Breathing: There’s More to it Than You Think

Written by: Bonnie Feldman, DDS, MBA, Ellen M. Martin, Kelsey O’Donoghue

Many of us reminisce about our childhoods: The good ‘ol days when “everything was simple” and our main concerns were what game to play during recess and what Mom was making for dinner. Most of us took the luxuries of childhood for granted – and before we knew it, we had become adults.

But grammar school recess and mom’s home-cooked meals aren’t the only things we may have lost as we grew up. Studies have shown that while babies breathe optimally, as we grow up, we actually forget how to breathe well. In fact, as you read this sentence, odds are, you aren’t breathing optimally. Now, I know what you are thinking… how can this be? I’m inhaling, my lungs are taking up oxygen and I’m exhaling – what else could there be? But as simple as it seems, breathing specialists, such as Dr. Belisa Vranich, estimate that 9 out of 10 Americans do not breathe optimally. So what’s the problem?

What Hinders Our Breathing?

Oxygen is fuel for our cells, nourishing organs and tissues, muscles and nerves. Consequently, breathing incorrectly may contribute to serious health consequences. Most people have no idea they are doing anything wrong. We inconspicuously develop bad breathing habits as we learn to talk and walk as children and as our bodies change as adolescents. If you compare babies’ respiration patterns to adults’, you see vast differences. Children pick up bad breathing habits by modeling their parents, learning to speak and sing without good feedback, and through bad posture when sitting, walking, running and playing.

Let’s see how well you are breathing. Sit up straight, head balanced over neck and shoulders, spine erect. Take a deep, slow breath through your nose…

Did your shoulders and neck rise as you inhaled? If so, then you are one of the 9/10 individuals doing “vertical breathing.” This shallow pattern reveals a common misconception about how to breathe “correctly” – many of us, my past self included, exaggerate this upper movement when asked to take a deep breath. In actuality, this inhalation that expands our necks and shoulders leads to a variety of negative health consequences. A related problem is that most of us carry our heads too far forward, reflecting lifetimes of reading, writing, mobile devices and driving. This can lead to permanent changes in the neck muscles and cervical spine that stress our heads and constrict our airways.

Not only is vertical breathing bad for the muscles in our neck and shoulders, which were never meant to be utilized as breathing muscles, shallow breathing activates the sympathetic nervous system which may cause us to feel stressed and uneasy, regardless of our situations.

The Importance

Breathing is a unique function of our bodies in that it is the only autonomic process that all of us can easily learn to control consciously. Such controlled breathing can modify our bodies’ reaction to stressful situations and dampen the production of harmful stress hormones like cortisol. Because stress plays an immense role in autoimmune disease development and progression (1), breathing is a promising target for alleviating many symptoms associated with such chronic conditions. Furthermore, controlled breathing can restore a sense of self-control over emotional reactions to symptom flares.

In a study conducted at Yale University, researchers found that practiced breathing resulted in attenuation of the proinflammatory innate immune response, and thus, could have “important implications for the treatment of a variety of conditions associated with excessive or persistent inflammation, especially autoimmune diseases (2).”

What can we do to fix our breathing?

Correct breathing does not over-use the neck and shoulders. Rather, the focus should be on diaphragm expansion and contraction, also known as “horizontal breathing.” The diaphragm is the large internal sheath of muscle that separates the thoracic cavity from the abdominal cavity. It is the primary muscle of breathing that fills the lungs by contracting, and empties them by relaxing.

To learn to breathe optimally, start by sitting up straight, and inhale through your nose (mouth inhaling is another suboptimal breathing habit). For some people, especially those with a long-time habit of tense vertical breathing, it may be easier to learn diaphragmatic breathing lying on a hard surface with knees raised and feet flat.

Feel your upper abdomen–it should expand along with your chest – not your shoulders! Breathe slowly and fully in through your nose and out through your nose or mouth (the latter is a breathing technique used in Pilates and by singers). Controlled diaphragmatic breathing stimulates the Vagus nerve, the only cranial nerve that serves the body as well as the head, and a key to control stress response, especially blood pressure and heart rate. Activating the Vagus induces a “rest and digest” response, which lowers blood pressure and slows down the heart (3).


Relearning How to Breathe

Researchers at the Medical University of South Carolina showed that just 20 minutes of focused breathing can positively affect your immune system and lower stress levels. They divided twenty adults into two groups. The first group partook in two 10-minute breathing exercises. The second group was instructed to read for 20 minutes. During these exercises, researchers tested each subject’s saliva at various intervals. They found that the controlled breathing group’s saliva had significantly lower levels of three major cytokines that are associated with inflammation and stress (4) – demonstrating just how beneficial breathing exercises can be!

Once you relearn breathing using your diaphragm, a world of therapeutic opportunity opens to you. There are many more advanced breathing exercises you can do to decrease your stress and optimize your health. Below are some programs.


If you’re serious about improving your breathing and want one-on-one guidance to help you, the Breathology Academy might be right for you. This online program was founded by Stig Severinsen, PhD, known for his Guinness World Record of holding his breath for 22 minutes underwater. Upon registering with his academy, you gain access to training videos, daily support, and live monthly sessions with him. The program is designed to help you increase breathing capacity, achieve higher levels of energy, and reduce stress and anxiety. This personalized approach doesn’t come cheap, though, costing about $500 for a year of access.

Don’t worry if this isn’t in your price range – there are other available alternatives!


Similar to Fitbit’s monitoring of activity through a band around the wrist, Spire has developed a “stone” that can attach to your belt or bra. Like other activity trackers, Spire tracks physical activity and fitness. But one factor that distinguishes Spire from the others is that it also records an additional metric: breathing patterns. It will sense your breathing patterns and send data to an application on your phone. Algorithms in the app classify these patterns into correlating cognitive/emotional states. The app will then guide you through breathing exercises that are targeted at decreasing stress. The guidance from these exercises is based on protocols from clinical interventions shown to alleviate anxiety and pain, increase heart rate variability, and reduce blood pressure.


An alternative option is Serenita – an app that utilizes the camera on your phone to monitor your heart rate and breathing pattern during guided exercises. It takes this information and creates a report on your stress levels. It then develops personalized breathing exercises that are targeted at engaging the body’s natural relaxation response, clinically known as the Rest & Digest Response. The stimulation of this response shuts down the release of stress hormones into the bloodstream, and promotes the release of anti-stress hormones and enzymes such as acetylcholine, prolactin, vasopressin, and oxytocin.

There are many other breathing exercises to explore, from the popular Pilates breathing techniques (nose in, mouth out with core strengthening exercises) and the Fletcher percussive breathing variations, through singers’ and speakers’ exercises (to build control and endurance) to advanced pranayama meditation practices that include such techniques as belly breathing and alternate nostril breathing (hi, Hilary!).

So, while we may no longer be able to take a recess when we want a break from school or work, or enjoy one of our mom’s homemade dishes every night, we can rescue one aspect of our childhood – we can learn to breathe optimally again. All in all, even just taking a few moments each day to focus on your posture and breathing or practice simple breathing exercises will result in a healthier lifestyle and decreased stress. Feeling skeptical? Try it out now and let us know what you think!

For more information on alternative methods of stress reduction and movement therapies that focus on controlled breathing, please visit our website here.



(1) Stojanovich, Ljudmila et al. “Stress as a trigger of autoimmune disease.” Autoimmunity Reviews. Elsevier. Jan 2008

(2) Kox, Matthijs et al. “Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans.” Proceedings of the National Academy of Sciences of the United States of America. March 2014.

(3) Koopman, Frieda A et al. “Restoring the Balance of the Autonomic Nervous System as an Innovative Approach to the Treatment of Rheumatoid Arthritis.” Molecular Medicine 17.9-10 (2011): 937–948. PMC. Web. 20 Nov. 2017.

(4) Twal, Waleed O., Amy E. Wahlquist, and Sundaravadivel Balasubramanian. “Yogic Breathing When Compared to Attention Control Reduces the Levels of pro-Inflammatory Biomarkers in Saliva: A Pilot Randomized Controlled Trial.” BMC Complementary and Alternative Medicine 16 (2016): 294. PMC. Web. 20 Nov. 2017.


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