Is CO2 Tolerance the Answer? Deeper Explorations in Breath with Patrick McKeown

Boomer: [00:00:00] Welcome to decoding superhuman. This show is a deep dive into

obsessions with health performance, and how to elevate the human experience. I explore

the latest tools, science and technology with experts in various fields of human options. This

is your host Boomer Anderson. Enjoy the journey.

Welcome back to the decoding Superman podcast. Today. I'm pleased to have back Patrick

McKeown for a round two on all things. Breath work. If you go in any sort of publication right

now, you realize that breath work is sexy and why? Because we do it. Every single day is

breath work, finally getting attention.

Well, Patrick's been at it for a long time. In fact, almost 20 years, he was the person who has

brought the Buteyko method worldwide. He's taught over 200 people, the oxygen advantage

method, and he has written a bestselling book, entitled the oxygen advantage. And he is my

go to person when it comes to.

Everything breath work. And so when I had questions after a recent foray into free diving, I

reached out to Patrick and said, Hey, do you mind recording this conversation? Of course,

we got into a lot. This episode may actually be titled LSD and it doesn't stand for the

psychedelic. It stands for light, slow and deep, which is a lot of stuff that Patrick

reemphasizes throughout the episode.

But we talked about CO2 tolerance and training it, particularly when it comes to free diving

and why that may not be the only marker to focus on. Talk about devices and technologies

like capnography and pulse flux symmetry. We look in specifically training protocols. How

can you, in a matter of six to eight weeks or even less start to feel some of the benefits of

breathing light breathing, right?

The show notes, this one, or decoding superhuman.com/oxygenadvantage2. So that's

oxygen advantage 2. And enjoy my conversation with the fantastic. Patrick McKeown. All

right. If you go over to YouTube right now and you tune into this episode, you'll notice that

my tongue is blue is not because I've had a lollipop or a ring pop or whatever would die.

Your tongue blue from the candy world. No, it's because I am taking a product from church.

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And you'll get 10% off your purchase, which is just a nice lot of gift from me to you. Let's get

on with my discussion. With Patrick McKeown.

Mr. McKeown, back on the show. Welcome back.

Patrick: [00:03:35] Thanks very much Boomer good to be here.

Boomer: [00:03:37] So Patrick, you know, you and I have exchanged emails over the months,

over a multitude of different things. anything from Scott Carney and the wedge to,

capnography to my recent obsession with free diving. And so I'm really glad to just,

First off that you're just so generous with your time that you're coming back on the show

today because you know, your episode has generated a lot of interest in a lot of questions.

I would love to delve a little bit further with, with those today.

Patrick: [00:04:05] Sure. Sure. Of course.

Boomer: [00:04:07] Alright. So as I may have alluded to before, I have this sort of recent

obsession with the idea of free diving and, you know, trips to Majorca can do that for

people, right? Like beautiful sun, go under water. And that, you know, the free diving

instructors are obsessed with this idea of CO2 tolerance.

And I just would love to understand a little bit more from you, you know, CO2 tolerance. Is it

the right focus for free diver? And you know, if it is, you know, why is it important? And if it's

not, you know, what, what should we be focused on?

Patrick: [00:04:47] I think it's one of them. I think it's one of the factors. There's no doubt.

And carbon dioxide is one of those gases that, you know, If we look at traditionally and we

looked at the beauty command to dr. Buteyko, he said that Brett told time is correlating

with, with resting carb, with arterial CO2 levels, and studies show that that's not necessarily

true. However, Brett hold time is lower in people with dysfunctional breathing patterns.

That's correct. Brett told time as it improves and during rest. And I'm talking more about the

board score that once it's above 25 seconds, a fairly recent study showed that in 51

individuals that when the breath hold time is about 25 seconds. There's an 89% chance that

dysfunctional breathing is not present.

Now, how does that relate then to free diving? I think number one is I don't think it's just

CO2 tolerance. That's influencing the person's ability to hold their breath. And there was an

article written by prior acts back in 2012. And he looked at same issue. So he said, it's

actually what is causing the termination of the Bret toad, because that's ultimately what free

divers are about.

They want to, how long can, can they stay underwater? How long can they hold our platform

before they are forced by the body to resume breathing? That's not carbon dioxide. Carbon

dioxide will be one of the factors. It seems to be the less common oxide is increasing in the

blood. Of course the brain is going to react to that.

So the response to central reacts by sending increases impulses to die from breathing

muscle to resume breathing. And it seems to be the involuntary contractions of the diet

from breathing muscles, which in turn is feeding that information back to the brain. And

that's, what's terminating the retro time.

So when we're looking at extending Brett total time, one of those factors is reducing chemo,

sensitivity to carbon dioxide. But another factor is, is improving lungs. Because if, for

example, you have any individual with Bronco, construction, or airway, narrowing, or asthma

or any respiratory complaints, it will negatively impact their Bret tool time.

Now that's going to be independent of CO2. And to give you an example, if you have

somebody with asthma and if they have chest tightness or if they're freezing, and if you gave

them a puff of a Ventalin inhaler, Within about a minute or two, their breath over time will

increase their carbon dioxide.

Sensitivity has been reduced in that minute or two. So there's also feedback from the lungs

back to the brain. Just feedback from the dye, from back to the brain, just feedback from the

brain back to the breathing muscles. And there's a cognitive component as well. So the

training is correct because how do you improve your breath total time, other than practice

techniques, you know, exposing your body to air hunger, but the mechanism behind us

what's happening there.

I'm not sure if anybody knows, and there's possibly a number of dimensions happening. And

not just about reducing the sensitivity to carbon dioxide. So, you know, carbon dioxide,

again, you can have it individuals, they are they're prone to breathing pattern disorders and

their CO2 levels can be normal. And you know, it's also show him back in 1990 that you can

produce the symptoms of hyperventilation without having to lower CO2.

So there's a behavioral mechanism as well with breathing. Like there's, it's more complex

than we, of course it's more complex than anybody thinks it's about. And the other thing I'd

say about free divers, you know, it's all very well practicing breath, holding under water, but

how are you breathing outside of the water?

How are you breathing when you sleep? How are you breathing when you do physical

exercise? And that would be an interesting thing to do. You know, if you were to get two

groups of free divers, one, you train and traditional free diving techniques and the other,

you train by looking at their everyday breathing patterns and improving their everyday

breathing patterns, because you would have to assume this, that if you're, if you have a free

diver and they're training indirectly in their normal free diving techniques, But then if they

sleep with their mouth open at night, if they spend time breathing your hard and breathing

fast.

In other words, if they have dysfunctional breathing patterns and also if they are prone to

anxiety and panic disorder. Sure. you know, how is that going to impact her ability to free

time? And I think that should be considered that we cannot necessarily look at breathing in

one dimension in time.

What do we have to look at the 24 hour picture?

Boomer: [00:09:49] Okay. So there are just multiple levels that I can take that one, Patrick.

So I just want to, want to break a few things down for people. So let's say if we were to

pursue that second Avenue of training whereby. Not training as a traditional free diver, but

training out of the water and just looking at day to day breathing techniques.

If we're looking at that benchmark, the right benchmark, I guess, should be, is that the bolt

score and if

Patrick: [00:10:17] boats, the boat score is only going to, it's going to be one of them. And I

think the maximum breathlessness test is probably going to be more, more applicable

because you're holding breath. You're holding the breaths until the extreme.

But both are correlated. You know, even though the correlation can be a little bit off with

some people, we have to think of this, the board score is more objective because it's not

influenced by willpower and determination. It's a fizzy, it's a length of time that you can hold

your breakfast and there's until there's a physiological reaction to resume breathing.

And that reaction is that you either feel the first step in a desire to breach, or you have the

first involuntary contraction of the breathing muscles. The maximum breathlessness test

that's you take, can Omar breath in and out through your nose? You're pinching. Yeah. You

start walking and you count a number of paces that you're to hold your breath to a

maximum and that's influenced by willpower and determination.

So we could have a guy, we can have an athlete coming in with a boat score, 20 seconds, and

a maximum breakfast since test of 80 to a hundred. And literally because of sheer willpower

and determination that athlete has held their breath to the point. You know, they go blue,

they can have a high MBT and they don't necessarily have a high bolt score, but typically if it

was to be done and that there was a reasonable application of willpower and determination,

you'd find that there's some correlation there.

Okay.

Boomer: [00:11:47] So. The bolt score and I'll link to our first episode in the show notes.

Cause I know we, we did a little bit on that, but just to recap for people it's

Patrick: [00:11:56] best to

Boomer: [00:11:57] especially take it at approximately the same time every day. Does it

matter morning, noon night, what

Patrick: [00:12:02] time? The morning, morning time is always best.

You know, as soon as you wake up, we sit up in the bed, allow your breathing to recover.

And, take your boat score and that's the more important measurement because your

breathing isn't being changed, you know, in terms of, you're not influencing your breathing

during your sleep. So you're breathing RD morning is kind of a more reflection.

That's a more accurate reflection of your everyday breathing pattern.

Boomer: [00:12:30] And so when we had, we had the bolt score, the maximum breathless

test, but. On, it sounds like there's a few muscles that we can train here as well. Right? You

have, you have lung? Well, I guess maybe not the lungs as a muscle, but you can certainly

train lungs and you can certainly train diaphragm.

How do you look at training those particular areas?

Patrick: [00:12:55] I think, you know, well, number one, you can train the breathing muscles.

A number of ways nasal breathing is going to be absolutely key because your nose in

comparison to my operating nose, breathing imposes a resistance to your breathing two to

three times out of the mouth.

So if you went for a jog or run much are my closed, that's likely to help maintain, dive from

strength because you're breathing against resistance. You know, if you're taking the air in

through your nose and you have an extra load on the dye from that's going to help to take

and just die from, to strengthen, to die from.

Another aspect. And we use sports mask, which is seminar to the traditional training. I have

that right here and we use that again to breathe against resistance. So we set the valve that

we do encourage nasal breathing while wearing it. it doesn't make sense, kind of, you know,

I know there's a lot of respiratory muscle training devices and they're using the mouth to

breathe, but Mt.

Breathing is invariably activating the upper chest regions. Now I'm not saying that.

Respiratory devices using the motor Brea. They're not going to be effective. But what I

would say is that it just seems logical that when you breathe through your nose, that you

are, you have a great ramp that should have died from nasal breathing in the limited studies.

Because of course, this is very understudied. Yeah. You know, but it makes sense then to

breathe through your nose while wearing those devices to the extra load onto the breathing

muscles. Another aspect is we use breathing belt. So we use Buteyko about, and we have

the individuals wear a belt around their midriff.

We have them wear it during sleep. We have them wear it during physical exercise. And

again, it's adding an extra load onto the breathing muscles because you're pushing against

resistance and then breath tolling itself is going to help improve diaphragmatic strength

because as you hold your brat, you have involuntary contractions of the breathing muscles.

So there's a number of ways to improve dive from attic strength, but also we have to

consider functional breathing patterns. So it's not just about improving diaphragmatic

strength, but it's also about breathing. According. Like if you look at breathing, if you, if you

look at any paper written by researchers and if researchers are screening, breathing, Pattern

disorders.

They will look at breeding from three dimensions. First of all, they look at breeding from a

biochemical point of view. That's all centered on capnography. That's measuring entitled

CO2. So basically the measure of the carbon dioxide on the exhaled, Bret on the end of the

Bret. And that gives you a good indicator of CO2 in the blood.

So capnography is looking at the biochemistry dimensional, breathing. And then you look at

the biomechanical dimension of breathing, and this is centered on whether the person is

breathing high or breathing low. So we want low breathing with lateral expansion and

contraction of the lower risk, because that's a very good gauge of degeneration of what's

called intra abdominal pressure.

And intraabdominal pressure den is influenced by what's called the zone of opposition and

the zone of opposition is the distance. From the top of the die from after an excalation,

when the diaphragm has moved back up to its resting position. What's the distance from the

top of the die from down to the lower ribs.

And if you can increase the zone of opposition, you can then increase intraabdominal

pressure. So that's the bio mechanical aspect is looking at what's called the high load tests.

And then there's another dimension that researchers look at as the psychophysiological

dimension. And they use a questionnaire called an eye Megan questionnaire.

From your country. Sorry, what's the

Boomer: [00:16:42] repeat that one. It's the nine Megan questionnaire,

Patrick: [00:16:44] nine Meg and eight diversity. Exactly. So I'm assuming it's came from the

university. Now I have to say it's a, it's a pretty useless questionnaire, but it's validated. So

the fact that it's validated and the only reason I say that is because there's symptoms on us

that shouldn't be honest.

And then we see very common symptoms and chronic hyperventilation that aren't on us. So

you'll find the NY Megan questionnaire online. And, you, you, you, of course, it's a

questionnaire and it's asking you some of the symptoms, some of the symptoms tingling

around the mouth. We don't see that, you know, if somebody comes in to me, I've never

seen that in 20 years.

I've never seen that. Anybody saying to me, tingling around them out fusion, losing contact

with reality. I've never seen that with chronic hyperventilation. there's other symptoms. I

can't tell. I can't remember them, but you see there's two I've mentioned there there's

about four or five of them that have no relevance whatsoever and then there's symptoms.

That should be on it. That aren't on it. So, so we then look at breathing. If I'm working with

breathing, you know, I'm working with students. I'm working to improve their functional

breathing. Also from three dimensions, slightly different to what the researchers are looking

at. Of course, we do breed light, which is biochemistry.

That's all about air hunger, pretty low, which is the biomechanics. And then we bring in

resonant frequency breathing as well. And that's to slow it down. The response rate for two,

between 4.5 and 6.5 breaths per minute. And that's to influence the autonomic nervous

system, just stimulate the vagus nerve to increase the sensitivity of the borrower receptors.

And, you know, it's, it's really about improving resilience. So we bring all three together. So.

Breathing is just more complex, you know, and as well as a lot of breathing, instructors will

focus primarily on one, as I mentioned. So if they've historically only spoke about one

dimension, that's what they focus on.

You know, your yoga and structure traditionally, they will focus on the biomechanics. They

don't focus on the biochemistry and they don't focus on resonant, frequency breathing you

take off for years. My focus was primarily on the biochemistry and I didn't focus on the

biomechanics and I didn't focus on resonant, frequency breathing.

Then you've got a heart rate, variability and structure, you know, heart Mark practitioner,

for example, they would focus on resonant, frequency, breathing. But they don't focus on

the biomechanics are the biochemistry. Now I'm not saying these to complicated because

people are saying, Oh my God, now he's after making a whole of, you know, turning a two

recourse into a PhD kind of thing, which oftentimes can happen, but it still has to just that's

the way it is breathing is a little bit more complex and the whole focus on carbon oxide while

it certainly is part of the picture.

There's no question about it. It's definitely part of the picture, but it's not the full picture.

Boomer: [00:19:45] Okay. So I want to unpack a little bit of those, those three pillars that

you just mentioned, and maybe if we can just go through them. So breathe light in terms of

its impact on, on the biochemistry. Are we talking about.

Cadence here or how are you, how are you looking at this? Because breathe light can be

interpreted many different ways. And I know we'll link to your book. Of course.

Patrick: [00:20:11] Yeah. Like pretty light is all about reducing the volume of air that you

breathe in to allow carbon dioxide to accumulate in the blood.

Because if you breathe slightly less there than what you're used to. Carbon dioxide is going

to accumulate in the blood because it cannot leave the blood so quickly to the lungs. And as

carbon dioxide accumulates in the blood, you will feel air hunger. You will feel the need to

breathe more air, but it has been shown that if you expose the body to increased carbon

dioxide for short periods of time drive today.

For say, we'd say four to six weeks that in turn is it does reduce the sensitivity to carbon

dioxide. But I'm talking about, as I'm talking about exposing the body to carbon dioxide,

three millimeters of mercury pressure are three Thor. So the body is very, very sensitive to

an increase of CO2. Normal carbon dioxide in the blood is typically about 40 millimeters of

mercury.

And if we increase it by between two and three millimeters of mercury, it can double

ventilation. So it's, you know, exposing our body to higher CO2. And this is during the breed

light exercise that it's totally different if we do a bread tolls, and we don't do

hyperventilation before toning, like say for example, that will be the difference with the VIM

half mathematics.

So hyperventilation during the VIM half methods throws off a lot of carbon dioxide removes

it from the blood through the lungs. And even during the breath, toad, carbon dioxide

doesn't recover. So the VIM half mattered this hypo Catholic hypoxic.

Boomer: [00:21:52] Yeah, you definitely don't want to do that during free diving, right?

Patrick: [00:21:55] No, it's, if you could die simple as that, you know, so the risk of

underwater black cash and it's happened to, unfortunately it has happened. It's happened

even with swimmers. You know, they take a few big breaths as they sit at the side of the

pool, they deplete their carbon dioxide levels. They get into the water.

They're staying on the water and without any warning, there's no warning whatsoever. And

it's blackout. The reason being is because carbon dioxide is that alarm to breathe and that

feeling that one needs to take a breath. The primary driver is, is carbon dioxide. So if we get

rid of too much carbon dioxide, of course, we don't feel the need to breed your stay under

water, and then your oxygen levels go too low.

So you faint as a result of hypoxia. so yeah, the biochemistry aspect of it, you know, you can

look at reducing the center. It's typically to carbon monoxide, a number of ways. One is

you're breathing during rest. You're gently slowing down. And reducing the volume of air

that you're taking into the body.

It can be done two ways. Number one is when we block a bridge, we have to consider that

minute ventilation are the volume of air that we breathe typically measured in one minute.

That is got by multiplying the response rate by the title volume. So say for example, you

have an individual with 10, 10 breaths per minute.

That's their response to rate and their tidal volume is 500 mil. So that's giving you a minute

ventilation of five liters. Now, if you wanted to reduce breathing further, what you could do

is you could reduce the response rate. Say down to seven breaths per minute, but keep the

tidal volume relatively constant at a halfway house.

Sure. So now you're reducing minutes, the ventilation from five days down to three, 3.5

liters, or you can keep the response rate relatively constant. And you could reduce the tidal

volume. So you could have your 10 breaths per minute, but instead of breathing 500 mil,

three, three, 300 mil, and that gives you a three liters or you could change both.

But the whole thing is that, you know, you're doing it practically if you have air hunger. So,

and the air hunger should be tolerable. If I remember during the breed light, biochemical,

we want to have a feeling of our hunger, but we don't want the air hunger to be too strong.

That the brain reacts by sending in violent, by sending an increased impulses to the die from

so that we have involuntary contractions of the breathing muscles.

Okay. So that's during rest. And then if you're doing Bret toning, now it's a different story in

terms of CO2, because you're going to increase the carbon monoxide in the blood much

higher than what you would do with rejuice goose to find your breathing, but the dose, the

dose is high, but the duration is short term.

Like, if we have somebody to breed like biochemistry, we're going to have them reduce their

breathing for between four and 10 minutes. They feel air hunger for between four to 10

minutes. But if you were doing a breath, hold. You're not going to expose your body to

where hunger that for that length of time, because you can't, you know?

so in terms of then the, the, we, we always look at what's the dose and what's the duration

reduce breathing while you're sitting down, slowing down your response rate, the duration

of the air hunger is longer, but the dose is quite low black toning. The dose is high, but the

duration is short and a different story.

Then go for a run, which are my clothes. And that also is increasing co two in the blood. How

do you know about quite simply you feel increased air hunger? Know if you have your

macros during physical exercise? There's no doubt. That it helps to reduce the sensitivity to

carbon dioxide, or at least there is a training effect that the individual can tolerate a higher

CEO too.

and you know, it can take a number of weeks, but typically we would say about six to eight

weeks. And so there's three different. We need to look at three different fields. We need to

look at breathing during rest breath, tolling itself, and also physical movement.

Boomer: [00:26:13] Okay. So. If I just look at sort of the protocol for somebody, you said six

to eight weeks, four to 10 minutes a day after that, are they done or is it something that you

want to prolong over a period of time?

Like do, should, should I be doing this the rest of my life?

Patrick: [00:26:32] I really depends on the person's lifestyle. You know how many people are

working enough? Well, not now, but they're working at home. There could be talking all day.

They're not getting access to physical exercise. They're in overhear environments.

It's very, very unnatural how we live. We don't live anything like our ancestors were living

out in and out in the outdoors doing lots of physical movement. Eating natural foods. So we

do have, we have to realize that yeah, how we live is certainly impacting our breathing and

it's impacting our breathing negatively stress is probably especially chronic stress is probably

the biggest.

It exerts the biggest impact to breathing patterns because our breathing gets faster and

harder. And of course, prolonged stress it's causing a reduced scent. It's causing an increased

sensitivity to carbon dioxide. And it's reducing the offering. So, so the theory goes that if you

expose the individual to prolong stress, their breathing is going to get harder and faster.

Their minute ventilation increases, they're blowing off too much. Carbon dioxide, blood pH

increases. The body doesn't want to be in a state of respiratory alkalosis. And as a result,

then the kidneys, the body in order to maintain or bring normalized blood pH, you can just

dump bicarbonate now, your left foot to reduce buffering capacity.

So yeah, like it's coming back to your question. I think the best way to do it. I says, number

one is we have to realize nobody is going to do this indefinitely. Yeah. Not possible. Yeah.

okay. I did the breathing exercise myself for years. Formally, I'm putting it into practice. And

now I would try to bring it into my everyday life.

Get out, do physical exercise, make sure the mouth is closed. Is taped at night, slowing down

my breathing, bringing my attention onto my breathing at different times, tried today, doing

Bret hauling during the physical exercise itself and doing our best to bring it into one's way

of life. I think there's, there's we have to realize that, you know, how has the person

breathing normally?

If they go around with their mouth open, are they breathing upper chest breathing? Are

they sighing regularly? Do they have their mouth open during sleep? Do they have their

mouth open during physical exercise? Well, just the simple realization that that's not the

ideal way to do it. There is no comparison mouth breathing versus nasal breathing.

Absolutely no comparison. And it's really bizarre that sports medicine hasn't. Locked into

this. It is so, so bizarre. I cannot, I cannot understand how these intelligent individuals and

universities from an academic point of view, that they haven't investigated nasal breathing.

There's only one professor.

Who was investigating it that I'm aware of. And his name is professor George Dallin from,

I'm not sure he's from, I think it's Colorado, but if you put in D a L L a M into Google, you'll

come across some and he's published some papers on it. And here's the difference, you

know? So you can imagine all of the sports scientists and all of these guys to really are

supposed to know their stuff.

And yet they never stepped back and they ask about the fundamental question. How should

we breathe? During physical exercise is a true, the mouse is a truth that knows what are the

disadvantages and advantages of both, but more importantly, The real question is what

happens if we get athletes to breach with our nose period of time, what adaptations take

place and those adaptations?

That's what George does. I'm not touch that. We've been talking about this for 20 years, but

of course we don't have the signs because we are not affiliated with the university. But we

have seen the benefits firsthand and yeah, sometimes people might say that are anecdotal.

It's not really anecdotal when you see it happening with hundreds and thousands of people,

you know, it's anecdotal.

If you see it happening in a couple of handful here and a handful there, and you're not quite

sure is, is there an effect there, but when you see it being reproduced, continuously and

over a long period of time, You know, then we have to wonder there has to be something in

it, but the science hasn't caught up.

But in terms of like, when an individual first goes for a run with their mouth closed, they're

going to feel an increased air hunger, simply because it's more difficult to take in that larger

airflow through the nose than through the mouth. because of that, then they've increased

their hunger, which is due to the carbon dioxide increasing in the blood.

So now they are training with higher carbon dioxide. And as carbon dioxide is increasing, it's

going to enhance the board effect in terms of increased oxygen delivery from the

hemoglobin to the tissues. So now you have, you're able to stay, you know, with practice

aerobically for longer. The fraction of expired oxygen is less.

In other words, the athletes who was training with their mouth closed, they're utilizing

oxygen better. Nasal breathing also enhances gas exchange from the lungs to the blood. And

this has been known since 1988, that the PO two in the blood increases by 10% with nasal

breathing. But nasal breathing also is activating the diet.

You've got great or amplitude of the dive, breathing muscle. And the die from breathing

muscle is not just for respiration, but it's also provide, stabilization of the spine. And also, as

we spoke about earlier, we just went on to a little bit intrabdominal pressure. So basically

functional movement and functional breathing go together.

And if we are going around with our motto open and we are breathing fine, which is very

uneconomical because we waste so much more air in what's called dead space. You know,

as opposed to breathing slow and low. So think about the individual Stan who get right

current chest infections, headquarters, exercise, and juice, Bronco, constructions, dry mouth

dehydrated, dysfunctional movement patterns, increase risk of injury needs.

A breathing can influence all of that. And also the recovery from the, from the, the evidence

of people, reporting back to us because. We've with oxygen advantage. We've got about 200

instructors on the ground. So, you know, they are in contact with a lot of clients and this

feedback comes into us.

Recovery is better. So there's something going on here. And I think we would love to see the,

the, the sports, the intelligent people in the universities, the academics looking into it. And

there's no point in just getting a group of athletes and say, Oh, today guys, we're going to

split you up two groups.

I'm going to have group a, you're going to do all of your physical exercise with the mouth

closed and group B. You're going to just do it with normal breathing, because that's going to

be a total joke because. Group a has never performed with nasal breathing in their life. And

if you suddenly get a group of individuals on the first day and you test, how does it, what

happens when you switch to people from out to nose breathing there, the results are going

to be dreadful.

And the reason being is because the increased resistance to breathing will be taxing on

them,

Boomer: [00:34:11] but so increased over time. But if you did it over

Patrick: [00:34:13] Tufts, we need to measure and test this. When adaptations have taken

place. And I know when Donald was looking at it, like he looked at recreational athletes start

their ventilation at six month.

Followup was 22% less nasal breathing versus my operating. Like there's an economical

saving there. If you can do the same work, ration tends to be with 22% less ventilation. You

have to think of the savings in terms of VO too, you know, because there's an energy

expended on breathing. And if our breathing is inefficient, We're going to be wasting energy

on necessarily.

So I would say is a really, this is really crying out for a few studies and get your groups of

individuals are randomized them. but it's different groups. You have the experimental group,

you've got the normal, the control group. And put them into a training for about eight to 10

weeks, two months, and measure them after two months, because I would say that it's

eight, six to eight weeks to spend the adaptations would take place.

You don't need six months, but give it two months

Boomer: [00:35:22] call to arms there from Patrick, about

Patrick: [00:35:25] the scientific studies course. So

Boomer: [00:35:28] one of the other things that you mentioned earlier is something called

resonant, breathing frequency, and I'm. And so I love the concepts I know in practice, it's

very hard for the average Joe, to identify what their resonant breathing frequency is.

Do you mind just explaining what it is, why it's important, how somebody can figure it out.

It's been a while since we have the sponsor on the show, but there are dates where I have

back to back calls, meetings with clients, podcasts, involvements, where I'm an advisor and

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exhausting from a nutritional perspective.

It's very hard to plan meals. And so what do I keep by my side? It's something called long

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coconut flavor, which if it's still in stock, I'll grab all of that.

Again, resilient nutrition.com and use the code boomer for a nice little discount. And let's

get back to the show.

Patrick: [00:36:55] Yeah, for sure. Many decades, a good term pissed. When, when a client

or a patient to a good term poster, the doctor would be interested to find out what stage is

this individual in, in terms of their autonomic nervous system?

Are they in a stress state or are they, you know, is there a balance there? And what they

would look at is they would measure, they were tying the client's policy, the patient's policy.

So they would locate the pulse and they would then observe the patient as they were

breathing. And the doctor is looking out for, as the person is breathing in, the heart rate

should be getting slightly faster.

And as the person is breathing out, the heart rate should be slowing down. And that's called

that's called respiratory sinus arrhythmia. And when that happens, it gives you a very good

indicator that the person is, there's a nice balance there of the autonomic nervous system

and a balance between the parasympathetic and sympathetic response.

That's what we want because as human beings, we need to be able to, to adapt to different

environments. Now, conversely, if a patient, and if the patient is unwell, either mentally or

physically. The doctor is monitoring their, their timing of their heartbeats in synchronization

with their breathing. And if the doctor notices that the timing does not much of a difference

between the timing of the heartbeat and the way on the breath in versus the timing of the

heart beat on the breath out.

Well, then the doctor knows this is PR this person is very much in a stress state. So it's very

important then to have, bring that person into a better balance and you can do this by

slowing down, breathing too, between 4.5 and 6.5 breaths per minute. Now, much of this

research started back in 1919 with a researcher called Paul laborer, Ellie H, or ER, and

basically.

The optimal and probably a good average is about six breaths per minute. And when you

slow down your breathing to six breaths per minute, you stimulate the vagus nerve by

stimulating the vagus nerve, it increased or secretes a substance called acetylcholine. And

that in turn then seems to be what's modifying.

What's called Baro reflex. And Baro reflex is that. It's a very good indicator of the functioning

of the human body. In terms of we have pressure receptors inside the major blood vessels

and when our blood pressure increases, the buyer receptors will notice this increase in

blood pressure and we'll immediately send signals for the blood vessels to dilate.

And for the heart rate to slow down. So the baroreceptors receptors are communicating

with the brain and the brain is communicating with the blood vessels and the blood vessels

dilate the heart rate slows down and blood pressure normalizes. And conversely, if our

blood pressure goes too low, the bar receptors send immediate messages for the blood

vessels to constrict and the heart rate to increase, to normalize blood pressure, the

sensitivity of our bar receptors and the traffic from the Vegas nerve.

Both of those seem to be feeding into heart rate variability. And I'm not sure if it's been fully

understood. Exactly. What's the precise mechanism now increased heart rate for your Bashi.

Like if you look at elite athletes, they're monitoring us. If you look at military, they're

monitoring their heart rate variability and then athletes, if they have reduced coherence

that their variability between their heartbeat has been, has reduced.

They typically don't train hard that day because they haven't recovered from previous

trainings. So they will train hard when they know that they've recovered. But if they haven't

recovered, they don't train hard because there's an increased risk of something going wrong

or an increased risk of injury.

So I think it's, you know, as oppose. Like all of us, you know, we're, we're all going to be

exposed to stress, workload, et cetera. And if you went to your local doctor and you say to

your doctor, I'm feeling stressed, but that doctor is just looking at you and there's no way of

clinically measuring the impact that distress has in the body.

Well, what heart rate variability, you can, you can measure that impact. So, and it has been

shown like the research on breathing has really centered and focused around the HRV. Now,

HRV is only a measurement. The real question is, well, how can we improve heart rate

variability? So how can we achieve a better balance of the autonomic nervous system that

we are more resilient?

To do that. There's a number of ways of doing it. Number one is breathe through your nose

during sleep. That's been shown. And again, anecdotally, no studies, but

Boomer: [00:42:01] hundreds I've done that myself, right? Like mouth taping has. I can

notice that bump significantly.

Patrick: [00:42:08] You'll see it. and another one is reduced volume breathing.

So all of the breathing exercises that we do are increasing heart rate variability. However,

during the exercise HRV drops, but after the exercise and HRV increases, there's been

limited papers and that since 2017 looking at hypercapnia high SCIO too, and the impact that

that's having on HRV. Number three, increased diaphragmatic movement.

So for example, by slowing down the response rate and engaging the dive from an increasing

tidal volume that in turn can increase heart rate variability, and number four then is slowing

down the response rate to between 4.5 and 6.5 breaths. So, you know, and the other things,

boomer Sergeant request you there, I would say like, How would we expect if an individual is

going around with their mouth tope and they have chronic nasal obstruction, they have their

mouth open during sleep or sighing, their upper chest breathing.

I would expect them to have reduced HRV. And if we look at individuals with anxiety, post

traumatic stress disorder, depression, panic disorder, they typically have low heart rate

variability

Boomer: [00:43:25] going back to the resonant frequency. Is there a specific device where

you can actually identify like, Hey, if I'm breathing to X point X breaths per minute, that's my

resident frequency or is it best for the average person to just ballpark it between four and a

half and six beats per minute,

Patrick: [00:43:44] there are devices, but I think they're quite complex.

When you want to find out what is the optimal frequency for you? I think you can't go wrong

if you're centering it around six breaths per minute. Okay. there is a device which I'm looking

to get it's the leaf. Cause I'm not technological anyway, I haven't

Boomer: [00:44:03] I'll I'll I'll connect you to them afterwards if you want.

Patrick: [00:44:06] Yeah, well that would be great because I bought in her balance. I've used

it about three or four times and. I'm just not into technology. Yeah. But the leaf one I'm

intrigued with because from our instructors that are wearing it, you're strapping it just

below the heart. And, when you get stressed, it's sending some signal that you're in that

state of stress, and it's telling you really to slow down your breathing, to have activate the

body's relaxation response.

And I also like the reading lavish in terms of, it's going to give you a measurement of where

you are and typically up to a hundred or thereabouts. Whereas with the Hartford, with the

heart month, one, it's quite difficult to see exactly where are you at with that?

Boomer: [00:44:49] We'll have that conversation afterwards, but those guys, I am friends

with them.

Patrick: [00:44:54] So

Boomer: [00:44:55] one thing I wanted to come to now that there's this sort of cat, no

theme that we continue to hear throughout this conversation is capnography and looking at,

you know, I do love technology. and I like measurement. And so you have the ability to,

Patrick: [00:45:15] look at a

Boomer: [00:45:15] capnography machine versus a, let's say a pulse oximeter.

Are they comparable? Which one should we choose? And why?

Patrick: [00:45:26] I have another few, first of all, I think it's very difficult to get one that's

accurate and we haven't gone down that route. So the reason being is because I don't want

to put two, $3,000 into something and then realize that it's going to be absolutely not

Boomer: [00:45:43] six or 12 or whatever,

Patrick: [00:45:45] more correct.

And the other thing we have to consider is that. Capnography you're, you're taking, it's

measuring entitled CO2 and of Brett. So, and Tyler, and that should give you a good

approximation of the CO2 in the blood. But if you will have an individual have really

prolonged exhalation, the CO2 from the blood is going to come into the lungs.

And maybe that can show as a higher reading versus somebody with shallow breathing. So

it's, you know, like what are we measuring here? Are we measuring their end tidal CO2

during their normal, everyday breathing is an actress or are we measuring their CO2 levels?

During the practice of reduced volume?

Breathing are slow breathing. so I suppose it was a couple of things to take into

consideration, but yeah, I haven't just gone down that route and primarily because I don't

know how accurate these, this equipment is. Can you accurately measure entitled CEO two

in terms of pulse oximetry, we use it all the time.

as you can get devices, which are fairly accurate, traditionally, we were using non which

stands for noninvasive. They're very good devices they're made in the United States. The

only issue I'd have with them is that they are very expensive. And when I was buying them,

we were buying them typically in batches of 10 and 20 pieces and they were breaking on us.

So then I looked at contact medical. There was a study of Dawn of cheaper pulse oximetry.

And they locked in a particular one at the cm. I'll show it to you here. And this in the study,

this one here has been shown to be accurate when comparing it against the more expensive

devices. And this one here is the CMS 50 DL.

So I bought a thousand of them in from contact medical. Of course they're all made in China

anyway. Yeah. But at least we had a study showing that when it was compared against the

more accurate ones that it was and that's we're using. So we're using contact medical at the

moment. Not on would be my preference.

but limitations in terms of typically you might be, I think about 200 Euro for an Anon with

contact medical. We sell them for example, for about 26 year old, 47 years. Yeah. So there's

a huge difference and I think it's sufficient. In terms of a more robust postdoc cemetery,

which is cheap and can provide you an accuracy.

Why not?

Boomer: [00:48:25] What about a, you know, Garmin has these features, right? And their

watches, any concern about the accuracy of a wrist wearable on pulse oximetry? I

Patrick: [00:48:35] don't know, having looked at it. the feedback on the garments has been

very good from any of our instructors who are using it. And I think it's tracking HRV as well.

Isn't it? The garments, they have

Boomer: [00:48:46] this sort of esoteric stress score, but it's, it's effectively HRV. Yeah.

Patrick: [00:48:53] Okay, so I've heard good stuff about it, but I don't know, again, it's $600

Boomer: [00:48:57] to get one of those things

Patrick: [00:48:59] done. I suppose, if you want to get just a simple post SOC seminar,

because they're very simple, you know, in terms of there's a little, a little infrared light

inside, basically that this one here is.

Isn't kicking in, but basically what that is doing, it's monitoring, your hemoglobin, which is

carrying oxygen. And it's looking at the fraction of your hemoglobin occupied by oxygen. So

yeah, they're, they're pretty, pretty simple and good devices. Do you, is that we use them

from two points of view.

Number one is we use them during bread, tolling. To motivate athletes to show them that

yes, we do put you into an anaerobic stage. You know, we are holding the breaths, your

blood oxygen saturation is dropping. You can visually see that by virtue of the pulse

oximetry, Andrew carbon dioxide levels are increasing, and this is producing a combined

effect.

Hypoxic hypercapnic training. Which disturbs the blood acid base balance, which in term is,

is it improving the buffering capacity inside in the muscle compartments? Now earlier on, I

spoke about functional breathing and I spoke about nasal breathing, not getting a whole lot

of research, but thankfully Brett tolling on the exhalation, which we've been practicing for

20 years is getting a good lot of research.

And that's coming out of Paris and there's researchers there. One is. And we're on S w O R O

N S. And putting out research every few months on it, and even looking at repeated sprint

ability. For example, in rugby union, there's divided them into two groups. We're 21 years of

age professional athletes had them do.

In the first week, two sets of eight, the 40 meter sprints on the bread told at departure every

30 seconds on the second and third and fourth week, I think increased to three sets a week

and then measured at this beginning of the trial, both groups were achieving about nine

reps, nine repeated sprint Burgy 40 meter sprints before exhaustion.

And at the end of four weeks training with Brett and with the experimental group, they

increased the repeated sprint ability from nine to 14.8 and the control group increased it

from nine something like 10.2. Now we have to bear in mind. These are aleesh professional

athletes during peak season. And to get those gains to increase from nine to 14.8.

It's tremendous, you know, so I think there's definitely something in it. Looking at breathing.

Yeah. Not just from the point of view of stressing the body. Cause that's what we do when

we do bread. Tolling also bring in functional breathing and bringing in breathing during

sleep.

Boomer: [00:51:54] So looking at training protocols for people, if you were to start

something like this, and of course the guide here is the book and the classes, but also if you

were to start looking at this as sort of, a day to day protocol, how do you.

Recommend for, let's say somebody who's a busy person to start working this into everyday

life and then is six to eight weeks, the right duration, just to see.

Patrick: [00:52:19] Yeah, like you'll feel different than less than six to eight weeks. Just no

question. Like we can see people feeling a difference two to three days depending on the

person.

But the first thing that I would say is get your mouth closed at night and there's a couple of

options. I'm going to show you a couple of options in terms of my closure. This was one that

we were using traditionally.

Boomer: [00:52:39] That's the one I'm using right now, by the way,

Patrick: [00:52:41] three on microphone. Yeah. So you typically take off as strip of about six

inches or so 10 centimeters for the tab, either side of it, close the lips.

Boomer: [00:52:56] Now, this may have my girlfriend by the way,

Patrick: [00:52:59] but she'd be happy to reduce snoring and reduce the flatmate and things

like that as well. And that's very important too. And there's this significant difference now,

do you remember when that we use is we have a tape called myo tape, which I brought out.

I'm not sure if it was out the last time I was talking to you.

And we launched this about three miles. No, it's about Morris, but five months ago. Okay.

And I suppose as devoted, first of all, for children and teenagers, because. Children who are

sleeping with their mouth open, it's having a negative impact on craniofacial development.

And they're more likely to have crooked teeth, their jaws set back and academic

achievement, is impacted because children who are mouth breathing are more likely to be

sleepy.

And children who were sleepy have 10 times the risk of learning difficulties. And it's even

worse than that. If we look at a study by Kara buttock and the Stratford upon even in the UK,

over an eight year period, she looked at 11,000 GOK children. And children would sleep

disorder breathing of which mouth breathing is a contributing factor.

These kids, if untreated, if they're, if they sleep disorder breathing, which included snore at

age five, if on trees at age five, they had a 40% increased risk of special education needs by

ADH. And I remember, or dr. Christian gave him an Oh, I was at a conference in Bordeaux

back in 2016. I was talking there and he was talking, there was asleep Congress.

And he stood up and he said, they says, we need engineers and we need all of these

professions, but he said, children, their brains are getting fried. That's what he said. Here is

the founding father of state medicine. And he's talking about the brains of children getting

fried. And he said, we must have our children get their lips together.

We must restore nasal breathing. And I go on that. The only valid peak production of

pediatric sleep disorder breathing is restoration of nasal breathing both during wakefulness

and sleep. Okay. Totally overlooked boomer, absolutely overlooked. I was giving out a bad

lack of science early around the lack of awareness in the middle, like a profession of the

importance of nasal breathing.

It's almost a doctors. They don't realize that the Noah's perform some function of the

human body, people would say by the couldn't be as simple as that. Look at it this way. Can

you give me any function that the mouth does in terms of breathing? And the answer is no.

And even if we just love it because the anatomy of the mouse here.

So say for instance, here's this here's you have the nose here, you'll have the chin. And here

you have the Mount itself. When we take air in, through the Mount here, that air is going

straight down the trout. The Mt. Performed zero functions in terms of breathing. And it's not

just about moistening or warming or filtration.

The nose performs up to 30 functions in the human and body. And yet between them 25 and

50% of study children, persistence, some female breed, and very few people is talking about

this and that's really a problem. So anyway, I'm going to answer your question and I'm just

going to show this tape here. So this is my old tape.

And we developed a primarily for Maya functional chart, beard, dental fashion. Now I've

only got the children's one too hard, so it's going to be a bit smaller, but it gives you the

idea. You get the tape it's Kinesio tape. The glue has been altered. That is the kids variation.

So you see it being stretched here.

Yep. It's pulling the muscles in a bi-directional relationship, which is helping to ensure nasal

breathing, but there's no risk. The charge was to get sick, something like that. The child can

have the mentor. So if you were looking at a protocol, I would say, absolutely. Nobody

should wake up with a dry mouth in the morning.

That's number one, number two, practice slowing down your breathing, breathing in and out

through your nose, but really reduce the volume of air that you will breed. For about 10 to

15 minutes before sleep, and that will have to improve sleep. Number three, do all of your

physical exercise, but your mouth closed.

If you walk for a half an hour a day, you go for a jog. You go for do it with your mouth closed,

but in the first couple of weeks, You might feel that the air hunger is little bit, you know,

stronger. It's going to be normal. Now you put, you could do is if you have a nose like mine,

but very small nostrils and deviated septum, and it's very common.

The air hunger can be too much. So what I would suggest then is that people get a nasal

device and nasal dilator, and that simply goes up into each side of the nose and you just

gently push it up. And it opens up the nose and it allows easier nose nasal airflow. So then I

would say is during your run, if you're not pregnant, if you've got no med medical conditions

after you've warmed up in your physical exercise and you're going fairly likely, it takes a

normal breath in and out through your nose, pinch your nose and hold your nose and hold

your breath for maybe 10 or 15 paces as you continue to run.

Then let go breathe in through your nose, continue running then jogging for about a half a

minute to a minute and do it again. Do five reps of Bret toes during your run. it gets more

complex. I'm only giving you a few simple things that people could bring in.

Boomer: [00:58:36] I'm glad you are, because I think the book is a great place to refer

people because you're getting in a lot into nitric oxide there.

Right.

Patrick: [00:58:43] There's more stuff than, yeah,

Boomer: [00:58:44] of course. I'm trying to simplify it, but there's obviously a lot more

complexity behind it.

Patrick: [00:58:49] And the other thing is then, you know, really make, make sure that you

are breathing through your nose and, you know, you could have your hands, either side of

your lower ribs. And as you breathe in that your ribs are gently moving out.

And as you breathe out, your ribs are gently moving in. Like think of breathing. It should be

light, should be slow. It should be deep LSD, an easy way to remember it. So light is about

breathing a little bit less. Slow breathing is about slowing down the respiratory rate and

deep breathing simply means that you have lateral expansion and contraction of the lower

ribs.

Boomer: [00:59:24] May have to title the episode, like slow and deep.

Patrick: [00:59:27] Yes. Yeah. That's good. People remembers that. What better town to talk

about that then

Boomer: [00:59:32] Amsterdam. Yeah, I'm sure damn. Or just, you know, the Beatles have,

have run that one a few times and you know, we've, we've talked recently on the show

about psychedelics, so I think it'll resonate pretty well.

Patrick: [00:59:43] Good stuff. Good stuff.

Boomer: [00:59:46] Patrick. This is fantastic. And thank you for all of the really tactical

information when it comes to breathing. And I always love your work because, and I

mentioned this on the last episode and I do mean it. It's the audio book that I go back to

again and again, when it comes to breathing and I know breath is very sexy right now, and

there are a

Patrick: [01:00:05] number of books out there,

Boomer: [01:00:07] but your book is how many years old

Patrick: [01:00:09] now?

It's five years. Yeah, 2015.

Boomer: [01:00:12] And I've, I think I've gone through it. At least a half a dozen times, which

just in the grand scheme of any book, I don't think it's, I think it's a, probably up there in

terms of repeat reads, but in terms of health books, that's probably number one in terms of

repeat. So thank you for everything that you do.

Where can people find out more about you, the work that you're doing, oxygen advantage,

B taiko, all of that stuff.

Patrick: [01:00:40] Sure. For, for sports performance, the best website will be oxygen

advantage.com and Instagram has oxygen advantage. And then for people say with sleep

disorder, breathing for panic disorder, anxiety for asthma.

That's Buteyko clinic.com. And the thing is Buteyko clinic is the Instagram feeds. I don't tend

to look after social media, whatever girls does it. So I'm not totally unfair with them. And

then the tape for the mouse's space. Simple, my old tape, my old tape.com. Yeah. Yeah. I

have another book written and I've just finished it about a month ago.

So we're doing final edit stuff. It's 140,000 words. it's moved away a little bit from the

oxygen advantage to sports performance, kind of in health to primarily health. And it's

looking at different topics, diabetes, epilepsy, and it's looking to ask them again, huge

emphasis on children, because I think it's really being overlooked even though boomer, this

has been discussed since 1909.

No, it's been written about back in the dental journal back then. Dental clouds must about

the impact of my breathing, pause and crooked teeth and children. And how many kids now

have overcrowding of teeth and mouth breathing is contributing to that. But again, no. Are

we talking about as are there are some but very few.

So I'm hoping that the books are helping shed some light and to Jay generate some

awareness, generate some debate. And it's very simple. You know, the only problem is I

think the reason that this hasn't scaled is because you've kind of bottled, it kind of put it into

a

Boomer: [01:02:13] no pattern,

Patrick: [01:02:14] no patent. And that's why it has some Gotti attention.

So, so that's why I'm always appreciative. Thanks very much for your podcast. But putting

the information out there. I think it's great,

Boomer: [01:02:25] Patrick. Thanks again. And to everybody listening out there, I know

Patrick referenced a few diagrams. We're going to link to those on YouTube, but, and of

course, the show notes for this one are@decodingsuperhuman.com slash oxygen advantage

to Patrick.

Thank you so much.

Patrick: [01:02:39] Thank you Robert

Boomer: [01:02:41] much, like the first episode, Patrick is such a wealth of information. I'm

so glad he came on and was willing to entertain a lot of my questions. We got into CO2

tolerance and why that's not really the right thing to focus on when it comes to or set

another way. Not the only thing to focus on when it comes to free diving.

We talked about why the Wim Hof method is probably something you don't know. I want to

do well free diving. We get into the diaphragm bolt scores. LSD, which stands for light, slow

and deep, not psychedelics in this case. The difference between capnography and pulse

oximetry machines and so much more. So if you enjoyed this episode, please head over to

Apple podcasts or wherever you listen to your episodes and leave us a five star review

because candidly, all of those reviews help out so much and they absolutely light up my

freaking day.

The show notes for this one again are@decodingsuperhuman.com slash oxygen advantage

two and superhumans. I appreciate you having an Epic.