Rediscovering Healthy Breathing – James Nestor, Author of Breath: The New Science of a Lost Art

Shiv Gaglani: Hi, I'm Shiv Gaglani. Our show today is going to focus on something most people do about 25,000 times a day, but rarely think about. And that's really the point. We should be thinking about it, because breathing properly is essential to good health, and research shows that making even small adjustments to breathing can yield major benefits.

This is all detailed in fascinating fashion in the international best-selling book Breath: The New Science of a Lost Art (https://www.mrjamesnestor.com/order-now) by the award-winning science, journalist, James Nestor. His previous writing includes the acclaimed book, Deep: Freediving, Renegade Science, and What the Ocean Tells Us about Ourselves, and numerous articles that have appeared in The Atlantic, the New York Times, Scientific American, and other major outlets. He also helped found a nonprofit research group to use machine learning and artificial intelligence to crack the code of interspecies communication. So, James thanks for taking the time to be with us today.

James Nestor: Thanks for having me.

Shiv Gaglani: You have a fascinating array of interests and background. I would love to hear in your own words what got you interested in science and writing in the first place.

James Nestor: I never set out to do this. I never studied journalism in college or anything like that. But I've always been writing and I used to write ads and copy, and that work got to be so monotonous, even though it was good for my bank account, I wanted a little more. I started writing just out of sheer joy of it for magazines. Did that for years, years, and years until I had enough magazine articles that I cut the cord from my “real job,” and just started doing this for a living.

Shiv Gaglani: That's fascinating. I've really enjoyed your articles and, then obviously the book Breath, which is why we sent out the invite. You've written on this broad range of subjects as I mentioned in the introduction. How do you decide what to write about and then decide what becomes a book versus an article?

James Nestor: That's a great question. I have no methodology. I just go out into the world. I talk to as many people as I possibly can. I especially want to talk to people that I have been told I shouldn't talk to, and I found that those people can have insights into things that other people do not have. And once I've accumulated enough research in a particular area, I try to figure out if it's a magazine story, and I'd say about 90 percent of the things I pursue don't even make it to a magazine story.

After years and years of accumulating information is when I would sit down and say, "Huh, is there something larger than a magazine story here? Is there a possibility that there might be a book?" But I'm never shooting or never looking for book ideas. I have a very different approach and luckily, I haven't had to search too much. I have a whole list of things I want to tackle and hopefully, I won't die before I'm able to do that.

Shiv Gaglani: Let's go right into the most recent international best-selling book, Breath, which I read a couple of months ago on the recommendation of two of our teammates at Osmosis, Caleb and Hillary who spoke highly of your work. There's been a huge revolution in sleep. One of our previous guests on Raise the Line is Arianna Huffington, who wrote a book about sleep as well. And one of the main arguments people proponents of good sleep say is that we spend a third of our time doing it. We should really invest in sleep hygiene.

Now, Breath can take that even further. We spend all of our time breathing, but we really don't spend much time thinking about it. Can you give us a bit of background as to how you got started writing Breath? And I know now, currently, you're doing breath retreats. Tell us more about that whole journey.

James Nestor: Several years ago, I started looking at all of the literature, all of these books and magazine articles about how we needed to relearn how to eat. What a ridiculous thing that is that we now need to learn how to count how many vitamins are in our foods, count how many minerals, count how many fats. Am I eating too many carbs? Am I eating enough protein? Our ancestors never had to do that. No other life form on this planet ever had to do that.

We’ve become so distant from our evolutionary environment, in which we formed, in which we became modern humans, that we've had to relearn all these seemingly simple things. How absurd it is that we have to relearn how to sleep. My dog doesn't need to go read a book about how to sleep. She does it great all day long. But again, modern humans, the majority of our diseases come from us being so distant from an environment that can nurture us, the environment we came from.
 

Breathing ties into that. The first question people have is, “why the heck would I need to relearn how to breathe? I'm breathing all day long, doing it good enough, right?” And I think what you have to understand is that compensation—just getting by—is different from being healthy. I could eat 20 Twinkies a day and get by and have enough calories, but that wouldn't mean I was healthy. And when I started talking to researchers about this, this was several years ago—maybe seven to eight years ago—they were saying that the vast majority of us are breathing in a dysfunctional way.

I said, "what does that mean? Prove it to me." They said, "why don't you look at the rates of asthma, chronic sinusitis, emphysema, other breathing dysfunctions, chronic obstruction, deviated septum..." I mean, I could go on and on. And the proof is all over the place. It's something that's so simple—like literally right in front of our noses—that few of us ever pay much attention to it.

Shiv Gaglani: Yeah, absolutely. I know in your book you profile the experiments you've done: going to see an ENT where they're measuring the sizes for your oral cavity or nasal cavity, injecting all this type of stuff into it. I couldn't help but think of DEXA scans. DEXA scans become very popular—What's my brown adipose tissue? What's my bone density?—all of that. One of the most compelling things I took away from the book was that when we mouth-breathe, that itself will maybe make your nasal cavity smaller, because your oral cavity becomes bigger because you're just more used to breathing through your mouth, so it becomes harder to nose-breathe the more you mouth-breathe.

I'm curious, do you think there's a wave of biohacking that is going to start happening because of work like what you've done, where people are doing a DEXA scan for their nose, or is it more simple than that? People should just start putting a little tape over their mouth when they're sleeping and that'll be a good first step?

James Nestor: There's been a wave of biohacking for the last few thousand years. It's called yoga. It was a technology of sitting and breathing. There were no yoga poses in the original yoga, and this thing called “vinyasa flow,” which is considered a standard yoga practice here in the West, is about 100 years old. This is all stuff we made up recently, but that technology of breathing—focusing on your breath, hacking your breath to elicit different physiological changes in your body, to elicit different moods in your mind, to increase your heart rate, to increase your blood flow—all of this has been around for thousands and thousands of years. We can call it whatever we want; yoga, qigong, breathwork, who cares? It's all the same thing.

What I found is that these different methods have been celebrated in cultures for thousands of years because they obviously worked. But what we have now in the modern age is machines and these machines can provide objective data on exactly what they're doing, how they're affecting us. And what these machines have been telling us for the past few decades is that these breathing techniques play such a huge role in how your brain operates, how your body operates, your sleep quality, your athletic performance, anxiety levels, and more and more. And if you don't believe me, you can just make your own measurements and see for yourself.

Shiv Gaglani: Our audience tends to be current and future health care professionals. They like the research, they're very science-driven. Again, that’s one reason I like your book. You cite a lot of the research, you've gone and done studies on yourself. What are some of the things they could be doing today to start experimenting and learning more about their own breathing and then potentially, hopefully, that will influence how they see this whole field and ultimately take care of their patients?

James Nestor: There's doctors in my family. My father-in-law is a pulmonologist. My brother-in-law is an ER doctor. We talk about this stuff all the time, and what they have told me, and what dozens and dozens of other doctors I've been working with for years and years have told me, is that the system is very good at treating acute problems. If you get a car accident, if you have lung cancer, don't go to breathwork, don't focus on alternate nostril breathing. You need serious care.

But what we have been pretty bad at—and again, this is not my opinion, this is coming from medical professionals at some leading institutions—is identifying and treating the lower grade issues before they become big problems. One thing a lot of doctors have told me is they're like, "I just deal with the working dead. You have to be bad enough to see me. Until you're bad enough, I can't do much for you." If you look at how traditional Chinese medicine worked, you stopped paying your doctor when you got sick, and you kept paying your doctor when you were well. We've got that completely inverted here.

Obviously there is huge value in Western medicine, and I hope that nobody listening to this or reading the book thinks I'm bagging on Western medicine. I wouldn't be alive today without Western medicine. Most of us would be dead without it. I think we should look at the strengths in these certain areas and looking at the deficits in trying to form an integrated way of health. Prevention is always so much better than treatment. And that's what I think. Breathing, eating, exercising, sleeping—all of these things are really preventative maintenance, so you don't get so bad that you need more severe therapies to get you back to normal.

Shiv Gaglani: Absolutely. That mix is important. I think F. Scott Fitzgerald is famous for saying, the sign of an intelligent person is being able to hold two seemingly conflicting thoughts in one's head, and resolving those. Similarly, this is not a binary choice, and I think a lot of our audience understands that. It isn't you're gonna do acupuncture for someone who just had a car accident, or you're going to do trauma surgery on someone who's 10 pounds overweight. It's not that binary even though in this age of clickbait, I think people go that way. It's very much more nuanced and I like that.

I'll give you a personal anecdote. There's a particular chapter in your book where you talked about athletic performance. I do a lot of endurance sports and had been breathing through my mouth a lot when I was running. I would do fast miles, like sub 6-minute mile, and then there was one part where you outline some Olympians who were in studies where they were told to switch to nose breathing exclusively, and initially, they were very skeptical of that. But then they started doing it, and there was a controlled trial as well, and their performance improved just like that over the course of a couple of sessions.

I tried that with my runs and I was shocked to know that I could nose-breathe my way through a fast run. And now, I only nose-breathe as I run, a mile every day for the last six months since I read your book. What are some things you've heard people tell you that they've taken away from your book—research-based things, and things they've been able to implement? I know you have a whole section on breath techniques at the end of your book. What are the things that they could be taking away from this episode if you wanted them to start exploring this themselves?

James Nestor: Well, the goal in athletic performance, especially in competition, is efficiency. Everything's about being efficient. The more efficient you are at controlling your energy and using that energy to go further and faster, the more races you're going to win. There has been so much focus on shoes and so much focus on nutrition, but there hasn't been that much focus on our breathing. How do we get most of our energy? We get it from breath. If you are not taking in your breath in an efficient way and exhaling it in an efficient way, you are expending energy you can't afford to expend if you want to win that race. This is not some touchy-feely new age conceit. This is the most basic principle of athletic performance, and we've known this, again, for decades and decades. These different studies go back decades, and in the 50s and 60s, people were really hip to this and were using it. But for some reason, some new pill or powder came out and people defaulted to mouth breathing.

I'm not saying that mouth breathing isn't going to get you across the finish line and not allow you to be competitive. It will. But if you're able to work at a certain capacity using less energy, less breathing, you then have that extra energy to push even faster and further. And this is one thing I've heard just about more than anything else. Athletes—people who are into jogging, ultramarathoners, soccer players—have said, "Yeah, the first few weeks is terrible converting to nasal breathing. But once you get over that hump, not only does your performance increase, but your recovery time decreases because you're exerting less effort.” Rumor is the U.S. men's soccer team is now practicing breath-work preparing for the World Cup. This stuff is getting major, even though it's been around for decades and decades.

Shiv Gaglani: That was also a fascinating thing about the book was, you go from Tummo, which is a practice in Nepal in Tibet in monasteries for thousands of years to then—I think one of the most interesting things was this late 19th century painter-turned-author who toured across the U.S. and studied Native Americans and found that Native American mothers would actively promote nose breathing in their children versus mouth breathing, and that had impacts on asthma and COPD and all these other breathing issues. In your title, it's called “The New Science of a Lost Art.” I think we keep tending to forget some of these things that people had discovered in different cultures, which is a key theme in your book.

James Nestor: Well, if you look at indigenous cultures, they have celebrated nasal breathing for probably thousands and thousands of years. We just understood this once a Westerner went out there in the 1830s and lived with these different cultures, lived side by side with them before they were completely destroyed by Western culture, before they were given alcohol and tobacco and canned foods. This knowledge didn't come from this Western painter, George Catlin. It came from these indigenous cultures and what he found is, every single Native American culture celebrated in the wonders of breathing, specifically nasal breathing. They said your face is going to grow ugly if you breathe through your mouth. We find later that that's true! How you hold your mouth, how you hold your face when you're going up, will impact how you look later on, and will impact your breathing.

Then he went down to South America and found the same exact thing, which is why if you see any portrait of these cultures, they had these extremely wide faces. They all have perfectly straight teeth. They had these huge airways, and we lost that. Our ancestors used to have that as well all over the world, but we have lost that in industrialization, and our breathing had taken a big hit because of it.

Shiv Gaglani: I want to take a turn and go back to your personal life. You're a science journalist. You write about the stuff you engage with it. What are some of the lasting changes you've made right now? I know you're running breath retreats, but do you have a daily breath practice I assume that you've continued after investing in this for yourself?

James Nestor: Yeah. Since the book came out, a lot of people think I just spend my days in a robe, just sitting in a corner downstairs at my house breathing, but I don't do that. I talked to a lot of people who do that. It's part of my job as a journalist. But at the same time, obviously, I picked up a few tricks along the way. You can't talk to dozens and dozens of people who have had their health transformed by simple breathing practices and not want to adopt some of those practices. Yeah, I wake up in the morning. That's the first thing I do. I do some stretches. I do a little workout. I do some breathing. But I think the most powerful effect that people can get is by just normalizing their breathing throughout the day. When I'm talking about healthy breathing, this doesn't mean spending an hour a day doing, you know, kriya or kundalini or whatever.

Most people are so detached from what normal breathing is that they will show marked, measurable improvement just by breathing normally: breathing through your nose, breathing slowly, breathing rhythmically. Breathe like any other mammal breathes. Breathe like a healthy baby breathes. Notice how slow, into the belly. That's how we're supposed to breathe. This breathing into the chest, breathing through the mouth, constantly stressed out: This is not how we're supposed to breathe, and we're paying a price because of it.

Shiv Gaglani: At Osmosis, we train doctors nurses, PAs, and a lot of the videos we've produced are around how to use an inhaler for your asthma. We're trying to do a little more proactive, preventative type medicine. That's why you and folks like Scott Carney have been on as well, who can translate some of this research and turn it into something more accessible for current and future physicians—and then hopefully, their patients—to incorporate.

James Nestor: It's really hard because I know how slammed doctors are. You don't have time to sit someone down, assess their breathing, and then take them through 20 minutes of breathing exercise. I even asked a pulmonologist, my father-in-law, "Is the best breath like five seconds in, five seconds out, or four, seven, eight?” He's like, "I have no idea. I'm dealing with people who have punctured lungs." His job is to keep people breathing. It's important that you are breathing, not how. 
 

I want to be very clear. I'm not pointing fingers of blame at anybody, but I think having an awareness of the importance of breathing for your day-to-day function—for mental health, for physical health—is very, very important, and how you get that is really up to you. Maybe a breathing therapist can help, maybe you can watch online courses. But especially for people who have chronic issues—asthma, PTSD, panic, anxiety—I have seen this work wonders. I've seen it do things nothing else could do. You could read Dr. Richard Brown's book, and his research, to support some of what I'm saying.

Shiv Gaglani: That's fantastic. It's definitely a rabbit hole. Once you start pulling on some threads or going down in the hole, you'll keep finding interesting things. I know we're coming up on time so I had a couple of quick other questions for you. What are you currently writing about or researching? What's getting you excited right now?

James Nestor: That's a good question too. I'm in several different areas right now and seeing what's going to really catch. I’m in the middle of some prospective film stuff as well. So, I have this wonderful fallow period where the book tour for this book is starting to wane, and I'm like, "Oh, I can go back to my little outside office and just sort of sink into researching." So, to answer your question, nothing in particular, which is actually the most fun. I can just go and spread my wings in every different direction and just see where it leads me.

Shiv Gaglani: We have many current and future health care professionals listening to this podcast. What advice would you give to them—breathing or otherwise—about meeting the challenges of COVID and beyond, because they're entering this workforce in a completely different environment than, say, a decade ago?

James Nestor: I think for the same reasons you would tell your patients to eat well, to eat a balanced diet, for the same reason you would tell them to sleep well and to exercise, you should bring awareness of their breathing, especially if you notice they're breathing in a very dysfunctional way. 

If you see labored breathing, if you see shoulders going up and down, if you see chronic mouth breathing, there's something wrong with that person. Either that's the result of an underlying issue or that breathing can exacerbate or cause its own laundry list of issues. Just by having people become aware of their breathing—that seems so cliched and simple, but you'd be surprised how many people never pay attention to the breathing at all. Once you become aware of it, then you can focus on where the issue is, then you can treat it and you can fix it.

Luckily breathing is cheap in the way that it's completely free and it's very easy to do. Asking someone to go keto or vegetarian, who's been driving down BK broilers their whole life—that's a big ask. But just having them breathe in a different way and feel that change in the body is less of an ask, and I think you'd be surprised how effective it can be.

Shiv Gaglani: Yeah. It was really interesting because the recommendation as you're sleeping for nose breathing and mouth breathing is a little piece of scotch tape, right? Just across the lips as opposed to some crazy Fitbit contraption or anything like that.

James Nestor: Not scotch tape. I happen to have the tape that I like here. This sounds crazy, by the way. The doctors listening to this probably aren't going to prescribe this—nor should they. But I heard about this down at Stanford when I was with the chief of rhinology research down there, and then it turns out that this has been a dirty little secret for dozens and dozens of doctors and dentists I've talked to, which is to put a teeny piece of surgical tape—micropore tape—just across the lips like this. People say, "Oh, you can't do that with a beard." Well, I'm living proof. I can. That's the technology everybody. It comes right off. You take it off with your tongue. It's supposed to come right off. This is just a reminder to keep your mouth shut.

Try it in the day first. Do not try to go to sleep with this immediately. Try it in the day for a couple of weeks. Maybe for an hour or two if you can do that, then slowly work it into your sleep. More than 60 percent of the population sleeps with an open mouth, and that is so damaging to our sleep quality and our general health. You have to find a way of shutting your mouth. I found this tape works pretty well.

Shiv Gaglani: Well, hopefully, insurance will cover that surgical tape at least here in the U.S..

James Nestor: Three bucks, it'll last you four months. It's pretty good. It's better than a CPAP, right?

Shiv Gaglani: Here in the U.S., who knows how expensive that surgical tape will go.

James Nestor: So true. Someone's gonna patent their own sleep tape, coming up real soon and this will be $4,000 a month.

Shiv Gaglani: Yeah, they'll be a Tim Ferriss sponsorship around it, yeah, who knows?

James Nestor: That's our world.

Shiv Gaglani: Well, my last question. Is there anything else you'd like our audience to know about you, about your work, about Breath that we haven't had a chance to cover today?

James Nestor: I have a number of different free videos, all the scientific references for the book. My publisher allowed me to publish that for free. No paywall, not asking for your email, none of that on the site because I realize how much of this sounds pretty wacky and out there. But again, don't take my word for it. Look at the scientific references in the studies and the experts in the field what they have to say about it.

There are also breathing techniques there on the site at mrjamesnestor.com. Again, I'm not selling bottles of pills or anything there. You can look at that. And if that's entertaining and useful for you, you can just take those different YouTube videos of those breathing practices or interviews and share that with your patients or with whoever you like with it.

Shiv Gaglani: I can personally vouch for the fact that was pretty illuminating to me. Again, just like when you read about how much time we spend sleeping—a third of our life—and we don't really think about it. Similarly, we spend all of our life breathing, and until books like yours—and your book in particular—I didn't spend as much time personally. So, I'm a big advocate, and I appreciate you taking the time to join us in the podcast today.

James Nestor: Thanks a lot for having me.

Shiv Gaglani: With that, thank you to our audience for checking out today's show. Remember to do your part to flatten the curve and raise the line. We're all in this together. Take care.