How to Breathe Well
Insights with Dr Rosalba Courtney (Osteopath)
Our Advisory Panel member Dr Rosalba Courtney is an osteopath with over 30 years of clinical practice. She wanted to identify the key piece of advice to help her patients improve their health.
To find the answer she completed a PhD on dysfunctional breathing and discovered there is a lot more to breathing than simply the exchange of oxygen and carbon dioxide.
Previously she discussed The Importance of Breathing Well.

Dr Rosalba Courtney shares her insights below...

How to Breathe?
It seems simple. You breathe in and you breathe out. We've all been doing it since the day we were born. And we haven't really given it much thought. But if taking too many breaths per minute is considered to be dysfunctional, how many breaths per minute should we be taking?
The optimal number of breaths per minute is not a single number, it is a range. A normal breathing rate is thought to be between 9 and 15 breaths per minute. If you are using your breathing to calm yourself and control your blood pressure and heart rate, you would probably only breathe 6 breaths per minute.
While it may seem to make sense that we should all try and slow down a bit to better control our stress levels, it would seem a bit fake and forced to be constantly trying to take only 6 breaths per minute. But it is a good idea to set aside some time everyday for meditation when you can focus on your breathing and go to that optimal state. We actually need to go there. 
 It's a lovely place to go to renew, restore and rebalance yourself.
Is nose breathing better?
As important as it is to have an optimal breathing rate, how you breathe must also be taken into consideration. For some people it is simple – your nose is for breathing and your mouth is for eating. But many people continue to breathe through their mouths instead. If you consider that the nose has as many as 30 different functions, if you bypass the nose, you miss out on those functions.
Some of the important functions of the nose include:
  • Cleaning and filtering the air
  • Kills certain viruses, bacteria and fungi
  • Resonance chamber for your voice
  • Smell
Looking at the functions of nose breathing:
  • It improves memory and learning functions
  • It calms and clears the mind 
  • Improves the function of your diaphragm, giving you a better breathing pattern
  • It is involved in reflexes that open the throat
  • It is important to breathe through you nose to prevent snoring and sleep apnea
  • It encourages the production of nitric oxide in the paranasal passages. Nitric oxide has an enormous number of functions in the body, including the transport of oxygen
Mouth breathing bypasses all of these very important functions of nose breathing and the nose itself. All of the dirt particles and microbes that would have been filtered out of the air you breathe by the nose, now enter your lungs. And you miss out on all of the calming, memory and learning benefits when you breathe through your mouth.

So, yes, nose breathing is definitely better!

A quick look at the diaphragm
Yes, we breathe through our nose (or our mouth) but the diaphragm is our most important respiratory muscle. A lot of people don't use it effectively when they breathe, or even where it is and what it does. Dr Ron asked Dr Rosalba to give us a quick lesson on the diaphragm.
It is a huge muscle, found inside the body that separates the rib cage from the abdominal cavity. When you breathe in, the diaphragm flattens and presses down on the abdominal cavity, creating more space in the ribcage. The result is reduced pressure in the chest cavity, which allows air to come into the lungs. In other words, along with other muscles involved in breathing, it regulates the pressure changes in the chest cavity which allow you to breathe.

When you are stressed or anxious the excitability in the nerve to the diaphragm can cause the diaphragm to get over stimulated. It goes into a kind of spasm – it descends and flattens and gets too tight. Using the diaphragm to breathe when it is in this state is not possible, so you start using your chest and shoulder muscles to breathe. And they are not nearly as effective as the diaphragm at creating extra space in the chest to allow air to move into the lungs.

How to breathe better
Dr Rosalba has observed that many people believe that diaphragm breathing means moving your stomach in and out. To a certain extent that is true. We need a little bit of stomach motion, but ideally you should be breathing in a 360° ring. When you breathe in, the lateral rib cage expands sideways and the front and back of your chest move out, expanding the lower ring of your ribcage.

Dr Rosalba's advice is to focus on slowing and relaxing your breathing. Give the exhale the most attention and just give yourself time.

She says: "Make your breathing low, slow and soft." And then you will find that your diaphragm slowly starts to breathe better.

Dr Rosalba leaves us with these 5 tips:
  • 1. If you're breathing through your mouth, take care of that first
  • 2. Become aware of your breathing
  • 3. Breathe through your nose
  • 4. Breathe low, slow and soft
  • 5. Investigate your nighttime breathing
There are breathing exercises available in the Breathe Pillar Deep Dive here > 
This will help you to improve your breathing and address tips 1-4 above.
For nighttime breathing - we discuss this as the last part of the Sleep Pillar Deep Dive as well as in the Breathe Pillar.
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"Thoroughly researched and thought-provoking... Dr Ehrlich's five pillars are the real key to reducing the ongoing carnage from a modern disease that has strained and almost broken our current inappropriately named 'health system' "
Dr Ross Walker – Author, cardiologist and host of national radio program Healthy Living.
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