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Breath-Holding: the Art and Science of Voluntary Apnea

Breath-Holding: the Art and Science of Voluntary Apnea

Apnea can be defined as the “temporary absence or voluntary cessation of breathing.” In this article we will be focussing on the voluntary aspect of breath holding rather than the medical condition. Interestingly, people have been training to hold their breath for millennia. Although it may seem counter-intuitive, there are a range of benefits that come from training your ability to hold your breath for progressively longer and longer times.

Ultrabreath breath training device
These work quite well as a breath training device.

Why Voluntarily Hold Your Breath?

There are many, well attested, benefits to voluntarily holding your breath. Personally, I have been using the practice for decades. It started as a competition with friends as a teenager. We had gone swimming and were attempting to see how far each of us could swim underwater. I was relatively good at three-quarters of a length but I was not the best. Attempting to complete the length became a minor obsession for a few weeks but I managed to do it after about a month. I continued to enjoy the challenge over the years, progressively increasing the distance I was capable of.

Years later, in my early fifties, I had a seizure. According to my partner at the time, I slumped to one side and stopped breathing for at least two minutes. Later that day, whilst recovering in hospital, she described to me what had occurred. I couldn’t help but wonder if my ability to hold my breath had helped to protect me in this circumstance. As far as I could tell, there was no permanent damage from this incident, although it was quite frightening at the time.

Training in breath-holding can have a number of positive effects which help us on several levels: physically, mentally and cognitively. This has been known for several thousand years and practised in various physical and psychological training systems such as yoga, in the form of pranayama, and tai chi, in the form of qi gong.

Breath-holding increases your lung capacity

Breathing exercises that are followed as part of a regular practice is a surefire way to increase your lung capacity. This in itself will tend to improve your general health and overall capability to perform. In recent years, awareness of this effect has come to the fore because of the popularity of freediving and the training that it entails.

Our lungs are used for the exchange of oxygen and carbon dioxide. Both of these are absolutely essential for the body to function as it needs to. As we get older, our lungs will generally become less efficient. If we are also exposed to smoking and pollution, these will tend to exacerbate the problem.

Breath-holding may promote brain tissue regeneration

Learning to hold your breath for increasing amounts of time implies a higher level of tolerance for carbon dioxide in the brain. It is thought that this may offer a protective effect. In one experiment, it was demonstrated that if rats had experienced an oxygen starvation event and were subsequently exposed to CO2, it would decrease the amount of brain damage they suffered. This sort of problem occurs with newborn children, it is known as hypoxic-ischemic encephalopathy (HIE). The condition is caused by oxygen deprivation and limited blood flow. This study gives some hope that an intervention could be developed to treat this disturbing condition (1).

Given my own experience related earlier, my first concern was when told that I had stopped breathing for two minutes was cognitive damage. Happily, at least as far as I can tell, this didn’t seem to be the case. My father suffered a stroke late in his life, so the harmful effects of such oxygen deprivation were something that concerned me greatly. I recall checking various mental functions such as short and medium-term memory and was happily surprised at my own capabilities.

It took several months to recover fully from this event, but fortunately, one of the first forms of exercise I could take again was swimming. Once in the pool, the breath training regime was soon resumed.

Breath-holding strengthens the diaphragm

Because of their very nature, breath-holding exercises tend to strengthen the diaphragm in themselves. The diaphragm is a very large muscle that is found between the chest and abdominal cavities. It is the main muscle employed in respiration, or at least when we breathe correctly. When the diaphragm contracts and moves downwards, our lungs expand and fill with air. As the muscle is then relaxed and moves upwards, our lungs contract and the stale air is forced out of them.

Ideally, we should all be breathing diaphragmatically. Unfortunately, many people, perhaps even the majority, breathe in such a way as to only use the upper part of the chest. This is very inefficient and will mean that, in practice, they are depriving their bodies of much needed oxygen.

Simply breathing correctly will tend, in and of itself, to strengthen the diaphragm. Like any other form of exercise, repetition will bring results. There are, however, simple techniques that can be used to exaggerate the strengthening effects. Sandbag breathing, which involves simply placing a reasonably heavy object such as a sandbag over the diaphragm whilst breathing into the stomach, is one such simple and useful technique (2).

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Breath-holding helps to calm and relax the body

Paradoxically, breath-holding practice can actually be a relaxing experience. This particularly applies when performing such practices as static apnea in a pool. Human beings have a relaxation mechanism built into them known as the dive reflex. If you put your face into cold water your pulse rate is automatically lowered and your body begins to relax. It seems to be an evolutionary remnant that helps us survive whenever in water. The body seeks to conserve as much energy as possible, hence the relaxation effect.

I refer to the benefits of static apnea in a section below. Suffice it to say for now that, done properly, the whole experience is one of profound relaxation as the water relieves you of the need to carry your body and you simply release the tension that we habitually carry with us on dry land. The experience of this level of relaxation can be meditative in itself.

German freediver Nik Linder wrote an extremely interesting book on the subject of breath-holding and meditation. The German title is ‘Apneo und Meditation’, which may be a more accurate description than the title of the English version, is currently available on Amazon.

Breath holding book by Nik Linder
A freediver’s guide to apnea and meditation.

Breath-holding may increase longevity

With aging, many functions of the human body start to deteriorate. Breathing is one of these functions. Part of the reason for this is what is known as elastic recoil. When we are younger, the muscles around our ribs and lungs automatically recoil after we have inhaled. This means that effectively at least, there is no effort needed to exhale. As we age, however, this automatic recoil mechanism begins to become less and less elastic. An action that was previously effortless begins to require conscious effort (3).

Happily, there are breath-holding techniques that allow us to overcome this common deterioration in our breathing abilities. A breathing exercise known as kumbhaka in ayurvedic medicine allows carbon dioxide levels to build up and, by doing so, aims to restore the proper balance between carbon dioxide and oxygen. As carbon dioxide rises, it encourages the body to deliver oxygen to the cells, thus combatting hypoxia.

Hormesis

As ever here, we are looking at yet another hormetic effect, a theme that recurs again and again in these blogs. Although chronic cellular hypoxia contributes to aging, small amounts of hypoxia experienced through exercise trigger the body to respond in a compensatory manner.

Indulging in short bursts of breath-holding encourages the body to express genes that contribute to oxygen delivery at a mitochondrial level and increase the production of Adenosine Triphosphate (ATP), the very basis of cellular energy.

To go from theory to practice, I will describe the kumbhaka breath-holding exercise in the section below.

Methodologies

There is a huge range of methodologies that can be employed if one wishes to take advantage of the potential benefits of breath-holding. It would require a weighty tome to go through them all. For now, I will restrict this blog to a few of my own favourites.

Kumbhaka (from Auryeveda)

Whilst sitting comfortably, allow yourself to take six or seven second inhalations through the nose (all breathing should be through the nose, but more of that in a later blog). Each inhalation is followed by an equal length exhalation, again through the nose. Simply keep this alternate breathing process going.

After five minutes, allow yourself to hold your breath for approximately five to six seconds following each exhalation. If you are uncomfortable at this level at first, it is quite OK to restrict the hold to four or even three seconds. On the other hand, if six seconds is too easy, you can adjust up to eight or nine seconds if you so desire. Do not strain, however.

Practice for around ten minutes a day. Over time, you should notice that you are comfortably able to increase the breath-holding time. There is no need to rush, though. It is not a competition. You will naturally improve with patience and over time.

Techniques from Ayurveda and Pranayam book

Wim Hof

An alternative approach comes from Wim Hof, aka ‘the Ice Man’. He employs several different breath-holding techniques in his practice but has become known for one in particular.

To follow this technique, sit or lay down. Then start breathing in through the nose. Breathe as deeply as you can. Draw the breath deeply in, as if you were drawing the air deep into your stomach. Now, simply let that breath go. Don’t force it out but simply let go of the tension from the inhalation.

Repeat the process thirty to fifty times. After the final inhalation, let go and hold. Just simply sit there quietly without breathing. Most people, having performed the preamble before the hold, will manage to comfortably wait between 90 seconds and 2 minutes before needing to breathe again. Many manage more.

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Another interesting effect of breathing this way is that it enables short-term better physical performance. To test this, see how many press-ups you can do before the breathing exercise. Perform the breathing exercise and then test again. Most folks find a pretty significant increase in the number of press-ups they can do.

(Note: if you don’t like press-ups, then simply substitute some other form of callisthenic that you do enjoy).

Breath Holding Book with the Wim Hof Method
Learn from the master himself. Some great breathing techniques discussed in this volume

Freediving Techniques

Freediving comes in many forms. Perhaps the most spectacular, but also the most dangerous, is attempting to see how deep you can go on a single breath of air. Personally, I admire the impressive physical and mental feats accomplished by people partaking in this form of the sport but wonder if it is really necessary to take such extreme risks.

Fortunately, there are other forms of freediving that focus on improving the time you can spend enjoyably underwater on a single breath without taking the risk of putting yourself beyond help and recovery. Freediving in warm water, nimbly moving amongst the flora and fauna found in the sea can be a wonderfully liberating experience.

Even if you wish to be more competitive, this urge can be met through the sports of static and dynamic apnea without the need to risk life and limb. More on this later.

Freedivers use many breathing techniques some of which have been borrowed from pranayama yoga. Several of these will aim at CO2 tolerance and some at the ability to utilize O2 more efficiently. Added to these, there are also exercises to increase the flexibility of the rib cage, inter-costal muscles, and the diaphragm.

One technique that is oft used just prior to committing to a dive is oxygen packing. This consists of filling your lungs with as much air as possible before you start and then employing a series of short, jerky breaths to pack yet more air in. It is an effective technique but it does come with some dangers. There have been a number of incidents that should cause people using the technique, especially if in the water, pause for thought. It is believed that lung packing may have caused pulmonary barotrauma (effectively, lung squeezing), arterial embolisms, collapsed lungs and even bleeding in the lungs (4).

Specific Training for Breath Holding book
Discusses specific freediving techniques

Static Apnea

Static apnea is, as the name implies, a method of breath holding that involves no dynamic action. It is usually performed in a pool. The practitioner simply allows himself to relax whilst attempting to hold their breath as long as possible.

This is something that I used to do (pre-lockdown) on a regular basis. I always did it with a friend, or at least someone to supervise. It is a surprisingly relaxing experience. Indeed, part of the art of static apnea is the degree of relaxation that you can attain.

As much as it is a physical challenge, it is also very much a mental skill. It feels like one is observing the reactions of one’s own body while monitoring for any unnecessary tension. Once found, you relax that area and then seek others. The net effect is that you become more and more relaxed as the session proceeds. In many ways, it feels like a particularly pleasant form of meditation.

There can be some stress at the end, but even this is very manageable. It is wise not to go for records every time you attempt this process. My own technique involves several rounds. I usually start at around 1.45 for the first round and then add 15 seconds on for each subsequent round. My ‘norm’ for this technique is around 3.30, though I will occasionally achieve over 4 minutes.

Often, after a session of static apnea, I will move on to some dynamic apnea. I find that after such a session, my dynamic apnea distances will invariably be greater.

Dynamic Apnea

Dynamic apnea, as the name implies, involves movement. In this case, it is usually swimming up and down a pool. My own best is two and a quarter lengths. This is not that exceptional, though it might seem so when you start this practice.

Again, the main focus is to stay relaxed and save energy. A big part of this is the efficiency of the stroke. I try to do as few strokes as possible per 25-metre length. In my particular case, 7 is relatively normal, though I have managed to reduce this to as few as 5 on several occasions. There is a balance to be struck: too many strokes wastes a lot of oxygen, too few strokes can take too much time.

Again, safety needs to be stressed. Always do this with a partner and be aware that your body will not always give you accurate feedback. You can be feeling bulletproof underwater, yet when you emerge find that you are close to passing out. Be safe!

SEAC Freediving watch
If you do want to get into freediving then having the right equipment is essential.

Pranayama

Pranayama, a branch of the yoga tree, has been practised for quite literally thousands of years. It has developed many techniques and exercises to improve the breathing and thus reap the mental and physical benefits that such improvement brings.

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A person can, and many people have, spent years going ever deeper into this ancient art. For our more practical purposes though, we can adopt a cherry picking approach; choosing the exercises that are best suited to our own aims and desires.

Personally, I like the exercise known as nauli. It trains the diaphragm and stretches the ribs, thus increasing the amount of air you can physically take in over time. To do this, from a standing position lean forward until you can rest your hands on your knees. Take in three slow deep breaths. Exhale slowly and completely after each. After the third exhalation, pull up your diaphragm thus creating a hollow space between the bottom of your ribs and your pelvis. Hold this position for between 15 and thirty seconds. Repeat 3 times.

Some Nauli variations

Once you have mastered the basic exercise, you can try some more advanced variations. In the first, once you have achieved the basic position after exhalation, try tensing and relaxing your abdominal muscles without breathing in. When I started this exercise, I could only manage 6 or 7 at a time. These days, I can do 25 on a good day. Be careful when you inhale at the end of each session, air can be inhaled too suddenly to fill the void unless you control that moment.

A further variation on this is to again adopt the basic position but then, instead of simply tensing the stomach muscles, you rotate them causing a wave-like motion from one side to the other. For the sake of balance, it is wise to repeat the process and move the muscles in the opposite direction once the first set has been performed. When you first attempt this, you may find it difficult to exercise this degree of control over your stomach muscles. Over time though, it becomes easier and easier. If nothing else, it is a great party trick!

Pranayama book for breath-holding
A highly recommended book that goes deep into pranayama and breath control.

Dangers of Breath Holding

As long as a sensible approach is taken, breath-holding is a remarkably safe activity. Even if you are able to take it to the point of passing out, your body will simply resume normal breathing without any permanent damage being done. This only applies, of course, if your body is in a position to be able to breathe in the first place, ie not underwater.

Any breath-holding technique in water needs to be respected. Care must be taken and you should not indulge in such activities if you are not accompanied, or at least supervised. One of the main problems here is that you won’t always get a clear signal from the body when breath-holding. Most of the time, it is very clear when you need to resume breathing, but it is quite possible, and I have experienced it, to get to the point of passing out without realising that there is any problem at all.

Several years ago, I was practising static apnea in my local pool. Before I submerged I asked three friends to keep an eye on me. I told them that I would signal on request by giving a thumbs-up sign. After doing this four times, I still felt very relaxed and totally in control. I was beginning to become a little suspicious though. I was feeling a little too good considering the duration of my breath-hold.

A further minute went by and I gave the ‘OK’ signal when asked. By now though, I was realising that this was one of those situations that I had read about. Although I felt as if I was in no discomfort whatsoever, I was aware that this was becoming an exceptionally long time to spend without breathing. Despite still feeling very good, I decided it would be wise to come to the surface and take a breath.

As I emerged it was immediately noticeable how the whole world seemed to be spinning and tilting uncontrollably. The feeling was very similar to be very, very drunk. I tried to reach over to the ladder but the disorientation and lack of coordination were almost too much. You know what you want to do but it is so difficult to make your body actually do it. With some assistance, I made it to the ladder and pulled myself unsteadily out of the water.

Be warned: such exercises performed in water are not without their dangers. Dive responsibly.

Conclusion

Breath-holding, and breath control in general, comes with many benefits. It can be freely and safely indulged in and positive results will occur if you practice consistently. There are numerous ways to approach the art of breath-holding. Some will be drawn to the more spiritual side represented by such activities as qigong and pranayama. Others will enjoy such iterations as freediving in its various forms. Personally, I enjoy both static and dynamic apnea, but each to their own. As ever though, if the form of breath-holding you enjoy involves immersing yourself in water, please ensure that you take sensible measures and never do it alone.

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