing airway resistance, reducing lung compliance, and increasing bronchial constriction make
it more difficult to breathe.
(2) Fact: Increasing airway resistance, reducing lung compliance, and increasing bronchial constriction
increase the likelihood of asthma symptoms and attack.
(3) Fact: Lowering CO2 levels in airways (local hypocapnia), through overbreathing, increases airway
resistance, reduces lung compliance, and the likelihood of bronchial constriction.
(4) Fact: Making it more difficult to breathe, increases the effortfulness of breathing, and may introduce a
sense of not being able to get one’s breath, worry about breathing, and intentional efforts to get more air.
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(5) Fact: Effortful breathing, “trying to get one’s breath,” increases the likelihood of overbreathing, which
lowers CO2 levels and results in increased airway resistance, reduced lung compliance, and increased
bronchial constriction. These effects, as stated above, may then lead to greater difficulty in breathing and an
increased likelihood of an asthma symptoms and attack.
(6) Fact: These factors described above, taken together, provide the ideal circumstances for vicious circle
learning described in classical learning theory, involving both Pavlovian (emotional responses) and operant
conditioning (breathing behavior) principles.
The vicious circle might go as follows:
(a) Anticipation of difficulty in breathing leads to fear of not getting enough air.
(b) Fear leads to reaching for more air.
(c) Reaching for air leads to overbreathing.
(d) Overbreathing leads to airway (local) hypocapnia.
(e) Airway hypocapnia increases the difficulty in breathing and likelihood of symptoms.
(f) Increased difficulty in breathing increases apprehension, worry, and fear.
(g) Cerebral hypocapnia exacerbates emotionality, and triggers fear, disorientation, and symptoms.
(h) Cerebral hypocapnia results in dissociation, e.g., emergence of defensive (asthma) personality.
(i) Emotionality and defensiveness result in “trying harder,” failure, and sense of helplessness.
(j) Overbreathing sets the stage for the development of learned helplessness.
(k) Secondary gain for overbreathing sets the stage for learning dysfunctional breathing.
(l) Overbreathing generalizes as a coping style and becomes embedded in defensive personality.
(7) Fact: It has been clearly demonstrated that reducing breathing effortfulness through learning good
diaphragmatic breathing helps people with asthma. This is the based on which “incentive spirometry” is
implemented as a behavioral intervention worldwide to help reduce the likelihood of asthma attacks.
Why can incentive spirometers be so helpful? What is the physiology that explains these results?
It is hypothesized by many that the following considerations taken together make asthma
symptoms and attacks less likely:
(1) Diaphragmatic breathing means much more air per breath.
(2) Diaphragmatic breathing means fewer breaths per minute for greater volumes of air.
(3) Diaphragmatic breathing by itself is less effortful than multi accessory muscle (chest) breathing.
(4) Greater use of the diaphragm eliminates the need for using accessory muscles.
(5) Effortless breathing reduces the physical “struggle” associated with “getting one’s breath.”
(6) Effortless breathing reduces fear, anxiety, and worry about breath.
(7) Diaphragmatic breathing results in slower breathing.
(8) Diaphragmatic breathing translates into relaxation, relief, a sense of confidence in breathing.
AND, teaching effortless diaphragmatic breathing may lead to:
(1) self-management of underbreathing,
(2) reduction of autonomic arousal, and
(3) a sense of self-empowerment.
Clearly, in the case of pulmonary pathology, good diaphragmatic breathing may very significantly improve
tidal volume, and be absolutely essential to matching ventilation with perfusion, i.e., to ensuring adequate
ventilation. This is the physiological basis for the benefits of learning through incentive spirometry. Although
this is a significant self-management tool for increasing tidal volume, it says little, if anything, about factors
that set the stage for bronchial constriction, increased airway resistance, reduced lung compliance, and the
onset of asthma symptoms. In accounting for these physical changes, many practitioners point to the
importance of emotional triggers and concomitant autonomic changes as the key factors, and hence to the
importance of learning effortless breathing, relaxation, positive self talk, and physical confidence building.
Simply pointing to autonomic correlates, however, does not directly account for the physiological changes
and symptoms associated with asthma. For example, how does autonomic arousal increase airway
resistance, when, in fact, sympathetic activity actually decreases, not increases, airway resistance? And,
how do slower breathing, decreased fear, and effortless breathing actually reduce the likelihood of asthma
symptoms and attacks? Some of the physiology accounting for these considerations is likely to include: (1)
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reduced airway (local) hypocapnia and its effects on airway resistance, lung compliance, and bronchial
activity, and (2) reduced systemic hypocapnia (e.g., cerebral) and its effects on emotional reactivity and
physical symptoms.
Diaphragmatic breathing is regulated by the brain stem medullary dorsal respiratory group (DRG) in
accordance with the Henderson and Henderson-Hasselbach equations, which includes changes in pH or
[H+], HCO3
? (bicarbonates), and PaCO2 (and other fluid PCO2). Using other breathing accessory muscles,
such as during so-called “chest breathing,” may quickly result in deregulation of this basic brain stem reflex,
and increase the likelihood of deregulated chemistry; in fact, the onset of its effects, overlooked by most,
may even be falsely attributed to both asthma and autonomic arousal. And, of course, breathing training
which decreases the likelihood of hypocapnia, reduces the probability of deregulation. Here is a partial
accounting of such variables:
Factors that trigger hypocapnia Factors leading to hypocapnia prevention
Worry about breathing Breathing self-confidence, trust
Using accessory muscles Diaphragmatic control
Intentional breathing Allowing breathing to happen
Deep breathing Quiet effortless breathing
Rapid breathing Allowing for exhale and its transition
Fear and anxiety Relaxation
Defensiveness Embracement
Negative self-talk Self-affirmations
Misinformation about breathing Education
Secondary responses to physical symptoms Counterconditioning
Variables that decrease the likelihood of hypocapnia are implicitly embedded in effective breathing training
protocols, e.g., incentive spirometry training. Unfortunately, however, behaviors which increase the
likelihood of hypocapnia are also often encouraged by trainers, who unfortunately don’t know about the basic
biochemistry involved. Emphasis on deep diaphragmatic breathing during incentive spirometry training may
result in the self-defeating effects of hypocapnia, whereas emphasis on quiet effortless diaphragmatic
breathing is likely to normalize PCO2 levels.
OVERBREATHING BEHAVIOR
Optimal respiration means regulating chemistry, through proper ventilation of CO2, relaxed or not, such as
during the acrobatics of talking, emotional encounters, and professional challenges. Good breathing
chemistry establishes a system-wide context conducive to optimizing physical and psychological
competence, where chemistry needs to be balanced regardless of what we are doing, thinking, or feeling.
Nevertheless, overbreathing behavior, like any other maladaptive behavior can be quickly and easily learned,
and unfortunately, like so many habits, are often challenging to disengage, manage, modify, or eliminate; the
learning principles, are the same.
Overbreathing can be learned as a defensive response to specific challenges (e.g., performing before an
audience, or confronting a distressed partner), or it can mediate shifts in consciousness that set the stage for
learning constellations of defensive behaviors that serve to protect against trauma, including people, things,
and oneself. The desire or need for “control” is a metaphor frequently embedded in deregulated breathing
behavioral patterns. These defensive behaviors, like many vicious circle behaviors, may come at a high
cost, as described above: physical symptoms, emotional reactivity, cognitive deficits, and performance
decrements with immediate, long-term, and profound effects. Herbert Fensterheim (Timmons & Lay, 1994),
an internationally prominent psychotherapist, points to these considerations in addressing mental health
professionals when he says:
“Given the high frequency of incorrect breathing patterns in the adult population, attention to the symptoms of
hyperventilation [overbreathing] should be a routine part of every psychological evaluation, regardless of the
specific presenting complaints. Faulty breathing patterns affect patients differently. They may be the central
problem, directly bringing on the pathological symptoms; they may magnify, exacerbate, or maintain symptoms
brought on by other causes; or they may be involved in peripheral problems that must be ameliorated before
psychotherapeutic access is gained to the core treatment targets. Their manifestations may be direct and
obvious, as when overbreathing leads to a panic attack, or they may initiate or maintain subtle symptoms that
perpetuate an entire personality disorder. Diagnosis of hyperventilatory [overbreathing] conditions is crucial.”
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Although breathing is subject to the same learning principles as any other behavior, it is a unique behavior in
a number of significant ways, ways which makes its deregulation of very special
concern to practitioners interested in teaching self-regulation for health and performance:
(1) It is a “perpetual” behavior. It does not emerge only at specific times and places. It takes place
virtually all of the time, and when briefly it does not, its absence is still relevant.
(2) It is a behavior that is necessarily woven into virtually every mindful-physiology tapestry. It is an
inevitable part of every behavioral topography. It transitions from one topography into the next, and may
carry with it behaviors, emotions, memories, thoughts, symptoms, senses of self,
personality styles, and physical reactions from the previous topography.
(3) It is serves as a gateway wherein it set stages, creates backdrops of meaning, establishes contexts, and
changes states for management of the mindfulness of physiology.
(4) It is controlled centrally from diverse neurophysiological sites as well as locally by cells and
tissues. Throughout the day it is voluntary and involuntary, conscious and unconscious.
(5) It is critical to basic human functions, including not only acid-base physiology and the delivery
of oxygen and glucose, but is vital to social behaviors such as verbal communication.
(6) Its basic nature is reflexive. Intentional practice can be difficult because you can’t do it for a while, take a
break, and then continue again when you feel more confident. It will happen anyway. You can’t avoid it. It’s
always there. You can’t put it aside if you don’t like it.
CAPNOBREATH TRAINING
CapnoBreath Training (where “capno” means CO2) is about learning and teaching adaptive respiratory
chemistry within a wide range of breathing mechanics. It means precision coordinating of breathing rate and
depth through reflex control of the diaphragm, a brain stem coordinated reflex mechanism which can be
easily deregulated, consciously or unconsciously. CapnoBreath training is about reinstating this reflex
mechanism. It means integrating knowledge of respiratory chemistry with the mechanics of breathing, where
emphasis is on the relationship dynamics of breathing mechanics for achieving good chemistry, rather than
on specific “mechanics” prescriptions (e.g., a specific breathing rate), where the effects of breathing
chemistry are neither accounted for during initial evaluation nor included as a part of self-regulation learning.
Good respiration requires neither relaxation nor a specific mechanical prescription, save one: the varied
melodies of breathing mechanics must ultimately play the music of balanced chemistry.
CapnoBreath training includes exploration, education, play, and training as follows:
(1) exploration: originating and sustaining factors and circumstances;
(2) identification: dysfunctional breathing patterns, when and where;
(3) phenomenology: feelings, memories, thoughts, and sense of self;
(4) knowledge-learning: understanding basic breathing concepts;
(5) sign-learning: recognizing physical, psychological, and behavioral symptoms;
(6) mechanics-learning: play for diaphragmatic, rate, & depth awareness;
(7) visceral-learning: developing an internalized sense of chemistry; and
(8) state-learning: developing a sense of chemistry for consciousness (e.g., emotions).
CapnoBreath training, in the larger context, is about learning “to embrace” (or to engage) a challenge rather
than to “defend from” a challenge. Embracing means “being present,” connecting, and learning, where
defending (or bracing) means armoring, isolating, and disconnecting. Healthy breathing should not be state
or context specific, e.g. during meditation, relaxation, or prophylactic intervention. CapnoBreath training is
about learning to breathe with the whole body; every cell breathes, not just the lungs. Learning good
respiration is learning about what breathing “feels like,” and is ultimately not about what breathing “looks
like.” CapnoBreath training is about learning to breathe inside-out, rather than outside-in.
THE EFFICACY OF CAPNOBREATH TRAINING
Clinicians and researchers everywhere substantiate the “efficacy” of their techniques, protocols,
interventions, training methods, and educational programs based on how they “stack up” based on whether
or not, and to what degree they impact, for example, hypertension. But, what about the efficacy of reducing
hypertension itself on heart attack or stroke? Does reducing hypertension through biofeedback, for example,
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actually reduce the likelihood of a heart attack, or is this just an assumption based on statistics about
hypertension? Few of us ask these questions. We simply assume that biofeedback regulated blood
pressure is synonymous with reducing the likelihood of heart attack or stroke: the link is simply a leap of
faith, not science.
Curiously, on the other hand, although the clinical research literature very clearly, without controversy, and
with exceptionally well documented science, points to the profound effects of hypocapnia, no one talks about
substantiating the efficacy of their interventions, e.g., biofeedback, based on changes in PaCO2 which lie at
the very heart of acid-base physiology and its effects on health and performance! Additionally, and important
to point out, is the fact that breathing regulation is under our immediate and direct control (in healthy people),
and unlike methods contributing to changes in blood pressure physiology, shifts in breathing are not indirect
and do not require life style changes.
Although the importance, relevance, and efficacy of breathing training is indisputably acclaimed and widely
practiced in professional and lay circles worldwide, it is curious, indeed, that the practical relevance and
efficacy of breathing chemistry (CapnoBreath) training, which rests on the firm ground of a vast empirical
science, is so frequently challenged and questioned by these very same practitioners. It is this chemistry
which, in fact, offers up perhaps the most fundamental reason for the efficacy of breathing learning and
training so widely embraced by all.
Making the case for (1) the clinical and educational relevance of the management of hypocapnia, and (2) the
potential effectiveness of clinical and educational interventions for its amelioration, far exceeds making the
case for blood pressure reduction, or most any other behavioral intervention that involves physiological selfregulation
learning. Why is training for good chemistry not widely recognized and practiced by practitioners
everywhere? The answer is simple: this fundamental, highly-documented, non-controversial practical
science has not been adequately and effectively brought to their attention. Now is the time.
Note: When perfusion is greater than ventilation, some of the blood that passes through the pulmonary capillary network
is not ventilated. This means that some of the CO2, which would otherwise diffuse into the alveoli, is returned to the
arterial system. This blood mixes with the blood that has been partially or fully ventilated, with the result that the arterial
PaCO2 is higher than it would be otherwise. This is known as “CO2 retention,” a phenomenon identified with people who
suffer with asthma and other pulmonary disorders. There is, of course, immediate compensation for “CO2 retention,” as
a result of increased ventilatory drive, which restores normal PaCO2 (arterial) levels.
Although PaCO2 levels may be normalized (eucapnia), ETCO2 levels (end-tidal CO2) will be lower, giving the uniformed
observer the false impression of overbreathing and hypocapnia. The readings are lower because of (1) the mixture of
alveolar gases containing different partial pressures of CO2, and (2) the diffusion of proportionately greater amounts of
CO2 in alveoli which are fully ventilated. Thus, although alveolar and end-tidal CO2 are low, PaCO2 may be normal. This
is often the explanation as to why people with asthma “overbreathe:” they have “CO2 retention.” If this is true, of course,
they aren’t really overbreathing: there is no (systemic) hypocapnia. Unfortunately, this “organic variable,” leads many to
precluding further behavioral considerations, when in fact its very presence establishes the basis for learning
dysfunctional breathing: the resulting local airway hypocapnia may produce asthma symptoms, leading to the vicious
circle learning pattern described above, with the consequence of systemic hypocapnia (low PaCO2) and its effects on
emotionality and physical symptoms. Mismatch of ventilation and perfusion does not preclude overbreathing behavior in
people with asthma, but rather serves to set the stage for its acquisition.
REFERENCES
Fried, R. (1999). Breathe well, be well. New York: John Wiley & Sons.
HealthCare Professional Guides (1998). Anatomy and Physiology. Springhouse: Springhouse Corporation.
Laffey, J.G., & Kavanagh, B.P. (2002). Hypocapnia. New England Journal of Medicine, 347(1) 43-53.
Levitzky, M. G., (2003). Pulmonary Physiology. New York: McGraw Hill.
Thomson, W. S. T., Adams, J. F., & Cowan, R. A. (1997) Clinical Acid-Base Balance.
New York: Oxford University Press.
Timmons, B. H., & Ley, R. (editors, 1994). Behavioral and psychological approaches to breathing disorders.
New York: Plenum Press.
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