Deep vs Shallow Breathing
Why Your Calming Breaths Are Often Not Calming At All
Deep breathing is one of the best ways to lower stress in the body and calm the mind. Practiced correctly it has many other incredible health benefits, from relieving gastric reflux to preventing back and neck pain. Unfortunately, it’s surprisingly common to misunderstand what deep breathing actually involves, and what it feels like. If you have ever found yourself dizzy and lightheaded after deep breathing exercises, it’s likely that you are either taking big, shallow breaths or breathing ‘too deeply’. If your child suffers with asthma or anxiety or regularly breathes through an open mouth, it is important for their long-term wellbeing that you understand the value of deep vs shallow breathing, know how to apply deep breathing techniques to your own breathing, and understand how to practice deep breathing for kids. With that in mind, let’s look at the difference between deep vs shallow breathing and why deep breathing is often confused with breathing ‘big’.
Here’s What You’ll Learn
- The effects of shallow breathing
- Shallow breathing symptoms and the shallow breathing anxiety connection
- Shallow breathing causes
- The benefits of deep breathing
- The dangers of shallow breathing at night when sleeping
- The physiological benefits of deep breathing
- Deep breathing for kids
- Deep breathing exercises for anxiety
- Deep breathing techniques
What is Deep Breathing?
Deep breathing is breathing from the diaphragm. It’s the kind of breath you will see a small baby take. A natural, inaudible inhalation that makes the belly rise and fall gently as you inhale and exhale.
The diaphragm is the main breathing muscle. It is a thin sheet of striated muscle, the same kind of muscle as those that move your joints. It sits below the ribs, between the chest and the abdomen. As you inhale, the diaphragm flattens and contracts, moving downwards into the abdomen. When you exhale, it returns to its natural domed shape. Inhalation requires more work from the diaphragm, and exhalation is largely passive.
The diaphragm needs room to move in order to function properly. If you constantly sit slumped at your desk or on the couch, the chances are your diaphragm is not getting much of a workout. If this is the case, you probably breathe predominantly into your upper chest without even knowing it. The same goes if you regularly have tension or pain in your lower back, neck and shoulders. When your posture or movement is less than optimal, your breathing will suffer as you tense up and hold your breath to avoid pain.
Deep breathing involves more than just breathing deep into your tummy. In fact, what generally happens when you tell just about anyone from the age of 3 to 103 to “take a deep breath,” is that they scrunch their face up, tense their shoulders, open their mouth and take a big gasp of air straight into their upper chest. Even if you are instructed to take a deep breath through your nose, the chances are you’ll take a breath that is faster than normal, and if you observe what happens to your body, you will notice your chest lifting as you breathe in. This is a big breath, but it is not necessarily a deep one.
Equally, a deep breath that reaches the diaphragm but involves a larger-than-normal volume of air can adversely affect the balance of essential gases in the blood. When this happens, rather than increasing body oxygenation, the opposite occurs. This is when deep breathing can actually become unhelpful.
What’s Wrong With ‘Big’ Breathing?
The problem with breathing too much air is that it unbalances the breathing biochemistry. The term biochemistry refers to the relative concentrations of oxygen and carbon dioxide in the blood. It is responsible for vital processes like oxygen getting to the cells and organs, and regulation of the acidity of the blood. When you breathe too much air in, you also breathe too much air out. This lowers the level of carbon dioxide in your blood. Carbon dioxide (CO2) is essential because it stimulates the process by which oxygen is released from circulating blood cells into the body to be used. CO2 also has many other vital functions. Suffice it to say, it’s not just a waste gas, and breathing too much of it out in the name of deep breathing is not great for your health.
Deep breathing requires you to slow your breathing down. When deep breathing is also slow breathing, more air reaches the tiny air sacs in the lungs where oxygen and carbon dioxide are exchanged. Contrary to common understanding, deep breathing does not involve taking in a larger volume of air per breath to ‘fill your lungs up’ and get more oxygen. The body simply doesn’t work like that.
Breathing too much air on a long-term or habitual basis is called chronic hyperventilation. Hyperventilation just means ‘over breathing’. It might seem odd that over breathing is synonymous with shallow breathing but read on and you’ll begin to understand why.
In this short video, Patrick McKeown tells us that breathing has three dimensions; biochemistry, biomechanics and speed of breath. He explains why it is so important not to focus on one dimension to the detriment of the others:
What is Shallow Breathing?
Shallow breathing, as you might expect, is breathing that does not engage the diaphragm. You might take what you think is a deep breath, but the air you take in doesn’t get very far. When you take a big breath into your upper chest, it doesn’t get all the way down to the air sacs in the lungs (called the alveoli). The result is that the lungs are unable to access the oxygen in that air, and no matter how much air you breathe in, you feel breathless.
Shallow breathing is often fast breathing. When the breathing is too fast there is not enough time for air to get deep into the lungs. This leaves the lungs unable to extract sufficient oxygen from the air. Fast breathing also results in the loss of too much carbon dioxide, which adds to feelings of breathlessness by reducing breathing efficiency and oxygen uptake.
While newborn babies instinctively know how to breathe, many of us have lost the ability under layers of bad habit, lack of awareness and poor understanding. It can be the case, especially for people prone to overthinking, that we need to relearn basic skills with a clear understanding after years of getting ourselves in a muddle. This can certainly apply to things like mindset and negative beliefs. And it can apply to breathing too.
Many of us have become shallow chest breathers. Environmental stressors such as pollution, noise and stuffy buildings, and societal pressures like the desire to have a flat stomach encourage us to tighten our abdomens, lift our shoulders and hold our breath.
Fast, shallow breathing has all the hallmarks of stress. Even if it isn’t triggered by stress, it can activate the fight, flight or freeze stress response. If you continue shallow breathing on a long-term basis, you will experience chronic stress and stress-related illness, even if your life seems relatively stress-free. In fact, because your shallow breathing makes you constantly on edge, it will be more difficult to deal with minor obstacles and challenges, and stress will self-perpetuate. Shallow breathing causes stress, and stress causes shallow breathing, and so you end up in a cyclical pattern of chronic stress and unhealthy breathing patterns. Stress becomes habitual, as if a switch is jammed on somewhere in your nervous system.
Shallow Breathing Symptoms
It is curiously difficult to pin down a list of shallow breathing symptoms online. This is because shallow breathing exists in more than one form and is more often described as a symptom of another condition. Shallow breathing symptoms that come from breathing too little air normally stem from illnesses that involve some sort of chest problem or trauma, such as chronic obstructive pulmonary disease (COPD) or a lung infection.
Most of us will experience shallow breathing in a more habitual way. In this case, shallow breathing symptoms include an unhealthy breathing pattern in which air is drawn into the upper chest rather than deep into the lungs. Shallow breathing symptoms include fast breathing, noticeable breathing, breathlessness and obvious movement of the upper chest during breathing. You may even notice the abdomen pulling in during inhalation and pushing out during exhalation, which is a breathing pattern called paradoxical breathing. A paradox is something contradictory, and so the term paradoxical breathing indicates that the body is doing the opposite of what is normal.
As we’ve already seen, shallow breathing is not always associated with breathing too little air. It is actually more common for shallow breathing to be the effect of chronic hyperventilation – breathing too much air, too fast, into the upper chest. In this instance, shallow breathing symptoms will mirror symptoms of hyperventilation syndrome, and include all of the physical and psychological symptoms caused by hyperventilation. Remember, hyperventilation is breathing more air than the body needs causing a reduction in levels of arterial carbon dioxide. Hyperventilation is associated with a huge list of symptoms including breathlessness, headaches, dizziness, poor circulation and much more.
The Effects of Shallow Breathing
The effects of long-term shallow breathing can be serious. The chronic stress, poor posture and inadequate oxygenation that result inhibit the immune system, cause pain in the lower back and neck and leave the brain feeling foggy and muddled. Shallow breathing also affects the way you sleep. If your body is constantly in high alert ‘fight or flight’ mode, you may be suffering from hyperarousal, which is associated with insomnia. And when your breathing is dysfunctional during the day, your breathing during sleep will be abnormal too, causing you to experience shallow breathing at night when sleeping. This can lead to snoring and even sleep apnea, a serious condition in which the breathing actually stops periodically throughout the night, causing oxygen desaturation.
When stress is long-term, the body is more vulnerable to illness and takes longer to recover and heal if you do get sick. Shallow breathing can easily turn into a panic attack. It can cause the dry mouth associated with stress that subsequently affects dental health and can produce halitosis. The effects of shallow breathing include fatigue and the flare-up of respiratory symptoms in people with asthma and rhinitis or during exercise, and long-term shallow breathing is a strong risk factor for cardiovascular disease.
What is chronic stress?
In the scientific literature, stress is defined as a physiological reaction to undesired emotional or physical situations. Initially, it triggers an acute reaction (fight or flight) that is mediated by hormones including adrenaline1.
When stress becomes chronic and lasts for a long time, the stressed body responds with physical/physiological changes. It adapts to the unfavorable conditions. This negatively affects the immune system and the way the brain regulates the interaction between the nervous system and the hormones. Stress is a common risk factor in 75 to 90% of all human diseases2.
Numerous scientific studies support the theory that the development of chronic stress can be, at least in part, due to an increase in oxidative stress, which may also contribute to rheumatoid arthritis, high blood pressure, heart disease, Alzheimer’s disease, Parkinson’s disease and aging1.
Diaphragm breathing, which is also called deep breathing, has been proven to reduce oxidative stress and levels of cortisol, the primary stress hormone. It also results in an increase in melatonin, which is known as the ‘sleep’ hormone3. This can help reverse symptoms of sleep disorders caused by shallow breathing at night while sleeping.
The Effects of Shallow Breathing on the Muscles
Further negative effects of shallow breathing include tension in big muscle groups in other parts of the body. This can lead to headaches, anxiety, back and neck pain, pain in the temporomandibular joint (the jaw hinge) and other unpleasant chronic symptoms.
One of the effects of shallow breathing is that the small breathing muscles have to work too hard to compensate for poor diaphragm function. As a result, small ‘accessory’ muscles such as the muscles in the neck, end up overworking. These muscles are called the scalene muscles. They are small muscles that lift the top ribs, making space in the chest for the lungs to expand.
When you breathe too much into the upper chest, these muscles are constantly working to help get air into your body. This can result in neck pain, back pain and, because the neck is important for balance and proprioception, it increases risk of injury. When the neck hurts, it’s harder to move properly, the shoulders slump, posture suffers, and it becomes harder to practice healthy deep breathing. Because when the breathing suffers, movement suffers and vice versa, one of the effects of shallow breathing is that it perpetuates shallow breathing.
Shallow Breathing Causes
As well as being a habitual condition caused by chronic hyperventilation and poor breathing patterns, shallow breathing causes include acute or serious illnesses. When infections, choking, blood clots or other acute issues are present, the breathing will often become rapid and shallow. In this instance, the volume of air breathed in per breath (tidal volume) is lower than normal. Infections such as pneumonia, bronchitis and COVID-19 can all cause difficulty breathing that may translate to rapid, shallow breathing. If infections like this worsen, the lungs can fill with fluid, which makes it very difficult to take in deep breaths. Untreated infections in the lungs can sometimes be fatal.
Acute shallow breathing causes include choking, during which the airway becomes blocked. Pulmonary embolism, which is a blood clot in the lung, is another cause. Pulmonary embolism can lead to hyperventilation and symptoms including coughing, irregular or rapid heartbeat, chest pain and something called diabetic ketoacidosis (DKA). DKA occurs when the body fails to produce enough insulin. It causes acids called ketones to build up in the body. It often produces rapid, shallow breathing and can lead to respiratory failure.
Chronic respiratory conditions can also be included in a list of shallow breathing causes. Asthma is a condition characterized by chronic inflammation of the lungs. It is a common cause of shallow breathing in children. Breathing symptoms can worsen after exercise or at night. Mouth breathing also exacerbates asthma symptoms, especially when the air is cold and dry, or when airborne allergens or pollutants are present. Hyperventilation can be a symptom of an asthma attack.
COPD is another common lung disease listed among shallow breathing causes. COPD is an umbrella term rather than a specific diagnosis and it can affect men and women differently. It includes chronic emphysema (deterioration and damage of the air sacs in the lungs where gas exchange takes place) and bronchitis (inflammation of the airways).
If you suffer with asthma or diabetes, breathing exercises to restore healthy breathing patterns can significantly relieve your symptoms and prevent flare-ups. Healthy nose breathing can also reduce the incidence and severity of respiratory infections and your vulnerability to airborne allergens and toxins.
Rapid Shallow Breathing Requiring Ventilation
When shallow breathing is the result of serious or acute illness, doctors use a standard scale called the rapid shallow breathing index (RSBI) to determine the need for ventilation. Intensive care patients who are using a ventilator and cannot tolerate independent breathing tend to breathe rapidly (high frequency) and shallowly (low tidal volume) and will therefore have a high RSBI. Normal breathing rate is around 12 breaths per minute, with a volume of around 500ml of air per breath. A patient with the kind of rapid shallow breathing caused by acute illness may have a breathing rate of 25 breaths per minute and an average tidal volume of just 250ml of air per breath. These two figures are used to calculate the RSBI. The higher the rapid shallow breathing index is, the more distressed the patient is likely to be.
One scientific study from 2005 reported that 21% of ward patients whose breathing rate is between 25 and 29 bpm die in hospital4. Another paper from 2008 revealed that a breathing rate of more than 27 breaths per minute is the primary predictor of heart attack in patients in hospital wards5.
The kind of rapid shallow breathing that occurs during asthma and anxiety attacks is different. The average volume of air breathed during healthy breathing is 6 liters per minute. Hyperventilation occurs when breathing volume is higher than 10 liters per minute6. And despite the fact that shallow breathing characterizes asthma exacerbations and panic attacks, breathing volume can increase to 12 or more liters per minute for people with these conditions7.
Shallow Breathing Anxiety
Anxiety is often thought of purely as a psychological disorder. But it can have physical symptoms including shallow breathing. It can also be caused by shallow breathing, and there is a strong link between levels of blood carbon dioxide and susceptibility to panic attacks.
When anxiety attacks have a psychological basis, they are physical responses to fear or feelings of worry. They often exist hand-in-hand with chronic stress. You may experience rapid breathing, shortness of breath or acute hyperventilation.
One of the most significant causes of anxiety in people who suffer with panic attacks can be the panic attack itself. During a panic attack, it is common to experience a terrifying shortness of breath or ‘air hunger’ that can feel as if you are suffocating. Because of this, it can be helpful to find treatments that offer a sense of control over your symptoms.
One scientific study compared psychological therapy with breathing exercises in the treatment of panic disorder patients and discovered that both treatments were effective in improving perceived control over panic symptoms. However, the patients who practiced deep breathing exercises also experienced changes in their breathing biochemistry. In the group who used deep breathing techniques, blood carbon dioxide increased from low to near normal levels8.
Low levels of carbon dioxide are common in people with panic disorder. For this reason, the researchers concluded that anxiety is not a purely psychological illness. They discovered that mental therapy (in this instance, cognitive behavioral therapy (CBT)) and breathing exercises work via different pathways within the body’s systems. This indicates that while treatments such as CBT are valuable in addressing the mental issues and thought processes behind anxiety, deep breathing techniques are also therapeutic. Unlike CBT, deep breathing corrects the imbalances that perpetuate or trigger shallow breathing patterns, anxiety and panic disorder in the first place.
Benefits of Deep Breathing for Oxygen Uptake
Deep breathing from the diaphragm is much healthier than shallow, upper chest breathing. By learning to breathe from the diaphragm, you can enjoy benefits of deep breathing including better lung health, a more relaxed mind, more efficient breathing and less breathlessness.
Breathing is more efficient when it is slower. As we already discovered, this is because the air spends more time in the lungs and has more time to reach the alveoli (the small air sacs) where exchange of oxygen and carbon dioxide takes place. When breathing is fast and shallow, more air remains in something called ‘dead space’. Dead space is air that is inhaled but never reaches the alveoli.
In one research study, scientists demonstrated the difference between fast, shallow breathing and slow, deep breathing. They found that during breathing at 12 breaths per minute, 4.2 liters of air reached the alveoli. At 6 breaths per minute, 5.1 liters reached the alveoli9. The oxygen in the air we breathe only becomes available to the lungs for diffusion into the bloodstream when that air reaches the alveoli. The calculations in this experiment reveal that breathing at 6 breaths per minute is 20% more efficient in terms of blood oxygenation. Breathing more slowly (and therefore deeply) gets more oxygen to your cells and organs including your brain.
This has important implications for sports parameters such as performance, endurance and climbing altitude. It has therapeutic applications for respiratory disorders and heart disease. And it has the potential to boost your focus, concentration, memory and learning ability, prevent or reduce cognitive decline in elderly people and support your mental health.
Benefits of deep breathing for mental health
In 2018, scientists in Italy published a review into the functions of the diaphragm and concluded that this breathing muscle has many systemic functions that are not just related to changes in tissue oxygen. The article reviewed some of the lesser-known functions, including oscillations in the nervous system, the influences of the breath on motor activities and the electrical responses of the brain.
The article concludes: “The diaphragm still has many mysteries to be unveiled, not only on the functions it exerts in the body system but also on the usefulness that a manual approach can have on the patient… we can conclude with this reflection: Breath has patterns. Schemes create behavior. Breath is a behavior. Behavior represents the person. Breath reveals the person.”10
One of the ways in which to diaphragm impacts systems outside of breathing is in regulation of the relaxation response. The respiratory system is closely related to the heart via the vagus nerve, a long cranial nerve which drives the function of the rest and digest (parasympathetic) branch of the autonomic nervous system (ANS). The parasympathetic nervous system balances out the other branch of the ANS, the sympathetic nervous system, which mediates the fight or flight response. The vagus nerve travels all the way down to the abdomen and connects with the diaphragm. Deep breathing activates the parasympathetic nervous system, in part due to its influence on the vagus nerve. This allows your body to slow down, rest and heal.
When we exhale, the vagus nerve secretes a neurotransmitter (a chemical messenger) called acetylcholine. Acetylcholine slows the heart rate, triggering relaxation. This supports physical and mental resilience and can be observed by measuring heart rate variability (HRV). The term heart rate variability refers to the fact that the heart does not beat at regular intervals. It speeds up during inhalation and slows during exhalation. These complex, constantly changing oscillations make it possible for the cardiovascular system to respond to external and internal stimuli and maintain homeostasis. For this reason, high HRV usually indicates better health while a low HRV reading is associated with poor health and risk of disease.
Deep breathing techniques that involve slow breathing at around 6 breaths per minute have been proven in many studies to optimize HRV and activate the parasympathetic nervous system, reducing stress and shallow breathing anxiety. This is partly due to the fact that more time spent in the exhalation phase allows for the release of more acetylcholine, which is why some deep breathing techniques involve an exhalation/inhalation ratio that favors the out breath.
Deep Breathing Exercises
Deep breathing from the diaphragm has been proven to have many clinical applications. But the more we look into the difference between deep vs shallow breathing, the more it becomes apparent that the diaphragm breathing – which is used in deep breathing exercises – is slow breathing, not big breathing. When you slow your breath down and breathe through your nose, you automatically begin to engage the diaphragm. And you spend longer in the exhalation phase, which is when the vagus nerve releases its relaxing neurotransmitter, acetylcholine.
Scientific studies have found therapeutic applications for diaphragm breathing in conditions including:
- Depression (including ‘comorbid’ depression in people who are unable to take antidepressants due to conditions like bipolar disorder. A comorbid illness is an illness that exists alongside another disease, but is not necessarily related to it)
- Emotional/mood regulation
- Blood sugar control in diabetes
- Seizure frequency in epilepsy or people with non-epileptic seizures (hyperventilation is a known trigger for seizures)
- Hiatal hernia and gastric reflux11
- Sexual dysfunction (particularly erectile dysfunction in men, though there is currently a dearth of research into sexual dysfunction in women)
- Core strength and balance, less risk of injury
- Back and neck pain
- Urinary incontinence following prostate surgery in men
- Stuttering and speech disorders
Benefits of Deep vs Shallow Breathing
It is also important to understand that the diaphragm forms part of the core, and so it plays a role in supporting and stabilizing the spine and pelvis12. This means that diaphragm breathing is essential for functional movement. As the diaphragm descends and the lungs fill with air, pressure (called intra-abdominal pressure or IAP) is generated in the abdomen. This acts like an inflated balloon, stiffening and supporting the spine and core.
You might have noticed a weightlifter breathing in directly prior to a lift. This is done in order to take advantage of intra-abdominal pressure. However, according to physiotherapist Josephine Key, the most effective IAP is produced by maintaining a constant diaphragmatic breathing pattern12.
When you breathe gently and slowly from your diaphragm you experience the following benefits of deep breathing:
- Promote the habit of slow respiration
- Calm your mind and enjoy a greater feeling of relaxation
- Draw air deep into the lungs
- Improve exchange of oxygen and carbon dioxide for maximum breathing efficiency
- Generate intra-abdominal pressure (IAP) for postural control and spinal stabilization
- Support functional breathing for functional movement
Conversely, shallow breathing performs none of these functions. Shallow breathing does not activate the diaphragm. It doesn’t support functional movement – in fact it impedes it by overuse of small, accessory muscles and compensatory muscle behaviors. It prevents air from flowing deep into the lungs where oxygen can be diffused for use by the body. And rather than helping to calm the mind, shallow breathing keeps you in a perpetual state of shallow breathing anxiety and chronic stress.
People who have shallow breathing experience more mental stress, more chronic pain, more injuries and more back problems. They are less resilient and more likely to become sick.
Shallow Breathing at Night When Sleeping
When breathing during the day is dysfunctional, it is highly unlikely that breathing during sleep will be healthy. Sleep-disordered breathing can cause symptoms including snoring, poor quality sleep and daytime fatigue, and it can develop into a serious sleep disorder called obstructive sleep apnea.
Obstructive sleep apnea (OSA) is a condition in which breathing is shallow during sleep, or periodically stops altogether. This disease, which causes shallow breathing at night when sleeping, is incredibly and increasingly common, partly due to an aging population. According to the American Sleep Apnea Association, around 22 million Americans suffer with sleep apnea, and as many as 80% of people with moderate or severe OSA remain undiagnosed13.
Obstructive sleep apnea is characterized by pauses in breathing called apneas. These can occur many times per hour. Some people experience 30 or more apneas every hour throughout the night14. These periodic pauses in breathing are normally followed by irregular breathing and hyperventilation when breathing resumes. This can lead to a central apnea (when the brain fails to send signals to the respiratory system to breathe), perpetuating the problem.
Sleep apnea results in poor quality sleep and is associated with an increased rate of mortality and illness, including sudden cardiac death. It’s also unsurprising that OSA is strongly linked with higher risk of road traffic accidents, because drivers with sleep apnea are frequently driving tired.
The Risks of Shallow Breathing at Night When Sleeping
Shallow breathing at night when sleeping activates the stress response. Chronic stress can lead to hyperarousal that contributes to insomnia. But this hyperarousal also makes you more likely to wake up easily during the night.
Another factor that contributes to insomnia is fast, shallow breathing during wakefulness15. This means that if you hyperventilate during the day, you are more likely to be aroused from sleep. Shallow breathing at night when sleeping leads to more arousals during the night, and shallow breathing during the day does too.
In 2017, an article published in Science described a discovery that directly linked the rhythm of breathing and the fight, flight or freeze stress response. Scientists found a neural circuit in the brain of mammals that may have evolved as a defense mechanism16. They believe that this circuit is responsible for mobilizing the animal when rapid, labored or irregular breathing occurs. Fast, shallow, irregular breathing increases the kind of alertness associated with panic and anxiety in humans15. In the same way, increased activity in the part of the brain that mediates respiratory rhythms, sighing and hyperventilation is thought to trigger arousal during sleep, meaning shallow breathing anxiety affects you at night as well as during the day. Conversely, slow, conscious deep breathing is known to encourage relaxation and is helpful for the treatment of stress disorders.
The discovery of a neural circuit that triggers arousal during shallow breathing is cohesive with the idea that insomnia can be caused by hyperarousal as the result of an overactive sympathetic nervous system during wakefulness. Previous research also supports the likelihood that ‘increasing ventilation’ causes us to wake from sleep, and that this arousal is not dependent on what exactly causes breathing to increase17.
Insomnia is an incredibly common problem that doctors struggle to adequately resolve. It is normally addressed with medication, some of which can be habit forming and disrupt sleep patterns. The understanding that fast, shallow breathing causes us to wake from sleep is relevant and valuable for people with sleep apnea and insomnia. Especially due to the fact that scientists have pinpointed high arousal threshold as the greatest predictor of all-cause mortality in sleep apnea patients18. In the simplest terms, this means that people who wake up more easily during the night are likely to die sooner, which means shallow breathing anxiety can be very bad for your health.
How Can I Prevent Shallow Breathing at Night When Sleeping?
The best way to prevent shallow mouth breathing at night is by making sure that your mouth stays closed. We already know that nose breathing helps engage the diaphragm and is deep breathing, while mouth breathing is shallow breathing. Mouth breathing also contributes to snoring and makes sleep apnea symptoms worse.
If you want to prevent shallow breathing at night when sleeping, tape your mouth with MYOTAPE. MYOTAPE is a specialist lip tape designed to restore fulltime nasal breathing. Unlike other lip tapes it is worn around the mouth not covering the mouth. This helps alleviate any anxiety that might initially stem from taping the mouth. And it means you can still open your mouth to communicate and hydrate when necessary.
Mouth tape is a helpful solution for treatment compliance in people who use continuous positive airway pressure (CPAP) devices to treat their sleep apnea. Scientists have found that a lot of people experience CPAP non-compliance because they breathe through an open mouth19. When the mouth is open, air escapes rather than working to keep the airway open. With MYOTAPE, the mouth stays closed so CPAP works better and you are able to get a good night’s sleep.
If you find it difficult to breathe from your diaphragm and want to normalize your breathing volume without increasing tension throughout your body, try the Buteyko Belt. If you want a simple tool that works to prevent shallow breathing at night during sleep, the Buteyko Belt can be worn at night to normalize breathing. The belt can also be worn for periods throughout the day to bring attention and awareness to the diaphragm.
Pregnancy and Shallow Breathing at Night When Sleeping
For pregnant women, shallow breathing at night when sleeping can be potentially serious. Women with obstructive sleep apnea are five times more likely to die due to complications including a blocked artery in the lungs (called a pulmonary embolism)20. One study that recorded maternal deaths in Michigan over the course of 15 years reported a link with obstructive sleep apnea and sleep-disordered breathing21. Scientists found that even after the baby is born, sleep apnea represents a risk for mothers.
It is natural that as the fetus grows and takes up space in the abdomen, breathing will become shallower. However, women with healthy diaphragmatic breathing patterns who practice deep breathing through the nose and deep breathing exercises will lessen their vulnerability to sleep-disordered breathing and sleep apnea. They will also be better able to balance the feelings of anxiety that often accompany pregnancy.
Physiological Benefits of Deep Breathing
When you slow down your breath to achieve deep breathing rather than focusing on the depth of the breath and trying to force deep breathing, you activate the relaxing effects of the vagus nerve. You also allow your body to send messages to your brain that indicate you are not in danger. This means that as you activate the parasympathetic nervous system, you also moderate and balance the stress response.
Physiological benefits of deep breathing include:
- Better heart rate variability
- Better heart-breath coherence
- More resilient, adaptable blood pressure
- Better oxygenation of the tissues and organs
- A healthy cardiovascular system
- Better lung health
- Optimum levels of carbon dioxide in the arterial blood
- Mental calmness and resilience
Plus, all of the physiological benefits for health that we already mentioned. There is still a need for more research into the physiological benefits of slow breathing for specific conditions.
Another of the physiological benefits of deep breathing can be found in a deep breathing technique called Heart Rate Variability Biofeedback or HRVB. HRVB was developed in the 1990s by a research psychologist and physician called Paul Lehrer. HRVB is a deep breathing technique that focuses on slowing down the breath to obtain beat-by-beat data about the heart rate. This allows the participant to optimize something called respiratory sinus arrhythmia, which is essentially heart-breath coherence.
The participant uses feedback about the heart rate and speed of the breath with the aim of producing a heartbeat that is rhythmically coherent with the breathing. This involves deep breathing at 6 breaths per minute – the same rate that is known to optimize gas exchange in the lungs.
Scientists believe that the physiological benefits of deep breathing with biofeedback may have therapeutic uses for conditions as varied as irritable bowel syndrome, COPD, asthma, recurrent abdominal pain, fibromyalgia, high blood pressure, cardiac rehabilitation, depression, anxiety, PTSD, cyclic vomiting and insomnia. The optimum gas exchange that can be achieved using deep breathing exercises with biofeedback is also helpful for patients with respiratory diseases22. HRVB is known to restore balance in the nervous system, and this may mean it is helpful in treating inflammation23.
Benefits of deep breathing and better diaphragm strength
Because diaphragm breathing uses the diaphragm, it helps to maintain a strong, healthy diaphragm. We already know that the diaphragm is made from the same type of muscle as those that move our joints, so it makes sense that if we don’t use this breathing muscle it will become thinner and its oscillations will become smaller. A stronger diaphragm is associated with better athletic endurance, less breathlessness and better functional movement and balance.
Deep Breathing Exercises for Anxiety
We’ve seen how it is possible to improve anxiety using deep breathing exercises for anxiety. This works in several ways.
- Deep breathing exercises for anxiety work by balancing the nervous system. This means that the ‘rest and digest’ functions balance out the ‘fight or flight’ stress response, giving the body a chance to rest, heal and recover.
- Deep breathing exercises for anxiety help normalize levels of blood carbon dioxide. Low levels of blood CO2 are known to trigger panic attacks, and when panic symptoms are out of control, you are likely to become more anxious in anticipation of an attack.
- Deep breathing signals to the brain that the body is safe. Shallow breathing signals to the brain that the body is in danger and triggers the stress response.
Why not try some deep breathing exercises for anxiety?
In this video Buteyko Clinic International founder Patrick McKeown explains the connection between stress and breathing and demonstrates some exercises to soften the breath:
Deep Breathing for Kids
Children with asthma and anxiety often have shallow breathing from the upper chest. Mouth breathing and chest breathing go together. Nose breathing creates deep breathing from the diaphragm. When practicing deep breathing for kids, it is important to explain the process very simply.
In these two videos from the free Buteyko children’s breathing program, Patrick McKeown demonstrates deep breathing for kids.
Remember, when practicing deep breathing for kids, it’s important to keep it simple. Try using a star/reward chart for every day practiced, and make sure the process is fun, never stressful. Deep breathing exercises for kids that cause the child to become bored and stressed will be counterproductive. Remember too, that if you are practicing deep breathing for kids, children tend to mirror their parents’ breathing. So, it’s worth learning some deep breathing techniques of your own in order to correct shallow breathing patterns, mouth breathing and chronic hyperventilation. This will benefit your child, and it will benefit you in terms of better health. You can use deep breathing exercises for anxiety, asthma or to help your child understand healthy breathing from the diaphragm.
Deep Breathing Techniques
Many deep breathing techniques exist. Some of them are specific to contemplative practices like yoga. Yoga practitioners understood the power of deep breathing techniques long before scientists began exploring why they work. Yogic deep breathing techniques include unilateral nostril breathing, where you breathe in and out through one nostril at a time, and 2:1 breathing, in which the exhalation is twice as long as the inhalation. The yogic breathing practice, called pranayama, also involves breath retention.
The Buteyko Method focuses on deep breathing that is also slow breathing. This is a method of deep breathing that reduces the volume of the breath towards normal, improves levels of carbon dioxide in the blood and reverses hyperventilation. Deep breathing in this instance does not mean breathing more air.
One of the deep breathing techniques that has been proven beneficial in many scientific studies is deep breathing at 6 breaths per minute. To breathe at 6 breaths per minute, each breath in and out must last for 10 seconds. You can breathe in for 4 seconds and out for 6, or you can breathe equally (5:5) on your in and out breaths. Try placing your hands gently on your sides so you can feel your lower ribs expanding and contracting. Make sure your shoulders are relaxed. If breathing at 6 breaths per minute is uncomfortable for you, try just slowing down your breath. With regular practice, you will notice you can breathe more slowly.
Breathing at 6 breaths per minute provides the best results for heart health, blood pressure, gas exchange in the lungs and many other health parameters. Keep your breathing light and don’t try to fill your lungs up. Just allow a gentle breath in and a gentle, relaxed breath out.
You can practice deep breathing techniques either sitting or lying on the floor. If you are sitting, make sure you are on a firm, straight-backed chair and that your knees are level with, or lower than, your hips. Sitting on a soft or low chair will compress your diaphragm and make the deep breathing exercises harder. Remember, the aim is to activate your diaphragm, not fill your lungs to bursting.
You can also practice deep breathing techniques lying on the floor or on a yoga mat. Again, the firm surface is necessary for proper postural support. This exercise will be much more difficult to do lying on a soft mattress or couch. If you want to practice deep breathing exercises whilst lying down, you may like to place a book on your abdomen (tummy). This makes it easier to see what is happening. As you breathe in, the book gently lifts upwards. As you breathe out, the book lowers. Guide the book gently up and down using the breath, without consciously pushing your tummy out or deliberately sucking it in.
Further Reading About Deep Breathing
If you have enjoyed this article and want to know more about chronic hyperventilation and shallow breathing symptoms, why not read (link to keyword article about hyperventilation syndrome). To read more about the role of healthy nose breathing in preventing respiratory infection and protecting the airways against viruses including COVID-19, read Is Nasal Breathing Your First Line of Defense Against Coronavirus?
For more information about MYOTAPE visit MYOTAPE.com
- Martarelli, Daniele, Mario Cocchioni, Stefania Scuri, and Pierluigi Pompei. “Diaphragmatic breathing reduces exercise-induced oxidative stress.” Evidence-Based Complementary and Alternative Medicine 2011 (2011).
- Liu, Yun-Zi, Yun-Xia Wang, and Chun-Lei Jiang. “Inflammation: the common pathway of stress-related diseases.” Frontiers in Human Neuroscience 11 (2017): 316.
- Goldhill, D. R., A. F. McNarry, G. Mandersloot, and A. McGinley. “A physiologically‐based early warning score for ward patients: the association between score and outcome.” Anaesthesia 60, no. 6 (2005): 547-553.
- Cretikos, Michelle A., Rinaldo Bellomo, Ken Hillman, Jack Chen, Simon Finfer, and Arthas Flabouris. “Respiratory rate: the neglected vital sign.” Medical Journal of Australia 188, no. 11 (2008): 657-659.
- Rakhimov, A. “Respiratory Minute Volume in Health and Disease.” NormalBreathing.com, Updated September 23, 2019. https://www.normalbreathing.com/minute-ventilation/ (accessed November 18, 2020)
- Rakhimov, A. “Breathing Slower and Less: The Greatest Health Discovery Ever.” NormalBreathing.com, Updated July 29, 2020. https://www.normalbreathing.com (accessed November 18, 2020)
- Meuret, Alicia E., David Rosenfield, Anke Seidel, Lavanya Bhaskara, and Stefan G. Hofmann. “Respiratory and cognitive mediators of treatment change in panic disorder: Evidence for intervention specificity.” Journal of consulting and clinical psychology 78, no. 5 (2010): 691
- Bilo, Grzegorz, Miriam Revera, Maurizio Bussotti, Daniele Bonacina, Katarzyna Styczkiewicz, Gianluca Caldara, Alessia Giglio et al. “Effects of slow deep breathing at high altitude on oxygen saturation, pulmonary and systemic hemodynamics.” PloS one 7, no. 11 (2012): e49074.
- Bordoni, Bruno, Shahin Purgol, Annalisa Bizzarri, Maddalena Modica, and Bruno Morabito. “The influence of breathing on the central nervous system.” Cureus 10, no. 6 (2018).
- Eherer, A. J., F. Netolitzky, C. Högenauer, G. Puschnig, T. A. Hinterleitner, S. Scheidl, W. Kraxner, G. J. Krejs, and Karl Martin Hoffmann. “Positive effect of abdominal breathing exercise on gastroesophageal reflux disease: a randomized, controlled study.” American Journal of Gastroenterology 107, no. 3 (2012): 372-378.
- Key, Josephine. “‘The core’: understanding it, and retraining its dysfunction.” Journal of bodywork and movement therapies 17, no. 4 (2013): 541-559.
- Yackle, Kevin, Lindsay A. Schwarz, Kaiwen Kam, Jordan M. Sorokin, John R. Huguenard, Jack L. Feldman, Liqun Luo, and Mark A. Krasnow. “Breathing control center neurons that promote arousal in mice.” Science 355, no. 6332 (2017): 1411-1415.
- Smith, Jeffrey C., Howard H. Ellenberger, Klaus Ballanyi, Diethelm W. Richter, and Jack L. Feldman. “Pre-Botzinger complex: a brainstem region that may generate respiratory rhythm in mammals.” Science 254, no. 5032 (1991): 726-729.
- Gleeson, Kevin, and Clifford W. Zwillich. “Adenosine stimulation, ventilation, and arousal from sleep.” American Review of Respiratory Disease 145, no. 2_pt_1 (1992): 453-457.
- Butler, Matthew P., Jeffery T. Emch, Michael Rueschman, Scott A. Sands, Steven A. Shea, Andrew Wellman, and Susan Redline. “Apnea–hypopnea event duration predicts mortality in men and women in the Sleep Heart Health Study.” American journal of respiratory and critical care medicine 199, no. 7 (2019): 903-912.
- Bachour, Adel, and Paula Maasilta. “Mouth breathing compromises adherence to nasal
continuous positive airway pressure therapy.” Chest 126, no. 4 (2004): 1248-1254.
- Karan, Suzanne, and Yehuda Ginosar. “Gestational sleep apnea: have we been caught napping?.” International Journal of Obstetric Anesthesia 26 (2016): 1-3.
- Mhyre, Jill M., Monica N. Riesner, Linda S. Polley, and Norah N. Naughton. “A series of anesthesia-related maternal deaths in Michigan, 1985–2003.” Anesthesiology: The Journal of the American Society of Anesthesiologists 106, no. 6 (2007): 1096-1104.
- Lehrer, Paul M., and Richard Gevirtz. “Heart rate variability biofeedback: how and why does it work?.” Frontiers in psychology 5 (2014): 756.
- Lehrer, Paul, Maria Katsamanis Karavidas, Shou-En Lu, Susette M. Coyle, Leo O. Oikawa, Marie Macor, Steve E. Calvano, and Stephen F. Lowry. “Voluntarily produced increases in heart rate variability modulate autonomic effects of endotoxin induced systemic inflammation: an exploratory study.” Applied psychophysiology and biofeedback 35, no. 4 (2010): 303-315.