Hi everyone and welcome to Airway First, a podcast from the Children's Airway First
Foundation.
I'm your host Rebecca Downing.
My guest today is Patrick McKeown.
Patrick is the creator, CEO and director of Education and Training at the Oxygen Advantage.
Director of Education and Training at the Boteco Clinic International and President
of the Boteco Professionals International.
He is a leading international expert on breathing and sleep and author of bestselling books
including The Oxygen Advantage.
His focus is to empower more people every day to breathe better, feel better and achieve
their potential.
You can find out more about Patrick at OxygenVantage.com and BotecoClinic.com.
And now let's jump into my conversation with today's guest, Patrick McKeown.
All right, thank you so much for joining us today, Patrick.
I really appreciate it.
Sure, it's a pleasure.
Thanks for inviting me, Rebecca.
Absolutely.
And a lot of what we were going to talk today, I just kind of want a level set for parents,
so the expectation is focused more on proper breathing and things, ways that we can help
children that have breathing issues to help them with some of the other elements, like
the mental aspect, so that anxiety, things like that.
There's a number of fronts to it.
Interestingly, today, I went in on PubMed, which is accessible to all parents.
I put in mouth breathing and malocclusion, and it brought up something like 749 papers.
I spent a half an hour to an hour going through just randomly selecting papers.
And looking at the connection that mouth breathing and malocclusion, so Crocatete, for example,
the connection is really, really common.
Now, does it necessarily show that there's cause and effect, but the connection is there
all the same?
And this has been debated since 1909, and probably even before that.
In Dentistry, I remember reading an article that was published in the journal Cosmic Dentistry,
and it was by an author called DeJohn.
And they were talking about the effects of mouth breathing, and the child was in a tentive
in school, the child's face was dull and expressionless, the teacher was accusing the child of not
paying attention.
And then I asked the question, we haven't moved on in over 100 years.
How come has this been forgotten about?
And I have my own personal journey.
I got into breathing because of my own issues.
Most people who work in this field fell into the field of breathing primarily because of
dealing with their own issues.
And as a kid, I was very frustrated in school.
And I was frustrated in school because we're required to sit there and to absorb information
and to be attentive to what the teacher is saying, but we don't have the energy levels
to back it up.
We're sitting there with brain fog.
We're sitting there with fatigue because of, and very often, a sleep disorder.
And I had that sleep disorder.
So at 14 years of age, I left school never to go back to school.
And this was back in the 1980s, and I'd say people sometimes shocked when they heard that.
I wrote about it first in the book, Atomic Focus, which was published last year.
So it's not something that you go and tell everybody about, you know.
But I left school out of a total sense of frustration that there was no point in me
being there if I wasn't picking up on what the teacher was saying.
And yet in junior school, I was very up at the top of the class.
Now, it turned out that I did go back to school one year later, and I studied hard,
and I got my grades and I got into university, and it could have been a lot easier.
So we as a society, we're labeling children as whether they are intelligent or not based
on their academic achievement.
But in order to excel academically, you need to be able to focus and concentrate.
Right.
Focus is narrowing your attention to one thing.
So deciding what are you actually going to place your attention upon.
Concentration is the act of holding your attention on that one thing.
So you might be reading a particular book.
Are you able to hold your attention on the text as you're reading the book?
And your attention span is the length of time that you're able to hold your attention on one thing.
Now, in order for us to excel, we need to have both focus, concentration, and also attention span.
So the kids in terms of that are being labeled as being intelligent or not.
Nobody is teaching them how to concentrate.
Nobody is talking about attention span.
And very few people is talking about the connection with poor sleep.
What about these kids?
What about the 25 to 50 percent of children who are persistently mal breathing?
Who are snoring?
Who are stopping breathing during sleep?
And these are the three hallmark symptoms, mal breathing, snoring, and apnea.
Those children are going to have sleep disruption.
They're not going to do as well academically as the children with good breathing.
So society have forgotten about the kids who have mal breathing and sleep disorders.
It was no different for me back 40 years ago when I was that nine year old child.
Or the child that's sitting in the classroom today.
But leave goes beyond that.
If parents put in into PubMed or put into Google, Karen Bonnock, B-O-N-U-C-K, and pediatrics,
or Karen Bonnock and sleep disorder breathing, they'll pull up a paper that she conducted.
It was published in the journal Pediatrics in 2012.
And she looked at 11,000 British school kids.
She looked at children who had sleep issues at age five if untreated.
Now a sleep issue is simple snoring.
And I don't mean to talk about simple, but most often these kids, it's completely overlooked.
Those children with sleep issues at age five if untreated,
they have a 40 percent increase risk of special education needs by age eight.
So she talked about, if we read that paper, she talked about that the brain is developing
during slow wave sleep.
And slow wave sleep is deep restorative sleep.
But if the child is snoring or mal breathing or stopping breathing,
it prevents the child from going into the slow wave sleep.
And it's affecting development of the brain.
So the children with poor sleep, their IQ levels are going to be significantly reduced
versus the children with good sleep.
And unfortunately, this is being overlooked.
So coming back to PubMed today, looking at that connection, how many children
have overcrowding of teeth?
And when a child is overcrowding of teeth, what is this telling us?
It's telling us not necessarily that the teeth are too big, but the jaws are too small.
There's not enough room for the teeth, because the jaws have not developed the way they should
have developed. And because the jaws are narrower, more V shaped, there's not enough room for the
tongue. The jaws are set back in the face. The tongue is more likely to encroach the airway.
The airway is narrower. The child now is going to have disruptions to their breathing during sleep.
And what's more, this doesn't just affect the child during childhood.
This carries through for the rest of their life.
Right.
So dentistry has debated this for 100 years, but I would say to any parent,
go in on PubMed and put in mild breathing and malocclusion,
put in sleep disorder, breathing, and brain development, and put in these keywords and
look at the papers that you pull up.
Now today, I could not find one single paper.
I'm sure there's a few of them out of 700 plus papers.
You would expect a few, but I could not find one single paper that did not show that
mal breathing children have changes in the shape of their face.
Now, one could argue, well, the child was born with a narrow palate.
The child was born with a high palate.
This infringed the child's nasal cavity.
And as a result, the child had to mal-breathe because the child was feeling that they weren't
getting enough air through their nose.
Okay, that's fine to think of it that way.
Or one could think that while the child was having their mouth open, especially during
those critical growth periods, age one to five years of age,
it's when the fastest growth sport takes place.
Right.
Because the mouth was open and the child was breathing through it, the tongue wasn't able
to rest up in the roof of the mouth.
And because the tongue wasn't resting in the roof of the mouth,
the jaws didn't develop the way they should do.
Now, either way, we have a connection between narrow jaws, longer facial structure,
overcrowding of teeth and mouth breathing.
Whether it's the genetic that the child was born that way,
or whether it's environmental and the genes coming together,
the real issue here is that dentistry one way or the other has a role to play.
Because the dentist is in an ideal position to be able to do something about it, to expand the
palate, to bring in myofunctional therapy, to eliminate oral behaviors such as mouth breathing,
tongue sucking, pacifier overuse of pacifier, eating soft foods, to check tongue tight,
to encourage breastfeeding, because these are all the necessary habits that are important
for the correct development and the growth of the face of the child.
And it goes, we were talking about academics, but it goes beyond that because when the face
grows correctly, the face is good looking. Good looking people have it easier in life.
It's been shown good looking kids will tend to get better marks,
good looking kids will tend to get away with misdemeanors.
And there was a study of individuals put in their photographs were put in front of judges.
And the individuals with the less attractive faces were more prone to receiving a harsher penalty
from the judge. So we as human beings, unknowingly, we do judge individuals based on locks and
probably because it comes down to survival of the species.
A good looking face is the face that nature has intended.
We select our partners based on locks, parking.
Partly, sure.
We select it probably because we know that if I select a good attractive looking moment,
her airway is good, her genetic pooling is good.
So our face is, it's a very important, I suppose, it's very difficult while in terms of the words
and I'm trying to, but our faces, it's almost that our face is the first thing that people see.
It's as a measure of health.
And it comes back full circle.
The children with mouth open, it can contribute to abnormal craniofacial development.
I know there's debate on it, but I am going to come back to,
even if it's a genetic influence in the child who was born with the high upper narrow palate,
something could be done about it.
That's what we need to start recognizing.
And I remember reading an article by an orthodontist called Catherine Vague and she was asking,
is there a role for the importance of nose breathing and orthodontics?
And she was saying that it's difficult because there's a number of scientific questions that
can't be answered.
Number one is, at what age if the child gets the stuff he knows, does it have the biggest impact?
Is it when the child is two years of age and causes mouth breathing or is it six, seven or eight?
Okay, these are the questions she's putting out.
For how long does the child have to breathe through the open mouth before it has a negative impact?
How much nasal obstruction is clinically relevant?
How do you define mouth breathing?
We don't have the answers to these questions, but we have to ask and we have to allow common sense
kick in here.
If the child is persistently breathing through an open mouth when they are distracted during sleep,
during rest, it points that at least for some of the time their mouth is open.
If they're breathing through, their tongue isn't resting in the roof of the mouth,
and that is going to impact craniofacial development, their looks, but also their academic ability,
especially when the airway is compromised due to setback of the jaws.
And not just looks and intelligence, but also how they can function.
We're starting to see this correlation between ADHD and anxiety and depression, things that
in the beginning none of us even thought there was a connection.
But as you dig into it, to your point, if it's impacting your intelligence,
then it is logical to say, obviously it is impacting their emotions.
Because we're in an increased stress response and society is demanding that the child is able
to be attentive. And also there's an awful lot of pressure on kids to get grades.
There's pressure by the parents, there's pressure by the teachers, and the child who is not performing
so well, their self-esteem is going to be affected.
But coming back to ADD and ADHD, in that same paper by Karen Bonock,
she said there are three million children aged between six and 21 years of age in the United
States, three million kids that have issues associated with sleep disorder breathing,
including ADD and ADHD. So can you imagine this is a moral cost, it's an economic cost,
it's a societal cost. Unfortunately, why has it been overlooked?
Why has the importance of breathing in and out through the nose?
Why has the importance, the recognition of correct and resting posture, as a need to
developing forward growth of the jaws, to help open up the airways that child grows into an
adequate good breathing for the rest of their life? How come it has been overlooked?
It's a really pertinent question. It's one that I've been asking myself for about 12, 13 years.
Tomorrow morning, I interview Dr. John Mu and Dr. Mike Mu.
Okay. John Mu is 94 years of age now, and he's been talking about nasal breathing,
correct and resting posture for about 40 or 50 years. Mike Mu is a little bit older than me,
he's in his early 50s. It's going to be a really interesting conversation. And it's going to be
a conversation because what they have been saying, even though they've been, in essence, pioneers
and what they've been saying, there has been some kickback from traditional orthodontists.
And that is really unfortunate because we have to start asking these questions. And I would say
to parents, listen, you go into a restaurant and look at the face of the mouth breathing kid,
you will see it. If mouth breathing didn't have an impact on faces, the term adenoid faces would
never have come into being. So a situation, and it's a medical term, that when the adenoids are
enlarged, the child is not going to feel comfortable breathing through the nose,
because the space at which the nose meets the throat is too narrow, too small.
Right.
The child feels air hunger breathing through the nose, so it switches to mouth breathing.
When the child switches to mouth breathing, they have to drop the tongue.
Adenoid faces are not the change in the face solely because the adenoids are enlarged.
Adenoid faces are the change in the shape of the face owing to the mouth breathing pattern
as a result of the enlarged adenoids. It's not just enlarged adenoids that cause mouth breathing.
It's the mouth breathing that's causing the abnormal impact on the face.
Go in and Google and put in adenoid faces and just take images and you will see image after image.
We see these kids, they could have been beautiful looking kids. They're undergoing orthodontics,
11, 12, 13 years of age. There's often a belief out there that if you straighten teeth,
it will make an enormous impact on the child's face.
Right. And we're doing retractive orthodontics and we're adding insult to injury. We're taking out
teeth and this small airway is getting smaller because we're not
pulling things forward and widening.
Yes. A straight teeth do not create a good looking face, but a good looking face will create straight
teeth because if the face has grown the way it should have gone.
It has room. It has room for the teeth. And then you have to ask, well,
is this just some minority of kids that are experiencing this? Of course not.
You walk into any 11-year-old school classroom and ask how many children here
are undergoing orthodontics and it's probably 60, 70% of these kids.
Right. Right. And as parents, we didn't know because it was none to us.
We're doing it to our children. So now, you know, we're on the second generational impact of
airway and now you're starting to see our generation. I'm licking you in with me.
You're with my generation that we're starting to see these sudden
spikes and high blood pressure and sleep apnea. I mean, how often,
how many people do you know that have CPAP? I mean, it's just common.
It's epidemic. It's epidemic. And Dr. Krushan Gimel, though, who's considered a founding father
of sleep medicine, he talked about a few things that are impacting and increasing the risk of
sleep apnea or sleep disorder breathing. Two of the genesis is one. So for example,
if the child is missing one or more, T. as an adult, and he's saying these are risk factors
that could be identified early in life. So he, when he was working in Stanford, sadly,
he's passed on a patient might walk into his clinic and the patient may be 40 years of age.
The patient is after having sleep apnea for probably 30 of those years.
The patient is missing one or two T. This could have been identified early on life.
This could have been predicted. He also talks about extractions. So for example, extraction
of wisdom teeth, that when there's an extraction, it in turn is making them out smaller.
When the mouth is smaller, there's not enough room for the tongue. And the tongue is nowhere to go,
but back into the throat. Now, of course, a sleep medicine specialist would say it's not just as
simple as that. It's not sleep apnea is more complex, but these are one of the factors.
Right, right. Just to be clear. Yeah.
All of the phenotypes in sleep apnea, there is four in particular in adult sleep apnea.
One is anatomical, but it's the single biggest contributory factor to sleep disorder breathing.
And that would be peak risk is the pharyngeal closing pressure,
the suction pressure at which the airways collapsing. So it's an anatomical phenotype.
There are three others which are non anatomical, but they are also influenced by how we breathe,
such as upper airway recruitment. That's influenced by myofunctional therapy.
Loop gain is influenced by your breathing pattern and your chemo sensitivity to carbon dioxide.
Arousal threshold refers to whether you're a light sleeper or a deep sleeper.
So for example, if you have insomnia, you have lower arousal threshold.
If you're a really, really deep, deep sleeper, you've got higher arousal threshold.
We can still influence true breathing because we can show how to downregulate.
So an individual who is having insomnia, they're overstimulated.
They can't fall asleep readily. Their mind is racing. They're overthinking.
Or they may be waking up at two o'clock or three o'clock in the morning.
They're lying there for an hour or two. They can't fall back to sleep.
So how can we help to downregulate? By changing breathing patterns,
by slowing down the exhalation, by breathing in and out through the nose.
And especially when we have that really slow and soft exhalation.
The body is telling the brain that everything is safe.
When the brain interprets that the body is safe, we're more likely to go back to sleep.
But if we're lying there and we're mouth breathing and fast breathing and hard breathing,
the body is telling the brain that the body is not safe and the brain will keep us up.
So we have to be careful of the communication that the body is telling the brain.
And part of that communication is relayed via the vagus nerve.
80 to 90% of the communication by the vagus nerve is from the bottom up,
from the body up to the brain. And we can tap into that via the breath.
You are listening to Airway First with today's guest, Patrick McEon.
You can find out more about the Children's Airway First Foundation and our mission to fix
before six on our website at childrensairwayfirst.org. The CAF website offers tons of great resources
for parents and medical professionals, including videos, blogs, a recommended reading list,
comprehensive medical research, podcasts, and more.
We also encourage parents to join the Airway Huddle, our Facebook support group,
which was created for parents of children with Airway and sleep-related issues.
You can access the Airway Huddle support group at facebook.com backslashgroups backslashairwayhuddle.
If you're a medical professional or parent that's interested in being a guest on an upcoming episode,
shoot us a note via our contacts page on our website or send us an email directly at infoatchildrensairwayfirst.org.
As a reminder, this podcast and the opinions expressed here are not a medical diagnosis.
If you suspect your child might have an airway issue, contact your pediatric airway dentist or pediatrician.
And now let's jump back into my interview with today's guest, Patrick McEon.
So the mouth-breathing child as I was, poor sleep, were already in an increased stress response.
We can't focus during the day. The adrenaline from sleep has carried through to during the day.
We're sitting in a classroom and mouth open. Mouth-breathing is a faster breathing pattern,
a shallow breathing pattern. This also is telling the brain that we're in a stress response.
So both during wakefulness and also during sleep, how we breathe our airways,
the quality of our sleep is going to influence the balance of the autonomic nervous system.
No child is going to reach their full potential if they have sleep disorder breathing.
And the three hallmark symptoms of this is snoring, mouth-breathing and apnea.
And just to be clear, every time we bring up sporeening kids, I like to mention it's not cute.
It's not normal. As a society, we've made it that way, but it's not.
So if your child is a chronic snore, that is a sign.
We should not hear breathing of a child during sleep.
And also, you might think that, well, an adult having an apnea,
it has to last for about 10 seconds or so. For a child, it's only two breaths.
And all the child has to have is one apnea every hour to be clinically significant.
Now, the other thing that I would say is, any parent who wants to
explore this because the gold standard of treatment for obstructive sleep apnea is
tonsillectomy and adenoidectomy. And in a paper published in the American Journal
of Respiratory and Critical Care Medicine, co-authored, well, the lead author was
batter Chargy. They looked at 578 children who underwent tonsillectomy and adenoidectomy
for sleep disorder breathing. Out of the three hallmarks,
out of the 578 kids, only 27% had their sleep apnea cured post tonsillectomy and adenoidectomy.
73% of these children continue to have residual sleep apnea post T&A.
Now, at the top of that paper, you will read that the efficacy of tonsillectomy and adenoidectomy
in the treatment of sleep disorder breathing in children is unknown. This was published in 2010.
This practice has been carried out with children since the late 1970s.
How can a practice be carried out? And it's not a walk in the park.
Without it's the efficacy of it being known. Now, in fairness, the AHI, which is a measurement
of the sleep apnea severity, it did reduce from 18 events down to four events per hour.
But four events per hour is bordering on moderate sleep apnea with children because five is the
cutoff point. So then we have to ask the question, well, there's something else going on here.
Right, there's still no room. There's no room. And we have to be considering retronatia. We have
to be considering inflammation. We have to be considered our breathing patterns. And it was
Dr. Christian Gimelow again. He spoke about the critical importance of restoring nasal breathing
during wake and sleep as the only valid and complete correction of pediatric sleep disorder
breathing. Restoration of nasal breathing during wakefulness and sleep as the only valid and
complete correction of pediatric sleep disorder breathing. We must teach our children to breathe
in natural nose. And into that, I mean, I would like to take some time to demonstrate some things
parents can show their children. But I don't want to get too far away from it, because you mentioned
inflammation and carbon dioxide. And from reading your books, and I'll put the links
within the show notes, parents can grab them. And because they're great references for working
with kids, but also ourselves. You really stress this part of proper breathing is how we're processing
and working with carbon dioxide, because we were always taught it was just this waste gas.
But it's actually that's part of proper breathing. Could maybe we talk a little bit about that to
help parents understand that. Yeah, you know, as human beings, we breathe in to bring an oxygen,
and we breathe out the excess CO2. But the key is don't breathe out too much of it. Right. It's not
about getting rid of it all. All of it. Right. What does carbon dioxide do? We must have a certain
amount, not too much, not too little, just right. So we're talking about the pressure of carbon dioxide
in the blood, which in turn is influenced by the partial pressure of carbon dioxide in the lungs.
And the pressure of carbon dioxide in the lungs is influenced by how hard and fast we breathe.
So if we're example, I start breathing hard and fast, I'm going to remove too much carbon dioxide
from the lungs as I'm breathing out hard and fast, a lot of volume of air. And with that,
I'm getting rid of carbon dioxide from the lungs. This in turn is going to get rid of carbon dioxide
in the blood. And this in turn is going to cause my blood vessels to constrict. It also causes
hemoglobin, which is the protein that carries oxygen to hold on to oxygen more readily. So
it's ironic that the harder and the faster we breathe, the more blood vessels constrict,
and the less oxygen that's delivered throughout the body. But also the harder and faster breathing,
the brain is interpreting that the body is going into fight or flight. So it needs to,
you know, in terms of breathing, and if somebody is looking at what's the physiology behind this,
just Google the Bohr effect, B-O-H-O-R. So this was discovered back in 1904,
that the functions of carbon dioxide are well written in any medical textbook with a section
on respiratory physiology. It's the primary regulator of blood pH. It's a vasodilator,
tapping to open the blood vessels. It's a bronchodilator, taps to open up the airways.
And it also assists in the release of oxygen from the red blood cells to the tissues and organs.
You know, so the idea of telling a child if they're stressed to take a big deep breath,
well, that may be in essence the absolute wrong thing to do. We should be teaching children how
to regulate their states. We should be teaching kids who are going in to do exams. And again,
it's been documented, children who are going to do exams, how does their breathing change?
Those children with the most anxiety, their breathing gets faster, harder, upper chest and
irregular. And there's a correlation between the change in breathing and anxiety. But the one thing
about the breath is that you've got some degree of control over it. So if we had a child who is
predisposed to anxiety, if that child knew that by changing and controlling their breathing pattern,
they can help to minimize, to reduce, to control their anxiety. It's a great tool.
It's not happening, not yet, but I think it will. And you know, we use breathing techniques. We use
them with the military. I used them with police. I used them with top fighters, Olympic athletes.
We use them with all walks of life. So breathing is something now that is getting out there because
this isn't about taking the deep breath or taking the full breath. This is about knowing how do you
breathe when you want to upregulate, when you want to downregulate, when you want to improve your
sleep quality, when you want to change your state of mind. And really, we have to be thinking of
it this way that breathing does need the attention. Now, in terms of children, the breathing exercise
for kids are all free. We've put them up there. They're all up on YouTube. If any parent goes
into our YouTube channel or even downloads the butyco clinic app, which is free, all of the
exercise for kids are there. So, you know, we, there's different videos, why does the child breathe
through the nose? Because the child's, it looks natural. You're better at your sports, it helps
with your dental health. You know, is there a connection between children who are mouth breathing,
which is causing a dry mouth, which in turn is increasing the instance of bacteria in the mouth,
which in turn is contributing to dental cavities and gum disease?
Children with chap lips, do children with mouth breathing get chap lips more than nasal breathing?
And of course, the answer is yes. Is there a connection between mouth breathing and
halitosis, bad breath? Is there a connection between mouth breathing and speech,
speech and speech problems? Is there a connection between mouth breathing and
eustachian tube? We already spoke about development, you know, so that connection is there. I think
the parents are very important, but this information is readily accessible. And, you know,
that's why when I was writing the books, I always wanted to try and reference as best we can and
support that the information, there is nothing new about this. This has been here for decades,
but yet parents, it's almost as if it has been hidden from parents. Yeah. Yeah, no one talks
about it. And the other part to me that is so astounding is not just parents aren't talking
about it. What we're finding with cath is doctors, pediatrician, dentists, they weren't talking about
it. They weren't taught it. And that's mind boggling to me personally, just something so simple.
But I think that's the problem. I think, you know, there's very much in medicine that if you're
doing research that you have to be doing research of what's trendy, what's cutting edge, what's at
the top of the game. Very few doctors are going to tell their peers, what are you doing research on?
I am researching the importance of nose breathing. They will be laughed out of the park. There is no
incentive to do research and breathing, because it's seen as so simple, so mundane. Why would you
be doing anything research or not? And the other aspect of, of course, it doesn't promise profit.
And that's a problem too. I was about to say that's the other unfortunate thing that I have heard
from other dentists that you're hearing is we're telling people don't do braces. Don't pull teeth.
And for a lot of dentists, I mean, we'll just call it what it is. It's the bread and butter. And
we're saying don't do it, because it's dangerous. So right, it's definitely,
definitely a hot topic. So with regard to breathing, and I will absolutely put,
we have, and I'll put links in here, but we do have several of your links already on our website
and our YouTube channel as references for parents. But maybe we could just do something quick that
parents could do. You have a child, you have a teenager, they're stressed for a game, like you
said, maybe before an exam. It means just a hard day. What's an easy exercise that maybe we could
help bring them back into focus and help them regulate? There's two exercises that are pretty
good for that. Now, what I would say is don't introduce the exercise when the child is stressed.
Introduce the exercise to the child when the child isn't stressed. Okay. And have the child
practice it when things are going okay. And always explain to the child, if things are not going your
way, this is your friend to fall back on is your breathing. Because if you control your breathing,
you can have to control your mind. The first exercise is small breath holes. Take a normal
breath in through the nose, out through the nose, should be silent. So it's a normal silent breath
in through the nose, a normal silent breath out through the nose, pinch the nose and hold five,
four, three, two, one, let go. And just breathe now for about three four breaths.
And then again, take a normal breath in through the nose, an out through the nose and pinch
the nose and hold five, four, three, two, one, let go. I'm breathing normally now for about
three to four breaths. And again, take a normal breath, Inter
to nose and hold, five, four, three, two, one, let go and breathe normally for about three to four
breaths. If the child has small little breath pauses, it helps to keep their breathing more
regular. It helps to reduce the risk of hyperventilation. That's one way to do it. The second way is
anytime, and I would say to parents actually, practice this yourself first. Okay. Do it when
things are going well and fall back in it when things are going not so well. Anytime that we
get into a difficult situation, the most important thing is not the hyperventilation.
And if we start breathing hard and fast, of course, the body is telling the brain that things are not
good. The brain is here to protect us. And the brain will want us to get out of the situation,
launch us into a fight or flight response. Whenever we get into a difficult situation,
as best as you can, bring your attention onto your breathing might be a minute or two afterwards.
You may not be able to do it there and then because the situation sometimes can take over.
But after a minute or two to step back and just bring your attention onto the breath,
nobody will even know that you're doing it. Take a soft breath in through your nose and have a
really relaxed and slow gentle breath out. So even though you might want to feel that you're
breathing hard and faster, you might want to feel that this is the way to breathe. Always remember
if you're breathing this way, it's only going to feed into your stress response. How do you tell
the brain that the body is safe? Slow down the exhalation. Take a soft breath in through the
nose and a really relaxed and slow gentle breath out. So when we have that very soft and slow gentle
breath out through the nose, we're stimulating the vagus nerve, which secretes a neurotransmitter
called acetylcholine, which causes the heart rate to slow down. And when the heart rate is slowing
down, the brain interprets that the body is safe. So the child that's about to go into an exam,
and their breathing is getting hard and fast, and they start sighing and taking these big breaths,
that is going to affect the child's ability to do well in that exam. And it has nothing got to do
with the child's intelligence. It's just that the child didn't have the tools to self-regulate there.
You say to the child, whenever you feel that your breathing is getting a little bit off,
focus on slowing down the exhalation. Don't wait until the exam. Start doing it with small things
first. See, the one thing about breathing is that if you bring it into your everyday life,
it's there for you anyway. And things will always happen. Something happens, you could even have a
patient who's giving out, and the patient is giving out, they're opening and closing their
mouth, and there's noise coming out of their mouth, and you have your attention on the breath.
You're taking a soft breath into the nose, and a relaxing slow gentle breath out.
You're still listening to the patient, but you're going to be remaining calm. And what you'll find
now is that the patient will start coming down. You're in a better situation to deal with this
situation. You're not going to be, you know, almost being consumed by the mood, because
of course, every now and again, people are in a bad mood, and they're going to take it out on
somebody, and that's normal. That's human nature. Right. So these are the tools that we should be
able to use. Every one of us is always something that'll happen. If it hasn't happened, don't worry
it soon. Well, it will. And it's interesting, because one of the things I've heard you mention,
and I've pulled into my daily life, aside from, I actually, I can't tell you how many times a day
now I actually monitor and notice my breathing, which is funny. Somebody with an airway issue
never thought about it before, but I do now. I notice it, and these tools have helped me.
But watching other people, you know, I was always taught to watch body language,
and watch their head, watch their shoulders, watch what they're doing. Never occurred to me,
watch their breathing. And I heard you say this, I think it was in the TED Talk one time.
Wow. And I'm noticing now when I engage with people, I do watch for that, and especially even
with my children, because such a subtle nuance. Child looks just fine. And I started watching
her breathing, and I'm thinking, wow, she's a heavy breathing moment right here. Something's
going on in its nose breathing, but had it not been attuned to it, completely would have missed it.
So just another great tip for parents, you know, as you're thinking something so simple,
watch their breathing patterns, watch what they're doing when they're awake, because even if they
look okay, you know, and this is an example, I'm thinking of my child was in fight or flight,
she was in complete freak out mode, and I had, I would have, there was no other way I would have
known it. Yeah, yeah. And it can be a very important tool because kids now, you know, they spend a lot
of time on social media, they spend a lot of time on mobile phones, we've, we will not always know
what's going on there. That's just the way it is. Nope. Nope. So typically at the end of a podcast,
I like to completely turn the floor back over to our guests for final thoughts, be it for parents,
or medical professionals, or both. So I would like to give that, give the floor totally over to you
now. You know, I think the most important thing is for the individual to be informed and to do your
own digging on this one. There's questions that are unanswered. And we, but we still have to ask
the common sense of it on the logic of it. You know, I think the more we observe and the interesting
thing from the medical health point of view is most medical professionals who were into airway,
when I actually asked them what brought you into this, they came across it because when they were
working with their own children. And that's a very interesting one, you know, they're working with
their patients, but they don't see their patients when the patient goes home. Right. When you're
working with your child, you're seeing the child during, of course, the treatment, but you're also
seeing the child during sleep during their normal every day. And this is when then some people will
just ask the question, just something is off here. And breathing could be very that one thing.
I'm not going to say it's a cure all not a lot, but it is a fundamental function that influences
all of the major disciplines of medicine. 75% of individuals with panic disorder and anxiety of
dysfunctional breathing 75%. Now, we could say that it's the anxiety and the panic that's causing
breathing to be faster and harder and upper chest and irregular. But we also have to realize that
that faster and harder and upper chest breathing is feeding back into the stress response. So we
do have those tools. And I think it starts with us, like it starts with me, it starts with you,
it starts with the person listening, you bring it into your own way of life. If I'm on the treadmill
behind me here, I will do it with breathing in and out to the nose. When I'm asleep, my mind is
closed. If I get into a difficult situation as best I can, I bring my attention onto my breath,
I slow down the exhalation. I do breath holding during the day. I take my attention out of the
mind and I connect with my breath with many, many times throughout the day. And it's a tremendous
capacity to help to bring a stillness to the mind, a quietness to the mind, but also a connection
with everything that's going on around you. And ultimately, it helps with energy levels,
concentration, creativity, intuition, and above all, happiness. Because I remember when I was that
kid, even into my early 20s, and having spent 16 years in formal education, I come out of it not
knowing how to concentrate. I come out of it not knowing how to regulate states. I come out of it
not knowing how to deal with the stress and the challenges of when you first go into the workforce.
So it didn't teach me the very tools that I needed to learn to be able to go out there in society.
And I was very stressed in my early 20s in the workforce. And it wasn't necessarily the company
that was causing it. But it was my physiology. Because ultimately, our resilience and our ability
to cope with the daily, you know, ups and downs of life. You know, anybody listening to this will
identify with this, you know, something happens, one person can take it in their stride, and the
other person, it's a total drama that consumes the individual. So stuff happens. Do you
we want to be at the mercy of every small little situation that happens because all that's doing
is going to throw us into a state of chaos. So life is a bit softer when you have a connection
with your breath because you can regulate your states. And your breathing is also influencing
your sleep. Your sleep is influencing your emotions, your emotions are influencing your
breathing, your emotions are influencing your sleep. Your breathing influences your sleep as
well. So there's a three way connection there, you can't disentangle the emotions from sleep
and breathing. One is feeding into the other. So there's that bi-directional relationship
always there. Start with the breath, even just start breathing through your nose during rest,
during physical exercise, never wake up at a dry match in the morning. I just came across an
article there, but three days ago, that adults who wake up at a dry matter at a greater risk of
snoring and obstructive sleep apnea, we've been talking about this for 20 years. This was the
first paper that I've seen it being studied. If you have a dry mouth in the morning, you're at a
greater risk of snoring and sleep apnea. The very fact that the dry mouth is mouth breathing.
It's mouth breathing that's increasing the risk of snoring and sleep apnea and the dry
mouth is the result of that. Right. It's a sign. That's it. Well, I cannot thank you enough for
taking the time to come on and speak with me today. I really appreciate it. It's a pleasure.
Thanks very much, Rebecca. Thank you. Thanks again to today's guest, Patrick McKeown,
for sharing his political insight and to each of you for listening to today's episode.
If you're new to our podcast, please don't forget to subscribe. And if you enjoyed today's episode,
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working hard to help make the lives of kids around the globe just a little bit better.
Take care, stay safe, and happy breathing, everyone.
Bye.