 Hey, next session up is with Patrick McKeown, the author of The Oxygen Advantage. So I'm going to add Patrick in now. Say it, Patrick. That's all. How are you? Can you hear me okay? Very, very good. Thank you. The sun is shining finally again and all the better for seeing you. Well, I've just gave a very, very brief intro, but I'll just do it again for anyone that might be seeing you for the first time. I'm coming across stuff. We had such an unbelievable response to the podcast. It's been a number of some of the coaches that we sort of know and connect with as well. I've started reading the book and I keep seeing other people just like pushing it. I went on Amazon last night to buy my dad for his birthday and the one with the blue cover that I've got is sold out. Wow. That's great. Yeah, it's always great to see a book that you spend three years, four years writing that when it gets out there, that it's embraced. It's always, of course, it's super, you know. Yeah, yeah, yeah. So Patrick, for people, this is Patrick McKeown. He wrote his author of The Oxygen Advantage, something that I've been reading about for quite some time. You guys were reading about the podcast. Obviously, for the podcast live event, we had to have him live. And the idea with the podcast live event is to give us the opportunity to rather than just the audible experience of listening to a podcast is to actually like see what's going on, to actually interact, ask your questions. So put those in the comments and it allows us to actually do some of the things we're talking about rather than just describing them. So that's where I'd like to try and go with some of the stuff today. For those that haven't or aren't sure about what, you know, The Oxygen Advantage is the title of a book. Obviously, it's about the idea of oxygen. We're thinking about breath, but it is we've been coiling a hashtag nasal gang for quite a few people. And I think of you as like the CEO or the guru of nasal gang. In simple terms, just my first question to set the tone for people is like, why is why is nasal breathing important and trying to go initial just to start with like super for you. Like, like you go into lots of great detail in the book. I recommend anyone reading it. Even there's a part where you suggest like all the exercises are later and you can go to those if you want, but recommend you understanding the science behind it because that gets you to understand what you're doing better. I almost totally understand. We've done that with some of our programs for gone. The juicy stuff is up here, but the understanding at the beginning we recommend you read that. And some people skip that bit and you're missing out on all of the good stuff. Like from me just to help people what resonated with me was I was on a it was actually Richie Norton recommended your book to me. He was just on last with me when I was asking him about only decent books to read. Like, I'm intrigued about I'm questioning, am I breathing correctly? Can I breathe better? Is that an area of my life that I could maximize or improve? And so I was on that bit of a journey that he recommended the Oxford Advantage and the two things that jumped out that me or what resonated with me so much in those early chapters and why you've got my buy-in straight away was two things. One was this notion of getting away from the fight-or-flight response. And that's one element of my understanding of why nose is important. And then the other is getting away from this upper chest breathing. Richie made a very good point earlier where he said, some people just aren't even aware. If you ask them, where's your breather? And I've done it to people since. Do you think you breathe through your nose or your mouth? And some people go, oh, they know they like I breathe from my mouth. And other people go more than those. But then a lot of people are like, I don't know. And I was one of those. It was like, where do I breathe from? And then you start just that part of the process of going, asking yourself that question and throughout the day trying to understand where you're breathing from is a, for me, was like the powerful starting point of it. But there were two things that resonated with me. I'll show up now and just let in a nutshell why, set the tone of why nasal breathing is so important. Well, it's quite simple. The mouth performs zero functions in terms of breathing. If you look at the nasal cavity, I'm not sure how this is going to appear. Better than where we did the interview. But if you look at the mouth itself here, there is absolutely no function in the mouth here, which is regulating breathing volume, which is moistening it, warming it. The mouth does absolutely nothing for breathing. It's all in the nose. And despite that, I actually find it amazing that this hasn't received so much attention over the years, but the science is starting to catch up with it. There are a few professors, more so in the United States, who are getting behind it. And in a nutshell, Jaco, it's really about if you breathe through your nose, it is tougher at the beginning, but after six to eight weeks, it gets easier because the air hunger reduces. But when you look at the benefits of nasal breathing, you have a 10% increased pressure of oxygen in the blood. You've got increased carbon dioxide. It reduces ventilation. You've got less trauma to the airways. The nose is directly connected with the lower regions of the lungs to diaphragm. Diaphragmatic breathing is absolutely essential for the generation of intraabdominal pressure for stabilization of the spine for functional movement. Functional movement is essential for athletes that don't want to run the risk of injury. So nasal breathing is where it's at. The mouth is directly connected with the upper chest. Mouth breathing is fast breathing. It's shallow breathing. And just even if we were to look, and I'm not sure again because I can't see a camera for myself, but if you see here, typically with human beings because of gravity, the greatest concentration of blood is in the lower lobes of the lungs. And when we are mouth breathing, we are ventilating the upper regions. But when we breathe through the nose, we carry the air deeper throughout the lungs, but also we harness nasal nitric oxide, which redistributes the blood throughout the lungs. Nasal breathers, much less likely to have exercise-induced bronchoconstriction. Also, in terms of COVID, it's really, really topical. And only one article has come out that was published in The Science last week. If you go into a gym or if you go into a dance class and you have a group of individuals who are mouth-breathing, hard breathing, fast breathing, they are emitting a lot of water vapor into the atmosphere. So you have individuals who may be infected emitting a lot of water vapor, and then you've other individuals who are mouth-breathing, and they have literally no defense from an airborne point of view. So the nose, if you breathe in and out through your nose, your nose captures the moisture on the exhale breath. But if you breathe in through your nose and out through the mouth, there is a 42% greater water loss by mouth-breathing. And that's even just looking at physical exercise. You know, I think there's so many misconceptions out there about breathing. People don't realize the impact of it. It's not just about taking the full, big breath. It's nothing but to do with that. And let's look at what we can do with sleep. Let's look at what we can do with focus concentration. And let's look at what we do when we do breath-tolling to drive the body into an anaerobic stage, to increase carbon dioxide, to disturb the blood-acid-base balance, to force the body to make adaptations to improve the buckling capacity. So with breathing, there is functional breathing, and that's our everyday breathing patterns. And I'll give you an example. I work with professional athletes. And last week, no, this week, this week I had a professional MMA fighter. A young star woman. And gassing out too soon. This proportion of breathlessness during physical exercise. And also before she would get into the ring, she doesn't know whether she's going to gas out or not. And that creates anxiety. So it's really a vicious circle. And then when I talked to her, my breathing during sleep tired all the time. And this individual has reached a professional, really high level in the sport. And her bold score was seven seconds. Now imagine the potential with that individual. Number one is we get her sleep right. Number two is we get her functional breathing right. Number three is we get her to do breath-tolling to make adaptations. And I think there are, I'm just going to say it very quickly. I never think if you take a big breath that it brings more oxygen to the tissues. Big breathing. You often hear take a deep breath. Take a big breath. Big breathing will not increase the blood oxygen saturation. It won't drive up how fully loaded your hemoglobin is with oxygen. And during normal breathing, your SPO2 or the saturation of your arterial blood with oxygen is typically about 95 to 99%. If you breathe harder, you don't increase that. And if you do increase it, it might be by one or two percentage points. But the issue with breathing hard is you get rid of too much carbon dioxide from the blood through the lungs. And carbon dioxide is not just to waste gas. Back in 1904, Danish physiologist Christian Bohr discovered that the pressure of carbon dioxide in the blood is what influences the affinity of hemoglobin for oxygen. In other words, it's not just to have oxygen in the blood. We need to get the oxygen out of the blood to the working muscles. They're driven by increased temperature of the muscle and increased carbon dioxide. As carbon dioxide increases, blood pH drops and the affinity of hemoglobin for oxygen reduces. Our red blood cells release oxygen more readily to the tissues in the presence of carbon dioxide. Yeah. And that was especially just to jump back. That was one of the, that was like the other, when that was the other big thing that really jumped out at me. And I want to just unpick something. You've just covered like so much good stuff there. I just want to unpick a little bit of that because there are, you know, there was one, there was a question from Mont Saladin. Are we talking about breathing in and out through the nose? Like, so some people are watching and we're at that point where we don't, we're not even, we're asking a question of, so the answer is yes, we're talking about in and out through the nose, as our normal everyday breathing. The example of the MMA fighter was the, was the same as me. I was a, I used to play professional rugby. I had a post even finishing rugby. My 5K time was 20, like just 20 minutes. I was fit and yet my bolt score was probably similar. It was under 10 seconds. It was, it was abysmal. And by changing to some nasal breathing, just not even initially, just like being a bit more aware as I was talking about and actually trying to just do it a little bit more and noticing, am I just out of breath? And even just this realization of, we'll do the bolt score with people. This, I couldn't handle, my body couldn't handle not, or couldn't handle this buildup of carbon dioxide. And when I read the bit about the importance of carbon dioxide, it's not just a waste gas. That was a real light bulb moment for me. Because I've read the science from you to help me understand it. And then I felt it. I could feel when I held my breath for more than five seconds, I was like, let's, I've got to get, I need to start breathing again. And it was almost like panic kicking because I couldn't handle being that far out with that tiny amount of time without breathing. And you go, you've said, I've heard you said this a number of times where, well, nothing magical is going to happen when you then go and start exercising. You're going to be able to deal with all this exchange of oxygen and carbon dioxide better if you can't do it well at rest. I want to just unpick that a little bit for people and give people the chance to have a go effectively. And I think I thought it would be interesting to ask initially for people in the, if you've got any specific questions as we go along, just ask them in the comments as you have been doing. And we'll answer those as we go through. Also, just give us some feedback. Are you, those that are listening, are you, do you know that you breathe through your nose? Just your normal everyday breathing. Are you aware that actually you tend to breathe through your mouth? Or third option is, I actually, I haven't ever thought about it. There's almost the three types, there are the sort of three answers generally when we're asking ourselves how are we breathing? So let us know in the comments. How are you breathing during sleep? Do you wake up at a dry mouth in the morning? Yeah, we'll get on to taking our mouth at night, but I thought we won't go too hard on people too early doors. So body boot camp is a more through the mouth. So just starting to get that awareness. Splunky woosh mostly mouth. So people are generally breathing, so generally breathe through a nose. So people being aware, I'm sure there'll be a ton of people listening that are also not aware, but we're going to brighten that awareness now. And I thought it would be good to do, just explain what that bolt score is, because someone's asking already, explain what that bolt score is. You've already talked about the need for carbon dioxide to allow for more oxygen, because it's true that we want oxygen, we need oxygen for the muscles to help with the fuel for muscles to work. But what the understanding of the science is that without any carbon dioxide presence, that exchange is not as effective as it could be, or it's necessary to happen. And therefore our ability to deal with carbon dioxide buildup is a good marker of our level of cardiovascular fitness and efficiency of breathing. Yeah. Bolt score is breath hold time. And breath hold time is a measurement of dyspnea or breathlessness. Since 1975, because what determines how hard and fast you breathe during physical exercise is influenced by your sensitivity to the gas carbon dioxide. Yeah. And if you were overly sensitive to the buildup of CO2 in the blood, your breathing is harder and fast. We don't. The primary stimulus to breathe is not oxygen. It's only when we go up into altitude that our oxygen in the blood drops by about half, the oxygen drive our breathing. The primary stimulus to breathe is carbon dioxide. And how sensitive we are to that gas will determine how hard we breathe during physical exercise. Yeah. So athletes who are breathing have a habit of everyday breathing if their breathing is up or chest and just that little bit faster. And it's not that they are having a panic attack. It's not that they are having an asthma attack. But it's just that their everyday breathing is a little bit faster, a little bit harder, up in the upper chest. And that everyday breathing translates into dysfunctional breathing during physical exercise. Which just based on that, there are some stuff, because a lot of people are doing some of the stuff in calisthenics like handstands and things that require good overhead mobility, that if we're very dominant from breathing from our upper chest like all day, every day, that has an impact on our rib cage, that has an impact on our thoracic mobility. So extension, which is important for overhead rotation, has an effect on our, around the first rib that can be really restricted for the shoulder. There's a whole host of things that go into it, not just from a cardiovascular point of view, as well, which I think that was one of the, to be honest, that was one of the things that I was interested in, because I knew about the potential effect of poor upper chest breathing on shoulder mechanics. And that was one of my drivers to try and understand a little bit more about it. So I think whether, it doesn't matter whether someone's interested in both, or someone's interested in more on the cardiovascular side of things, I mean, my 5K time went from just below 20 minutes to 19, 16 in the course of about five weeks. So it has that massive effect. But then also, you're going to do some stuff that's going to help to actually loosen up, potentially some stuff around your neck, particularly your thoracic spine and your overhead, and your shoulder mobility as well. You're going to get those things as a benefit as well. Well, it's not just about respiration. It's also about functional movement. And individuals with lower back pain tend to have dysfunctional breathing patterns. You can imagine, it translates the whole way through, the body, right? Yeah, and we need to die from that stabilization. And with diaphragmatic breathing, is having a normal exhalation where the diaphragm moves back up to its resting position. Because it's when the diaphragm, when we have a normal exhalation, then we can have a normal inhalation. And when the diaphragm moves back up to its resting position, this increases the zone of opposition, which is the distance from the height of the diaphragm down to the lower ribs. And this, in turn, then, is increasing intramdominal pressure. But coming back to it, like, in terms of the science, Professor Kiesel published a paper in 2018 and looking at 51 subjects, healthy subjects, and only five of those, 10% of them, had normal breathing patterns. And, you know, this is very common in the population, but it's more common in some subgroups than others. So a copper in review said it was about 9.5% of the population. But with asthma, in other papers, it's about 30%. But with people with anxiety and panic disorder, it's about 80%. And the other thing is, I've only started going down the route of female breathing is significantly different than male breathing, especially for younger women who are having the monthly cycle. And we're talking about the luteal phase where hyperventilation kicks in and hyperventilation is a natural reaction to the change of hormones progesterone. This, in turn, is increasing breathing. This is lowering carbon dioxide in the blood by up to 25%. This is increasing pain, increasing anxiety, increasing fatigue. Now, most studies on breathing don't differentiate between male and female breathing. I is a breathing instructor for 18 years because I'm a typical man. I overlooked female breathing. And the more I go down this, considering that 50% of my students over the years were females and yet we weren't reflecting the change in performance of a female during just times of monthly cycle. So hormones do influence breathing. And we have to bear in mind that if we are in a habit of over-breathing, yes, it does influence activity of the mind. You cannot have a calmness and stillness of the mind. You cannot be in dissolve so readily. You don't have a good night's sleep. Your energy levels, your focus, your concentration is all impacted. But we have to bear in mind that with breathing, the degree of breathlessness consumes oxygen. As we sit here now, about 2% to 3% of our oxygen consumption is going to support the breathing muscles. If we go for a walk, fast walk, it's about 5%, 6%. If we go for more intense exercise, it's about 10%. If we do maximum physical exercise, it's 15%. But if we have chronic hyperventilation, that our breathing is in excess of our normal metabolic requirements, the VO2, the oxygen consumption going to support breathing muscles is as high as 30%. There is a cost associated with breathing hard. And this is good in terms of when you first switch from mouth to nose breathing, of course there is an air hunger and there's a degree of suffocation. And the reason being is because the nose exerts a resistance to your breathing 2 to 3 times that of the mouth. Nose breathing is slowing down breathing and with that, with a slowing down of the breath and a reduction to breathing volume, carbon dioxide increases in the blood and carbon dioxide is the stimulus to breathe. So when you go for exercise, initially with your mouth closed, the VO2 in the blood is higher, you feel a greater air hunger. But if you continue doing all of your physical exercise with the mouth closed, the body is forced to make adaptations to tolerate carbon dioxide. Now that translates into reduced breathlessness and only one study would you believe. I find it amazing that professors of exercise science have missed this when you look at physiology. How are they missing the elephant in the room? And I talk about that because even the professional athletes that I work with, not just of course professional athletes, five-year-old kids right up to people in their 70s and 80s. But how on earth are we missing breathing? That we are looking at nutrition, we're looking at psychology, strength and conditioning. And yet the athletes who maybe have a tendency towards anxiety and panic, a genetic predisposition towards hard and faster breathing, anybody with any sort of sensitivity towards exercise induced bronchial constriction. So those individuals who get frequent colds, they have inflammation of their lungs, their chest feels tight, they feel they're not getting enough air. Because that's going to hold back progress. And if I look at George Dallam's paper, he looked at, he spent 10 years, sorry, he spent two years trying to recruit athletes. And he's a professor of exercise sports in the United States. He did a study. He says, I'm going to have athletes breathe through their nose for six months only during physical exercise. And I'm going to measure, how do they perform after six months? When they switched from out to nose breathing, when they were tested at six months, they had 22% less ventilation, nasal breathing versus mouth breathing. The fraction of expired oxygen was less, nasal breathing versus mouth breathing. In other words, they weren't bringing in oxygen, that oxygen during a round trip blown back out that oxygen so much. With nasal breathing, your body utilizes oxygen better. With nasal breathing, your recovery post-physical exercise is better. It hasn't been studied. Many people have told me over the years, they go out for a run with their mouth closed. And they don't have the same lactic acid buildup. They don't have the same, you know, in terms of that recovery that's needed, that they fit, they feel very well in physical exercise. Yeah. Coming back to your question, the bold score, Kiesel looked at 51 subjects, and he looked at breathing from a biochemical point of view, a bio-mechanical point of view, and a psychophysiological point of view. He concluded that the easiest way to screen for breathing pattern disorders in the general population and athlete population was breadth whole time. Now, he didn't call it bold score, but it's exactly bold score. You see the description. I'll explain what it is. Yeah, explain it, and then we'll do one together and see how we get out. So you take a normal breath in through your nose, a normal breath out through your nose, you pinch your nose, you hold your nose, and you time it in seconds until you feel the first definite desire to breathe. And when you let go, your breathing should be relatively normal. So it's not the length of time of a maximum breadth hold, but it's the length of time that you can hold your breath for comfortably. Yeah. So I suppose, you know, you want to be sitting... You're finishing. Kind of it like that, yeah. Because if you hold your breath for as long as you can, it's influenced by willpower and determination. Yeah. That first inclination to want to breathe, you might feel, what do you describe some of those respiratory muscles just like kicking in? When you stop breathing, at some point the brain is going to react to the fact that you stop breathing. And the brain reacts by sending a message to the diaphragm and to the intercostals. So the diaphragm breathing muscle, you can have involuntary movements of the diaphragm breathing muscle as a result of it, or you might notice it in the throat. Is it the barring receptors in the brain? In terms of the respiratory centre, it's located in the most primitive part of the brain because of course we've been breathing since day dot. And in the medulla itself, there are central chemo receptors which are monitoring primarily carbon dioxide and blood pH. And that's why carbon dioxide is the primary drive to breathe. And then there are peripheral chemo receptors located at the angle of the jaw. They're monitoring carbon dioxide and oxygen to a lesser extent. So they are the secondary regulations of breathing. Reading in your book that you're literally you have by over breathing and upper chest breathing too much all the time that we change that dial effectively of when those receptors are telling you to breathe and by doing some of the exercises that we'll go through, we're basically trying to reset that and you feel the difference You're like, you sat there and you're like you know I can actually just I don't need to take, I don't have this urge to take a break. Can we try, can we can we get people to... I have no time or nothing, so people, I'll do the description so... Thank you. You give the description when I pinch by those I'm going to hit the time and the people join in with us. Okay. So whenever you're ready take a normal breath in through your nose and a normal breath out through your nose pinch your nose with your fingers and time it in seconds, just continue relaxing into the body and keep holding your breath until you feel the first definite desire to breathe or the first involuntary movement of the breathing muscles or the first stress to breathe and when you let go your breath should be fairly normal and that looks as if it was normal so that's 21 seconds now... My PB is 30, I've been a good a good lesson has been it's the same as anything that we train your respiratory muscles, the new mechanics of it, if you don't like if I stop doing pull ups I get worse, I'm not going to get it I'm not going to still be good at them it's the same thing I've worked really hard to get myself up to 30 and then I've just slackened off a little bit and you notice the difference Yeah, but also I don't always think it's good to measure both score live because psychologically it will influence the both score however, like if you look at Kiesel's study he said that 25 seconds if you're above 25 seconds there is an 89% chance that dysfunctional breathing is not present 25 is a good marker to get up 25 is a good mark people put in if anyone's done it there in time let us know what you actually managed to get interested to see how people did so Jack Oden, in order to improve both score it's essential to start off breathing through the nose but about 30% of your listeners are going to have nasal obstruction now you can decongest your nose holding the breath I love this one by the way the difference this makes is unbelievable because as you said when you and I've had this someone a friend of ours they tried to they've managed to probably run about 10 meters just through the nose and that was it so when you're as you described now sorry, as you described at the beginning if when you try to breathe in someone's asking when running should you breathe through your nose and out through your mouth and actually from the techniques that you're talking about about resetting those effects with receptors so that you can breathe your normal everyday breathing in the background we're trying to encourage it to be in and out through the nose and when you first try and do that exercising or even if you just first try to do and we'll get onto it the breathe light to breathe right and stuff that you do that can be difficult but certainly when you try to running and we have to apply the principle like anything we're going to change like progressive overload you cannot go all out and suddenly you might have to progressively like build up slowly you might have to start running very slowly to be able to build up to doing it and it will feel your nose might feel completely blocked at the moment but just stream with a snot and it literally didn't feel like I could get in I'd end up breathing so hard through my nose that it would like like I would close on itself but it it changes I feel like now and I'm still my box score is anywhere between low 20s to mid 20s on a normal day but I feel like now I can pretty much do any exercise just in and out through my nose but I did not feel like that when and it's been a while and you do have to work at it like anything but it massively changes and at the start feeling congested is a problem and like not literally you don't feel like you can get the you just like it doesn't feel like you can do it you're like I can't get the air in and out through my nose fast enough it's just it's blocked and so this can't take people through I'll show you the exercise but I'm just going to make a quick comment your ability to nasal breathe during physical exercise is going to influence is going to be influenced by two things one is your boat score as your boat score increases minute ventilation reduces so people who are breathing hard like for example if I see somebody and they're walking and they're breathing hard during their walking or gassing out an athlete if I see their breathing during rest is typically faster, upper chest no natural pauses following exhalation and their boat score could be ranging anything from 6-7 seconds up to about 16-70 in seconds that individual gasses out too soon and I know a threatened condition coaches might say it's due to poor condition it's not, we have the fittest individuals who are training professionally and yet it's their everyday breathing that's holding them back they are mouth breathing during the day they are fast up or chest breathing during the day, their mouth to open during sleep now the second thing which determines your ability to do physical exercise which your mouth closes the size of your nose so if you have a compromised nose like mine, you probably need to get a nasal dilator so for example if you do this, put one finger here and one finger here and if you just gently press the nostrils it's called the Cottle Maneuver and it helps open up the nose and that will also help to prevent nasal valve collapse so we're currently designing a nasal dilator for sports to help open it up so the nose unblocking exercise and the reason I think it's really important because I was a chronic mouth reader for 20 years I was highly strong my sleep was always impacted and I used to be exhausted and then going into school and trying to get grades exhausted you can decongest your nose in five minutes holding your breath don't do this exercise if you're pregnant don't do this exercise if you have any serious medical conditions but let's give it a go do you want to give it a go? so can I have you stand up? yeah are we walking? I'm going to have you walk into the spot okay so if you take a normal breath in whenever you're ready yeah but first of all you can block one nostril and breathe through it and then block the other nostril and breathe through it so you get an idea of how open and closed the nose is to decongest the nose take a normal breath in through your nose a normal breath out through your nose pinch your nose, hold your nose start walking holding the breath now go into a jog go into a jog holding the nose and keep going holding your breath keep going, keep pushing until a pretty strong air hunger let go so maybe the first couple will do easy let go there and breathe in through your nose let go there typically if you hold your breath for more than 30 seconds your nose opens up how does it happen? ear nose and throat doctors are not exactly sure I gave to 150 ENTs in Madrid in 2019 I was in Madrid it was in conference room I had them all do it and then I started seeing them looking at each other they weren't aware of holding up the breath but it also increases blood flow to the brain so let's do it again I want to do the first couple easy and then I push it take a normal breath in through your nose and normal breath out through your nose pinch your nose, hold your nose start walking start jogging hold your breath, keep going keep going so let go of that one there so we do the first two easy because I think it's always kind of better see I've got more than that punch I've got a lot more than that so the next few we're going to do more stronger I think it's always better to do the first two a little bit easier so this exercise is about up-regulation we do slow breathing to down-regulation but this one here is about up-regulation so it's not just going to open up your nose I'll talk about what it's doing so let's go again the difference, the bolt score is just when you then it's not a maximal hold at all whereas this one we are looking to push it on the bolt score I put the inclination to breathe whereas this one we're actually looking to make an adaptation but there is a correlation if you see that perhaps there if the bolt score so this now is the maximum breathlessness test that I'm having you do a slight variation of it and if your bolt score is 20 seconds your maximum breathlessness test is 40 to 60 paces that you're able to hold your nose so what I'd like you to do try this with us people try it of course take a normal breath in through your nose a normal breath out through your nose pinch your nose, hold your nose start walking but count your paces count the paces now walk faster now go into a jog and jog faster and keep relaxing into the body you will feel involuntary contractions of your breathing muscles keep going keep pushing keep going keep relaxing into the body when the air hunger gets pretty strong let go but then minimize your breathing for six breaths at the end so when the air hunger gets strong let go breathe in through your nose and minimal breathing for six breaths get your breathing under control now that exercise will open up your nose even if you have a head cold now with a head cold the bolt score drops and the nose after a head cold the nose can get congested again you literally feel the difference of the air being able to come in and out of the nose it's phenomenal like I've used that exercise with at least seven and a half eight thousand people and I've been able to get them breathing through the nose without surgery without nasal steroids without antihistamines if you have a stuffy nose you don't just have a stuffy nose your sleep is impacted and your exercise performance is impacted yeah to do the nose you have to do that exercise about five or six times but there's more stuff happening when you do that breath hold your lower airways are also woken up so people with asthma it will greatly help anybody with asthma or exercise induced bronchial constriction you will continue to have exercise induced bronchial constriction until the bolt score is 25 seconds or the maximum breathlessness test to 60 paces and you know when we have athletes doing a warm up say they're doing a warm up for 15 to 20 minutes I have them do slow breathing with lateral expansion and contraction of the diaphragm to help with anxiety and to bring a stillness to the mind to improve focus but then they are too relaxed then I have them do two easy breath holds during the warm up and five strong breath holds and then I have them do a couple of bigger breaths to get rid of the carbon dioxide if they're too acidic exactly then we down-regulate them first to calm the mind and then we up-regulate them breath holding is an up-regulation and with that also during training you are dropping your blood oxygen saturation that you are achieving generally severe hypoxia and high carbon dioxide to disturb the blood acid based balance to improve the buffering capacity probably inside the muscle compartment to delay lactic acid and fatigue and repeated sprintability in rugby this was tested about two years ago a paper by Wurrons looking at 21 professional rugby union players in Australia they divided them into two groups 11 individuals in one group 10 in the other four weeks of practice so for four weeks one group did high intensity interval training with normal breathing and the other group did 40 meter sprints with breath holding they measured repeated sprintability after four weeks the group were doing high intensity interval training they had no improvements in repeated sprintability before exhaustion the group who were doing breath holding during the 40 meter sprints their repeated sprintability increased from 9.1 to 14.9 before exhaustion so in other words they could do 14.9 reps of 40 meter sprints with a 30 seconds with a departure every 30 seconds before exhaustion now these are elite professional well trained rugby union players during competitive season to get a gain in repeated sprintability which is a measurement of performance in sports to get that gain the reason being is because breathing has been totally overlooked in sports performance because there is misinformation out there it kind of had bad connotations in terms of it was seen to be the domain of the guys tree huggers or the guys going around with the open sandal brigade you know and it was kind of this airy-fairy thing one of the things that's so good about what you've done is because the option of advantage it's sort of it isn't necessarily when you read the book it's not just about sports performance and for improving your sport but you get in the buy-in from that area of people and I'm seeing it grow out more and more there's a number of questions Skater kid said the book is amazing it's changed my life and there's no question but I just thought that's the time thing that you need to be hearing because that is the impact having on people and after his nose when running we covered and explained that same for someone else there's not many people getting over 25 on their Boltz score which that was the level that you were saying as a marker to get to there was a number of people we mentioned taping through taping the mouth at night Craig Riles saying the mouth taping is a game changer at night there was a number of people the podcast collective mouth taping at night thankfully I met Patrick at these five years ago it's still a bit far behind my goal but the Boltz score is working on the Boltz score so Paul Anchovies Dave Fosterer is there any physiological difference between basic breath hold and for example the nose and blocking exercise no the nose and blocking exercise that we do is we always do breath holds after an exhalation a normal exhalation and the reason being is if you breathe in and hold your breath there is more stress in the lungs but also you're unlikely to drop your blood oxygen saturation so like people do high intensity interval training to stimulate anaerobic glycolysis but the only issue with it is it's traumatic and it can increase the risk of injury if overdone when you do high intensity interval training your blood oxygen saturation will drop down to about 93 91% you're barely hypoxic even during what you were doing there if we measured blood oxygen saturation during that time you're likely to go into severe hypoxia about 85% so we're able to achieve a much greater degree of anaerobic glycolysis to force the body to make those adaptations but you can do it during jogging no trauma you are putting a load onto the breathing muscles and nasal breathing helps to maintain diaphragmatic strength and the one thing about diaphragmatic strength is that if the breathing muscles fatigue blood is stolen from the legs to feed the diaphragm that breathing is one of those absolutely vital functions and if breathing is not up to power other functions of the body will be sacrificed I mentioned to you before about the feeling that when you do some of those maximal breath holds when walking when you do go to your limit you feel that your legs go a bit sort of the thing that you mentioned about diaphragmatic breathing at the start you showed the diagram of trying to fill the lungs from lower down and the fact that diaphragmatic breathing deep breathing as in that sense of it rather than just taking a big breath being a difference and the nasal breathing stimulates more does that have the right word more breathing into the so nasal breathing more diaphragmatic breathing which helps you fill up the lungs more as opposed to the shallow breathing that comes from the chest breathing if you look down if you look down at your chest and take a breath through your mouth when you breathe through the mouth you'll typically see that the movement is tend to be upper chest breathing and upper chest breathing is totally inefficient and totally uneconomical and the reason being is because mouth breathing and fast breathing there's so much more air wasted in dead space that the air that you're taking into the body isn't getting down into the small air sacs in the lungs now what I would like to qualify is that when we think about functional breathing everyday breathing I look at it in terms of three different dimensions one is the biochemistry and it's very common for people who have poor breathing patterns to have cold hands and the reason being is because it's not just that the affinity of hemoglobin for oxygen is stronger when we breathe too hard but also when we breathe that little bit faster than what we should be breathing our blood vessels constrict so we have 70,000 miles of blood vessels throughout the body and if we are breathing faster and harder our blood vessels are constricting and that's why cold hands and cold feet and brain fog is often common so the first dimension of breathing is when we have people put one hand in their chest one hand just above their navel and I have them tune into their breathing and I have them really slow down the speed of the air as they take it in and out of their nose to the point of an air hunger we get them to deliberately underbreed for a period of time the benefits of that is that when you underbreed carbon dioxide increases in the blood the body is very sensitive to an increase of CO2 you feel air hunger but even though you feel air hunger your blood vessels start opening up you start to feel internally an increased temperature and also it's a great way to activate the body's parasympathetic response you will notice increased water is sliving them out in about three to four minutes I'm often amazed by individuals who have anxiety, they have panic disorder and even individuals with depression very few people is talking about changing the respiratory physiology to improve blood flow to the brain and to improve the functioning of the autonomic nervous system in terms of the biggest nerve improving heart rate variability improving respiratory sinus arrhythmia and also Jaco sleep is overlooked you can't have quality sleep unless you breathe through your nose and your nose and lower breathing, diaphragmatic breathing come together and just when you mentioned parasympathetic those of us that are trying to maximize recovery I talked before about that upper chest breathing feeling like stuck in that fight or flight mode that actually when we're trying to rest and digest and when we're trying to recover the breath being a great way to stimulate that part of the process and using the breath to slow down and down regulate so important Dr. Sally Bell is actually going to be she's a functional health doctor she's going to be on to the next guest she's been watching and she said she's seen great results in her clinic practice with asthma patients and the patients with mental health issues and she's now going to say it's fascinating about the female health so she's going to stop looking into that so you're inspiring Doctor, I'll have a new book and I've just written 120,000 words and I've no idea where it's going to stop but the female there's 14,000 words devoted for female breathing so apologies from me as a man to the female population how on earth did we miss that one but in any event trying to catch up but you're doing exactly Steven, Torino, Patrick you are my hero love your book and research been taping the mouth for over a year I'm just going to have a look at the final last few minutes I'm just going to look at some of these questions so if you just maybe it's the last thing that we cover being that nasal because you've covered there like the breathe the light to breathe, right I only covered one dimension so we're talking about air hunger which is biochemistry but then we go into cadence breathing with lateral expansion and contraction of the lower ribs lateral contraction and expansion of the lower ribs is to target the biomechanics and then we change the cadence to 5 and 6 breaths per minute because it's the optimal cadence of the breath to practice to influence the autonomic nervous system so bodily systems disturbed by stress in order to improve and stimulate the vagus nerve and to stimulate the bioreceptors to increase heart rate variability and heart rate variability is a measure of vagal tone to get a balance between the parasympathetic and sympathetic so with functional breathing when I'm working with somebody now I don't just look at the biochemistry but I'm also looking at the biomechanics and the cadence and here's the thing Jacko for 16 years I was stuck looking just at the biochemistry the yoga instructor is looking mainly at the biomechanics but they're not looking at the biochemistry they're not looking at cadence and the heart rate variability instructor is looking at cadence breathing nothing about the biomechanics and nothing about the biochemistry the thing is we have to look at all three dimensions and we also have to consider our breathing during sleep now I want to show you this this is our own idea I don't know if I showed it to you the last time I'm not trying to plug it around but taping of the mouth is really really important anybody who wakes up at a dry mouth in the morning they are not likely to have that deep and refreshing sleep that we all need and one of the slides that I use in my book is this isn't the book that's out there but this is the book for our instructors if you see this the relationship between the emotions sleep and breathing if our breathing is off our sleep is off sleep quality is reduced if sleep quality is reduced we're not going to have a calm mind but if we have an agitated mind we cannot sleep well because we can't switch off and if we have poor sleep it can impact our breathing and if we are stressed it impacts our breathing and if our breathing is impacted it causes and contributes to stress so the taping you could get 3M 1 inch micro port tape with a local chemist and it'll work better for beards but this one here I developed this originally for children because I needed children like I see in one of the comments there the dentists are asking about children they're not the doctors have got greater increased risk of palatosis gum disease dental cavities dry mouth saliva is a protective agent within the mouth and if we have the mouth open our mouth is dry we are more dehydrated so this tape is more suitable for people who would be anxious about wearing the tape it's stretchable we stretch it by 30% and it's the elastic tension of the tape which brings the lips together it encourages it to be closed but you can't open so you're not going to panic at night I just went straight gaffer tape I'm the type of guy if I'm doing it I'm doing it I saw questions when I pulled the gaffer tape out as we got in bed I started taping in 1998 it totally changed my life it was one of those things I was waking up feeling exhausted I was snoring I had obstructive sleep apnea asthma, nasal congestion you don't just have asthma within your population at least 10% of the people listening to us here they have problems with their lungs and they don't just have problems with their lungs they're tired sleep is also impacted by asthma there's a number of questions we're going to end up getting cut off it doesn't let us go longer than an hour but there are some questions Patrick's book is called The Oxygen Advantage you can get it on Amazon The Oxygen Advantage is his Instagram page I've put the link in there the tape that you've just shown is the tape that you've developed so you can buy that from your it's called Myo Tape because it was mainly developed for dentistry and orthodontics what's the website? it's MyoTape MyoTape.com I'm not sure if we have it on Oxygen Advantage it's only a new product we're just putting it out there MyoTape.com MyoTape MyoTape.com thank you so much for being part of today we couldn't have had our favourite guests without having you on thank you so much for taking the time even just seeing the comments from people that are like you've changed their life anything that congratulations to the amazing work that you're doing to keep spreading the message, it feels like it's getting out there into the sport and fitness world which is great and then it's a great opportunity that that will then start to filter out into the general population because this is something that's so simple for everyone to do even if your take a message from this is your first experience of it just ask yourself that question throughout the day where am I breathing from my nose or some of my mouth do I notice the difference that when it's mouth it's here and when it's nose it's lower down from my diaphragm just start that process and if you then you're intrigued and want to know more by the Oxford Advantage book it's like nine quid or something on Amazon it's absolutely it's a no-brainer and read all of it, don't skip to the exercises because the science and the understanding of the beginning is so so important and definitely worth the read it's one of the fastest books I've ever read because it's just easy to read and I'm not good at reading I've got to see it in English at school so yeah thank you so much because this is how the awareness spreads for us and it's tremendous to see it getting out there so thanks a lot for that Chaco super pleasure, thank you very much Dave Foresters, I'm off to read the book again good lad thank you so much for coming on I'm sure we will be in contact again very soon but if anyone's got any questions head over to Oxford Advantage and you can obviously get the book, get the tape ask Patrick any questions on his Instagram there take care, thanks bye