I imagine that for many people, the word “hyperventilation” brings up the image of that comedy movie where someone at the hospital is freaking out and the doctor hands them a paper bag to breathe into. I think we’ve all seen that scene at some point. But let’s dive a little deeper into the actual process of hyperventilation and what that does to the body over time.
Hyperventilation Syndrome (chronic hyperventilation) is a surprisingly common occurrence in a world that encourages us to move so quickly, both physically and mentally. I’ve often found that many of my patients are not even aware that they hyperventilate.
Breath work and functional breathing are something I emphasize heavily to my patients because I believe that the way we breathe is so fundamental to how well our bodies work. We need a good supply of oxygen to function well, and any impairment of that flow can actually have significant long term effects on health and wellbeing. A lot of research has actually shown that just a few minutes of hyperventilation can deprive the brain of a significant amount of oxygen-rich blood supply (some studies report up to 30% in just a few minutes). Think about the implications of that over the course of years as opposed to minutes.
First, here are some conditions/symptoms that have been associated with hyperventilation syndrome:
Irregular heartbeat, chronic cough, insomnia, chronic colds, headaches, TMJ, cold hands and feet, constipation, poor memory, difficulty with concentration, sexual dysfunction, IBS and ulcerative colitis. There are many others, but I think these are especially interesting. I would even say that I’ve noticed that many of my patients with depression and anxiety have dysfunctional breathing patterns. This should make sense if we know that hyperventilation deprives the brain of oxygen.
Simple definition of hyperventilation:
When the body breathes out carbon dioxide too quickly, or faster than the body produces it.
TO THE PHYSIOLOGY!
What’s happening with oxygen and carbon dioxide when we breath normally?
In a normal physiological state, what should be happening is that we breathe in oxygen and breathe out carbon dioxide at a relatively balanced rate. The oxygen (O2) enters the blood stream and is then distributed as fuel to our muscles and organ tissues. Those tissues then spit the garbage back into the blood stream in the form of carbon dioxide (CO2), which we then breathe out. There’s a lot of complex respiratory physiology here, but the simple idea is that the body is constantly trying to maintain equilibrium between fuel and waste.
So let’s look at this in a little more "sciencey" detail:
When you’re at rest, the body naturally breathes at a normal rate. Not too quick, not too slow. Oxygen goes into the body and carbon dioxide goes out, maintaining a delicate blood pH balance. This balance is important because of two physiological processes called the Haldane and Bohr effects (I've posted a Khan Academy video at the end of this post for those of you science nerds who are more interested in this concept). These two effects determine how oxygen and carbon dioxide are exchanged between the blood and tissues.
When our metabolisms increase (i.e. doing physically demanding work), the tissue demand for oxygen increases, and we produce more CO2 waste. In order to maintain that pH balance between O2/CO2 in the blood, the nervous system tells you to breathe faster. More oxygen in, and more carbon dioxide out.
Now…enter hyperventilation
Visualize for a moment what happens if we’re breathing quickly (hyperventilating) even though the metabolism hasn’t increased… The demand for oxygen hasn’t increased, but we’re still breathing out that waste product. So basically, the body doesn’t need the amount of oxygen we’re breathing in, but we’re still breathing out CO2faster than we’re making it. In relation to oxygen, CO2levels drop in the blood, tipping the delicate blood pH balance we talked about. By doing that we have tricked our red blood cells into binding tightly to oxygen in the blood, keeping it from entering the tissues. So even though we don’t need all of the oxygen we’re breathing in, the change in pH tells the red blood cells to hold onto oxygen rather than releasing it into the tissues. Even though we’re breathing in plenty of it, it’s not actually getting out of the blood stream to where it’s needed as fuel. This turns into a chronic cycle whereby the body thinks it’s not getting enough oxygen and continues to breathe faster, but at the same time we’re continuing to breathe out too much CO2. The balance is never restored, and we experience symptoms of chronic hyperventilation.
AND NOW, enter said paper bag… We have patients breathe into the paper bag so that they can breathe back in carbon dioxide to restore that O2/CO2balance, thereby restoring the body’s ability to distribute oxygen to our organs and tissues efficiently. The amazing thing is that as soon as we start breathing properly, the balance gets restored incredibly quickly. In the short term, learning how to breathe functionally is an easy quick fix. The challenge is in changing the long-term habit.
To zoom out again think about some organs that really need oxygen – the heart and brain. If we consider that, then we can understand on a deeper level how chronic hyperventilation can have such a profound effect on our physiology. I explain this concept in detail to many of my patients, because I feel that having a better connection with how our body works makes breathing practices more powerful.
Haldane and Bohr effects: https://www.khanacademy.org/science/health-and-medicine/advanced-hematologic-system/hematologic-system-introduction/v/bohr-effect-vs-haldane-effect
Now that I've laid some foundations, keep an eye out for future blogs with some actual practices! I'll also be talking about other important aspects of breathing that give a more scientific perspective on how breathing well quiets the mind.