Breathing the wrong way: Insights from a Breathing Specialist – Dean J. O’Rourke


from Luke’s Journal 2020 | Breath of Life | Vol.25 No.2


What Does A Breathing Specialist Do?

As a Breathing and Orofacial Therapist, I specialise in the detection and correction of breathing dysfunction and related orofacial conditions.

On a regular basis, clients of all ages are referred to me by medical, dental and allied health professionals. Yet during initial assessments, essentially, I am looking for the same functional problems each time. I find that regardless of the pathology or variety of symptoms present from case to case, a functional breathing disorder is often present, ranging from mild through to severe. I have found that when functional breathing is established, clients routinely enjoy a reduction in symptoms; many experiencing significant and long-term change.

How Are Breathing Disorders Detected?

Detection of breathing dysfunction is achieved through a proforma screening documentation completed by the client, clinical observation of key indicators, and the use of biofeedback technology in the form of capnometry and oximetry. It is important to note that currently many people suffering from breathing dysfunction are unaware of their condition and their dysfunctional breathing remains undiagnosed. Even in moderate to severe cases, breathing dysfunction may never have been detected prior to referral. Some sufferers are diagnosed with Sleep Disordered Breathing through sleep testing, however daytime dysfunctional breathing which are often also present, remains undetected.

What Are The Key Indicators Of A Breathing Disorder?

1. Constant or excessive mouth breathing.

2. Chronic upper thoracic breathing pattern (including at rest) with limited diaphragm movement.

3. An excessive breathing rate.In some cases also:

4. A low tongue posture with poor swallow pattern.

5. Inability to seal the lips without conscious effort.

Mouth breathing - low tongue position
Mouth breathing – low tongue position
Mouth breathing – low tongue position

What Happens If Breathing Dysfunction Is Present?

If a breathing dysfunction is detected, I clearly explain the nature and severity of the dysfunction. The client is then provided with a simple explanation of the therapy that is appropriate for them and is given ample opportunity to ask any pertinent questions. Therapy strategies can vary from person to person dependent upon their age, lifestyle and also prevailing pathology.

Following the initial assessment when detailed pre-therapy information is gathered, the majority of clients complete four to five training sessions with one or two follow up sessions including post-therapy testing. This enables clear measurement of any functional change, as well as changes in symptoms resulting from breathing retraining. All referring practitioners receive a detailed pre- and post-therapy report, including biofeedback results.

In the training sessions, clients are taken through a targeted step by step process to permanently alter their habitual breathing pattern. Essentially, it is a simple program in breathing habit change. During the training phase clients are provided with a lot of support because even though the process is simple, it is not always easy to change breathing habits. Afterall, we are creatures of habit.

How Does Breathing Therapy Improve Health?

In short, breathing therapy establishes what may be referred to as Autonomic Optimised Respiration (AOR); which by definition is constant nose to diaphragm breathing at a slow speed (between 4 to 10 breaths per minute at rest). AOR has many potential benefits. Nasal breathing enables full filtration of all inhaled air at the right dosage for the lungs, it stimulates increased diaphragm function promoting parasympathetic dominance (through vagus nerve activation) and increased immune function. Nasal breathing stimulates nitric oxide release in the sinus cavity promoting tube system dilation and increased blood oxygenation. Carbon dioxide levels may also increase, thus enabling more efficient release of oxygen to all tissues of the body including the brain.


What Are The Outcomes Of Breathing Therapy?

The therapy normally results in a new habitual breathing pattern including the following:

1. Constant nasal breathing day and night.

2. Full diaphragm excursion with no upper thoracic recruitment at rest.

3. A respiratory rate around 10 breaths per minute.

4. Tongue positioning in the upper palate with improved swallow pattern.

5. A relaxed and comfortable lip seal.

From more than a decade of clinical experience, I do not claim this therapy is a panacea. Far from it. However, I have seen it transform the health of people suffering from a broad range of health conditions. Examples include asthma, COPD, hay fever, enlarged tonsils, chronic cough, anxiety, snoring, sleep apnoea, restless sleep and breathlessness. It has also allowed many sufferers of chronic pain to achieve a better quality of life, with less reliance on medication. Functional breathing can also play a key role in pre-orthodontic care and to promote optimal orthodontic outcomes.

“Regardless of the severity of breathing dysfunction, it is a condition that can be improved.”

Functional Breathing Is God’s Design

From a faith perspective, breathing retraining finds its foundations in the book of Genesis chapter 2 verse 7. “For the Lord God breathed into Adam’s nostrils the breath of life and the man became a living being”.

A single word ‘nostrils’ in Genesis 2:7 gives us a critical clue as to how the Lord designed us to breathe. It is fascinating that this bit of detail is included in the text. God did not give Adam mouth to mouth. The truth is the Lord designed us to nasal breathe on a constant basis, day and night. The nose is our specialist breathing instrument, whereas the mouth is a multiple purpose device designed as our back up breathing system.

Why Do So Few Of Us Rate Breathing As Important?

For decades, the health message on diet and exercise has predominated the media. People are aware that breathing is essential to their survival but few have any real awareness of how critical breathing is in their day to day health. Nationally, schools and health professional curricula have paid little attention to breathing function either. Consequently, there is little community awareness of this critical health habit.

What Should Anyone Concerned About Their Breathing Do To Get Help?

Due to its foundational nature, any person suffering from conditions like asthma, COPD, respiratory allergies, recurrent respiratory infections, breathlessness, sleep disorders such as snoring and sleep apnoea, anxiety, orthodontic conditions and even chronic pain would be well advised to have their breathing function analysed by a therapist specialising in the detection and correction of breathing disorders.

Options For Health Professionals?

When conducting an examination of a patient, take note if a mouth and upper chest breathing pattern is observed, as this is a reliable indicator that a breathing dysfunction is present. If the patient’s breathing is audible, and/or if breathlessness is detected during speech, and/or if there is shoulder lift when breathing in, these may indicate that the breathing dysfunction of a moderate to severe level is present.

The good news is that regardless of the severity of breathing dysfunction, it is a condition that can be improved. Breathing Therapy is a non-invasive, extremely low risk, highly cost-effective training system and can routinely be applied as part of an integrated approach to health care. It can often enhance and will not hinder any other forms of treatment undertaken concurrently.

Breathing Therapy is available in most major cities and some regional centres.

Skype consultations are also available for long distance clients with similar outcomes achievable to face to face training.

Breathing Therapy Case Studies:

In the cases below it is worth noting the decrease in breaths per minute and increase in end tidal CO2 readings. In case 1 there was also a significant reduction in resting pulse.

Case 1.

Gretta* 46. Non-smoker. Suffered chronic anxiety, restless sleep, multiple overnight toileting, night sweats, breathlessness. Pre therapy stats – Post therapy stats after 4 sessions: O2 saturation: 95% 98% Resting Pulse: 103bpm 69bpm Resting Breathing Rate: 10.4bpm 7.1bpm End Tidal CO2: 33.1mmHg 36.8mmHg Breathing Pattern: Intermittent disruption stable (sighing habit eliminated) Due to ‘deep sighing’ habit.

Post therapy – Gretta reported a significant reduction in breathlessness, a significant increase in sleep quality with no overnight toileting required, no night sweats and a significant decrease in anxiety on a daily basis. These outcomes have been maintained in the 12 months since therapy.

Case 2.

Jemma* 11. Asthma Pre therapy stats – Post therapy stats after 8 sessions O2 saturation: 99% 99% Resting Pulse: 56bpm 61bpm Resting Breathing Rate: 23.8bpm 10.9bpm End Tidal CO2: 28.5mmHg 44.5mmHg Breathing Pattern: Constant disruption and intermittent disruption due to very poor diaphragm function. Increase in diaphragm ROM.

Jemma is an elite junior athlete who had reached the point of being unable to train and compete anymore due to repeatedly suffering attacks, despite daily doses of preventative and reliever medications. A few additional sessions were needed for Jemma to achieve a full range of motion of the diaphragm in order to obtain the optimal result of being symptom free when running. Post therapy – she reported zero asthma symptoms, including when training and competing, and was able to cease medication under medical supervision. These outcomes have been maintained now for more than 2 years since therapy.

*Consent given to share names.

Dean J. O’Rourke Following 15 years teaching PDHPE, Dean became a pioneer of functional breathing in the Central Coast and Newcastle. He is a member of the Buteyko Institute of Breathing and Health, and the International Society for the Advancement of Respiratory Psychophysiology. He is also qualified in Orofacial Myology through the Coulson Institute USA.

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