By Phac Le Tuan, Certified Integrative Nutrition Coach, Breathing Science Evangelist.

"One hundred push-ups in one breath? I don't believe you," I said, incredulous, and yet humbled by what the unassuming middle-aged doctor and QiGong practitioner (Dr. J.) just casually confided to me at a fundraising dinner in Silicon Valley for a charitable organization operating in Vietnam, about a year ago.

This could be a typical case of confirmation bias. Still, since then, I have been increasingly noticing issues related to breathing in the news: "I can't breathe" signs have popped up in many places, COVID-19 is attacking people's ability to breathe, wildfire smoke in Northern Californian was thickening the air last summer, wearing masks has been raising questions about our freedom to breathe, an instant New York Times Bestseller, entitled "Breathe" by James Nestor has come out this fall, famous Wim Hof "The Iceman" develops a novel breathing method for extreme athletes, and… we're holding our collective breath given the upcoming election.

Until that conversation last year, I had been practicing various breathing techniques for more than 20 years, mainly based on Eastern philosophy practices (meditation, martial arts, Qi Gong). Thereafter, the perceived zeitgeist led me to research the topic even deeper, poring over several dozen books and articles in science magazines, PubMed, and more. I was amazed by the wide variety of breathing alternatives proposed by many authors, with their associated benefits. Still, I was even more intrigued by the fact that none of the authors actually explained what exactly happened inside the body during such practices, at least to the satisfaction of my modestly scientific mind.

So I came up with the following layman explanations, where all the physiological facts are derived from scientific articles. How I bring it all together is my own personal analysis, which might not be perfect, but appears to meet the common sense test. If you are a Ph.D. student or a post-doc interested in researching this area, please contact me.

So what's so mysterious about breathing? Let's do a quick dive.

The average respiration rate is 16 per min, meaning that the inhaled air stays on average less than 4 seconds in our lungs, or more exactly in our alveoli, the millions of little bags separated from our bloodstream by a very thin membrane through which oxygen (O2) passes into our blood and carbon dioxide (CO2) passes in the other direction, leaving our blood to be expelled at the next exhalation.

Oxygen molecules cross the membrane effortlessly, but they need to find depleted red blood cells that would carry them to all the tissues of our body. The process is described as "perfusion-limited," meaning that the loaded red blood cells need to move on to leave room for new depleted cells to come into contact with the membrane and capture more oxygen molecules. The speed at which the blood cells move depends on our heart rate, which is about 5 times our respiration rate.

The air we inhale contains about 21% O2 and 0.04% CO2. Surprisingly, the composition of the exhaled air is about 16.4% O2 and 4% CO2. In other words, in one respiration cycle, we only absorb about 22% of the oxygen available in our lungs (absorbed O2: 21 - 16.4 = 4.6%, divided by 21%, or 4.6/21 = 22%). We are leaving a lot of oxygen on the table, so to speak, and that also limits the amount of carbon dioxide we can exhale in one respiration cycle.

How could we absorb more of the oxygen already available in our lungs? Simply by holding our breath and exhaling more slowly, giving more time to the red blood cells to get loaded. Notice that while we exhale, oxygen molecules are still crossing the alveoli membranes to get hitched on red blood cells.

Now, what happens with CO2 molecules? Unlike oxygen molecules, they are dissolved freely in our blood and do not need any cell to carry them. They are generated as metabolic waste within our bloodstream by all our tissues' respiration. When they come in contact with the alveoli membrane, they cross over into the alveoli if, and only if, the partial CO2 pressure is lower in the lungs than it is in the blood. This process is said to be "diffusion-limited" as it stops when the CΟ2 partial pressure in the lungs equals or exceeds its partial pressure in the blood. The alveoli membrane is designed to prevent any CO2 molecule to cross back into the bloodstream, so when we exhale by increasing pressure in the lungs, the CO2 is forced to leave our body.

Then, what happens when we hold our breath for some time? More CO2 fills our lungs (while a little more oxygen continues to cross over to our red blood cells) until the CO2 pressure differential goes down to zero, and then, more CO2 accumulates in the bloodstream. Fortunately, before it reaches a toxic level (hypercapnia), an automatic reflex of the respiratory muscles is triggered to inhale fresh air. If you think that it sounds paradoxical to fill the lungs with fresh air when you have too much carbon dioxide in the blood, you are not alone, and yet, this is what we do. Why does our body react that way?

It's very logical actually: to extract excess CO2 from the blood, its partial pressure in the lungs has to be lower than its partial pressure in the blood. The only way to do that immediately is to expand the rib cage to increase the lungs' volume. The process will extract the CO2 from the blood and bring in fresh new air from the outside. In other words, we breathe in urgently to remove excess CO2 from the blood rather than to get more oxygen in as the primary reason.

Of course, the excess CO2 is expelled in the next exhalation, but not completely if we immediately inhale new air in a panic breathing mode. The situation might last several respiration cycles until the blood's CO2 level is down to normal and until the level of oxygenation of our red blood cells is also back up to normal. That's the recovery time.

Based on what we now know, do you think there's a way to shorten the recovery time? Yes, of course, although it is not intuitively done: Instead of inhaling right away, we have to exhale slowly and completely, to expel as much CO2 as possible, and to let as much oxygen as possible onto red blood cells. Waiting a little bit more before inhaling, that's what we need to do.

So the next time you are out of breath, such as after sprinting over 100 yards at full speed, or feel deeply anxious just prior to a make-or-break presentation in front of investors, try to practice the slow and complete exhale, and see how you will be able to shorten your recovery time, or how quickly you can return to your natural confident self.

To learn more about simple breathing techniques that will improve your well-being and your performance, as well as reducing oxidative stress, please sign up for my FREE 5-day Start-up Stress Reduction Challenge, which will start on Nov 9, 2020.

Note: This event has ended. However, you can still sign up to access the PDF archives.

Like it or not, we have to live with the constraints of the current pandemic, and one of the most controversial constraints is the recommendation to wear a mask when interacting with strangers nearby. Without getting into the fruitless debate about its utility, let's see how we can apply our knowledge to make it a little bit easier to breathe with a mask.

Breathing with a mask is uncomfortable, but the discomfort has nothing to do with the myth of having less oxygen intake because of the mask. The mask discomfort has several causes, which get worse over long periods of time:

1 - Increased inhalation effort: Although the molecules of carbon dioxide and oxygen are 5,000 to 10,000 times smaller than the pores of an N95 mask, respectively, it actually takes a tiny little bit more work from our respiratory muscles to get fresh air to go through the mask, and over time, the additional effort can take its toll.

2 - Mask wetting: water vapor in the exhaled air will tend to wet the mask after just a few minutes in certain cases. As the mask gets wet, forcing air through it becomes even harder, not to mention that the mask will tend to stick to the skin, thereby increasing the discomfort even further.

3 - Mask attachments: The most common over-the-ear loops can put unwelcome pressure on sensitive skin behind the ears and interfere with hearing aids, particularly when removing a mask quickly without dislodging the devices in the process. There are elegant, cheap, or do-it-yourself alternatives to such loops. Follow me on Instagram to get tips and ideas about improving your well-being.

What can we do about the first two causes? There are some simple breathing adjustments we can make to offset some of the discomforts in the following way:

A - Breathe in and out through the nose as much as possible.

If you breathe in through the mouth, the mask will tend to stick to your mouth, particularly when it has become wet, and require even more muscular effort to get fresh air through it. More importantly, when you breathe out through your mouth, your exhaled air contains a lot more moisture than when you exhale through the nose.

In other words, breathing out through the nose will reduce the exhaled amount of water vapor, keeping your mask drier and less hot, longer than breathing out through the mouth.

B - Reduce your respiration rate by breathing out slowly through the nose whenever possible. We have seen how this enables more oxygen to be captured in our blood and more carbon dioxide to be expelled from your lungs, which is a good thing, whether you wear a mask or not. The additional benefit of doing this is that it will keep your mask dry for a longer period of time when you wear a mask.

Breathing in and out through the nose has, in fact, many more benefits for our health, and I will talk about it in a future blog. For now, remember that it can help reduce the discomfort of wearing a mask, and although it will require some constant awareness initially, over time, it can become a good habit to have.

Slowing down our respiration rate has an additional long term benefit. It reduces the production of Reactive Oxygen Species (ROS), responsible for the oxidative stress that can damage some of our organs. It also triggers our parasympathetic system, facilitating the "rest and digest" process within our body.

To know more about breathing techniques you can apply at any time, as well as complementary ways to reduce stress, please sign up for my upcoming FREE 5-Day Start-up Stress Reduction Challenge from Nov 9 to 13, 2020.

I was about to forget a piece of good news: After about 9 months of medium intensity practice, I can now replicate Dr. J.'s feat! I'll talk more about that during the 5-day challenge. Please check it out by clicking on the button below..

Note: This event has ended. However, you can still sign up to access the PDF archives.