47. Patrick McKeown - The Oxygen Advantage
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Improving your breathing can revolutionize your life and fitness. Patrick McKeown is an expert in breathing re-education and provides breath training and programming that has helped elite athletes increase energy and focus, improve resiliency and reach their full athletic potential. Author of The Oxygen Advantage and Founder of the training program by the same name. One of the world's leading trainers in the successful Buteyko breathing method, Patrick uses simple techniques that will help you reduce breathlessness, improve your sleep and reduce anxiety and stress.
Patrick explains the BOLT score and why it’s a required measurement. He talks through the right way to breath and why breathing dysfunction is a new human problem. The negative physical and health consequences of mouth breathing. The many advantageous physiological adaptions that take place with consistent nasal breathing. How to replicate altitude training with breath holds and train like an elite athlete.
Mentioned In the Show:
Books: The Oxygen Advantage: Simple, Scientifically Proven Breathing Techniques to Help You Become Healthier, Slimmer, Faster, and Fitter
Oxygen Advantage Store: https://oxygenadvantage.com/store/
Follow Patrick:
Instagram: @oxygenadvantage
Oxygen Advantage website: https://oxygenadvantage.com/
Oxygen Advantage (YouTube): https://www.youtube.com/c/OxygenAdvantage/featured
Show Transcript:
Ken Gunter 02:59
Patrick, thank you for coming on the show.
Patrick McKeown 03:01
Thanks very much, Ken. Good to be here.
Ken Gunter 03:03
Yeah, so we were just we were just catching up before we started recording. And I was actually introduced to your work from a previous guest, Christian potensi. Actually, if people haven't listened to that one, go back. It's a really good one. And he was kind of so inspired by a lot of the work in your book, that in addition to other research that he's done, he's incorporated a lot of these techniques into his like overall program for helping create, you know, quote, unquote, what they call a more durable athlete. And so I absolutely was interested, you know that in something that was so motivating for him, went out and got the book and I've just, I've absolutely been tearing through it. I'm really enjoying it so. And when did you write the oxygen advantage?
Patrick McKeown 03:48
I started writing it in around 2011 2012. Wow. Because I'm like I'm working in the field almost 20 years, but I was working mainly with people which who are unhealthy. Asthma, people with anxiety, people with sleep disorder, breathing people, I was working with some people that wouldn't be able to walk up the stairs. And then in 2010, I started giving out courses on mindfulness and functional breathing for focus on performance and also dealing with stress, post economic crash 90 90% of the people coming in were female, and very few males are coming in. And I was intrigued because males are the ones that often don't do so well in terms of mental health, and yet they weren't attending a breathing session. So, lo and behold, I wanted to start putting breathing with performance and adapting to it and that was the whole essence of the oxygen advantage. And the uptake is mainly men. It's mainly men between the ages of 20 and say 45 years of age. People are putting it for performance based so both for the mind for sleep for heart rate variability. For resilience recovery, and also for exercise performance, now we're changing it slightly because I've just written a new book called The brain Tour, which is going to be out in the next six months or so in the United States. Now perfect, we'd have it in Europe in the next two weeks. And that's looking at the application of about 26 to 30, different breathing exercises, designed to tap into different disciplines. You know, we have sections for women, because female breathing is very much different to men. I don't even know this has been written about since 1905. And there's very little research on it, because most of the research done on breathing is done by men. And it's really important that female breathing is you know, that it's adopted differently. And under health conditions, diabetes, epilepsy, functional movement, because functional breathing and functional movement go together. And if breathing is off, movement is off. And if movement is after as an increased risk of injury, sleep apnea can which is very common, and it's common. This, regardless of whether the guy is a top athlete, or God as a top athlete or not, it affects more men than women. But it puts a tremendous pressure stress in the heart, linked with many different conditions. But most definitely, if one has obstructive sleep apnea, you don't wake up feeling refreshed. And there's no way a narrative that you can focus on perform your best if you haven't had a decent night's sleep. And also heart rate variability is going to be impacted. So I suppose we have to consider the breath, the breath has had a bad rap for many years. And most notably, because it was taught by people number one that often didn't have an understanding of breathing. Number two, follow the tradition and stock wishes like a guru without looking at, really what can we do about breathing. And this is not just for tree huggers. You know, it's not for the guy, he's going around with the open sandal brigade. I've worked with military, we've worked with swash some of our instructors, our swash, we've had instructors from Delta forces attend the training courses, we've had corporate corporate leaders. And, you know, I suppose the one thing is, breathing is a function that when we change us, we can influence other functions in the human body. And I think it will influence more functions in the human body than any other modality that we can do more so than physical exercise, etc. And there are exercises of course, the downregulate, does exercises to up regulate drugs, exercise to improve your blood circulation, improve your oxygen delivery, decongest your nose, improve your sleep, and also stress the body, you know, like we dropped blood oxygen saturation down into the mid 80s and down into the 70s. I don't want to go below that because there's a risk of passing out. So there's a degree to which I want to stress the body. But I don't want to overdo it at the same time, you know, so yeah, I think it's really interesting breathing now is finally getting out there.
Ken Gunter 07:58
So understanding that a lot of breath work traditionally was taught, like you said, by gurus, people who were either like steeped in tradition, or had you know, their own dogmatic approach is the right word. But, you know, what about your kind of exposure to breath training, kind of set you down this path of taking a more innovative scientific approach?
Patrick McKeown 08:21
Well, I suppose because I was teaching mainly and helped oriented, and, and a lot of the work was presenting at conferences, dental conferences, conferences, who were attended by healthcare professionals. And in order for me to make a statement, I had to be able to support it as best that I could. Now granted, the science is only starting to catch up in terms of breathing. There's things that we've been using with breathing 20 years that we're starting to see papers now in the last five years, for example, Brett or time now as a screening protocol for functional breathing. One professor of physical therapy Professor Kiesel, in 2017, he conducted conducted a study 51 individuals and there were 27 years of age. And he looked at breathing from a number of different dimensions, biochemical, biomechanical and psycho physiological, and concluded that if the brettell time, which pretty much was described exactly as the bolts for you take a normal breath in through your nose, and your breath out, you're pinching your nose, holding your breath, and you're timing it in seconds until you feel the first definite desire to breathe. If your retro time was above 25 seconds, there's an 89% chance that dysfunctional breathing isn't present.
Ken Gunter 09:36
So with apologies for interrupting is, is that a good definition of the bolt score for people listening? Yes. Is that Yeah,
Patrick McKeown 09:46
yeah, now I can go a little bit more detail. You should be sitting down resting for about five minutes before you take it. You have normal breathing before measuring the breath hold. Yeah, don't hyperventilate, because if you're hyperventilating, you get rid of carbon oxide, obviously, your breath towards is going to be longer. You have a normal breath in and a normal breath out and you hold your nose and your time within seconds until the first involuntary movement of the breathing muscles are the first definite desire to braid. So you and when you resume breathing, your breathing should be fairly normal. So it's not the length of a maximum breath told. But it's the end of time. How long does it take for your brain to react to the fact that you've stopped breathing. And, you know, that gives us crazy, that gives us some idea of the chemo of what's called a chemo sensitivity of the body to carbon dioxide, but it's a good measurement of breathlessness as well. So say for example, like I've seen Olympic athletes with a brettell time aboard score of 10 or 11 seconds. Now these guys achieved what they wanted to achieve, but they pushed our body through hell to get there. Because if you have a bowl score of 10 or 11 seconds, it's implying that you have dysfunctional breathing patterns, your breathing during rest is faster. Your more upper chest breathing, you're not economical with your breath, you're breathing inefficiently, you're wasting energy. Yes, there's a cost associated with breathing. And it's your everyday breathing. that determines how you breathe during sports. So you know, your breathing is not just going to fix itself when you go for a run. How you read during your run is determined by how you're breathing? The previous, you know, 24 seven. Okay, even if we think of people, how are they breathing during sleep 50% of the adult population sleeping in open mode. Oh, wow, that's not good. They're breathing, faster breathing, upper chest and more ups, more prone to obstructive sleep apnea, snoring etc. and that in turn, then is going to impact their everyday breathing as well. Hmm.
Ken Gunter 11:47
Well, it, what came through in the book too, is that the bolt score is really critical, because it becomes kind of a good measuring stick. And maybe we can talk later in the episode about, you know, some of the various approaches and methods you can use to increase breath hold and crease. I don't know that the efficiency of your breathing seems like that's like the measuring stick that you provide a lot of times to say like, hey, look, if your bolt score isn't too here, like, it might not be safe for you to attempt this, you know, by yourself without supervision. So the bolt score was really interesting to me. And I had a lot of fun trying that. And I still don't know, if I have an accurate bolt score. I'm gonna sit down, like you said and resume normal breathing and then give it a shot. Yeah. You mentioned the complications that come with open mouth breathing. Yes. You know, I would say and it's so funny, because breathing is just such an innate part of what we do every minute of every day that most people don't know what is correct breathing, even look like maybe maybe to take a step back, right? What is the right way to breathe,
Patrick McKeown 12:53
just how our ancestors breathe, just how we should have been how we would have been breathing throughout evolution. And breathing pattern disorder is a very much more modern mouth breathing is modern, our ancestors, even distant cousins, Neanderthals weren't mouth breeders, they were nasal breeders, we know despite the shape of the face, that when the mouth is closed, the tongue is resting in the roof of the mouth. It's the it's the pressures exerted by the tongue is addressing the roof of the mouth, which helps to develop the maxilla, which is the top jaw, and also the lower jaw. So the fifth, the fifth, the lower 50% of the face is influenced the growth of that is influenced by how you breathe as a child.
Ken Gunter 13:33
So which I thought was fascinating when I read that as I immediately ran down and I was like, Listen our kids and start breathing through their nose if they're not right now. It's,
Patrick McKeown 13:40
it's absolutely it's absolutely vital. And you know what, despite this being known since 1909, and this has been written about in one journal at a time dental cosmos, that children who are mouth breathing, they have crooked teeth. So crooked teeth is caused by poor breathing patterns. And they are likely to be more prone to ADHD. Study by current bilock in 2012, published in the journal Pediatrics looking at 11,000 children if sleep disordered breathing, which mouth breathing contributes to it, if these children have sleep disorder breathing by age five, if it's untreated, they have a 40% increased risk of special education needs by age age. So from a cognitive development, but also for the development of the face and the airways. nasal breathing is essential. we as human beings, we're the only species that persistently mo breed, a dog will have its mouth open for a period of time to regulate body temperature. And if we look at the anatomic the anatomy of the nose versus the mouth, and here's a sample anatomical model. Okay, if we look, say for instance, here's the front profile here. You see the nose and you see the lips and you see the jaw, the chin here. Yeah, so here we have an open mode. If we ask, what does the mouth do in terms of breathing well if air is inhaled insulin That mode, does the mode perform any functions in terms of breathing? And the answer is no. Deep mouth does absolutely nothing. Now if we look at the extent of the nasal cavity, most people think their nose is what they see in the face, this is the nose. But that's only about 25%, the nasal cavity is gone well back within the skull, and it's the nose that's connected with the diaphragm. Oh, wow, the nose is also connected with the brain. by breathing through your nose, it's known that the pressure of oxygen in the blood increases by 10%. That's been known since 1988. nasal breathing during physical exercises, better recovery. But not only better recovery, if you go for a run mature mind closed, you will have higher carbon dioxide in the blood, you know, despite the feeling of air hunger, and carbon dioxide as it increases in the blood will open up blood vessels, but also cause more oxygen to be released from the haemoglobin to tissues and organs. So you are likely to stay aerobically for longer breathing through your nose versus the mouth. Nose breathing is holding on to moisture in the human body, nose breathing is protecting the airways, nose breathing as activating the die from a greater greater amplitude, and functional movement using the diaphragm generates intra abdominal pressure, which in turn is providing stabilization, postural control. So it's related to functional movement. And if you were to look at, say, the functional movement screen or any screen, which is looking at movement, you will see that the predominant people who pass that screen are diaphragmatic breeders and functional breeders. And the nose is the critical component. And so I suppose, you know, it's really just the depth of where we go with breathing. It's not just about like, if you go to say, your yoga studio, which is excellent doing yoga, and the yoga instructor is focusing on the biomechanics of breathing. Typically, the yoga instructor is not looking at the biochemistry of breathing, nor are they looking at resonance frequency breathing. I, my background, originally was all about the biochemistry. And I wasn't looking at the biomechanics, and I wasn't looking at resonance frequency breathing. And then somebody whose interest with heart rate variability they're focusing is on resonance frequency breathing. And they're not necessarily looking at the biomechanics and the biochemistry. And what I wanted to do with at least the oxygen advantage, because the oxygen advantage, there is no tradition to us. And there's no this is the way you need to do it. No, it's wide open. Now, having that ability of a wide open approach gave me a freedom and a freedom to choose different exercises and different techniques and bring in our own as well our own influence, of course, our own exercises, and target breathing from all three dimensions. And that's looking at functional breathing patterns that we cannot just think of breathing from being breathe low using the diaphragm. And you know, you should never hear anybody breathe inside the yoga studio. Because if the emphasis is on diaphragmatic breathing and breathing low, it doesn't make sense to sacrifice the biochemistry in the process. Because how hard you breathe, and you know, there is an idea out there, then if you start taking full and big breaths that you increase oxygen delivery to tissues and organs. And it's the converse that's true, you know, if we want, which
Ken Gunter 18:26
I found really interesting, because I, you know, I thought I was doing the right thing. By taking like those deeper, like you said, I used towards diaphragmatic breaths. And then when I when I read in the book, like actually, the better approaches is quite the opposite. I was like, Oh, damn it?
Patrick McKeown 18:45
Well, you know, it is we do want to breathe using the diaphragm. There's no question about, but the question is, do we need to be taking these big breaths in order to engage the diaphragm? And the answer is no. As in the process, I think a lot of people make the mistake that, you know, in the belief of activating the diaphragm that we need to fill our lungs full of air. No, that's not necessarily true. Our blood is already almost fully saturated. 95 to 90 99%, saturated with oxygen with normal breathing. And if we breathe more air, we're not going to increase oxygen saturation. And if we do, we're not going to increase it by a whole lot. But say for example, if I was to, if we were to look at people with dysfunctional breathing, breathing a little bit faster, a little bit of our chest, mouth breathing, irregular breathing aboard score of less than 25 seconds. It's very common for these people to have cold hands and fish. Oh boy. And this will suggest as well, of course there's no it's normal. And the reason being is because blood vessels constrict due to the volume of air that we breathe, if we are breathing in excess of what we need. Some I often say to students, you know, listen What happens when you start for periods of time breathing a little bit less air. And I say some breathing through your nose, and really slow down the speed of the air coming into your nose, and then have a really relaxed and a slow, gentle breath out. And then take a very soft breath in through your nose, and a really relaxed and a slow, gentle breath out and breathed 30% less air into your body, simply by slowing down the speed of the air as it comes into the nose. And as it leaves the nose. And if you're doing it correctly, you feel our hunger. And if you do that for a few minutes, you start to notice increased watery saliva in the mouth, you start to feel drowsy, but your hands started become more and more. So you know, breathing a little bit less air for periods of time is exposing the body to higher carbon dioxide. And one theory is that it's reducing the chemo sensitivity of the body to carbon dioxide. But it is changing breathing patterns so that breathing becomes slower. And if we practice breathing lighter during the day, we do influence our breathing during sleep. Now, I can imagine that you know, snoring is very common. obstructive sleep apnea in men is very common. It's 25% of men up to the age of 50 years of age and 43% of men from 50 to 70 years of age.
Ken Gunter 21:23
Just talking about it with a with a family member unrelated to this podcast yesterday. I mean, it was a Hey, we got to figure this out. Like I think it's a real problem. I'm gonna go see a doctor. Yes, yeah, incredibly common.
Patrick McKeown 21:35
Yeah, well, breathing has a huge role to play there. I've just written an article a review article with an ear, nose and throat doctor, Dr. Carlos O'Connor from from Madrid, and Dr. galera Mo, and we've submitted it for publication to a scientific journal, we're going through the review process. When you breathe through your nose, which our tongue resting in the roof of the mouth, you have to open up the airway, you're opening up the architecture of the upper airway, so the airway is less likely to collapse. When you breathe through the nose, you're engaging the diaphragm, when you're engaging the diaphragm breathing muscle more, it increases lung volume, which causes the troll to be stiffer and less likely to collapse. We have to think that the troll has like a collapsible paper tube, okay. And if you breathe hard shrewish, the negative pressure as you're taking air into your lungs, is causing the airway to collapse. Even simple snoring, so I you know, the students and always use this example, make the sound of a snore through the mouth. And they go like this. And then I say, close your mouth, and try and snore through your mouth. You can't. So mouth snoring stops once you get the mouth closed. Yeah. And then I say try and snore through your nose and it goes like this. And now I say, gently slow down to speed of the air coming into your nose and then have a really relaxed and a slow, gentle breath out. And as you're breathing really slowly try and snore through your nose. And you'll find it it's a lot more difficult to snore through your nose when your breathing is slow.
Ken Gunter 23:11
I was just trying to do it. And yes, everyone knows I'm miked up. And I couldn't I couldn't get it to happen.
Patrick McKeown 23:18
So here's the interesting thing is that doctors in the Maine are looking at the airway, but they're not looking at flow, and no engineer would look at the diameter of a vessel without considering the flow that's going through it. Now, if we look at breathing pattern disorders in the population, 75% of people with anxiety have breathing pattern disorders 75%. Wow, this group of people is going to, you know, across all domains. So if we think if we think of the human airway, and we have to consider the airway as being the space at the back of the nose, and further, the mount meets the throat as well. So the back of the nose meets the throat, and where the mount meets the throat. And then the throat itself. A good airway is the size of our tongue. Okay, and the poor airway is the size of a pen, a big buyer of for example, and we don't have much room for error there. And if the mouth is open, and the jaws are set back, and if the individual is breathing hard, it's increasing pressure inside the airway, which increases the risk of snoring and collapse. Now, if we looked in at different populations with breathing patterns, disorders, including Say for example, people with anxiety, I can only think of the number of people with anxiety, people with high stress levels people with depression, and they are doing cognitive behavioral therapy, which is wonderful, but CBT does not change respond to physiology, and nor does sleep be impacted. And anybody coming in with agitation of the mind how can you get a clean a clear calm mind Unless we improve breathing patterns, and also unless we improve sleep. So if we think of breathing, and sleep, and the emotions, if the mind is racing, it's going to impact our sleep because you cannot fall asleep so readily when the mind is racing. Yeah, if we're stressed out, it impacts our breathing because we breathe faster and harder. But if we breathe harder and faster, is in turn is going to affect the mind. So the emotions, change, feed are breathing, how we breed is feeding the mind, our mind is feeding our sleep. And if we have poor quality sleep, it feeds the emotions, our breathing, if you're breathing hard and fast, it also feeds in to sleep. All three is interconnected. You know, you can tie in here with heart rate variability, because of measurement of resilience and recovery. You know, for any human being, traditionally, a medical doctor has no way of measuring the impact as a stress has on that individual, whether it's a psychological stressor or a physical stress or environmental stress. Doctor, you know, you go to your doctor, and you say, Doctor, I feeling really stressed out and the doctors only gone by subjective kind of evaluation that the person has. Measuring heart rate variability would provide the doctor with the tools to determine the impact the stress is having on that person. And heart rate variability refers to that, as human beings, the time in between our heartbeats should be variable, it shouldn't be the same. And pteropus of old would typically have realized that an inhalation, the heartbeat should be getting faster. So the timing between heartbeats should be shorter. And on exhalation, the heart rate should be getting slower, and the time in between heartbeats should be longer. So it's very easy to look at and feel, you know, if you have your students and they locate their pulse, and then they sync synchronize the timing of their how fast our heartbeat is relative to their breathing. Well, that's called as respiratory sinus arrhythmia. If we're in good balance that the autonomic nervous system is in good balance between the parasympathetic rest and digest versus the sympathetic fight and flight, yeah, that in turn will indicate good heart rate variability and vice versa. So individuals who are not well, physically unwell emotionally unwell typically have reduced heart rate variability. And by changing our breathing patterns on a number of fronts, one is known as breathing during sleep improves heart rate variability. Number two is the breathe light exercises whereby we deliberately breathe less air for periods of time to expose the body to a feeling of air hunger, that in turn increases heart rate variability. Number three, breathing low using the die from increases heart rate variability, number four, breathing slow to a cadence of between 4.5 and 6.5 breaths per minute, increases heart rate variability. And heart rate variability is as an objective and clinical measure of vago tone. And you can tie in that with that so many different things because inflammation For example, when inflammation is present in the body, it impacts heart rate variability. But if we can stimulate the vagus nerve, we can reduce inflammation. And we can do that by virtue of the breath, that by slowing down breathing by nose breathing by breathing light by breathing low, and bringing it into our everyday life, we in turn, then have the ability to help counteract the effects of stress, but also to recover quicker. So I'm here again, and I just mentioned before I forget, can so many people over the years have come in with depression. And and you start talking to them and you just ask, How do you feel when you wake up in the morning? And they'll tell you that they wake up feeling exhausted? And then I'll ask when has any anybody asked you about the quality of your sleep? And they say no, typically, because the healthcare professional is often thinking that it's the depression which is causing the exhaustion, the person is exhausted because of their depression. Or maybe we should be asking the question, this person could have obstructive sleep apnea, this person could have a combination of insomnia and obstructive sleep apnea, which in turn leads to depression. So I only have to look at the human body that we cannot just look at one function in isolation without looking at the bidirectional relationships the different functions have Yeah, breathing. The emotions and sleep are three functions that we can look at very nicely. And I will say this, you do not have focus or concentrate. Are the ability to handle stress, unless you can tap into breathing and sleep and the emotions. And for me, it changed my life 20 years ago, you know, my ability to focus and concentration. Yeah.
30:16
Well,
Patrick McKeown 30:17
so
Ken Gunter 30:18
evolutionarily, right? Like you said, if an engineer took a view of the human body, right, it would be very clear the way in which things are supposed to operate. Like what is kind of happened in recent modern history that has led to people to have this dysfunctional breathing like, maybe we even to start, like, what, why are people mouth breathing?
Patrick McKeown 30:37
I think there's so many different reasons for it. And it's probably difficult enough to pinpoint sure where to look at young infants. And, for example, midwives and 16th century France, they had an extra long fingernail, if the baby was tongue tied, they would just clip a clip to tie in order to allow a baby to raise their tone from the roof of the mouth so that the baby could feed from the mother, because breastfeeding is not just about nutrition, but it's about development of the muscles of the face necessary for cranial facial growth. So society has made sure that both couples are up to their dash and mortgages, that both the husband and the wife have to work or both partners have to work in the matter, of course, then, because of you know, bills, etc. So society is has played a role in this, look at the food that we eat. And you go to your local supermarket and look what you see in the shelves, our ancestors, that hard food, the food that you had to choose. Nowadays, the food comes pre chewed, in most instances. And I love that our stress levels, you know, you can think about our ancestors, and they had a lot of quiet time, they had a lot of time for reflection. Yes, they had time for you know that there was a time to haunt and to God or, and, of course, there were there were different tracks at the time as well. But it wasn't that chronic, that chronic stress, that chronic stress of getting fired working in a company that you absolutely hate working for a boss, that's an idiot, you know, all of this pressures and consumer pressures, advertising, look at COVID. At the moment, I've switched off radios, I've turned off T TVs, all of the news, all of the mainstream media, because all I'm hearing at the moment, and I'm sometimes feeling like it doesn't bother me to be honest with you. And but I'm just feeling for the people who are out there that are listening to every single news bulletin, that are engrossed in this and all their hearing is over and over and over and over and over COVID, COVID, COVID, COVID, post constant reminder exactly crazy stuff, we have to be selective with the amount of information that you know that we are letting in. And it's a Trump the another aspect, even in terms of breathing is, of course, stress is a factor. lack of exercise, talking is not good for breathing. And any of your listeners who talk for a living there know that they'd be pretty tired at the end of today's talking, not just because of the degree of concentration, but because of the impact that talking has on breathing because talking makes us breathe harder and faster, which in turn is going to reduce blood flow and oxygen delivery to the brain.
Ken Gunter 33:24
So it's so interesting to say that I you know what, I'm not doing my podcasts I I'm in sales, and there will be some days where I'll have you know, if it's a really busy day, I might go three hours having back to back our meetings in where you know, if I'm introducing whatever we do to the client, not you know, yes. Well, my sales leadership, like you should probably be doing more listening than just talking. But I'm doing a lot of talking over that time. And yeah, I mean, when I walk away from that I sit down I'm like, man, yeah. White? Yes. And I always attribute it to Well, I was just mentally engaged. Yeah, for three hours, you know, I was just so focused, that it's just mentally draining. I never considered the fact that by talking for that amount of extended time, you know, that I was actually maybe like robbing myself, quite literally, of oxygen.
Patrick McKeown 34:14
Yeah, pretty much. That's what's happening. And, and, you know, some people will cope with it better than others, depending on genetics, and depending on their breathing patterns, and because there is a genetic influence as well. And then if you look at people with different conditions, the anxiety population, you know, all those people who are going to psychotherapy and psycho psychiatry, and all of these different things, who is looking at their functional breathing. I work with people with anxiety, typically, they breathe a little bit faster, a little bit, upper chest breathing, and as long as they breathe that way, it's feeding into their conditions. People would ask me, they have inflammation of the lungs of travelers up to their nose, their noses, stuffy, they're not just having problems with their airways. They have problems with the nose, but they have problems with sleep. Because if you have a stuffy nose You're twice as likely to have sleep problems. No. Yeah. So you know it as human beings were so complex. And this is the thing about breathing breathing a simple. And yet it's not so simple, huh?
Ken Gunter 35:13
Well, and here's another really common question that often I know I've had a I've received from people in the past, just based on some of the conversations we've had on the show. You know, we've talked about the importance of engaging the diaphragm. I think a lot of people are a little surprised to hear that we need to pay so much attention to making sure that we're activating that diaphragm because a lot of people I think, have the experience and I count myself in that group. When I think back, you know, I was an athlete as well. And I remember vividly the sensation of like, the upper chest breathing, you know, whether it was before big game or after, like, a lot of exertion, like upper chest breathing is, Can Can you describe a little bit like maybe a how we should be breathing, but, but maybe even more importantly, like, what are some things that people listening can pay attention to. So as they start to try and work on their breathing, maybe even while they're listening, or just throughout the course of their day, like what are the things that they should be looking for, to understand if they're breathing correctly?
Patrick McKeown 36:15
Well, breathing should never be an effort. So breathing should be effortless. Now, though, if the individual feels that they're not getting enough air, or if they're feeling that they're sighing quite a bit, or, for example, if they feel that their breathing is faster, or if they're waking up at a dream out in the morning, or even going for like physical exercise with the mouth open, you know, in terms of breathing during rest, and also during like physical exercise, the chest movement should be relatively still maybe about 20% overall. And primarily, we should have about 80% of the movement driven by diaphragm. So the diaphragm is the is the muscle that's separating our chest from the abdomen, and it's shaped like a dome of an umbrella, and it's quite thin, and it's quite strong. And I suppose the best way to think of it would be like a sheet of ladder. It has been and it's strong. Now when, when the brain sends a message, so basically the brain is monitoring carbon dioxide in the blood and blood Ph. When carbon dioxide increases a small amount very sensitive, the brain is very sensitive to changes in carbon dioxide and result in blood pH, the brain sends a message to the die from to die from breathing muscle moves downwards during rest by about two to three centimeters. With dash, we have movement of lateral expansion, so we have movement of the sides, so we are lower ribs should gently move outwards, we should have some movement to the front, and we should have some movement to the back. So we should be thinking of the core as a box, you've got the pelvic floor, you've got to die from you've got the abs, you've got the spine, the muscles, and it's the diaphragm breathing muscle that is absolutely essential for massaging the internal organs. The diaphragm breathing muscles connected with the emotions, the diaphragm breathing muscles, providing stabilization for the spine to die from breathing muscles, generating what's called intra abdominal pressure, and functional breathing and degeneration of intra abdominal pressure. And a good gauge for this is simply have your hands either side of your lower ribs. Yeah, and as you breathe in, you should feel that your lower ribs are moving out. And as you breathe out, you should feel that your lower ribs are moving in. Now do the same with mouth breathing. So if you look down at your chest, and breathe showing up and mouth, so you will see that my breathing is temporarily activating the upper chest. Yeah, I know his breathing is more likely to breathe low. Now, in terms of breathing efficiency, every breath that we take one, the last 150 milliliters of that air doesn't reach the small air sacs in the lungs for gas exchange take place. And if we're breathing fast and shallow, we're taking more air into the upper regions of the lungs. But the greatest concentration of blood flow is in the lower regions of the lungs. by breathing through the nose, we're taking the air into the lower regions of the lungs. But also by breathing through the nose we pick up a gas called nitric oxide. And now when asked about this as well, nitric oxide has to redistribute the blood tried the lungs so that gas exchange improves. So go for a run with your mouth closed. Yes, at the start you feel more air hunger, you'll feel suffocated because you're breathing through a smaller and smaller entry to the airway stand the moat. However, if you continue doing your run, mature mouth closed the air hunger diminishes over time, and the body adapts to this and the body adapts in a number of positive ways. Number one is that the chemo sensitivity to carbon dioxide reduces. So air hunger reduces number two carbon dioxide in the blood increases during exercise number three, the fraction of expired oxygen is going to be less. In other words the the oxygen that you're taking into your body Your body is going to use it. So you're not breathing it back out again. Number four, you're protecting the opera. And number five, you're activating the diaphragm. Number six, you're not going to tire so quickly. And number seven, when you breathe through the nose, it's adding a pressure, and it's adding a resistance to your breathing. So it's helping to strengthen to die from breathing muscle. And having improved respiratory muscle strength is very important because up to 50% of athletes, they have respiratory, they can have respiratory muscle fatigue. And when the breathing muscles fatigue, blood is stolen from the legs to feed to die from. So if you seen an athlete, and the athlete is at full flight, and the next thing is you see the legs gone from under them. Yeah. Is that happening? Is that due to a buildup of hydrogen ion? Is it a buildup? Or is it for example, that the respiratory muscles are fatigued. And then we always have to think of this, the function of breathing is more important than money on our functions. And order functions are going to be sacrificed to maintain our breathing our respiration. Hmm.
Ken Gunter 41:12
Man, so that's so interesting. And I know, a lot of the things that we've talked about today are just, you know, beneficial for everyday life functioning as a human being, and hopefully close to your potential. And I know that you do a lot of work as well, helping people eke out what could I suppose be like a marginal gain? Yes, or making it making big enhancements in the way that their body's able to process oxygen, so that they can perform at a much higher level. And one of the things that I really enjoyed reading about was simulating altitude training.
Patrick McKeown 41:47
Yes, yes.
Ken Gunter 41:48
Can we talk a little bit about the ways in which you leverage altitude training? And I suppose you leverage it with the general population as well, but with athletes specifically, to help them improve performance? Yes, we do. Brett hauling a lot of pretzels. And we typically do bread tolls, but most of them maybe that's a good question to maybe I can even ask you to define because people like oh, altitude training would go up to the mountains. And could you even maybe start by defining what altitude training is in the terms of the way in which you use it?
Patrick McKeown 42:20
Sure. So say, for example, if you're going into the mountains, and you still have 21%, of the concentration of atmospheric air is oxygen. But the issue is that the higher you go up, atmospheric pressure decreases. And as a result, then you your, the amount of oxygen in your blood is going to be reduced. And you're if you're in the mountains, you're exposing your body to reduced oxygen for a period of time to force the body to make adaptations. Now, a lot of the time going to the mountain is not going to be accessible for people. So we do breath holding, and it's intermittent hypoxic hypercapnic training. And all that means is that we're doing bread hauling for short periods of time, to lower blood oxygen saturation, but to also increase carbon dioxide. And it's the combination of the drop to blood oxygen saturation, and the increased the carbon dioxide, which in turn disturbs the blood acid base balance button, we're forcing the body into a state of acidosis. That the body then is making adaptations to increase what's called buffering capacity. And buffering capacity is where by we can, for example, by increasing buffering capacity, we can delay lactic acid and fatigue. So that was just one aspect of it. So the exercise is fairly simple. Don't do this, if you're pregnant. Don't do it if you have serious medical conditions, but you could be at home, you could be even just listening, standing in the spot, take a normal breath in and out through your nose and pinch your nose with your fingers, and start walking. And then go into a jog and go into Iran. And you're continuously holding your breath as you're moving. Keep going until you have a fairly strong air hunger, then let go but minimal breathing, minimal breathing for six breaths, and then back to normal breathing for 12 to 18 breaths. And during that time, if you're wearing pulse oximeter, I don't have one post to hand. But basically, it's a little finger probe that measures your blood oxygen saturation.
Ken Gunter 44:20
And it gives you real time feedback on the saturation, right?
Patrick McKeown 44:23
Until you'll see your blood oxygen saturation going from 98% back down to say 85% time and this way because if you think of people do high intensity interval training to stimulate anaerobic glycolysis, and it's all very well but it's traumatic for the athlete, and a lot of athletes actually get injured during the training by training too hard. Now if you do high intensity interval training, breathing through an open match your blood oxygen saturation drops from about 98% down to 93%. You're doing mountains And if you do it, my upgrading your carbon dioxide in the blood is going to be the same, it's not going to change, okay, around 14 millimeters of mercury. Okay, if you do high intensity interval training with your mouth closed, your blood oxygen saturation will drop from 98% down to about 91% or 90%, mild hypoxia, carbon dioxide and the blood will increase from about 40 millimeters of mercury, probably to about 4445. So it's slightly hypercapnic. Now, if we do breath holding, even if we just did a jogging, we're dropping the blood oxygen saturation from 98% down into the mid 80s, or even into low 80s, even into the 70s are increasing carbon dioxide from 40 or 50 plus. So in terms of the changes of blood gases, during breath holding, has a much stronger response in terms of dropping blood oxygen saturation increase in carbon dioxide disturbing the blood acid base balance, but it's less trauma. And not only that, but you're also putting a load on to the breathing muscles. It has opened up the nose so you feel that your nose will decongest anytime Your nose is stuffy. Simply breathe in and out through your nose, pinch your nose and start walking around holding your breath. And then let go and breathe in through your nose. Do it a few times and your nose will open up for people so that whatever
Ken Gunter 46:19
and for whatever reason, but yeah, I think it might be time of year here. And you know, I do have allergies. But that was one thing that I found to be really interesting in the book is that these practices are not only beneficial for enhancing performance, right or to your point increasing that buffer capabilities. But it's like it can actually help alleviate a lot of these I guess symptom is the right word, the symptoms that we experience, that often we The first thing we do myself included, is I run to the nasal spray, I grab a decongestant, I go to an anti histamine. I personally haven't tried it yet. But that's one of those things that's kind of come out of the way of exposure to your work that I'm like, Oh, well, I need to try this because I would love to rely on something that's natural and inherent versus something that you know is that it compound that just kind of patches up the symptom for a short amount of time.
Patrick McKeown 47:09
Yes. And it's been known since 1923, that if you hold your breath, you open up the nose. People will ask me, why is that significant? Well, the thing about why isn't happening in terms of breath toning, it's not exactly sure. But there were a few papers that were published 30 years ago. And it focused on Brett hauling increasing carbon dioxide in the bud because as you hold your breath, carbon dioxide cannot leave the blood through the lungs. So carbon dioxide is going to increase in the in the lungs, it's going to increase in the blood. And it's taught that it's the increased the carbon dioxide which causes the nose to become more free. And the other thing that I'd say Ken is that anybody with hay fever or uneasily related symptoms, man,
Ken Gunter 47:53
you are barking up the right tree here. It's
Patrick McKeown 47:55
your sleep. Sleep is impacted. You know, you know you've an athlete, but hey, fewer and that athlete and doesn't realize the connection between yet their nose is stuffy. So why are they doing their mouth breathing, and nasal congestion and mouth breathing is going to impact your sleep. taping them out was one thing that I started doing 20 years ago, and it absolutely changed my ability to focus. I was waking up for years feeling groggy, and unrefreshed. And you know, we're supposed to go into school, we're supposed to go into university, we're supposed to be able to go in there and concentrate. How can you perform unless you wake up feeling refreshed. And I guarantee you 50% of the people listening to this, they wake up with a dry mouth in the morning, they're waking up feeling groggy, there, they may have snoring, obstructive sleep apnea, their attention spans and their energy levels are dipping in the afternoon. They are not performing at their best. And this is regardless of age, I was 16 and 17. And I was exhausted falling asleep. You know, this is unfair for kids because you have children with sleep disorder breathing that's undiagnosed, because despite the knowledge 25 to 50% of study, children persistently mouth read, many of these kids have to have sleep issues. These kids are told go into school, concentrate and get good grades. Now these kids are not going to achieve our Excel to the best of their ability. And it's not because these kids are stupid. These kids can be highly intelligent, but the problem is their sleep. If they don't have good sleep, they're not going to excel academically.
Ken Gunter 49:37
Yeah, it's like they're they're waking up and having a run underwater. They're just like they're just not starting anywhere near their potential for the day.
Patrick McKeown 49:44
Okay, and the unknowns are the same. You know, and that's the interesting thing. And, you know, to taping up the mountain, there's a number I'll show you a couple of different options. And the one that I started off using tape was this one here, three m one inch micropore tape. Okay, if you pick it up in any drawer store and you just tear off sailboats. And sometimes it's tricky enough to get where it is about 10 centimeters or about six inches or so. Okay, so just bear with me one second, I'm just ripping it off here. And by the way, your nose will never completely congest when your motors closed, as long as you breathe through your nose, your nose will stay fairly, it'll stay open, it might feel a little bit uncomfortable, but it will never completely close. So the tape is I just fold a tab either side. Yeah, my lips. Got it.
50:37
Now, my wife,
Ken Gunter 50:39
I can't I cannot wait to run this.
Patrick McKeown 50:42
This delighted.
Ken Gunter 50:43
She's gonna be like, is that what you're into? I'm like, No, no, you're not listening to me, for the nose breathing.
Patrick McKeown 50:49
But the other one that we brought out, we brought out a tape called Myo tape. And we brought it out specifically for children, teenagers, and adults who are a little bit apprehensive about taping. And I'll just show you this one. Yeah, please. This is a kind of a camouflage. So this is the Myo tape here. Now, this is just a test color. We haven't brought out the camouflage yet. But this is just going to show you just to get an idea. Yeah, it's a tape that we gently stretch. Okay. And you stretch it and surrounds too much. Oh. And it brings the lips together.
Ken Gunter 51:30
So so that your mouth actually isn't covered. But it provides enough kind of I don't know if compression.
Patrick McKeown 51:37
So it activates a muscle quality orbicularis Oris muscle because it's bidirectional tension. So it helps to activate the muscles to help ensure nasal breathing. We did it obviously for kids. And the reason we call it my old tape is because of the dentistry and myofunctional therapy, children who are out breathing, all mouth breathing, children develop crooked teeth. And even when you embark on orthodontic rush, if the child continues mouth breathing, the teeth are going to relapse, there's a 65 to 75% relapse of the teeth falling back in again. Because it's the tongue in the roof of the mouth, which helps to develop and keep keep the teeth.
Ken Gunter 52:20
So it's the proper placement of the tongue and keeping that out. Wow. Is that is that tape available? I know the colors not but the myofacial. It's that same with like, the gap in the middle? Because I imagine there's a lot of people were like, Look, this is really important to me. But I don't know if I'm ready to take the step of taping my kids mouth shut. But yeah, I feel like you would feel much more confident. Because if you know they have the ability to open the lips, if needed, but it's like creating that reinforcement for like proper breathing patterns. Yeah, I'm gonna put in an order as soon as
Patrick McKeown 52:53
possible. And all of the children's programs are free online. So if you just go to YouTube and just put in Patrick mckown, and children's breathing exercise. So there's there's exercise for kids to decongestion knows the importance of nasal breathing for children, helping children to switch from mouth to nose breathing, crack testing posture to steps exercise. So it's all there. Because I think, you know, we really need to get this information. This information has been overlooked by two industries, the dental industry and the medical industry. It shouldn't have been overlooked. And there have been wonderful doctors and wonderful dentists who have really put it out there of the importance of nose breathing. But the thing about this is that teaching a child to breathe through the nose is not going to generate money. It's you know, there's no return on it. And I think that's why it has been overlooked. It's so simple. And yet these kids you know, there was a study conducted published in the American Journal of orthodontics back in 1981. A Canadian doctor based in the United States called Harold ha or vo LD, he noticed that the patients coming into him. The children who are mouth breathing, had more of crooked teeth, but not only were their teeth over crowded, their jaws were set back. They had cranial facial abnormalities. their nose would lock and bigger The maxilla was set back the mandible is set back their airways compromised. And he said let's do an experiment. He got young rhesus monkeys six months old, and he blocked their noses with silicon nose plugs. And he forced the monkeys to breathe through an open mouth. All of the experimental animals developed craniofacial abnormalities similar to human beings. Now I say that, you know, sometimes that comes up in conversation and people are saying oh my god, he surgically blocked the noses of the monkeys. He did terrible, but think about the 2000s and millions of children who are going around with their mouths hanging open Day Two are partaking in this experiment, and nobody's telling these kids breathe through your nose. It's really an I was one of those kids. And there are so many children out there the same, you know, so I suppose it's not just for the children, but it's for adults as well. But let's get it out there, you know?
Ken Gunter 55:19
Absolutely. Well, and it's to your point, you know, like, if I just think about myself, I was an athlete, still am an athlete, you know, and people will correct me on that. But, you know, I'm also a very curious person, I'm always looking for like something with some way to get better some way to improve. Yeah, and this is not something that I've stumbled upon. And in fact, some people who I've gotten advice from in the past, you know, based off this conversation, I got bad advice. So yeah, it's not common knowledge. And to me, it is silly, right? That like, we don't, for whatever reason, we have all these dysfunctional breathing patterns. And it should be something that just comes so naturally to us. But I think to your point, there is a need to like educate. And I think what's exciting, and I'm finding myself doing it while recording this podcast, you know, it's something that I've been working on, as we're talking. And actually, just yesterday, I did my first cardio workout breathing only through my nose. And your right at first, it did feel a bit more difficult or uncomfortable. But I was actually surprised by how long and the amount of effort I was able actually to exert while breathing just through my nose that made me feel like wow, if I if I committed to this, I really think I could get to a point where I could just continue to breathe in that way, versus always feeling the need, you know, when I'm really exerting myself to get into a big gust of air. And maybe that's a good question for you, too. And I know we're probably running out of time here. Is there ever a scenario where it does make sense to mouth breathe? mouth? mouth, mouth, breathe?
Patrick McKeown 56:56
Yeah, yeah, you can once the intensity of physical exercise gets too high. But, you know, switch to mouth breathing, you could go for example, into nose and extra nose, and continue nasal breathing for as much as you can. And if the intensity is getting a bit too high, breathe in through your nose and out through your mouth, so you get rid of carbon dioxide easier. So that alleviates your hunger. And then if it gets too high, again, switch mode mode. But if we look at one professor of Sports Medicine jock Dr. George Dalam, from the United States, he is a triathlete. and international international triathletes, but also works with Olympic athletes. And he's intrigued with nasal breathing, and has done some studies out of one recent one, it was a couple years old now he got 10, recreational athletes, and he said, I want to test you guys. How do you perform breathing through your nose. But he said, in order to do that, I need you to breathe exclusively through your nose for six months, because what he wanted to do was to see what adaptations take place. If I just grab another fish. And I say to this person, I want you now to breathe through your nose, their performance is going to dip because I'm adding an extra load on to them. Right if I say to that it Keep breathing through your nose during all of your physical exercise, or at least even 50% of your physical exercise. During your warm up during your low intensity, get your mouth closed at night. Keep breathing through your nose. And having the idea of light slow and deep. Light is about the biochemistry. Slow is about don't breathe fast and shallow, because it's very inefficient. Deep is about breathing low. So LSD, I'm sure you know many of your listeners will remember that one. So in terms of light, slow and deep data, I've got 10 recreational athletes, had them breathe exclusively through their nose for six months, then he tested them. And they had 22% less ventilation with nasal breathing versus mouth breathing. So you can imagine going for a run now this was during high intensity. This was a great exercise test, pretty much high intensity training. And they were able to perform with nasal breathing to achieve the same intensity 100% of a walk rate with nasal breathing versus mouth breathing, but were 22% less ventilation. Now there's no question there. We have to think of it in terms of economy, especially with endurance athletes. 92% less ventilation because there is an energy cost associated with breathing. As we speak here, about two to 3% of our vo to is going to support the breathing muscles. If you do kind of light exercises about 6%. If you do high intensity exercise, it's about 10%. If you do maximum exercise, it can be as high as 15%. But if you have dysfunctional breathing patterns, it's going to increase it even further. So it's all about making you know what can we do with a given amount of air and an efficient breeder. They can do more with less, they can go for a run with less air. And that's important because they're able to they're just more economical with their use of air. They're not over taxing the respiratory system, they're less likely to fatigue, but they're more likely to not to gas out too soon.
Ken Gunter 1:00:20
So yeah. And that that has to be so important to thinking, because that's where my mind went to thinking about endurance athletes. Yes. You know, like the 100 meter sprint. It's such a short amount of time that I imagined to your point, those might even be some of those individuals who would would have a shockingly lower bolt score, mate, possibly, maybe, maybe they don't. But like an endurance event or a marathon or triathlon, it's like those efficiencies really start to matter. Yes, over the course of an extended amount of time. Yeah. And actually, here's a question for you. And maybe maybe we can start to wrap it up. You know, is like for a marathon runner? Would it be realistic to expect someone who's really trying to run a competitive marathon could do a whole marathon, just nose breathing, it
Patrick McKeown 1:01:03
depends on it depends on the size. So say, for instance, African different facial structure than a Caucasian. So me, I've one nostril smaller than the other have a deviated septum. So yeah, I would need a nasal dilator. So you know, if some people have a very compromised nose when I suggested that they use a nasal dilator, and this way, so it will depend on
Ken Gunter 1:01:29
that it's not like a, like a breathe, right?
Patrick McKeown 1:01:32
You're gonna have, like here, for example, you know, this is a dilator. Here, this is this isn't a size that's going to fit me but just to show you just a little plastic device that goes up our nose that helps to open up the nose. And it'll depend on both score, an individual with a decent board score is able to do more physical exercise with less air. And a person with a good sufficient nasal airway, or using a nasal dilator will be able to do it as well. But I just want to make a point before we get to Can I please hit sprinter Bertie is a performance indicator in team sports. And this is the ability to do all our effort, followed by a very brief recovery, an all out effort again. And it applies to boxing, it applies to MMA whenever you know. So there was one study that was conducted in Australia with professional rugby union players that were 21 years of age, they measured their repeated sprint adversity before the test, and it was nine reps. They divided them into two groups, one group was doing brettell training, the same breath tuning that we do during four meter sprints. And the other group was doing high intensity interval training. And at the end of four weeks, the group who were doing brechtl training increased their repeated sprint ability from nine reps to 14.8. Wow, the group who was who were doing high intensity interval training, increased it from nine to 10. Now, my point here is these are elite rugby union professional players during peak season, and to have a game between nine to 14.8 in a performance indicator in just four weeks. So the reason that there's something in this is because, again, you know, there's something really in this and for athletes who want to get that edge, because it's only the innovators who are using this at the moment. Now it's becoming more popular, but it still hasn't gone mainstream. So it'll be interesting.
Ken Gunter 1:03:38
Well, into your point to thinking about team sports. I mean, that that someone else who I really respect was talking about just the importance of this. But I mean that that's a difference of, you know, being flat and still coming on strong in the fourth quarter, right, you know, so it makes a massive difference, right. And so yeah, if you're someone who, you know, your team tends to fall flat at the end of a game, this might be a really interesting approach. And to your point, it's actually less taxing in a lot of ways, versus just trying to run these guys or gals to death.
Patrick McKeown 1:04:11
Yes, and it's also looking, let's look at their everyday breathing patterns, because you can have an athlete doing all of the training in the world. And if this person is sleeping with an open mouth, if they're having their mouth open during like physical exercise, if the person is suffering from anxiety, whereby they have a, you know, a condition which is feeding into their breathing patterns, and it's very easy to bring this because, like, all I do is I look at, here's a person, I want you to bring these breathing exercises into their way of life. You know, when you warm up, instead of doing a warm up with your mouth open, I want you to do your warm up with your mouth closed breathing through your nose. If you're feeling anxious pre competition during your warm up, get lateral expansion and contraction of the lower ribs to come to mind. But before that, improve your heart rate variable So you've got increased resilience. And then to stress the body a little bit before you go out into competition, do find Brett holds because the other aspect about this is that we have a blood bank called the spleen. Yeah, and it's located under the left side of the diaphragm. And it contains 80% of our red blood cells and the quality of the blood inside the spleen is very high 80% of Assisi Marrakech, which are richly densely packed red blood cells. If you do a breath hold for 30 seconds, your spleen releases red blood cells into circulation. And that has a maximum effect up to five Bretton Woods. So you can think of an athlete who has gone out to to perform to do an event. They do five long battles before a couple of minutes beforehand, their spleen now has released red blood cells into circulation. And it takes between 10 and 16 minutes for the spleen to reabsorb that extra blood cells back. Now, wow, the benefit of having increased red blood cells is increased oxygen carrying capacity. And this is the reason for example, why Lance Armstrong and Lance Armstrong, these individuals taken eco taking different substances to increase their Humira crush, you know, and it was normally I'm not blaming any cyclist, I think the system was at fault there, that they left it wide open for athletes to take as much dope as they could. And not to get hurt not to get found out. You know.
Ken Gunter 1:06:28
That's incredible. So for people who want to follow what you're doing, and I know that you also offer things like courses, in addition to a number of the products that we kind of talked about today, some of which I'm going to put an order in here as soon as we get off this. What's the best way for people to find you and follow you.
Patrick McKeown 1:06:46
And we have different following one is Instagram, oxygen advantage. And the channel on YouTube. Just put in oxygen advantage, website oxygen, advantage calm. We also have restrictive training devices called sports mask calm. And then the Myo tape is Myo tape calm. So you'll see different there's workshops as well, I give to our workshops. I also teach we have 300 instructors across 50 countries for oxygen advantage as well. So you know, it's it's, it's getting out there.
Ken Gunter 1:07:17
Yeah, well, and that's what I was wondering to like, you know, do you have programs for like, let's say, you know, someone at a university hears this, and they're really interested in starting to roll some of these techniques out to the teams or the athletes that they work with? Yes. Did they go to oxygen advantage for that? I imagine their training or program.
Patrick McKeown 1:07:37
Yeah. So we have full instructor training programs, we start to get into by two weeks time during instructor training. And at the moment, of course, they're all there virtual live the same as what we're doing here. And there, it's all working out, you know, so the reach is getting out there. We have a back end as well. We've got our training manuals, very extensive and videos and everything else that goes with it. Oh, perfect.
Ken Gunter 1:07:59
Okay, great. Well, I'll make sure to link to all of that in the show notes as well and very excited for this new book to come out. Yeah, maybe when it does, we can get you back out, because we'd love to talk about that as well.
Patrick McKeown 1:08:10
Great stuff can more than happy.
Ken Gunter 1:08:13
Awesome. Well, hey, thank you very much for joining the show.
Patrick McKeown 1:08:15
Likewise.