Describe your breathing

There is a lot to be learned about how you, and the people around you breath. As a trainer and 1st aider, I try and observe carefully how people breath.

A normal breathing pattern consists of between 12-16 (some argue 12-20) breaths a minute aka your respiratory rate. From a first aid and general fitness perspective breathing patterns out of this range should be investigated.

Respiratory rate has been described as the neglected vital sign, for instance a respiratory rate higher than 27 breaths/minute is one of the most important predictors of cardiac arrest in hospital wards

Changes in respiratory rate seem to be much greater than changes in heart rate or systolic blood pressure meaning that respiratory rate is likely to be a better means of discriminating between stable patients and patients at risk.

21% of ward patients with a respiratory rate of 25–29 breaths/minute assessed by a critical care outreach service, died in hospital. However, its not just the rate of breathing that indicates your current state. How you breath can be critical.

So, can you describe how you are breathing?

Here are some useful descriptive words that will help you categorise and explain to others what you see.

breathless: breathing very fast and hard, for example after exercising

choke  the action or sound of choking

deep breathing a lot of air into or out of your body

deeply if you breathe or sigh deeply, you breathe a lot of air into or out of your body

fighting/struggling for breath : almost unable to breathe

heavily if you breathe heavily, you breathe slowly and loudly

indrawn  An indrawn breath is one that is suddenly breathed in

laboured If someone’s breathing is laboured, they breathe with difficulty, for example because they are ill or extremely tired from physical activity

Out of breath breathing fast and with difficulty, for example because you have been running

puffed breathing very quickly because you have been running, jumping etc

shallow taking in only a little air

sharp a sharp breath is taken suddenly, often because you are surprised

short of breath finding it difficult to breathe

winded unable to breathe because you have been running or have been hit in the stomach.

Obviously you need to put these observations in context. If someone has just sprinted 400m, they will be breathing heavily and be out of breath. But you can see why. If someone has been sitting down for the last hour and they have a breathing rate of 27, you really ought to be getting some help. Apart from breath counting, it’ as well to notice how people are holding themselves, or their posture.

People with breathing issues often adopt a tripod position which is a “Physical stance often assumed by people experiencing respiratory distress or who are simply out of breath. In this position, a person sits or stands leaning forward and supports the upper body with hands on knees or other surface”(source)

Breathing and peak flow

Before anyone starts criticising your breathing and setting you weird breathing exercises, make sure they have at the least taken a peak flow reading. This is where you puff down a tube and compare the reading with your height, so you can monitor your lung function. There are too many trainers hanging around who attended an online course and are now taping peoples mouths up while exercising with very little assessment of the science behind it.

Make sure they do some basic assessments first. The peak flow meter is one of those basic tests! You may need breathing drills.

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Some breathing practice

Here are some useful methods to improve your breathing.

  1. Pursed lips

According to the Cleveland Clinic, pursed lip breathing has a range of benefits:

  • Improves ventilation
  • Releases trapped air in the lungs
  • Keeps the airways open longer and decreases the work of breathing
  • Prolongs exhalation to slow the breathing rate
  • Improves breathing patterns by moving old air out of the lungs and allowing for new air to enter the lungs
  • Relieves shortness of breath
  • Causes general relaxation

Practicing this technique 4 to 5 times each day  can help.

  • Keep your mouth closed, and take a deep breath through your nose hold for 2 seconds
  • Put your lips together and blow through them. (some say like a whistle, but don’t whistle. It’s annoying.) This is known as “pursing” your lips.
  • While continuing to keep your lips pursed, slowly breathe out by counting to 4. Don’t try to force the air out, but instead breathe out slowly through your mouth.

2) CO-ORDINATED BREATHING

Co-ordinated breathing uses 2 steps and combines them with an exercise (say a push up)

  • Inhale through your nose before beginning an exercise.
  • While pursing your lips, breathe out through your mouth during the most strenuous part of an exercise.

3) DEEP BREATHING

Deep breathing flushes your lungs and makes sure you have  expelled all that dank horrible air that been skulking in the outer reaches of  chest.  You  can now  breathe in more fresh air, accept if you are in London, where its packed full of pollution.

Here’s how to practice deep breathing:

  • Sit or stand with your elbows slightly back. This allows your chest to expand more fully, but you are still breathing through your Diaphragm.
  • Inhale deeply through your nose.
  • Hold your breath as you count to 5.
  • Release the air via a slow, deep exhale, through your nose, until you feel your inhaled air has been released.

4)THE DIAPHRAGMATIC BREATHING

The diaphragm is an important muscle involved in the work of breathing. People with breathing “issues” tend to rely more on the accessory muscles of the neck, shoulders, and back to breathe, rather than on the diaphragm. Diaphragmatic or abdominal breathing helps to retrain this muscle to work more effectively. Here’s how to do it:

  • While sitting or lying down with your shoulders relaxed, put a hand on your chest and place the other hand on your tummy
  • Breath in through your nose for 2 seconds, feeling your tummy move upwards. You’re doing the activity correctly if your stomach moves more than your chest.
  • Purse your lips and breathe out slowly through your mouth, pressing lightly on your stomach. This will enhance your diaphragm’s ability to release air.
  • Repeat the exercise as you are able to.

Meditation

This is going to be crucial to your future health. So, start practicing now!

Meditation 101: A Beginner’s Guide from Gobblynne on Vimeo.

The Buteyko control Pause breathing test

Dr. Buteyko developed a test to measure depth of breathing and consequent retention of carbon dioxide, resultant oxygenation and health. He named it the ‘Control Pause‘ breathing test. Get yourself a clock or stop-watch & try for yourself:

  1. Sitting down, close your mouth and breathe normally through the nose for  30 seconds
  2. Take a normal breath in through your nose
  3. Allow a normal breath out through your nose
  4. Gently close your nose with thumb & forefinger and start to count the seconds on the clock
  5. When you first feel the need to breathe, release the nose and take a breath through the nose
  6. Remember to keep your mouth closed throughout

The number of seconds that elapsed is your Control Pause. Less than 10 seconds, and you have health problems. Less than 25, your health needs attention. 30-40 seconds is satisfactory, while 60+ seconds is excellent.

The Buteyko control pause breathing test

Here are some more  tests based on breathing out, then timing (thanks to conscious breathing.com for the summary)


Exercise 2 – hold your breath while walking

 

 

  • Step 1 Sit down in an upright position, with your back straight, and relax for a few minutes.
  • Step 2 Stand up and take a small breath in and a small breath out in a calm way through your nose (approx. 2-3 seconds on inhalation and approx. 2-3 seconds on exhalation).
  • Step 3 Pinch your nose after the exhalation is finished and hold your breath and start walking while counting the number of steps you take.
  • Step 4 When you are not able to hold your breath any longer, let go of your nose, inhale and exhale calmly through your nose and note how many steps you took. Try to wind down by breathing calmly as soon as possible.

 

Health status Hold breath sitting Hold breath walking
No symptoms, optimum health 60 seconds 120+ steps
Very good health, most symptoms are completely gone 40 seconds 80-100 steps
Good health, symptoms present when exposed to a trigger 30 seconds 60-80 steps
Symptoms are often present 20 seconds 40-60 steps
Many different symptoms always present 10 seconds 20-40 steps
Medications, diseases, very heavy breathing 3-5 seconds 10-20 steps
Dead 0 seconds 0 steps

I chat  more about breathing and CO2 here