ļ»æEmma: In this episode of midlife AF, I am going to be talking to the really interesting Dr. Louise Oliver. And we're going to be talking about whether or not breathing might be the missing piece in your perimenopausal and menopausal chicks or pas puzzle. Again. Louise was part of my life a F series of Instagrams that I did in the lead up to the great Masyarakat experiment in June. And what's particularly interesting for me in this conversation was the effect of the perimenopause and menopausal hormones on snoring and what we can do to radically improve snoring by just using our breath and the contrary indications of snoring on our health, well being and sleep. So over to myself and Dr. Louise Oliver.
Emma: If you're a woman in midlife, his intuition is telling you that giving booze the elbow might be the next right move. Then midlife AF is the podcast for you. Join counsellor psychotherapist this naked mind and grey area drinking alcohol coach Emma Gilmore for a weekly natter about parenting quirky teens, menopause relationships and navigating this thing called midlife alcohol free. If you're feeling that life could be so much more that you're sick and tired of doing all the things for everyone else. If your intuition is waving her arms, manically at you saying it could all be so much easier. We didn't have to keep drinking. Come with me. Together we'll find our groove without booze.
Emma: Thank you so much for coming on and doing this with us. This is Dr Louise Oliver, I wanted her to come and speak to us because she has such an interesting specialism and particularly, for me, just things that she's been talking about that I've come across through social media, I have no idea. And I think there's probably a lot of women out there who have no idea the effect that breathing can have, and the ability that breathing has to change our outcomes in life. So Louise, I'll hand it over to you. Do you want to introduce yourself and tell us or tell everybody a little bit about yourself, sir?
Louise: Yes, sure. So I'm Louise Oliver. I've been a GP for over 20 years. And I was very fortunate beginning my career to have a little bit of extra training in women's health. So essentially follow the journey out throughout that time, and very bizarrely ended up. Well, if I'm being honest, I chose mindfulness in an appraisal just for just a random thing. I hadn't planned it. And then I've gone down this journey and just discovered breathing and actually how important it is, particularly as women transition through the perimenopause and menopause and become utterly obsessed with it. So I'm still a GP, but I do yeah, my breathing works as well.
Emma: So absolutely amazing. And I've, for me, breath is a phenomenal tool in our toolbox anyway. And I've worked with people who struggle with alcohol, or people who are looking to change that relationship with alcohol. And a lot of reasons why breathing and being able to regulate yourself using breath can be really, really helpful in that area. But I had no idea about the area that you cover now. Also, I wanted to fess up and I'm very open about my snoring. I'm an open snorer. But I find as I get older and I think the reason I say this is very common. I had no idea it was anything to do with perimenopause. My snoring has become like an everyday thing. It's not just oh, you know, it's an everyday thing. I know. Now, I cannot share a room with anybody if I go away. And it actually is a little bit of a problem in that way. But I think there's more to it than Louise than just, you know, the inconvenience of having somebody sleeping? Who's snoring? Oh, can you tell us a bit more about that?
Louise: I mean, what I mean, certainly breathing. You know, I know that we can use it to calm ourselves down and it's a really useful tool. The one thing I think that I didn't realise was how important your 24 hour breathing pattern is. You know, obviously, I did start meditating as I sort of went on my mindfulness journey and sort of recognized that breathing in a certain way, during that time was helpful, but not really sort of fully appreciated, how we breathe 24 hours a day, how that affects us. And how we breathe, when awake very much dictates how well we sleep actually, dictates whether we go whether we stay in that fight flight zone, or whether we actually end up going into that parasympathetic, you know, relaxation response. But what actually, what should happen when we're asleep is we go into that parasympathetic, relaxation response. And then our body's in and can do all those repair and recovery processes that we need when we're asleep. It's a very active sleep process, but if we remain in that fight flight zone, the body thinks we're being attacked unsafely and it will prioritise sort of waking us up patchily, perceiving that if we're breathing heavily in noisily, it perceives that there's a threat. So it actually affects our health and well being. And that's the thing that I don't think. Certainly, medically, I know all the negative things about sleep apnea, but snoring is on a spectrum. Yes, not as bad as sleep. Yeah, but it's still there. So it's really crucially important how we breathe at night.
Emma: I find that fascinating. I had absolutely no idea that you stay in fight or flight when you're breathing. I mean, no wonder people are so exhausted, right?
Louise: It's, um, you know, I'm an ex of an ex perimenopause, or SnoreRx. So I started, you know, I'm in a healthy way, I run three times a week. And I started drawing as a new thing. And, you know, going through that experience of my sleep was rubbish, and then trying to do a professional job the next day, it makes me irritable. My husband who's next to me, obviously, he's going to be disturbed. So then he gets irritable. And then you end up sort of in separate rooms, because there's an unpleasant person next to you. And that's not good for relationships. And certainly HRT for me, I had about four symptoms, and three of them disappeared when I started HRT, but my snoring digit, and then yeah, it until I corrected my breathing, and I didn't think my breathing was that bad. And it's gone, and then the transformation, then I sleep so much better. I don't get up to pass urine, which has been the most because what people don't realise is that one of the symptoms of sleep apnea is passing urine frequently at night. So ya know, it's a spectrum. And yeah, so, you know, is snoring on that spectrum. So, you know, we may be getting paid in the night because our blood is not as good as it was. But certainly, I don't get up to pressure now and it's a common anecdotal thing. I couldn't give you a scientific answer. But lots of people who improve their breathing don't, because they sleep deeper. It's all complicated how it went. I'm not convinced I can tell you the scientific thing behind it. But, but it is. Yeah, if you've got sleep apnea, it's possibly something to do with dropping the oxygen levels and the effects on the kidney. I'm not sure quite how snoring impacts that but, but anecdotally, people I've worked with sleep, and don't get up to pass you're in as much. Which is really because then you don't know, you're not then your mind's not active. If you don't wake up, then your mind's not active. Is it likely to sleep? Well, so I mean, this is
Emma: This is really huge, I think, because fatigue is such a huge symptom. For a lot of women of perimenopause. And a lot of women who drink in perimenopause are drinking just to push through, you know, because they're so tired. And actually, what it's doing is potentially making things worse. And then, you know, we've got this snoring, and to tell us, Louise, we've got things that can help what how can we know? What do you recommend people do in this situation?
Louise: When I think first of all, I sort of come at it from I've just created a sort of three A's approach to sort of awareness and action. The first thing being aware because I think so many women, you know, and I'm guilty of this, you know, I've, I've, you know, I've looked after when for a long number of years, I insist there that sleep disordered breathing increases as as we go through the menopause you know, Certainly I wasn't aware of it, and a lot of the menopause specialists I speak to are not completely aware of it. Now, it may be, I don't know, certainly, I used to think there's not a lot you can do about it apart from telling people not to drink alcohol, lose weight, you've got nasal congestion, use a nasal spray. And it wasn't that it wasn't that successful of us, I suppose perhaps, perhaps the patient's word gets out, it doesn't help. There's nothing the doctor can do. etc. But I think just being aware of how you breathe when you're asleep is important. So just just sort of checking, you know, sort of checking with your breathing. So if you started to sort of think, you know, what is my breathing, like, you know, how it helps me recess, this will just literally over the next week, check in with yourself and sort of think, you know, how am I breathing. So the first basic thing is, we've been given a nose, it's an organ, it communicates that the rest of our body uses it to breathe in. So are you nasal breathing, when you're asleep, you might have to ask somebody else to try and assess that. When you're moving, if you look at the number of people, and you walk down the street, just look how many people are now breathing, just like walking down the streets. It's the various reasons and I could go on and on. It's so inefficient, as soon as you breathe it. So just assess the simplest thing is, am I a nasal breathing 24 hours a day. And then yes, hurt really, really good breathing is it's, it's slow, it's gentle. The actual if you tune into it, The exhale is longer than the inhale, and is a very bite, pause before you breathe in again. So if you're at rest, and you can hear yourself breathing, and you're chugging away, there's some room for improvement there. We also should, generally, 8% of our brains from using our diaphragm. I don't talk about belly breathing, because we didn't have this brilliant ability to, we could all move our stomach and that actually moved our diet a lot it was anyway. So if we're moving our diaphragm, the lower ribs at the front, go out as we breathe in, and then as you go out as we breathe in, and then as we out, the lower ribs go in. But it's generally that the breath, the Breathing is slow, it's gentle, it's quiet, there's a slight, there's a longer exhale, and there's a slight pause before you breathe in again. If you breathe like that, in the day, that's how you're breathing at night, and it tells you your body's safe. And then you sleep better. And you can't stop, you can't stop. You can't stop everybody snoring because it sort of depends on the size of the nasal passages. But you can, you can generally make a very, very significant difference. And well, who's had gaps in their breathing at night? Who often. And to be fair, often people come to me because they don't want to be diagnosed with sleep apnea. They don't want the CPAP machine. So it's, it's their wife or their partner who's telling, you know, or their husband that says, no, she, you know, you've got gaps in your breathing at night. So not formally used. But then, you know, then their breathing becomes quieter at night, they are less noisy, and then their sleeping partner is reporting that the gaps have stopped. So yeah, but yeah, so. But I don't know if you'd want me to go on to sort of how people can sort of then help themselves.
Emma: Definitely. I wanted to ask you a really quick, silly question. You're probably going to be like, That is ridiculous. And also, that's unsafe, I don't know. But I've heard people talking about putting tape over their mouths when they sleep. Is that connected?
Louise: Completely? Yes. So we, if we think we're aiming for that breathing pattern to be in and out of the nose, gentle, slow using the diaphragm, we need to be using the nose. Clearly, if you are mouth breathing the day and you start to train yourself to nasal breathing the day that's gonna make it more likely that you're using your nose that night. But we know, there's muscle memory, there's nerve connections. If you've been mouth breathing for a very long time, that's a habit and you're trying to break an unconscious habit. Yes, mouth breathing, sleep that needs to be broken. But these, we've got, you've got to it's not just taping the mouth. So it's not just that and the reason being is if you think about it, the airway at night is actually not that big. It's probably about the size of a thumb. If it's right, open, perhaps the size of a bit by row if it's compromised. So it's quite small. So we've got two components to it. One is we've got to get the airway open and as strong as possible. Because if it vibrates, that snoring if it collapses, that's sleep apnea. So we've got to work, then you've got to see what volume of air you are. If you think of it like a straw, you know what amount of air is bringing in and out of that straw. So there's sort of two components of it. So the first one would be, if you what people didn't realise, so is the tongue. Actually, the back of the tongue actually forms part of the airway? So okay, if the tongue is in the bottom of the mouth, it's too far back. And it's actually narrowing that airway. Okay, see me
trying to work it out in my mouth.
Emma: I certainly don't have mine in the correct position at all. And if you think about it, as soon as we open our mouth, the tongue is connected. Connected at the bottom, isn't it?
Louise: Yeah. So it's going to be it's going to be it's going to be on the floor of the mouth or mid cavity? Yeah, I can try and breathe on the roof of my mouth. So you can because you can have an open mouth. So you can, it's just too hard, isn't it? Yeah. So yeah, the correct position is up on the roof of the mouth. So sort of actually sticking your tongue with a tiny bit of suction pressure to the roof of your mouth. Don't put the tip of the tongue right up against the front of the teeth. It's a really strong muscle and you're sort of funny shaped teeth. And I don't want any complaints about that. So do you stick your tongue on the roof of your mouth, just behind the front teeth, and then you want to seal your lips to make sure your face will breathe, and you don't want to clench your teeth? Because the first thing is that people are quite shitty. So I like it. I like just a tiny bit of space just between my teeth and three way space between the teeth. And just that relaxed face. And actually it takes a lot of practice to do that. Yeah. And you need to be practising that probably, I think for two to three months to create that muscle memory, that nerve connection. So that when you're asleep, yeah, that stays in that position.
Emma: Yeah. Wow. That's interesting. So tell me I'm sorry, I didn't mean to interrupt you. Do you? Would you be able to tell me a little bit about this? In perimenopause? I'm assuming it's oestrogen in some way. That changes what happens for us with our breathing?
Louise: Yeah, we're not, we're not quite sure what happens. Certainly, something happens. There's a sleep cohort study in America that really showed that as women transition through the menopause, there's a steep increase in the sleep disordered breathing rates, and is still less than men, there's still always more men that have sleep disordered breathing. But we have this sea breeze. And it took out confounding factors. So things like alcohol weight, and bite, bite when talking. It's difficult, there's not enough research on it. So we don't, it has something to do with the hormones, particularly the back of the throat, we tend to get, we lose some tone at the back of the throat, it's a muscle. So it's a series of muscles at the back that can collapse. So, some of it is that we just lose muscle tone. The other issue is progesterone is actually restoratively stimulant. So actually, what it does is when we've got progesterone around, it actually makes us more sensitive to either low oxygen or higher carbon dioxide. It actually makes us breathe a little bit faster. And then actually, so then we pretend that we have big changes, obviously, in these hormone levels don't wait. I'm but it's really interesting progesterone, like I haven't definitely, obviously the progesterone that I tend to prescribe now for you to adjust and it's definitely better well tolerated than the synthetic ones I used to prescribe. But, it's interesting whether I would say if you're someone that's progesterone intolerant. Really, really just assess your breathing because I have some women that have progesterone tolerance, and I think it's because they, when they have progesterone it makes them breathe faster. So then they start on symptoms of Hyper V ventilation. So it. So it's quite interesting because, you'd think from a disorder point of view, progesterone would help because it makes you breathe. It has some effects on the back of the airway. But actually some women, it seems to make it a bit worse. So it's really interesting. I don't think we know enough about it. Yeah. Yeah.
Emma: But it's definitely a thing that people notice, isn't it? Definitely.
Louise: And you can spend funds that, you know, when we're talking about the airway, so the tongue position, nasal breathing is crucial to open the airway. But the next thing then is to make the muscles of the airway the strongest possible. And then I know, there's a speciality called myofunctional therapy, and they're very much involved in that. But that's not something that we certainly have on the NHS I know have no access to. And Mr. Big Fear, he's an ANC surgeon in London, who runs a sleep apnea and snoring clinic, and he's got a video on YouTube. So exercises for sleep apnea and snoring, and he picked out the exercises. I've got some evidence that strength, the back of the throat, and practising those literally once a day can help as well.
Emma: Wow. Amazing. And so, Louise, you became your GP and got interested in meditation and I'm guessing breathing through that. And then you've been specialising in women's women's health. Yeah. Since then, in terms of breathing for health in the perimenopause and menopause. Yeah. Outside of improving your breath while you sleep. What are the other implications it has for us as parents, menopausal menopausal women?
Louise: I think I, my, my personal opinion, having you know, been looking after women for over 20 years is, I think you've got to look at transitioning through the perimenopause and menopause and thriving, post menopause. You have to see it as a jigsaw puzzle. That's my motion. And I think if you're someone that and I certainly was like that, and I'm not now were you just going to I'm going through, I feel rubbish, I'm just going to push through push, push, push through, not actually, that back, I, you're going to struggle, I think you've got to, you've got to step back, you've got to look at that jigsaw puzzle, you got to be honest to yourself, and there are loads of pieces to that jigsaw puzzle. So I'm going to rattle off a few. So obviously, you drink water and get what you eat when you eat hormones, breathing, spirituality, sexuality, fun, being creative, you know, exercise, resistance training, you know, on and on. So I think people need to step back, look at that jigsaw puzzle and be really honest with yourself, what one or two pieces, if you worked on them, what you have the most to gain. And it may be you know, alcohol is one of them that might go, that's a piece but I'm not ready to do that yet. I'm not, I'm not I'm not at the place in my life that I'm ready to sort of admit that or worse. What I'd say then is don't shove it under the carpet, I'd say put that to one side. Recognize, yeah, he's ready to work on it. And then pick another piece that you're ready to work on. And then and don't aim for, oh, God, you know, I'm a perfectionist to tell you. So I've learned the hard way. Don't aim for perfection, you always feel like it's an illusion, just work on it, to benefit from it. And then when you feel like you've got enough, but you've not run yourself ragged, and aim for perfection, then you can go on to another piece. But I would say breathing is one of those pieces and breathe how you breathe 24 hours a day. That's what I'm saying. And I would say to me, consider it, consider it and assess yourself is breathing relevant to me. Isn't and you're one of the lucky ones that you think you're breathing. Okay, that's fine. You know, choose your other pieces. But breathing, it makes our body if we're breathing in efficiently. Every cell tissue organ system in the body has to use breathing, you know, there's not one cell body that will not survive without breathing. So our body will survive if you breathe in efficiently. You're setting your foundation of your body to be an efficient one that's better than anything on top of that, you know and I will caveat that I am not saying breathing is a cure all. I will never say but um So it's the basic foundation of life. And to have an efficient breathing pattern is, I think, a great way to start.
Emma: So, yeah, and one of the ways of regulating the nervous system, which is like, as you say, it's like we're not when our anxiety that we're in fight or flight, that's, you know, one of the great ways to be able to do that I had no idea about the sleeping stuff. I think that's fascinating. And I, I was just wondering, because I know you do work with women in this way you do you have a course, don't you, which I am definitely signing up to because it sounds like exactly what I need. Because I would love to not be sent love and not to smile so much. But what do you tell me a little bit about that? How do you work with women?
Louise: So I think, I think it's recognizing, so obviously, we can talk about opening up the airway. And you know, as we say, the tongue position, breathing. But then the crucial thing is, a lot of us over breathe, right? This concept I didn't really sort of get a big handle on. And it's amazing how our body, particularly modern day times, generally feels a sort of slight propensity to sort of over breathe. And then if we overeat, various things happen then so we are using our bodies. The basic thing is we're using too much energy then on breathing. Because the actual breathing is, you know, uses a proportion of our body's energy requirements. So personally, I only want to spend the minimum amount of energy on my breathing, because I want more, all the other stuff I want to enjoy. So you see, you want it to be efficient. You want it, you want your breathing, because breathing as you said, your breathing actually sends a signal to your brain to tell your brain are you in a fight? You know, are you being threatened? Or are you safe? Yeah. So if we train our breathing, to be slow, gentle in and out of the nose, that exhale is slightly longer than the inhale. And there's a slight pause. It's telling our body 24 hours a day, we're safe. And one of the end, we're getting evidence through now that actually, in particular, nasal breathing, there's, there's a connection between our nose, our noses connected to our brain with the olfactory nerve. And actually that nerve is connected to the amygdala, which has a role. And it has a role our hippocampus is connected to Yeah. Which memories into Wow. Yeah, and if this makes sense, evolutionary wise doesn't because if you if you've got to remember smells, or tastes, that are either good or bad for us and get 10 kilos, or it's good for us, and it helps our survival. Yeah, we have to remember that and we have to remember whether to mount a fear response if we smell something that isn't good. So it's crucial. And if you work on making your breathing, as essentially as gentle and as slow as possible, you feel calmer. And you just and I, I definitely feel like this and there's lots of knock on effects. My hay fever has been low yet since I've been effective, even but, but then so a lot of the core course is about training your body to do more with less. So to essentially normalise the breathing volume that you breathe in. Because a lot of us over breathe and particularly if we overeat if we're not sleep disordered breathing out training the body to breathe with the amount of it it needs, you know?
Emma: Yeah, I find that so fascinating about the memory. I wonder if you know because a lot of it is one of my symptoms and it's ADHD perimenopause. Yeah, the lovely symptom together is a memory you know, short term memory issues, brain fog, those kinds of things. And so it sounds like that would have an impact on that as well.
Louise: This I mean, this I have to say when I'm looking into, particularly sleep apnea, which is obviously the very extreme end of sleep disordered breathing when you look at what it does to the hippocampus to that memory centre. Actually, I feel I'm definitely more emotional and more connected with them. You know, since I've been more mindful. Yeah, I sort of feel more connected with others don't when I read the papers of the did a study on people who had obviously died and they looked at the effect of that they all had sleep apnea. They looked at their campus, their memory centre, and they looked at the amount of D myelination. So D myelination means the amount of removal of the fatty covering on the nerves and that memory centre. And the severity of their sleep apnea matched the severity of the alienation. And that sort of makes sense. Because when you have sleep apnea, you d saturate your brain so you drop your oxygen levels that cannot be good in any way, shape or form for your brain, which is so metabolically active and requires so much oxygen. And certainly that study, I found it quite upsetting, really, because I thought about the amount of people that I see, and I asked like, you know, it's on my radar now and I asked them, you know, how do you breathe at night? Any snoring? Do you think you've got any gaps in your breathing? And the amount of people that laugh that and say, oh, yeah, my husband's always in the gym, me or your partners? And it's not a laughing matter. It isn't. And, you know, obviously, medically that you can have a CPAP machine, there's some other things that you can have done. But just the basics of Tom position, nasal breathing, strong throat muscles, and breathing volume, you're meant to breathe, not make a massive difference.
Emma: Wow. And tell us who he is. I don't mean to be scare mongering, but I had no real idea, again, from my own ignorance of the impact on our bodies. Because I know obviously we've got the fatigue side of things, because you're waking up. We've got the nervous system, which has so many implications anyway. Because if we're in fight or flight, we're like, you know, we're not working at full capacity. We're like this constricted space. But what else is there because they think you just really quite serious? Isn't it that you say it is and I find it?
Louise: The evidence is there and people want to be informed. But in that study that I mentioned about winning, and this increase in sleep disordered breathing as the transition through menopause, the women were less likely to come to the doctor or the health professional, and saying that snoring or they've got gaps in breathing, they were more likely to complain that things like fatigue, headaches, nightmares, things like that. So it's not on our radar. So it certainly wasn't on my radar before this deep dive. But essentially, when if, obviously, sleep breathing is a spectrum, you've got the gaps in the breathing, which is sleep apnea, you've got heavy, you know, heavy snoring in the middle, and then you've actually got this sort of increased resistance to the air coming in at the other end. And obviously, the data that we've got is more on sleep apnea, that extreme bit of it, but it's got to be effective in fixing it all. And the negative outcomes are generally due to either the oxygen levels dropping, or that pistons have that fight flight, fight flight system. So one of the things would be the cortisol remaining raised, and your adrenaline named race. So that feels unfortunately, increased risk of heart attack, stroke, blood pressure, you have an increased risk of weight gain and diabetes. Is that cortisol and adrenaline and you're holding on to everything? Yeah, completely should adrenaline cortisol drop overnight cortisol, that should drop, unfortunately, the more weight you gain, the more likely you're going to have sleep disordered breathing, it's a horrible circle. The memory problems are generally I believe, due to the dropping of the oxygen level. And some day myelination of that area, you're more likely to have an accident. And unfortunately, some of those are fatal and life changing. And, you know, just brain fog and you know, women, you know, women or men, you know, ended up choosing a job that's perhaps slightly less taxing on the brain. Because they can't concentrate. And that's such a shame. Because, you know, we've got so much at this stage in our life, we've got so much life experience and knowledge that we don't actually recognize, you know, a pat on the back. And actually, you know, for us to stay in the workplace and actually help and have that knowledge and life experiences actually, it's really important for our society and get brain fog because we're snoring or have gaps in our breathing, we, you know, and that could potentially be made so much better. So yes, there's some really negative outcomes.
Emma: So, yeah, absolutely. And what an amazing opportunity as well. And I think as you say, there's absolutely lots of lots of pieces in the puzzle. But to me, breathing feels like our real basics. It's a bit like sleep, it's a bit like rest. It's like if we don't have those things, you know, we can't carry and what function what?
Louise: So what I would say is if someone's got an inefficient breathing pattern, so they're not breathing, as I've described, then, you know, what, what would they gain from from working on that so even if you're not snoring or got gaps in breathing, generally, I find people sleep better anyway. Just because they're, if your breathing is quieter, you're always going to have more of a relaxation response. The other thing is, you're less breathless with exercise. That's a great you know, because if you can, if you press us with that, so I'm always with move Miss breathless with exercise, which is going to put let me tell you what happens. If I, when you get breathless, yeah. The common misconception is you think your oxygen levels have dropped, okay? I can promise you, they do not drop. So if I do too, and so I do all my running. Now I've trained myself to all my running, nasal breathing, even up a hill. And, you know, when you ask you to go for a walk or run, and I said, Write, maintain nasal breathing, keep your tongue in the correct position. But when you absolutely feel you have to open your mouth. That's what I call air hunger. So at that point, when you feel like oh, my god, I can't, I'm not getting enough oxygen. I can't breathe. It's not a lack of oxygen. Okay, it should cut carbon dioxide that's gone up, do we? If I tell you, when I take a breath in, I throw out about 75% of the oxygen I've just breathed in. So just know that when I breathe in, I actually throw out about 75%. Just breathe in. So if I take a bigger breath, that's not going to get more oxygen in because I'm already chucking out excess. Yeah. And even when I'm exercising, it depends on how heavy the exercise, I'm probably still throwing out about 25% of the option of breathing. So the issue is not this, we got loads of oxygen in our lungs, the issue is getting our blood cells to release the oxygen to our tissues. Okay, that actually you get better oxygen delivery, when carbon dioxide is around. Okay. So if you and we've all got so you know, like, if you go for that run, you go for that walk, or you do whatever. And I'm saying to maintain breathing, and you get to a certain point and you're like, Oh my God, no, you know, I have to breathe, yeah. Then if I checked your oxygen levels, they would be normal. And what's happened is your carbon dioxide has gone up. But you can train your body to be less sensitive to the buildup of that. That's what I'm saying. And it's that bad. Yeah. And it's that what makes you if you train yourself like that, that's what tends to make the breathing slower. Because if you think when you breathe in, if someone's breathing fast, it's the thing that actually drives breathing. The initial one is carbon dioxide. So if they're sensitive to the buildup of carbon dioxide, it's, it's that that drives the next breath. But if I train your body to be less sensitive to that, then you don't feel that need to take the breath quite as quickly.
Emma: That's so interesting.
Louise: Yeah, she her last, her last. I think it was her last film Avatar. And she had to do some freediving. And then for the stunt double, I heard her talk. And she was like, No way, you know, they made me a thing. And she was like, no train me to do it. And she was trained by a professional three days and she has to be trained properly. And she did a seven minute breath hole. And I think she'd be according to Google, she'd be Tom Cruise's breath, hold seven minutes. But you don't you don't need to do free diving to sleep a bit better.
But it's really interesting, because I can't when I've done Wim Hof breathing before, it's the one thing I can't do. So I've been to like the, you know, workshops and and thank you everyone who's saying that they're enjoying this conversation with Louise. It's fantastic, isn't it? I'm so delighted. But I get that and I get really panicky, there's a bit where you have to sort of like how it's already been holding your breath. It's just not breathing in or out for an elongated period of time. And everybody else in the room is totally nailing it. And I'm there I feel like I'm just I forget. Well, that's thinking, well, that's quite a big and probably a good indication that I'm not breathing completely.
So there is, there is another way you can. It's really, really interesting how breathing effectively, we've not actually got, we've not got a proper medical definition of it. And we've not actually got a proper way to really assess, which actually makes it very difficult to study. And this is one of the unfortunate, but if I can't diagnose it, and I don't have a decent, I don't have like a gold standard diagnosis and a gold standard assessment, I suppose really, we have got, we have got a definition of dysfunctional breathing, but it's the assessment part of it. So if I can't fully, easily assess someone enough for medical study, then how can I then prove improvement, so it makes it really difficult to do. But there were some people who did a paper, Kaiser and colleagues, and they did an assessment where they asked questions, and did a breath, hold time, a comfortable breath hold time. And that's a really good screening tool. It doesn't diagnose what we call dysfunctional breathing. But what it does do is it highlights that you could do some work on nothing perfect, but it's quite good. But the breath hold time is really interesting. And the breath hold time is, is, is generally so I would say so if you basically just want to sit sort of quietly beforehand, not over breathing, the best time to do it is before. So after you wake up and before you've eaten, and can just gently breathe in through your nose, gently breathe out through no pitch or cold, and you're just relaxing to it. And all you're doing is all that's happening is your carbon dioxide is building. And then at some point, your body will then say, Oh, you're not breathing. And we'll send a signal to breathe when you reach that sensitivity or personal sensitivity to carbon dioxide. And that's when you get a contraction in your neck or contraction here. And ideally, we want that above. We want that above 25 seconds. People who have sleep apnea though a particular type of sleep apnea, and they can have a falsely raised one. So just be careful with that. So you need to be you need to be looking more at how you breathe. But But yes, exactly. So that that the fact that you have snoring at night, you're very breathless with exercise. To me that's shouting out to me that you are sensitive to that buildup of carbon dioxide, and you would benefit from training yourself to be less sensitive. The one thing that is thought about carbon dioxide is it brings that feeling of air hunger, doesn't it? As you describe it makes you suffocate. Yes, yeah. Yes. But what is so bizarre about it, once you get past that, and there's various exercises that we do that that sort of, sort of make it more easy to tolerate it and you can sit with it more. Carbon dioxide is actually a narcotic gas. It's actually so dead and calming to the nervous system to the spinal cord and so you could use it as a general anaesthetic. But it causes that feeling of suffocation, and I believe they're doing some research on using it as a treatment for anxiety and panic. Wow. But you don't need a canister of cabinets, because you've got your own Roundup. Yeah, yeah, train yourself. What I find is that people then go through this period where yes, it's, you've got to train yourself to be a little bit less sensitive. So obviously, it's a little bit uncomfortable, just not not enough. It's very gentle. It's very teaspoon, to get used to that carbon dioxide. But then once you get used to it and you realise it's helping you people actually love it and actually find it really calm. So you go feeling suffocated. And actually, like, I don't like this, and then it's actually that I really like sort of sort of raise my carbon dioxide and just sitting with it a little bit because I find it really calming. And it's so I can imagine actually lovely to see.
Emma: I can see a question. Question. Yes from Carol. So what about asthma sufferers? I get a bit panicky holding my breath.
Louise: So yes, so asthma is asthma. It's so common in asthma to overbreathe. Absolutely. Because you have that fear of having an asthma attack and particularly, you know, if you've had someone that's been in hospital with asthma or had a really bad asthma attack, it is horrible, you know, to feel like you can't breathe in. So people with asthma commonly overbraid. So, most of us probably only need, say four to six litres a minute to breathe effectively. an asthmatic patient might breathe 10 litres a minute, 15 litres a minute, you know is that in that excess. And in order for them to maintain that breathing volume, there's a huge energy cost on that, they then start to get symptoms of hyperventilation. So you know, they might get the tingling around the lips, the fingers, they can, they can feel that there's lots of different symptoms, you know, people have a panic to get all those symptoms. And they start to use the wrong muscles as well. So they can start to get pain in their neck. Because they're not, they're not breathing effectively. And breathing retraining can be really great for asthma. For three reasons, one, you get the breathing volume better, but the other one is, if as an asthmatic, if your mouth breathing, you are bringing cold dry air into your lungs, and cold dry air triggers a cough reflex. So yes, you have to treat yourself if you've got asthma. You've got to warm it up. Warm it up and moisturise it.
Emma: Yeah. I did not know that. That's amazing. Carol, does that answer your question? I hope that's helpful. I thought that was just fascinating. I've always been a little bit asthmatic as well. So that's why I always have that cough. You know that little. That's so good. Louise and I are 100% That to me, I feel like that, you know, when you just get that kind of like, I feel like this is a bit that would be really useful to me in my perimenopause or journey, I am definitely definitely going to sign up for your course.
Emma: Could you tell us a little bit about it or just let me just see Carol saying I'm breathing through my nose listening to this. Thank you. That's me, too. I've been literally doing all of the things that Louise has been telling us to do. So when I look back on the video of this, I'll be like, Oh, my goodness. So we're going to make this into a podcast as well. So I'll also include all the information that Lou Dr. Louise tells us today in the show notes from the podcast as well. So if anyone misses anything, or just wants some more detail, we will have that but Louise, could you just share where people can find you? When is your course? What are the things that you know, anything that you want to share so people can find you because I think this has been a fabulous life in this little series of lives. So thanks. No problem.
Louise: Yeah, so I've got my website, so it's a long one. So it's Dr. Louise Oliver, therapeutic life coaching.com. And if you've forward slash menopause, I've tried to put stuff that's more relevant towards menopause there. And this is I do individual sessions, and I've got a group course that's a really popular virtual one. And actually, the next one starts this Sunday. I record it for those people that can't attend live. Yes. Yeah, the details are on there. And my email is info at Dr. Louise Oliver therapeutic life coaching.com
Emma: But we'll put this in the show notes when you I will put this in the show notes and I'm going to get this out as quickly as I can. And then also I'll put as much as obviously we've got Louise's Instagram on here as well. And I imagine that if you go into Louise's Instagram as well, the the details of your website will be there as well as
Louise: They aren't on social media. I'm on my mindfulness journey. I stopped doing it.
Emma: Yeah, good, very good for you. It's the way you're getting the messages out, isn't it?
LouisE: But yeah, I'm not great on electronics but there is my bio actually this link to my website.
Emma: So perfect. And I'm definitely going to join because it just sounds silly not to have a go at it really. It doesn't seem like it's going to do any harm and it could give so much benefit, right?
Louise: Oh, completely all all all I'm doing is teaching for those people that think they're not breathing effectively. We're just where essentially we're just we're teaching you to breathe as you were designed to breathe. That's a chatter. Modern day life is cueing us to you know, be more in fight flight so to mouth breathe fast breathing or not breathing, you know, if we all lived as we were designed to live, you know, in nature completely, you know, as we're designed to, you know,we wouldn't be in a situation
Emma: Yeah, yes. But here we are. So we need to be cool. Thanks for joining.
