The Sleep Is A Skill Podcast

013: Dr. Nina Bausek, Ph.D., Chief Scientist of PN Medical, Creators of The Breather, a Respiratory Trainer

Episode Summary

🌬️Have you noticed that your respiratory rate numbers are on the higher side while you sleep? This podcast will unpack how you can begin to train this area. I first heard about PN Medical and their respiratory trainer (The Breather) from XPT, a performance training company created by big wave surfer and innovator, Laird Hamilton, and former professional athlete, Gabrielle Reece. PN Medical has been in the respiratory training business for decades and recently gained a lot of attention in the face of Covid-19, as people look to improve their respiratory health. Dr. Nina Bausek, the Chief Scientist of PN Medical, go deep to understand precisely what weak breathing can do our health and sleep… and what to do about it.  Guest Bio: Nina Bausek, Ph.D., serves as Chief Scientist of PN Medical and is part of the PN Medical Science Board of advisory. A graduate of the University of Vienna, she developed her scientific and leadership skills during research and teaching positions at the University of Oxford, UK, the University of Sheffield, UK. She is also co-founder of Luft For Life, a European start-up company supporting respiratory health in performance. ***PN Medical provided a hookup for the Sleep Is A Skill community, ‘sleepisaskill’ gets 20% off for the Breather, and ‘breatherfitsleep’ gets for 15% off for the BreatherFit (made for athletes).

Episode Notes

In this episode, we discuss:
🌬️Why Dr. Bausek is passionate about this topic (and how she tracks her sleep in her own life)
🌬️How does having an actual contraption to strengthen our respiratory muscles benefit us versus traditional breathwork? What is the benefit of having an apparatus like this?
🌬️Dr. Bausek makes the argument that investing in taking the time to respiratory train could, over time, improve our respiratory rate readings at night (and how she sees results on her Biostrap)
🌬️How TheBreather can serve as an additional tool in the toolbox of personal wellness, next to yoga, meditation, and exercise.
🌬️How sleep apnea plays into this picture
🌬️A more in-depth discussion of ideal respiratory rates and what abnormal numbers can signal
🌬️Feeling faint while practicing and what to do about it
🌬️How the app works in tandem with The Breather


PN Medical provided a hookup for the Sleep Is A Skill community, ‘sleepisaskill’ gets 20% off for the Breather, and ‘breatherfitsleep’ gets for 15% off for the BreatherFit (made for athletes).

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Episode Transcription


Welcome to the sleep as a skill podcast. My name is Mollie McGlocklin. And I own a company that optimizes sleep through technology accountability and behavioral change. Each week I'll be interviewing world class experts ranging from doctors, innovators and thought leaders to give actionable tips and strategies that you can implement to become a more skillful sleeper. Let's jump into your dose of practical sleep training.



Welcome to the sleep is a skill podcast. Today's episode is all about respiratory training. Did you know that there are actual devices that you can get to help with this area? I was turned on to this company pn medical that creates a device that does exactly that for pretty affordable rates. And I learned about them through XP T. They are an extreme performance training company started by Laird Hamilton renowned surfer and of course breaths when you're surfing and finding ourselves under water any for an extended period of time often the ability to modulate your breath becomes a very important and sometimes life or death matter. So they take this element really seriously of their health. And so when they did recommend this product, I was all ears. So I'm excited to share with you my conversation with the chief scientist therapy and medical and where they get into the weeds on the ability to improve your relationship to your respiratory system through just daily practice with this device, a little background. Nina Balzac is a PhD serves as chief scientist of pn medical and as part of the pn Medical Science Board of advisory, a graduate of the University of Vienna. She developed her scientific and leadership skills during research and teaching positions at the University of Oxford, UK and the University of Sheffield UK. She's also co founder of law for life, a European startup company, supporting respiratory health in performance. Now let's dive in to all the great details that we go into around the ability to impact your respiratory health. And of course, as we know, that will weigh very heavily on your results with your sleep, and how rested you feel in the morning. All right, and welcome to the sleep is a skill podcast. Thank you so much, Nina, for taking the time to sit with us and go over this really interesting connection for many people of how understanding training our respiratory system can make a difference with our sleep. So thank you. Thank you.



Thank you for having me. Pleasure to be here. Oh, awesome. So



I'd love to let you know we got a lot of ground to cover today. And so what I'd love to begin is just understanding a bit about your origin story as to how you got your way into this area, why you're passionate about it, and why you believe that that this can make a difference, particularly right now in the in the time of war that we're at during COVID. And what could be possible about out of what you are researching and a part of?



Sure. I'm actually coming from a slightly different background image analysis?



Yes. So.



And then about five years ago, I started to change career because I've been in science for long enough and at some point, it is time to get out and do something else and kind of do something in the real world and got in touch with pn medical, they are the the makers of the breather, which is the respiratory muscle training device that we're working with. And I started working with them five years ago. And initially, it was just like a little bit. Mark carboni, the owner asked me to just kind of do a little bit of you know, what literature is out there? What's the evidence behind trading the respiratory muscles? Is there anything that's out there and actually, there's a ton of research out there, why it's good for you how you're breathing Muscle works, how you breathing muscles aches, actually like, like your other skeletal muscles, how you can just train them, like you would train your biceps or something, and then what it does to you as a person to you as an athlete and to you as a patient. And, you know, once I started digging into this, I was fascinated about how it works, how much it can help, and how overlooked it is. Because it's such a simple method, it can do so much, especially for patients who have respiratory muscle problems, and it's underused, and I don't understand why. So that's why I'm passionate about it, because I think it should be, you know, known everywhere, and everybody should be doing it.



Yes. Oh my goodness. As you're speaking I'm like, Oh, my God, I have so many questions. I completely agree. And so I should also share since we're talking about origin stories, the way I even heard about your company was through XP, which you know, as another company that's done some really great work, you know, certainly linked up with part of Laird Hamill. Kind of creation and understanding how to train the respiratory muscles certainly as it relates to surfing, but also just extreme sports in general. And so heard about your product about pn medicals product from there, got one myself. And it's just a fascinating area, particularly for many people that are coming to sleep as a skill are looking to one improve the ability to both fall asleep and stay asleep. But then in addition to that are also looking to often improve their overall health and well being and this area, this conversation around their respiratory rate as it relates, you know, their nocturnal respiratory rate, and their HRV are a couple metrics that come up time and time again, and understanding the fact that we do have power over how these play out and the fact that we can actually make a difference and that is really news to many people. So I think maybe we could start at almost just 101 One with you, helping to educate us how that the fact that this is even an option, then you're not just kind of fixed a particular area or particular rate and what there is to do about that and what that looks like.



Right? Where to stop. Okay, so



many things, I don't



know anything. So breathing is a funny thing, you know, because we all do it all the time. And it is autonomic. So it just happens when you sleep, you don't stop breathing, good thing. However, you can also influence it. So you can consciously decide to slow down your breathing, to speed up your breathing and to stop your breathing for a while. You can't do this with your heart rate. So that's kind of the cardiopulmonary system. So the lungs and the heart are really closely interacting that closely to neck connected together, but you can only influence and regulate the breathing. But that then backfires to the heart because for example, every time you breathe in your heart rate speeds up everything time you breathe out, your heart rate slows down. So that you get that's very, you can kind of effectively connect that. So the breathing muscles that you can control, the main breathing muscle is the diaphragm. And the diaphragm just kind of sits underneath your ribcage, and it kind of separates your thoracic cavity from the abdominal cavity. So kind of the chest from that from the gut. And it really sits in there, it's dome shaped, and it sits in there like a big, you know, a bit like a thick skin in there. And when you inhale, it moves downwards into the abdomen, and that kind of really expands the you know, the volume of the lung and makes the extends the surface of the elbow like that kind of sit at the bottom of the line so they get a really big surface because this is where the gas exchange happens. So that oxygen goes in there, carbon dioxide goes out, and this is you need a big surface for that the bigger the surface, the more effective that is. And then when you exhale, the diaphragm moves up again. And kind of pushes data out. So that's the main breathing muscle. And when you do respiratory muscle training, this is the main muscle that you're training. Then you've got accessory muscles like the one sitting alongside your hips, and they kind of have their extend the ribcage when you inhale and kind of push it together again, when you exhale together with with your lungs, and then you've got the shoulder neck muscles here and also the laryngeal muscles glottic muscles up here, and they are really important for swallowing and for speech. And this is kind of a muscle system that you're training by working against resistance. So when you use you know, I've got the breather fit version here. It's great, nice like an iPhone, it generates slightly higher pressure than the breather that you have or targeted for athletes that are starting at a higher baseline. And the idea is that you you set the resistance on the inhale, it's it's from one to six, and the excess from one to five, and you just see how it feels for you. Usually you start on a one on one and then you breathe in for a few seconds. Hold for a second breathe out for a few seconds. And you can feel the resistance and you can feel your muscle working. And if it feels too easy to you increase assist the resistance. So in that way you're kind of training your diaphragm and your other respiratory muscles like you would train your biceps with a weight. So it's the same idea and your muscles do exactly the same thing, they get thicker, they get more powerful, you get more muscle fiber, you get more mitochondria in the muscles. So it's just like you know, training any other muscle and that makes your breathing more effective, you get more oxygen uptake. The entire system just you get your improve your swallow your speech function, everything that is connected with it as long as you use the right breathing technique. So it has to be done diaphragmatic breathing, but by training this you kind of optimize the entire system, and that reduces the workload of breathing. That's kind of the technical term, the work of breathing is reduced. So that means the breathing becomes easier for your body to do.



So Would did was it necessary for the creators of this to make something like an actual contraction to strengthen these muscles versus, you know, just sustained breath work on our own? What is the benefit to having kind of apparatus like this?



Yeah, that's a good question. I mean, the advent of a Peggy Nicholson, she really saw the gap because she was working with COPD patients and there was dyspnea is the biggest and most burdensome symptom of COPD. So the breathlessness, the kind of when you move, you get out of breath. So you don't want to move anymore because you're just scared you're getting out of breath because breathlessness dyspnea really is really associated with anxiety because you feel like you're suffocating just by walking and there isn't much you can do it pharmacologically. You can you can use an inhaler that kind of gives you immediate relief, but it doesn't really solve the problem. And she really saw the gap and she kind of she was a therapist. She was a respiratory therapist, she kind of she understood the system and she just realized that you you have to train the system. And she was just kind of playing around with it. And they weren't giving exercises like pursed lips lip breathing, they're still around and you you have the resistance there as well. But she just thought if you follow the same principle, as you know what, doing the gym, yes, you might see the same effect and she was just kind of playing around with it. And if it didn't work and you know, 40 years ago, he invented the first version of the breather. And it's exactly the same effect. It is a gym for your lungs, and it follows the same principle and you do exercise your muscles when you're exercising, when you're running or something shows your your respiratory muscles have to work harder than when you're just sitting on the couch. But it is a little bit loud compared to you also exercise your legs when you're walking, but you exercise them completely different if you're squatting with a weight. When you're just walking where you're just using them. You're not actually gaining muscle mass, you're just using them so you're keeping them active to say with the rest of their muscles. Of course you're keeping them active, you're keeping them more active and exercising, but to train them in isolation like you do when Using the breather, you can only do this when you actually put a workload on the muscle to make them stronger and to make them bigger to make them more effective. Hmm.



So there's two camps of people in kind of speaks to the two different products. So the white one of maybe particularly beneficial to people that might be dealing with some pre existing conditions. So they're starting in that bucket. And then the black one is more to our athletes and looking to do this for kind of optimal health and well being. So would you make the argument in your opinion of what you know, of this area of the respiratory system that it would make sense for virtually all of us on the planet to be doing some work in this area?



Essentially, yes, if you haven't done it before, because I haven't really worked with a group of people that hasn't benefited you know, I was when I started with the company. I was like, right, I need to try this because, you know, I need to I need to know what I'm doing. Right And at the time, I did consider myself fairly Fit. I had a baby like the year before, so it wasn't at my fitness but I was still kind of doing a kid who had recovered. I started running again. I was actually training for my first and last triathlon. It's only a short one, I was straight out and I hadn't cycled. I've never had a road bike before. I haven't cycled much before. So I thought, but I try and start using the breather, I was just kind of, I had established a half hour trading route on my bike, and I used the breather for four weeks. And in those four weeks, I think I trained maybe once or twice because I just didn't get around to doing it. And off this 30 minute route, it shaved off two minutes, just



like that.



I didn't I



didn't have to train hard. I just had to train smarter, you know,



convinced me and yeah, so I think if you haven't done this even and I mean, the evidence is out there. They did research on Olympic rowers, even they saw an increase in performance and you know, they are built like like a boat. You know, they just like a steam engine. They really Can ventilate and they still sort of increased just because they haven't trained those muscles in isolation with the weight on them or within resistance again but against them Hmm



So I've so many questions so of course you know given the the title of this podcast being sleep as a skill we're looking to help all of us really understand the fact that there's so much that can go into getting great sleep night after night. Could you help us bridge the gap a bit more in how this you know the concert like taking the time we all have busy schedules, right? And yet, making the argument that investing in training our respiratory system how this could play out in increase, improve results in area of our sleep?



Sure, that kind of that two different ways to pitch that because one of them is of course, how breathing regulates the parasympathetic nervous system, baby killer vagal tone habit variability, that's the one aspect that really improves your sleep and the other aspect is That people who have have severe sleep problems such as sleep apnea, they usually have them that's usually associated with dysfunctional breathing, and often respiratory muscle impairment or respiratory muscle weakness. So they're kind of two different aspects how you should ideally you combine the two. So breathing, and let's start with it with the first part with the with the vagal nerve HRV how that is connected. So, as I said before, the kind of the breathing, the heart and the cardiac tone, they're really connected. And because you kind of can regulate the speed of your heartbeat, so to speak, of your heart. So one way to look at this and to measure this is heart rate variability. So this is one of the parameters you know, usually when you do when you look at your parameters that are important for your sleep, I'm using the bio strap which is a wearable that has kind of really focuses on the sleep Yes, and just the respiratory rate, the heart rate, the oxygen saturation, and The height variability overnight, as well as movement and other things. And the heart rate variability. What is that measures the resting heart rate variability. So the Hadamard variability is essentially the distance between two heartbeats. And that is different between each pair of heartbeats. So as long as short as long, it's shorter, and the more variable that is the better because the more variable that is, that means the reactivity to stressors is bigger, and also the recovery rate. So that means the heartbeat or the that part of the person off the pls is just more active is activated and just reacts quicker and kind of gives recovers from the stresses of the day overnight. And this is also that you see if you monitor your heart rate variability overnight, it's usually quite bad when you go to go to sleep and then especially If you've really looked at your sleep hygiene, your sleep latency is good, which means it hasn't taken you too long to fall asleep you've hopefully went to bed before midnight, and you've done everything right you haven't drank alcohol before you went to bed and all of that whatever suits you, you can find this out if you if you monitor yourself, you can see that it kind of recovers overnight and is the most recovery rate I usually get kind of is in the early hours of the morning. After you've if you've had a restful sleep, you hopefully haven't woken up during the night and then it kind of covers overnight. And you can really see what affects the heart rate variability is if you've had stress at night if you've been working late if you've been up at midnight sitting in front of the screen, you know blue light for example all these kind of poor sleep hygiene and working wearing my perfect I love it because it is late at night yeah. So just to kind of reduce that. And this is where the where the breathing comes in as well because if your respiratory system is more efficient Then you get away with breathing slower overnight, essentially. And kind of that improves the recovery rate overnight, you got the oxygen uptake is optimized, and you kind of your body doesn't have to worry about that. It can just concentrate on recovering, it doesn't kind of have to work on keeping you alive. Hmm. Because it's the system is optimized.



You know, maybe this is just a longer conversation, but when there's when it's the reverse, so you know, certain clients that will come in, and they'll have their HRV actually dips throughout the night and it goes, it gets increasingly lower throughout the throughout the course of the night, or they have a lot of variability in the respiratory rate. Are there certain things that you really take note of and that stand out for you? And that maybe can also be reversed through the work of training this area?



Yeah, I mean, this is when you don't recover. That means your sympathetic nervous system didn't really switch off overnight. You know, you're Fight or flight response was so switched on that it just the Vegas nap just didn't, didn't make it and break through. Because it's always a bit of a balance and breathing, you've got breathing techniques, but the diaphragmatic breathing You know, that's and the long exhales these are the two things that are really important to activate the vagus nerve. And if you activate that, then you kind of, you get what the the big because the big stuff actually goes into is connected to the lungs is connected to the heart to the liver to the gut. And if that's active, it kind of regenerates the whole system. The vagus nerve can actually you know, kind of widen the airways in the lungs, it can actively, you know, work on the heart muscle to slow that down. So it is it does actually, and it does when you slow down your breathing, you activate the vagus nerve, but the vagus nerve then promotes relaxation. So kind of by relaxing you activated by activated you relax even more. So, you just have to kind of break the cycle of being in the, in the sympathetic nervous system in the in the stress response. And just You can do this by the breathing by just kind of getting your breathing under control, because you can control it. And there we're working with breathing coaches as well to kind of get the, you can change the pattern of your breathing, sometimes it's actually a good idea to speed up your breathing first. For example, by circular breathing, just kind of get into a rapid breathing cycle that kind of catches up with what your body is experiencing, because it is in a stress response. And then do this for a few minutes and then kind of calm it down to go to a nice long inhale, long exhale, and then a pause to kind of this this triangle shape to kind of really slow it down and then activate the parasympathetic nervous system and kind of tone everything down. And you have to get into the habit of doing that kind of it might not work on the first time. So it's kind of all you know, the research for this has gone over centuries, you know, yes. yoga, meditation, you know, mindfulness, this is all not new. This has been in practice for centuries. And this is because this is your way of controlling that part of your nervous system.



So interesting. So because what I find cool about this is, you know, often to your point this, it's not late breaking news, okay? breathing will really help for lessons. And yet, often, particularly a lot of the people that might come to sleep as a skill are looking, it's almost a new way in at an old idea. And yet also this idea of being able to maybe with velocity tapping into a way of training that might have, you know, taken many, many years to get to a particular point and yet if we same way that we improve in our fitness by adding in heavy weights or what have you, these additive measures can make a difference at different points. And that was the other thing I liked about this breather was that the you know, the affordability of it, the ease of use, or That has that app that comes with it to help kind of guide you and make it just really like a no brainer, because I have seen certainly other breathers on the market doing great things. And you know, it's a bit more of an investment, as well. So I think the idea that this could be something for the masses is really excited. Yeah. And so, I guess the other question that I have is, what does something like this look like? So for instance, I have people right now that are concerned about COVID about their immune system, I do have a lot of people you know, over the age of 60, that are dealing with you know, the it feels it can occur as if now they've got a bunch of things are dealing with now maybe Melatonin is going down, they're, you know, they're reaching into different seasons of their life, that they're already kind of up against some barriers to getting great sleep. And now they have this, these other things to consider about their health and well being. And now if we the idea that we could actually bring some level of control into this area is really exciting. So I'm wondering if you could share a bit more about what you see as how this could fit into our lives. You know, we've got yoga, we've got these other options that are very in vogue. And yet there's this new way of doing this. So what would this paint the picture of how this could look for people?



Okay, they're kind of different aspects of it as well. One of them is stress and immunity, pulmonary hygiene. And the third one is prevention. So I'm going to try to cover all three of these. So stress and immunity, as you said, you know, yoga helps us well, this only takes five minutes a day, you know, that's, that's another advantage of it. You know, yes, I love doing yoga, I find it hard to find the time for every day. So saying, okay, with kind of COVID around, you know, it is a very, very scary thing. Breathing really has an impact on your immunity. And this is via stress. If you're stressed if your sympathetic nervous system is firing. It really that's really detrimental to your immune system because essentially your body Preparing for battle. So everything else in your body is switched off, your body is not taking looking after itself. It's just preparing to either run or fight, you're consuming energy, your muscles are ready to go, if your immune system is not working properly, so by being mindful of your breathing, doing breathing exercises, and this is what the breather is really good for, as well, you just, you know, you sit down for five minutes, and you only concentrate on your breathing, you know, you're doing diaphragmatic breathing. And you just you instill a habit, you instill a habit of good breathing and you've got a prop to not forget about it, you know, that's kind of a good thing as well, yes, at the strengthening effect as well, but it also it just kind of for these five minutes, that's all you're doing. And that's really important. And just by by controlling your breathing, proper breathing, and diaphragmatic breathing, that actually it activates the immune system, the diaphragm is, is also a little bit of an endocrine system. So it actually excretes things like interleukins or things that help your immune system and that are now stary. The other thing that you do by strengthening your respiratory muscle system is that you promote your pulmonary hygiene. So the the airways in your lungs there are lined with a layer of mucus. And we always think of mucus as something that's really disgusting I had to get pepper to get rid of. Right? That's true. That's true if there is excess mucus, but a thin layer of mucus that's really, really important because this is where your antibodies are, your T lymphocytes are everything that you need if because this is the space where the virus enters your body. It's a respiratory pathogen, you breathe it in, goes into your lungs, and then it goes into your body. So this layer in your lungs is your first light along with with the epithelium in your nose, you know, boost your nose, always really important during respiratory presidencies. The flu season always knows breathing because that belongs to that local immune system as well. So but this is the first encounter with your body. So if you've got if your mucous layer there is in tip top shape, that's it. That's a good start. So by having strong respiratory muscles, should you have excess mucus because I don't know you're allergic you for asthma, you've got COPD, you just kind of have mucus build up, then you've got strong calf muscles, because your respiratory muscle training has been effective, you're able to kind of cough it out effectively. You get rid of that. And you just keep your pulmonary hygiene in good shape. So that's really important kind of in the prevention part. And the other thing that has been exciting for us, I mean, we've because we working on it, it was fairly clear to us but it's, you know, we're biased to contain this. We're selling a device. So guess what, there has been a really nice statement paper that came out last week and that was published in the American Journal of Medicine by a physiotherapist, actually, he suggested that it would actually be a really good idea for anybody who's high risk and high risk includes anybody who's elderly, as you said, but also anybody who has respiratory comorbidities or heart failure or hypertension, obesity, these are always factors to, to catch cobit, for example, and everybody who is at high waist, the author suggested should be doing respiratory muscle training. And this is in prevention if they should get the virus and it should kind of get worse because many, most people still are asymptomatic or have very mild symptoms. And then a minority of people who actually develop symptoms and a further minority actually develop severe symptoms. So if you're in this group that if you develop symptoms, then it gets to the point where the work of breathing becomes harder and harder. And if that balance tips that your lungs actually can cope with the ventilatory demand anymore, so your body says, breathe out, breathe out, breathe harder, because you've got mucus in there, you've got inflammation in there, the system's not working anymore and the body tells you to breathe harder. And if you've got stronger rescue muscles, you can follow this demand for longer before the balance tips if the balance tips then you've got respiratory distress, if it works other tips you had respiratory failure. So that's kind of the worst case scenario. And their line of argumentation was just the stronger your baseline is, the longer you can resist and lead your body trying to recover in the meantime. So they really recommended that anybody who belongs to a risk group to kind of strengthen the system beforehand to just kind of be prepared, essentially, and then hope for the best.



Hmm. Okay, so, and out of this, like in this conversation, we've already established Of course, we're looking for optimal living and what have you. So really, all people could really benefit from training this area, and yet, there are particular groups that could be really benefited by taking this on, you know, like that more at risk group as it relates to Corona. And then in the conversation of sleep, certainly, in your opinion, would you say that most people that are dealing with anywhere in the spectrum have sleep apnea from you know, mild to severe that this would make a lot of sense for them to invest some time in



and with sleep Yeah, if you are this is the severe stages and you need see pup? Yes, it's still a good idea, but she might be too late. So it's better to catch it early here. Because what it really, if you've got strong respiratory muscles, you really increase the airway stability. And this is usually what happens you know, even if you're if you're snoring or something, that usually means that your airways are collapsing during the night. And then you get it comes to the app now where your breathing actually stops intermittently. So just kind of giving your body the stability and just kind of better ability to keep the airways open overnight for those people it has. And there's been a really nice paper from research in Australia. And she really nicely showed that by doing respiratory muscle training, people who had sleep apnea, they had fewer awakenings every night, they had fewer athletic But well, less apnea. They had also a few Olympic movements overnight and just you know, a lot more restful sleep, and the side effects that she showed which was really exciting at the time because she was the first one who showed this This has since been confirmed in other studies is that better to muscle training also reduces the blood pressure hmm that firstly I mean that yeah so you know if you're below that is a huge thing again



yeah because that is one of these you know so for people that maybe are not looking at their sleep regularly with some of the sleep check on the market and even for people that are looking at their at their stats, you know, certainly there's just a such an interesting correlation even just in the effects of how you feel that next morning if you've taken a exceptionally long time for your heart rate to lower and stabilize and get to that like the lowest point right before you wake up you likely will feel how that feels which is not always the best because you know there are also people that will come to sleep as a skill and they're sleeping you know, the numbers on paper, it looks fine, you know, they're they're getting a decent time duration. Not a crazy amount of wake ups but they just can't understand why they feel like crap when they wake up and I Often, that can be one of those things to look at. And, of course, as you're pointing to, if we're seeing changes in our heart rate, then you know, the flip side of that is that HRV impact, you know, we recently had a HRV expert on the podcast and he made the very, you know, just with such conviction that if you are looking to impact your HRV It is really impossible to do that without training and getting connected to the diaphragm. So the correlation for many of us because so many people okay, I want to get this athletic level HRV readouts and yet not interested in taking such a maybe esoteric stances. breathwork something like that can land is not, you know, particularly effective or what have you for many people. And I think you are providing for us the science on how that is maybe not accurate, right, maybe become



a shortcut, you know.



Exercising, you know, is a great idea, but I kind of just read the code today. You know, I don't get round to doing 30 minutes of exercise today, but I do get round to doing five minutes of breather. And it is like that, you know, on on. And also, we have also seen this on athletes who are injured, who are suddenly kind of sedentary for however, I mean, they usually get back into training fairly quickly depending on the injury. But this is something you can always do. You know, it's always, you can always, at least and then if you get back into trading, you're starting from a different baseline, your diaphragm because you get tired from a trophy from not using it like a muscle, you know, just breathing at rest does not train your diaphragm properly. You need to put either go exercise, or even better, you know, put a workload on it and work against resistance. Otherwise you get a trophy if you I mean, this is the evidence for people going into major surgery, you know, gain going into the ICU, do in six days in mechanical ventilation, you lose 30% of your diaphragm muscle mass.



You know that well,



yeah, if you're planning a surgery, this is another area where By respiratory muscle training is an immensely important just because you then start from a different base, because you will still have the muscle loss. But you're starting from a different baseline and then you can start again straight afterwards to build it up again.



Wow. Okay. And I'll try to be cognizant of your time because I know that you're, it's, it's late for you, I guess a couple quick questions when you see because I certainly get the sense from you, too, that you are mindful of some of your stats, and what is concerning to you, when you see certain amounts of so when we look at our respiratory rate, just understanding the amount of breaths that we're taking per minute while we're sleeping, when we see people on the upper end of that spectrum, they're breathing, you know, 18 1920 times a minute, while they're sleeping. Does that indicate for you just a clear stance that they could really take the time to do this? Is there something else lurking



it can you kind of always have to see it a little bit together with the other parameters, if you can, you know, if I see that my heart rate variability is, you know, not improving overnight and I've got this, then I might actually have an infection lurking around the corner I might actually be getting ill, or I am really, really stressed. But it is an indicator you know, is this just an isolation that if the respirator doesn't go down, it is an indicator that the system isn't working properly. So it might also be that then your oxygen saturation is not right. Because it means your body is telling him we need more oxygen, we need more oxygen and breathe harder with harder and training your respiratory muscles in this scenario would be a really good idea to see how that can help. Okay, that still doesn't help any we have to look at the overall picture and sort out anything else that might be a problem there.



Okay. Okay. And then you know, just for the last because I was very confused when I first saw in the SPT video they pulled out one of these they had the black one like you so seeing and it was just so foreign to me. I was like What is this thing? So then really just it's as simple as just you put in and out throughout a series of You got your app and you kind of just go through that process. And it's as simple as that five minutes. And is there because you know that will mention in the app different timing of the day, is there a thought process around the response for that,



you should train twice a day on at least six days a week. And the idea is just because it is a muscle that you're training, you also needed restless knee to let the diaphragm rest and recover in between, you know, so ideally, do it mornings and evenings worth the time from hard, but especially if you're, if you have COPD or heart failure or something, don't work it too hard. Yeah, it also counts for it. If you're an athlete, and you've just had a competition, where you've really kind of pushed hard, give it a rest day, you know, just do muscle training the next day because you can actually fatigue the diaphragm and you can protect the rest of your muscles. You don't want to do that, you know, fatigue muscles, not a good idea. You can overtrain it. It is unlikely, but you can do it. So ideally, you know, twice a day and you can work them fairly hard. So you can actually, I usually, the settings should be, you do two or three sets of 10 breath. And it should be kind of 70% of your maximum effort. So it should feel quite hard. But you should be able to finish a set of 10 and then be able to do two or three more before you run out of room.



And I've already got clients that have now ordered these and they've asked me about feeling faint after Is that something that you see people kind of work through as they're improving? What At what point is that problem or is that really a nice sign that they're stressing that area? What would you say?



And we see this a lot when people have not done this before it says it is basically just a rush of oxygen to the head really, you know, a little bit of a natural high, so to speak, enjoy it. It should go away after the first few times it's just because your diaphragm is not used to working so hard and suddenly is so just the first few times you feel light headed. If that's the case, you know, after after Set of templates, just you know, rest until it subsided again, and then do the next set, or kind of or finish this session for now and then start again in the evening, within a few days it should go away. If it doesn't go away, then you need to see your physician but that is where Yeah,



got that. Okay. Wow, so good. So how can people learn more about the breather about what this process would look like the app, all of the things



we've got, we do have a really good website P and We've got loads of videos there for how to use your breather, how to clean your breather. That's, that is really important, how to do correct diaphragmatic breathing and how to also for therapists how to kind of show the breather to your patients. Now we've got just put up a new video on telehealth how to how do you do that? And we also got to keep putting up new information especially around COVID you know people are really concerned case memory there should I use my visa. So just look on the website. There's lots of stuff there. We also So you can always get in touch with a clinician get in touch with me. So yeah, we're there to also the other thing is we've put up, we just started with the university. So we've put up webinars on how to implement, how to basically target respiratory muscle weakness. So that's the kind of underlying problem that we're treating with the breather, and how to kind of documented how to apply it also with loads of practical advice, but also all the science behind it. So we do provide lots and lots of resources. Anything you want to know, is there anything that's not there? Just send us an email, and we'll get back to you.



So cool. That's awesome. I didn't realize about the university. That's very exciting. Okay. Very cool. Yeah. And in my experience with, you know, because like I said, I saw this video and it went right over Google. And then, you know, so the, this is how my brain works. I'm like, oh, shoot, it's not on Amazon. It's going to take longer, and yet it was so fast and then the customer service was amazing. So I got it. So quickly and it was just really, really seamless. So I know we



were a small team were really tightly knit team. Everybody knows each other. And you know, if if we've got the care department if they don't know the question, they asked me if I don't know it, I asked our cmo, he's a pulmonologist. So we've got all the bases covered, and we really work well together. So you know, there's no delay anywhere is it is a bit like a family.



Yeah, this really what it felt like it was very cool. Well, so grateful to be connected with your family and, and really grateful that you're able to take the time, it's really been really beneficial. And I'm excited to get this information out. See if it gets so it's always important, but particularly important right now. So thank you.



Yeah, thank you so much for having me. I really hope kind of maybe I could have helped a little bit and support.



Oh, absolutely. This was so informative. I had to restrain myself from asking more questions. Really, again, it's hard to exactly Okay. Very cool. All right. Well, thank you so much again.



Thank you.



You've been listening to the sleep is a skill podcast, the number one podcast for people who want to take their sleep skills to the next level. Every Monday I send out something that I call Molly's Monday obsessions containing everything that I'm obsessing over in the world of sleep. So head on over to sleep as guild comm to sign up