Chasing Life

Welcome to Chasing Life. If you are listening to this podcast, you are breathing. And no offense, but there's a very good chance that you're doing it wrong. The average person takes something like 20,000 breaths per day, more than 7 million a year. And I've always thought of each of those as a reflex, something we instinctually do, rather than a skill that we can hone. But for me, that changed in 2020. As a global pandemic attacked our respiratory systems, this timely book came out called Breath, The New Science of a Lost Art. I read it, and it blew me away. Chronic diseases, brain function, even the way we physically look, the way our faces look. The author, journalist James Nestor, argues that mounds of scientific research makes clear that all those things can be direct consequences of the way that we breathe. And he wrote that as many as 90% of us are doing it incorrectly. But something that really struck me was the next part of his argument.

Whether you have asthma or snoring or sleep apnea, COPD or nasal congestion during allergy season, all of these are signs that you're not breathing well. And just adhering to a few extremely basic, deceptively simple guidelines, you can restore a lot of those issues.

So a new anniversary edition of Breath is out now, and I invited James onto the show to talk about what he has learned since the book came out. This is a really fascinating conversation. We're gonna explore how your diet can shape your face, how you can boost your stamina, like Olympians, just by how you breathe, and how your child's nighttime breathing can impact their development. Most importantly, we cover practical and immediately actionable ways to improve our health. One breath at a time, even the way that your tongue is currently sitting in your mouth. You can change that, and that changes everything. I'm Dr. Sanjay Gupta, CNN's chief medical correspondent.

And this is Chasing Life. Well, thank you for your time.

Thanks for having me.

It's so interesting because I think people think breath and they think it's just this reflexive thing that we do and the idea that we could be doing it wrong or that we can at least be doing better, I think it is inherently fascinating. That grabbed me out of the gate when I was reading your book. You start with this scene, which is essentially a free breath class in San Francisco and I think you write that your doctor said it could help your failing lungs and your frazzled mind. I'm just curious, first of all, what was your health like at that stage of life and what did you initially think when your doctor said that?

My health was pretty good. I focused a lot on exercising, eating well, sleeping eight hours a night, all of that stuff. But the issue was I kept getting respiratory problems. I kept giving bronchitis. I kept hitting mild pneumonia every year. And I was told by my other doctors that I would go to that this was normal, that I shouldn't be worried about it. But I started to question that after several years and that's where Dr. Friend. Mentioned I should do a breathwork class, which I had never done in my whole life. And so I took her word and explored it.

Were you a skeptic or a believer out of the gate?

Well, I've been a journalist for 20 years, so I'm very skeptical about stuff, especially when people start making very bold claims about how very simple things can transform your health in particular ways. So yes, I was extremely skeptical.

So, obviously your thoughts about this evolved over time, but take us back into that clinic though. What happened and what started to make you less of a skeptic and more of a believer?

'I think my personal experience right from the get-go, I had a really powerful experience in that breathwork class that didn't seem physically possible, that you could just sit with crossed legs in a cold room and breathe in a rhythmic pattern and break into a complete sweat, hair sopping wet, T-shirt sopping, wet, just within a number of minutes. It wasn't like I was exerting any serious physical effort to do this. It was just a very rhythmic breathing pattern. And I'm not saying this is proof of anything, there's no control version of me, but I've never had one of those problems since, after I learned these very basic principles. So that got me more curious from a journalistic standpoint of what else there was out there about it, you know, where was the science? And so when I started looking at the scientific literature, started talking to experts in the field, It turned out that so many of us are breathing dysfunctionally. So whether you have asthma or snoring or sleep apnea, COPD or nasal congestion during allergy season, all of these are signs that you're not breathing well. And just adhering to a few extremely basic, deceptively simple guidelines, you can restore a lot of those issues.

Can you tell us what a few of those simple basic guidelines are.

Sure, the first one is to breathe through your nose. The majority of time in the daytime and all of your sleeping time, you should be breathing in and out through the nose. If you look at any other animal in the animal kingdom, how do they breathe? Even a horse running at 45 miles per hour, breathing in an out through its nose, and we're designed to do the same thing. So that's the number one thing that you need to be doing. And after that, it's breathing slowly. Breathing rhythmically, breathing deeply, and having a full exhale. So you can remember all of those, you know, very easy. You can write them on a napkin, but actually adhering to those practices is a bit more of a challenge.

One respiratory therapist I talked to, I was at the hospital on Monday and I said I was gonna be interviewing you. And she said to talk to you about this idea of proper tongue placement within the mouth. And so just now, as I'm talking to you, this idea of taking your tongue and putting it right at the junction of your palate and your front teeth, your upper teeth. And I'm doing it right now. And if you're trying this, you'll find if your tongue is in that position, it's very hard to mouth breathe. You know i'm actually forces you to know spree

She's completely right and so this is something that so many of us are just coming back to. This is especially important for kids because the tongue is a very powerful muscle and if you have proper oral posture that tongue especially when you swallow will push against the upper palate and enable you to have a wider mouth and with that wider mouth teeth can grow in straight. And this is one of the reasons why so many kids have mouths that are too small. Because they have mouths that are too small, they have teeth that grow in crooked. So not only is it good functionally for how your bones are gonna be developing, but for breathing as well and keeping your mouth shut, this is the natural position in which we're supposed to be holding our tongues and breathing.

I think you just alluded to this, but why are humans more likely to be mouth breathers than other species?

It's a whole number of different factors, and the first one has to do with the size of our mouths. If you go back in time, you could go to anywhere in the world around 1,000 years ago, and you would see uniformly straight teeth. You would see very wide mouths, and then you could back in 10,000 years ago and 100,000 million years ago and you could see the same thing. And then right around the Industrial Revolution, depending on where you were 300 years ago, 400 years ago in a single generation, 50% of a population would have crooked teeth because their mouths are so small. And this was 100% tied to the consistency of the food they were eating. Industrialized foods are extremely soft. There's no chewing stress. Without chewing stress, you can't expand your mouth properly. This sounds crazy. But Dr. Robert Coraccini spent 40 years researching this and wrote 250 different scientific articles showing the same thing over and over and over. So that's the number one reason why we have mouths that are so small. With that small mouth, it's harder to breathe.

I just want to make sure I understand. So does a smaller mouth make you more likely to be a mouth breather? Is that the relationship here?

Yes, exactly. Because your tongue has a harder time fitting in your mouth. Your mouth is so small, your tongue is more apt to be laying over your teeth and it's more comfortable to to breathe like this. Because that mouth is so small. Also what happens is the upper palate here, when the mouth grows too small, that upper palate grows up and it takes away real estate in the nasal cavities. So that makes us more apt to suffer from congestion. And if we're congested, we're breathing through the mouth.

By the way, I have three daughters. My oldest is 20. She was visiting over the holidays. Went into her room to wake her up, as you often do with teenagers, and I noticed that her mouth was taped. I think for her, it's in part cosmetic. Like she thinks that it'll change the shape of her jaw. It's something that she would do for that reason, as much as she would for concerns about cavities and bad breath and things like that. Any validity to that?

'I've spoken at a lot of schools, and as you know, young kids don't care about being healthy. They usually don't have to worry about it, right? They're healthy. They're immortal, yes. They're mortal. But they really care about how they look. And the one thing that gets them to pay attention is to show them pictures of either twins or of young kids who have gotten hamsters or have gotten cats or dogs that they were allergic to. And you see within a few years of them adopting to this mouth-reading posture, their facial profile completely changes. Again, this seems nuts, but if you really think about it, during those stages of very fast development, If your mouth is constantly open, the scalicature and musculature is gonna adopt to that open, slack-jawed posture, right? And after a few years, it will affect your facial profile. This is so common that researchers call it adenoid face. When adenoids get inflamed, kids tend to mouth breathe. And if they do that for too long, they develop this facial profile where

What is too long?

It depends, right? It depends when that obstruction happens. Probably, I think, the most vital times to be a nasal breather are probably from the ages of eight to 15. That's just a complete guess based on growth patterns and what I've heard from Dennis. But that doesn't mean that you have to start when you're eight and you have to stop when you are 15. You know, this is a habit you want to carry through.

If you were to just define what correct breathing looks like, especially given the fact that 90% of us are probably breathing incorrectly, what does it look like?

If I were to show you, I would bore you to death because it is imperceptible. It is so soft and so fine and so easy and so natural. It looks as if nothing is happening. So in my view, perfect breathing is in and out through the nose. We already know that, right? It's able to bring breath comfortably down to the abdomen, to the stomach area. And be comfortable enough with yourself to allow that area to expand as you breathe in, as you're inhaling. And as you breath out, it's very soft. You're just letting it go. You're not forcing it out. This is a natural, cyclical, rhythmic thing. It should be very soft and very fine. As well, my shoulders shouldn't be moving. My neck shouldn't moving.

I think everyone, including myself, is trying it right now. I'm doing that. And again, maybe it sounds silly to anyone who's listening, but it shouldn't because it is so fundamental to get breathing correct. I was really fascinated. I consider myself at least an amateur athlete. I work out every day. You know, I remember when I was cycling up this hill once with somebody who was a really good cyclist and I was clearly getting to that point of suffering Up this hill on my bike and I started to breathe in through the mouth. And he basically came up behind me and he said, okay, stop that. You're gonna tire out really quickly. Just try breathing in through nose. But I think there's this tendency to, when you're in the middle of something really intense, to start really trying to feel like you can get as much air in as you can. And that would be through the mouse. But why is that not?

It's not correct because for most of the time exercising, breathing in and out through your mouth is not going to allow you to upload more oxygen. So if you are just breathing over and over and over, you are allowing all this air to come in. For one, you're not using it because you're just bringing it into the throat, into the bronchi, into areas of the airway that do not participate in gas exchange. That air never gets into your blood vessels. And another thing that you're doing is you are offloading this carbon dioxide. And without that carbon dioxide, oxygen can't do its thing. It can't function in your body. So it actually deprives you of oxygen if you are mouth breathing too much and breathing too much.

Why do you think we reflexively do that if it's not physiologically beneficial?

Because we have an extremely low threshold for carbon dioxide because we Habituated ourselves to be over breathers all the time the hottest new trend in Athletic performance and I know several elite trainers of Olympians and ultra marathoners is to condition their athletes to tolerate more co2 Because if you're able to tolerate More co2 you're to use more oxygen more efficiently and breathe less if you were able to breathe going up that hill, if you are able to breath 20 deep breaths instead of 60 shallow breaths, that's going to have a huge impact on your heart rate and your levels of fatigue.

And I should point out as well, nose breathing is not just an alternative to mouth breathing. There are other benefits to nose breathing as well.

Well, there's dozens of benefits to nasal breathing. The number one thing for me is that it forces you to slow down your breaths, right? There's a baffle in there. All of these different turbinates and different structures allow you to slow down that breath. And with that slower breath, your lungs are actually able to absorb more oxygen, right. You create more pressure. And with the pressure, you can absorb more oxygen. So it's much more efficient. Another reason, our noses are our first line of defense against bacteria and viruses. Not only do we have different structures to help filter out stuff, but we also produce a profusion of a nitric oxide which kills bacteria and virus very, very efficiently. And we produce that in our nose. We don't get that when we're breathing through the mouth.

So just just explain that to me. So if you're breathing through your nose, the nitric oxide is you have higher levels of it as a result of nasal breathing?

'You release six times more nitric oxide when you're breathing through your nose. It's that vibration, right? That rhythm of the air passing through your nasal cavities to the endothelial cells that release this nitric dioxide. So that immediately goes down to your lungs, and it's an extremely powerful vasodilator. So it allows your blood vessels to help open up. We can do that in our noses as well, and we can increase that even more if we hum. We get a 15-fold increase in nitric oxide, humming. You'd be surprised. I know this sounds goofy, but next time you're riding up that hill, next time, you're struggling and you're breathing through your nose, try to hum. And that this isn't some sketchy thing. There is biochemistry behind this and it absolutely works. And that's what a lot of athletes are starting to do.

'After the break, James explains connections between breath to ADHD and I'm going to throw a couple real-world scenarios at him to see what breathing techniques might help.

In the moment. Stay with us.

I love this book, I really do. Because these are basic things that you can absolutely, immediately incorporate into your life. It's quite remarkable. You know, this is something that you really started to highlight in the newer version of your book, the paperback version. I wonder if you can talk about, you focused on, I guess, basic fundamental concepts around breath might have impact on things like anxiety and ADHD even. What did you find there?

I had heard whispers of this for the five, six years that I was researching this book, but it wasn't until I went on the road and started speaking at conferences that I heard the real story. And it was shocking when I heard it. And so I went back and researched it for a couple of months and what these people had told me was true. And it's that kids with ADHD also suffer from sleep disordered breathing. What sleep disorder breathing is, is it's choking on yourself when you're breathing. Sleep apnea, it's also resistance when you're breathing, it snoring, it all of these different things. So, a lot of people say, well, you know, what came first, the ADHD and then the sleep disorder breathing, or the sleep disorder breathing and the ADHD. From the researchers I've talked to, they say one of the number one causes of ADHD, The causes of it are kids having sleep disorder breathing they said This is the main driver behind ADHD. What happens is a kid doesn't sleep at night, they're struggling, they're stressed out because they're choking on themselves all night long. They wake up, they are extremely tired, right? This goes on for weeks, then it goes on months, then it go on for years, and when we're sleeping, we're restoring, right, and if our brains don't get that, they're not able to develop properly. So that's what this growing group of scientists is saying. That this is the thing, and from what I've seen, nobody's looking at this.

So what are we to do with that information? I, as you're talking, I'm just thinking even my youngest daughter who's 16 years old, you know, when I see her sleeping, sometimes I do see her mouth breathing.

I'm not a doctor. I'm not here to recommend anything. All I can do is tell you what I've learned from the real experts in the field, and Christian Gimeno at Stanford studied this stuff for 40 years and has something like 500 different studies on the effects of poor breathing, especially the effects on poor breathing at night and what it does to your brain, and what is does to even your ability to to grow. To a certain height. So because we release human growth hormone at night, right? And if we don't enter those stages of deep sleep, we're not gonna grow to our full potential. So that's who I learned this from. Specifically, what do you do about it? First of all, you need to diagnose it. Just as you're doing, is there a problem? Can you hear your kid breathing at night? If you can hear your kids breathing at nighttime, that means there is some resistance to their breathing. They should be silent. Their lips should be closed. They should be breathing in and out through the nose. Once you diagnose this, then you're able to address, where is the problem? And then there are different solutions, depending on the issue there. But I cannot tell you, after talking with dozens and dozens of these people that are trying to get this word out, this can make such an enormous difference to a kid's cognitive abilities, to even their ability to physically grow to their epigenetic potential. That I'm trying to talk about this during every single talk I do, whether it's a lecture or whether it is a podcast, because I think it's that important.

Yeah, and I think this point that you've raised a couple of times, because I think the mind immediately says chicken and egg, is anxiety driving this type of breathing or could breathing be driving a higher likelihood of anxiety, ADHD? Look, I think about this all the time. And the idea that I would say, hey, look, proper breathing can increase your nitric oxide, could increase the amount of growth hormone you have, could physically change how you look. And some of that can be addressed by the foods that you eat, but also by something that people might think is silly, but even you do it, which is this mouth taping. I don't wanna make too much of that, but at the same time, I don't wanna ignore something that people have maybe dismissed as too gimmicky.

The mouth tape thing is, now you can see people are fascinated by this because it seems so sketchy and yet there seems to be a pretty solid foundation of science and reasoning behind it. I don't want to say everyone should go out and mouth tape. It's not going to cure everything for everybody. I would never say that. It is one of many tools you can do that some people can do to help improve their breathing, specifically to help make nasal breathing a habit so you don't have to think about it. One of the things that I've told so many people that if you want to experiment with mouth taping, do not run out by tape and try to do it at night immediately. You have to acclimate your body to this. So you wear it for 20 minutes while doing the dishes or watching TV or answering emails. Then the next day you wear for half an hour and then over two weeks you see how your body is feeling. Then experiment with napping with a little piece of mouth tape on, and then work up to sleeping with it. So I think so many people want to jump out and go from zero to 100. It's a bad idea.

Yeah, I totally hear you and I want to make sure we emphasize this point in the podcast as well. We're not suggesting that either, but I think part of the reason these things take on such fascination is because they're so accessible and people want quick fixes and I get that. I'm the same way. We realize there's a certain amount of work involved, especially if you're changing something as fundamental as what we're talking about here. You said this really interesting line, I think there are as many ways to breathe as there are foods to eat. And in the book, which everyone should get, there's this appendix that's essentially breathing methods that you've explored in the book. And I'd like to throw just a couple of scenarios at you and just see what breathing technique you might turn to in that situation. So let's say you're getting ready for a first date. What is the breathing technique that you might use then?

'I'm trying to imagine a scenario here. You're about to knock on the door, right? You've got your roses in your hands, some romantic rom-com visual here. And you're about knock on door. This is what I would do to remove those butterflies in your stomach. I would relax your shoulders, inhale, pause, inhale again, pause. Inhale again. Pause. Inhale again, Pause. Just inhale one more time. And just let it out, calmly out. And do that again, inhaling, pause, inhale, pause. Inhale, pause inhale all the way up.

And just let it out. Now, if they see this all happening on the ring doorbell, you'll have some explaining to do, maybe. I think.

You can do this. Yeah, make sure there is not a camera watching you do this, but what you can is on the, you know, in the car before you do that or on the subway. And another thing is this doesn't have to be a big pronouncement, right? You can do that so subtly, no one can see it. You are. Constantly breathing in, you are telling your nervous system, you're telling your heart that you are in control. It's not in control, this is not a subconscious thing, this is something that you are consciously controlling.

That's amazing. Let me ask one more scenario because I just wrote this book all about pain. Someone has chronic pain, like chronic back pain and maybe struggling with the flare up. You know, I see this even in my own practice for people like their breathing changes as a result of pain. What is the recommendation in terms of breathing techniques there?

'I think pain is extremely complex. I'm glad you're writing a book about it because I don't think anyone really has their head around properly how to manage people with chronic pain. I know a few people who've gotten very serious car accidents who are now living with chronic pain, it's very difficult for them. So I think the idea that when you are having a flare-up, your nervous system is reacting, right? You are entering a state of stress is to try to turn that around. Just like if you suddenly hurt yourself. To hyperventilate is about the worst thing that you can do. You have to remind your brain and remind your body that you're in control. Several people that have suffered from autoimmune diseases, including people have suffered, from chronic pain. Have discovered that using these vigorous breathwork techniques, like the Wim Hof method, which is actually an ancient technique. He just put his name on it. Or holotropic breathing. These very vigorous techniques can be beneficial. There's one called Sudarshan Kriya from the Art of Living that has been shown to be very beneficial. Will it work for you? I have no idea. But again, these things, for the most part, are completely free. And the only negative side effects are that you may lose 10 minutes of your time doing them.

'Well, a lot of people read your book, I will say. I mean, look, I'm not just saying this because I'm talking to you, but the fact that my 20-year-old read your books. You know, she's in college, she's got a lot things going on, and she read your bookstore. So, you know, for what it's worth, you got a fan club within my own household. So I congratulate you for that and writing the book. And thank you for spending this time with us. I learned a lot.

Thank you very much for having me.

'That was James Nestor, author of Breath, The New Science of a Lost Art, the anniversary paperback edition is available now. And if today's interview sparked any questions for you, record a voice memo, email it to pagingdoctorgupta at cnn.com, just the letters D-R for doctor, or give us a call 4703960832. And thanks so much for listening.