Pranayama – Difference between holding your breath after inhales vs. after exhales

Question proposed to me during a pranayama class; “What’s the difference between holding your breath after the exhale vs. after the inhale?”

I did propose this questions to my pranayama teacher, his response:

“It is different for different people in terms of how long one can manage to hold the breath. Some find it easier holding in and others holding out. It mostly depends on the body’s ability to be tolerant to C02 in the bloodstream.”

“A good way to practice and see is to do a BOLT test. After about 5 nice breaths exhale and pinch your nose closed until you feel the FIRST desire to inhale. There shouldn’t be any strain during this easy hold and the first breath after you let go your nose should be comfortable – not a gasp for air. That time in seconds is your Body Oxygen Level Test score. If it is less than 20 seconds more or less then your body needs more work to utilize available O2. If it is greater and up to about 40 seconds then good.”

What happens when you hold your breath after exhaling?

When we exhale we are breathing out the carbon dioxide that was returned to the lungs, so we just offloaded some carbon dioxide, which is helpful. However the oxygen in the lungs will diffuse into the blood on the exhale, which elevates CO2 quickly. This makes it harder to hold your breath.

The stimulus to breathe is not due to low oxygen but rather high CO2. As the CO2 rises in our blood is also lowers the pH of the blood making the blood more acidic. This comes with some benefits:

  • Stimulates our vagus nerve helping to control stress responses. On exhales the diaphragm moves up toward the heart where the vagus nerve is.
  • CO2 is a vasodilator which will improve circulation and open nasal passages
  • CO2 is also a bronchodilator, so it will decongest lungs while it opens nasal passages (and this can happen on inhale holds too)
  • Increased CO2 in the blood pushes the O2 to our tissues where we need it. We don’t breathe to just oxygenate our blood, we breathe to oxygenate our tissues. CO2 is what moves O2 from our blood to our tissues

Not responding to the need to breathe initially will get your more CO2 in your blood and over time will improve your CO2 tolerance. It is not dangerous unless you are holding longer than 90 seconds, up to that point it is safe (except if you are pregnant or nursing or have uncontrolled high blood pressure).

  • This allows you to tolerate more lactic acid build up in your muscles allowing you to exercise stronger, resist fatigue, and not get breathless as easy.

All breath holds:

  • Strengthen and stretch the diaphragm. When you are holding your breath your diaphragm is in an isometric contraction either pushing down against your stomach and liver (inhale holds) or pushing up against the vagus nerve and your heart (exhale holds).
  • Stimulates the spleen. The spleen is a reservoir of oxygen rich red blood cells, when we hold our breath the spleen contracts and expels more red blood cells into our blood.
  • Stimulates the kidneys to make more red blood cells (by stimulating EPO or erythropoietin. EPO is a hormone produced by the kidneys that tells our bone marrow to make more red blood cells. This process takes about 3-4 days.

How does that compare to holding your breath after inhaling?

The length of the inhale before you hold your breath in is not as important as the volume of air you take in.

When you hold after inhale it doesn’t blow off CO2, and the O2 in your lungs makes it easier to hold your breath longer because you have a reserve of O2. Even though there is still CO2 in your lungs with the O2 still in the lungs the CO2 absorbs slower, making it easier to hold your breath because CO2 does not rise as quickly in your blood.

We do want to improve our CO2 tolerance as this will better oxygenate our tissues. Without CO2 no O2 to the tissues. And this is the problem with people who over-breathe or take shallow quick breaths all day long, especially when mouth breathing instead of nasal breathing. They get too much O2 in relation to CO2 and the oxygen can’t release from the hemoglobin on our blood without adequate CO2.

Holding your breath after hyperventilating, or after the faster pranayamas of kapalabhati and bhastrika:

When you breathe in and out more air and more frequently you blow off a lot of CO2 making it easier to hold your breath longer. When you do 20-30 bhastrikas it lowers your CO2 by about 50%.

This does make it easy for one to get to a hypoxic state (low O2). But it is not without risk, if you hold your breath too long it causes vasoconstriction of your arteries reducing blood flow to organs such as your brain and heart.

Since you are coming into the breath hold with less CO2 you may not improve your CO2 tolerance in the amount of time you can safely hold your breath.

  • Holding your breath until you become slightly hypoxic has the same benefits of high altitude training, allowing our body to work harder with less oxygen improving your VO2 max. aka your aerobic fitness.
  • Holding your breath after hyperventilating stimulates the release of adrenaline which stimulates the release of anti-inflammatory cytokines.
  • Reduces inflammation because of the release of anti-inflammatory cytokines. Some doctors are now using these breathing exercises with auto-immune patients because of the reduction in inflammation.

It is not recommended to do breath holds after hyperventilating before sport or performance, nor before swimming.

Several people have asked me now about the long breath holds such as recommended in Wim Hof breathing exercises. All my pranayama training says you get the benefits of holding your breath no longer than 75 seconds without any of the risks, such as vasoconstriction or fainting. Long breath holds beyond 2 minutes are physiological acrobatics and not without risk, even holding your breath beyond 90 seconds can put you in a pre-comatose state. (Which there are some pranayamas where they do that to induce a meditative state.)

Ego … ego gets involved now that pranayama and breath holding is all the rage. Don’t let your ego interfere with enjoyment of a safe pranayama practice.

To improve your CO2 tolerance you could use a box breath for 3 minutes each day, but really any pranayama that includes breath holding will improve your CO2 tolerance.

Test your CO2 tolerance w/ hyperventilating:
To hyperventilate you do a combination breath of kapalabhati and bhastrika, you are working both the inhale and the exhale but at the intensity and pace of kapalabhati. It’s not a strong in and out as done in bhastrika.

2 minutes of hyperventilating using the kapalabhati/bhastrika type of breath.
Take a long slow inhale and hold. Time how long you can hold.

I have found that I can easily hold my breath longer after 2 minutes of hyperventilating.

Pranayama Breath Holding Benefits – Review of the the latest research

Who would have thought holding your breath can induce your body to increase nitric oxide, reduce blood sugar levels, and regenerate stem cells?  

Pranayama is a time tested tool that has been used by yogis over the millennia for improving physical health, and now we have more reason as to why.  How did the ancient yogis know this??

The USSR did some research on hypoxia — or lack of breathing and breath retention and they discovered it produces a molecule called hypoxia inducing factor 1 (HIF-1), which has been likened to superhuman effects. Hyperbaric oxygen chambers also stimulate this HIF-1 — actually when you step outside of the hyperbaric oxygen chamber after a session is when the stimulation happens. When you come out of a session in a hyperbaric oxygen chamber you suddenly have less oxygen — like being at 16000′ elevation — this lack of oxygen stimulates the angiogenesis process (which is what recruits stem cells!) just like a pranayama session with breath holding.

Here are some of the more recent discoveries of the benefits of developing a pranayama practice:

  • Increases hemoglobin levels Each hemoglobin protein can carry four molecules of oxygen, which are delivered throughout the body by red blood cells. Every one of the body’s billions of cells needs oxygen to repair and maintain itself.
  • Boosts stem cell production – In utero we are in a hypoxic environment … this environment is important for the multiplication and growth of stem cells during fetal development.  After birth we continue to make some stem cells only in some restricted areas such as bone marrow. When holding our breath in a pranayama practice we induce this slightly hypoxic environment therefore supporting stem cell production. 
  • Holding our breath makes our body form new blood vessels known as angiogenesis.  This can be helpful for heart patients, as their body forms new blood vessels around blocked arteries. Angiogenesis is also necessary for healing, after the initial injury and the pro inflammatory cytokines have done their job, anti-inflammatory cytokines show up to mop up the mess and continue the healing by stimulating angiogenesis to get more blood flow to the injury to heal the tissues. This process also stimulates stem cells to be made.
  • Brief breath holding has been found to enhance neuroplasticity — the rewiring of our brain as we learn information.  This has also been helpful in changing unconscious reactions and releasing old emotional patterns and baggage — and helping us learn new skills and learn and remember better.
  • Breath holding has been shown to increase resistance of our bodily tissue to to radiation!  Some have also said it slows the aging process.
  • Pranayama and breath holding increase nitric oxide.  Nitric oxide is a vasodilator — dilates our arteries for better blood flow and reduces oxidative stress.  Beets can help with this too 
  • Breath holding can protect and repair damaged DNA helping us hold on to our biophotons better!
  • Studies have shown breath holding exercises done both without exercise and with exercise improve glucose tolerance in the four hours following after practice. This means pranayama lowers blood sugar, and increases insulin sensitivity by helping your muscles take up and use glucose; by increasing mitochondrial enzymatic active and glycolysis (breakdown of sugar).  Mild breath holding improves glycemic control in people with type 2 diabetes.  This is a very big benefit due to the blood sugar issues rampant in society today. Breath holding causes the body to break down sugar to form O2 to compensate for the interruption from O2 from the outside.  
  • Pranayama with breath holding benefits breast health as well due to the impact of breath on lymph movement.  As I have mentioned many times, lymph is not pumped by the heart but has to circulate just like blood and make it back to the heart; where the cleaned lymph fluid is literally poured back into the heart where it mixes with blood only to be “leaked” out of the capillaries as it circulates with your blood and picked up by lymphatic vessels and taken to where it can do its job.  
    Once in the lymphatic vessels the only way the lymph gets moved is with muscular movement, gravity (one more reason to invert!), and pressure differentials from our breathing processes.
  • Deep breathing helps to move lymph specifically around the breasts — we have many lymph nodes around the breast — deep breathing helps move lymph fluid through these lymph nodes moving out the toxins the lymph picked up instead of letting it hang around the breasts.  Next time you get tender breasts — massage them with a little sesame oil which will move the lymph.
  • Even more recently, June 29, 2021 a study came out done by Colorado University showing breathing with resistance known as IMST, which stands for Inspiratory Muscle Strength Training, basically strength training for your breathing muscles done only 5 minutes / day with a device improves cardiovascular function more so than exercise or medication — and not only that, even testing at 6 weeks after stopping IMST maintained it! I write about this more fully in this pranayama which does the same thing without a device.

Other benefits of pranayama … This is what we used to know about pranayama before all the recent studies.

Pranayama and breath holding effect our subtle body. In yoga philosophy we have 3 bodies, a physical body, a subtle body, and a causal or spiritual body. Your subtle body can leave your body, and many living people have experienced that without dying. 

  • For example near death experiences where people witness being outside of their body looking down on themselves
  • During some altered states of consciousness this can happen too.
  • However when you do die your subtle body leaves completely

Pranayama is exercise for your subtle body, your subtle body is what shines your eyes and grows your hair, and flows the blood through your veins and arteries. When all your nadis or channels in the body are open and flowing and not blocked by knots known as granthis in yoga philosophy you have more vitality. Pranayama gives you vitality.

Imagination, sound, and breathing all effect your subtle body and pranayama uses all these tools through visualizations, chanting, and breathing consciously.

While breathing exercises may not be as exciting as asana exercises, as we age it becomes even more important. As we modify our asana practice we need ways to maintain our fitness and move energy in our body, pranayama can do this — pranayama maintains and improves fitness without stress your joints:

  • Increases lung capacity – improving our VO2 max.
  • Removes toxins, the slower breath rate allows more time for CO2 to be expelled
  • Induces a meditative state
  • Mental activity correlates with our breathing pattern, more thoughts = more breaths and erratic breaths.  By reducing the number of breaths we take in a given period it makes concentration and meditation easier
  • Pranayama is a tool for living in a meditative state where ease and happiness is easier.
  • Increases our Life Span. The sages observed animals and noticed that animals with a slow breath rate such as elephants, tortoises, and pythons have a longer life span than animals with shallow breaths such as rabbits, birds, and dogs.  From this observation they realized the importance of slow breathing for increasing our life span.  Our respiration and heart are directly related, a slow breathing rate keeps our heart beat slower and stronger.

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