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Can the way we breathe affect brain health?

Can the way we breathe affect brain health?

Inhale. Exhale. Breathing is an activity we perform thousands of times per day without thinking, and yet it is absolutely essential for life. Research indicates that the way we breathe has a multitude of effects on our physical and mental health, and that we have the power to positively impact our health by altering our pattern of breathing [1].

Inhale. Exhale. This time focus on the nature of your breathing. How long did your breath last? Was the inhale the same length as the exhale? Did you use your nose or your mouth? Did you breathe only from your chest, or did you fill your belly? Understanding your natural breathing style is the first step on the journey towards breathing for better health.

Our breathing rate varies based on our activity level, but we tend to have a relatively stable natural breathing rate at rest. Changes in this rate can greatly impact our physiology. One of the primary ways this occurs is through the regulation of the autonomic nervous system [1]. Rapid breathing activates the sympathetic nervous system, or the so-called ‘fight or flight’ system, which prepares the body for action. Activation of this system increases heart rate and vigilance; such that chronic activation can lead to high blood pressure and anxiety. Slow breathing can counteract these effects by activating the parasympathetic nervous system, the so-called ‘rest and digest’ system, which promotes a state of relaxation. Engaging in breathing practices that shift the balance toward parasympathetic activation can reliably lower blood pressure and alleviate anxiety states [2]. One method of shifting the balance involves adjusting the length of the inhale relative to the exhale. Increasing the length of the exhale drives the parasympathetic state of relaxation, and can be a useful technique to practice before bed.

Improving breathing efficiency can promote the delivery of oxygen to our tissues, including the brain. One of the most common forms of breathing inefficiency comes from an overreliance on the chest, with minimal contributions from the diaphragm [3]. Diaphragmic deep breathing is a technique that involves inhaling through the nose focusing on using the diaphragm, which will fill the lungs, leading to an expansion of the belly. This is followed by a slow exhale, with a belly contraction. Breathing in a more efficient manner facilitates the slowing of the natural breathing rate.

Respiratory efficiency can be further increased by coordinating the heart and breathing rates [4]. Heart rate increases during inhalation, and decreases with exhalation, consistent with longer exhales promoting a relaxed state. The difference in heart rate between the inhale and exhale is associated with a health indicator called heart rate variability. Synchronizing the heart and breathing rates improves heart rate variability. Individuals with higher heart rate variability have a higher capacity to adapt to stress, which is associated with improvements in mood, sleep, and overall health. The breathing frequency that maximally synchronizes respiratory and heart rates is called the resonant frequency. It varies from person to person, but is usually around five to six breaths per minute. Studies have found that resonant frequency breathing improved heart rate variability, sleep quality, and other quality of life measures in both patients with chronic disease and their caregivers [5; 6].

The ability of efficient breathing to improve sleep and cardiovascular health is also beneficial for the brain, as poor sleep quality and cardiovascular disease increase the risk for dementia. There is also evidence to suggest that certain breathing techniques, particularly alternate nostril breathing, can impact cognition [7]. The effects are typically seen in the short-term, immediately following the technique, though long-term practice is recommended for maximum benefits. Alternate nostril breathing is associated with increased attention, and may also promote motor learning [7]. This technique involves inhaling through one nostril while holding the other closed, then switching to exhale through the previously closed nostril. The nostril used for inhalation switches with each cycle.

Practicing good breathing habits is one of the easiest ways to make a positive impact on your overall health and wellbeing. It is never too early or too late to start breathing better. Start paying attention to your natural breathing style to figure out which changes you can make to improve your breathing efficiency so you can maximize the life-giving nature of every breath.

  1. Zaccaro A, Piarulli A, Laurino M et al. (2018) How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological Correlates of Slow Breathing. Front Hum Neurosci 12, 353-353.
  2. Yau KK-Y, Loke AY (2021) Effects of diaphragmatic deep breathing exercises on prehypertensive or hypertensive adults: A literature review. Complementary Therapies in Clinical Practice 43, 101315.
  3. Hamasaki H (2020) Effects of Diaphragmatic Breathing on Health: A Narrative Review. Medicines (Basel) 7, 65.
  4. Shaffer F, Meehan ZM (2020) A Practical Guide to Resonance Frequency Assessment for Heart Rate Variability Biofeedback. Frontiers in Neuroscience 14.
  5. Hasuo H, Kanbara K, Shizuma H et al. (2020) Short-term efficacy of home-based heart rate variability biofeedback on sleep disturbance in patients with incurable cancer: a randomised open-label study. BMJ Supportive & Palliative Care, bmjspcare-2020-002324.
  6. Hasuo H, Kanbara K, Sakuma H et al. (2018) Self-Care System for Family Caregivers of Cancer Patients Using Resonant Breathing with a Portable Home Device: A Randomized Open-Label Study. Journal of Palliative Medicine 22, 18-24.
  7. Ghiya S (2017) Alternate nostril breathing: a systematic review of clinical trials. International Journal of Research in Medical Sciences 5, 3273

Betsy Mills, PhD, is a member of the ADDF's Aging and Alzheimer's Prevention program. She critically evaluates the scientific evidence regarding prospective therapies to promote brain health and/or prevent Alzheimer's disease, and contributes to CognitiveVitality.org. Dr. Mills came to the ADDF from the University of Michigan, where she served as the grant writing manager for a clinical laboratory specializing in neuroautoimmune diseases. She also completed a Postdoctoral fellowship at the University of Michigan, where she worked to uncover genes that could promote retina regeneration. She earned her doctorate in neuroscience at Johns Hopkins University School of Medicine, where she studied the role of glial cells in the optic nerve, and their contribution to neurodegeneration in glaucoma. She obtained her bachelor's degree in biology from the College of the Holy Cross. Dr. Mills has a strong passion for community outreach, and has served as program presenter with the Michigan Great Lakes Chapter of the Alzheimer's Association to promote dementia awareness.

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