My studies with Better Physiology and their Capnotrainer have been very enlightening. They made me look at breathing more objectively (literally with the Capnotrainer).
Here are 5 Important Aspects of Breathing
- where is the majority of breathing coming from?
- sternal breathers
- has been associated with headaches and neck pain
- belly breathers
- not the only thing that you should stress
- along with anterior movement of the abdomen, there should be lateral and posterior rib expansion, indicating good thoracic mobility
- what is the breathing rate?
- without a capnograph, there is no objective method for knowing the patient's PECO2 levels
- with practice you will be able to find a rate of breathing that may help relieve the patient's complaints, anxiety, etc
- there should be a pause between the inhale and exhale
- the exhale, in particular should have a pause at the end prior to inhalation
- otherwise the exhalation is aborted, and this often raises lower PECO2 levels
- inhalation should be active, but not overactive (accessory muscle use at rest)
- exhalation should be passive
- have the patient close their eyes and concentrate on their breathing in a relaxing position to start
- have them really pay attention to whether or not there is effort with exhalation
- I was even surprised to note my exhalation was active
- many overbreathers are compensating with improper brain stem regulation
- as a result of anxiety, stress, or being in a sympathetic state, the brain strem tries to regular breathing by slowing down breath
- this increases oxygenation, and lowers PECO2, thus causing a hypocapnic state
- often, increasing the rate, and/or decreasing the depth of breath, will actually improve a patient's complaints
- however, this initially may be very uncomfortable and may increase their anxiety, due to feelings of air hunger
I still have to take the official courses in the Capnotrainer which I am starting this weekend. Hopefully I'll have enough sleep!
Keeping it Eclectic...