This article was previously published on June 29, 2020 and has been updated with new information.
Breathing is universal, accustomed and almost always automatic. When you get stressed, your breathing pattern and frequency will change. This often leads to more chest breathing in response to a “fight or flight” situation, which is a reaction triggered by the autonomic nervous system.1
In April 2019, a headline in The New York Times announced, “Americans are among the most stressed people in the world.”2 It was just under a year before the COVID-19 pandemic further increased stress levels.
Stress is not foreign to Americans. The survey was conducted in 2007 by the American Psychological Association (APA). In a press release, they said one-third said they lived with “extreme stress” and 48% thought their stress had “increased over the past five years.”3 Russ Newman, APA’s Executive Director for Professional Practice, said:4
“Stress in America continues to escalate and affect every aspect of people’s lives – from work to personal relationships to sleep and eating habits, as well as their health.
We know that stress is a reality and some stress can have a positive impact, but the high levels of stress that many Americans report can have long-term health consequences, from fatigue to obesity and heart disease. “
Fortunately, your breathing is not completely automatic. Controlled breathing is one of the strategies that has been shown to be effective in reducing physiological indicators of stress and improving feelings of calm.
This means you can control your breathing to help manage stress, improve relaxation and take bigger steps to gain control of your health. Let’s start with a brief explanation of some different parts of the nervous system.
Functions of the sympathetic and parasympathetic system
Stress and your body’s response to the environmental stimuli that cause stress are survival mechanisms. However, chronic activation of the system causes a continuous release of hormones, which cause harmful physiological changes.
While a fight or flight reaction is critical if you face a bear or run from an attacker, continued exposure to social stress can increase the risk of chronic illness and death.5 Your stress response begins in the amygdala of your brain, which plays a role in how you manage emotions associated with stress, joy, and other scenarios.6
The amygdala sends a signal to the hypothalamus, which communicates with the body through the autonomic nervous system. This system controls the functions in the body that happen automatically, such as heart rate, blood pressure and respiration.
The autonomic nervous system has two parts, one that triggers an alarm and the other that helps you calm down. The sympathetic nervous system signals that a fight or escape response has begun. It gives you the energy and concentration you need to escape a risky situation. Once the danger is over, the parasympathetic nervous system helps to slow down the release of hormones so that the body can rest.
Each of these changes happens quickly and without your intervention. That’s why you can jump out of the way of a snake in the grass before you fully recognize that something is standing in your way.
Keeping the sympathetic nervous system up and running has a detrimental effect on your health. With controlled breathing, you can calm down and make real physiological changes, including:7
- Decreased heart rate and blood pressure
- Reduction of stress hormones
- It balances the level of carbon dioxide and oxygen in the blood
- Improving immune function and energy levels
- Increasing feeling of calm
Box breathing reduces stress and promotes health
Boxing breathing technique is what SEALS use. In this video, Mark Divine from SEALFIT demonstrates box breathing and tactical breathing. He explains that tactical breathing is used during exercise to calm your mind when you are under pressure. For those of us who are not in combat situations, this can happen in a boardroom, during an athletic competition or during testing.
SEALS use boxing breathing as a training technique, so tactical breathing is effective when needed. There are four steps and each is done at the same time. Breathing affects how you think and how you feel.8 Lynne Everatt is an author, personal trainer and wellness expert from Toronto. She spoke to a reporter from Forbes and said:9
“Stress and anxiety trigger neurocirculation, which has been designed to be used sparingly to deal with threats to life or death, not on a daily basis in response to rubbish, a toxic boss or work overload.
Chronic stress has a corrosive effect on the brain, which is associated with degeneration of the hippocampus (brain memory center) and impaired functioning of the prefrontal cortex, which can manifest in our lives as depression, dementia and impaired executive function. “
To start practicing box breathing, stand in a quiet place where you can concentrate and maintain proper posture. Ideally, you will want to measure how many cycles or minutes you can perform the technique and work for up to five minutes.10
Take each step below with a focus and intent on your actions. Most people who use this technique recommend inhaling and exhaling by four or five. Both are acceptable as long as each phase lasts the same amount of time.
Step 1 – Start by slowly exhaling air from the lungs to four. Some recommend exhaling through the mouth; Divine recommends exhaling through the nose.
Step 2 – Hold your breath for a slow count to four.
Step 3 – Slowly inhale through your nose at four, keeping your back straight and breathing through your stomach so that your shoulders do not lift.
Step 4 – Hold your breath for a slow count to four and return to step 1.
Nose breathing offers many benefits
Nasal breathing offers specific health benefits. Researchers have found that people who usually breathe through their mouths have a higher risk of sleep problems and attention deficit disorders.11 One theory is the difference in brain oxygenation.
Mouth-breathing individuals tend to hyperventilate or receive more oxygen than needed.12 This reduces the level of CO2 in the body, which is important because you need a balance of oxygen and CO2 to function optimally. Nose breathing helps.
Your stray nerve is a major part of the parasympathetic nervous system.13 Diaphragmatic breathing, which you may have heard as slow abdominal breathing, triggers the wandering nerve and stimulates the parasympathetic nervous system. Since the 1970s, deep breathing has become a central part of helping to reduce stress and anxiety, which is widely accepted by Western physicians.14
By stimulating the stray nerve and thus the parasympathetic nervous system, nasal breathing can help reduce stress, anxiety and the release of stress hormones. Breathing through your nose helps you breathe less.
This may sound like a bad recommendation, yet many people chronically breathe excessively and deplete their carbon dioxide reserves. Chronic mouth breathing has been linked to several health problems, including:
- Sleep apnea15
- Bronchoconstriction with exercise-induced asthma16,17
- Abnormal facial development18,19
- Poor dental health20
- Hyperventilation, which results in a reduction in oxygen to your brain and heart21,22
More breathing techniques to improve health
As I wrote in “Best Breathing Techniques for Better Health,” a boxing breathing feature that reduces stress, increases your CO2 levels, and signals your parasympathetic system is diaphragmatic breathing. You can easily assess your body’s tolerance to CO2 at home using a technique developed by Dr. Konstantin Pavlovich Buteyk.23
This Russian doctor found that the level of CO2 in your lungs correlated with your ability to hold your breath after a normal exhalation. Start by sitting straight with your feet on the floor. Small inhale and exhale through the nose. After exhaling, pinch your nose to prevent air from entering, then lower the stopwatch. Hold your breath until you feel your first desire to breathe. When you feel the urge, resume breathing and note the time.
Your first breath should be calm and controlled by the nose. If you feel that you have had to take a deep breath, then you have held your breath for too long. What you have just measured is called a “check pause” or CP. This is a reflection of your body’s tolerance to carbon dioxide. Most people take 20 to 40 seconds, but 40 to 60 is optimal. Anything less than 40 can be a cause for concern.
One strategy for improving your CP is to increase your fitness and endurance levels. Another is to improve the technique of breathing by stretching the abdomen rather than raising the shoulders. When your shoulders rise during the inhalation, it is called vertical breathing.
This can make you feel taller and does not include stomach elongation. However, proper breathing causes your middle part to expand and is called horizontal breathing. This will engage your diaphragm, allowing you to breathe more fully and stimulate your stray nerve.
Nose-breathing nitric oxide may have antiviral properties
Another reason to breathe through your nose is to increase nitric oxide (NO) production.24 Your body also produces NO in other places, including endothelial cells. It is a soluble gas that has some exceptional health benefits, some of which I discuss in “The Importance of Healthy Bacteria in Nitric Oxide Production.”
Many of these benefits may be due to the fact that NO is a signaling molecule. Doctors use the gas in a number of clinical situations, including helping to reverse high blood pressure in the lungs of newborns. NO produced by your endothelium helps to relax the arteries and lower blood pressure. This helps to promote the oxygenation of all your organs.25
Another benefit of inhaled nitric oxide is the treatment of viral infections. Clinical trials are currently underway to treat people infected with SARS-CoV-2. The main actions that could help in the fight against COVID-19 include:26
- Dilation of the pulmonary arteries to help the lungs get more blood
- Opening the bronchial airways to increase oxygen supply
- Direct induction of antiviral activity against the virus
Louis J. Ignarro, Ph.D., author of an article in The Conversation, was one of three Nobel laureates in physiology and medicine in 1998. A group of pharmacologists discovered how nitric oxide was formed and how it works in the body.27 Nitric oxide is formed in the nasal cavity but not in the mouth.
This means that those who breathe chronically through the mouth bypass the production that can be inhaled into the lungs.28 This direct delivery helps increase airflow and blood flow in the lung tissue and inhibits the growth and replication of viruses and other microorganisms. A clinical study is currently underway to:29
“… Determine whether inhaled NO improves short-term respiratory status, prevents future hospitalization and improves the clinical course in patients diagnosed with COVID-19, specifically in the emergency room.”
You can help increase your NO production at home with a simple four-minute workout three times a day. Dr. Zach Bush, whose triple certification includes expertise in internal medicine, endocrinology and metabolism, named the exercise Dump Nitric Oxide. He says it’s anaerobically effective and the more you do it, the better it works.
Exercises can be performed at home without equipment and can be adapted to any condition. It works by stimulating the release of nitric oxide. For more information on exercise, how to do it, and why it is so beneficial, see “Fitness Control: Why You Need to Try Nitric Oxide Exercise.”