4-7-8 Breathing?

In a recent episode of the Feel Better Live More podcast, Dr Rangan Chatterjee interviewed a sleep doctor who revealed that he and his wife sleep with the TV, not just in the bedroom, but on at night and with a dog sleeping between them at pillow level, with the doctor getting the rear end!

The interview is nevertheless worth a listen.The discussion covers a range of sleep-related matters including the issue of waking up at around 3am and not being able to go back to sleep. The doctor suggests that pretty much everyone does the former even though many people barely notice because they do fall asleep again. Why do we do this? Most typically it's due to an increase in body temperature  .. we can't perpetuate the cooling that helps to promote sleep at the start of the night. At some point body temperature needs to come back up and it generally happens in the small hours. This, he says, is accompanied by faster heart rate and, not unusually for some, a touch of unwelcome anxiety which can easily spiral out of control as the prospect of poor sleep followed by a potentially busy day becomes a source of worry .. assuming some other worry hasn't already taken hold. 

And the doctor's solution? He recommends 4-7-8 Breathing. This breathwork practice is attributed to Dr Andrew Weil who, if I'm not mistaken, regarded it primarily as a mindfulness meditation exercise. The practice involves breathing in for a count of 4, holding your breath for a count of 7 and exhaling for 8. Nobody breathes like this naturally so the need to give it your attention in order to maintain it most definitely makes it a mindful practice. Great. As long as it suits you. But using it to lower anxiety and heart rate as a means of getting back to sleep? That's where I'm less enthusiastic. Before I explain why, let me just say if you love this exercise and have found it works for you, keep doing it! We're all different and you may well have a baseline of very good functional breathing. But for those who don't, there are one or two things to consider. 

4-7-8 Breathing 

With your fingers gently resting on your neck to the side of your windpipe, can you feel your pulse? It may be a subtle feeling especially if you're currently calm and relaxed. If you can feel it, inhale and exhale slowly. Does the pulse change? There should be a slight speeding up as you breathe in and a slight slowing down as you breathe out. This is your heart rate responding to your breathing. This is why the longer exhale is valuable in the context of calming down: more slow exhales per minute mean the body is spending more time in ‘rest and digest’, giving the body the opportunity to tell the brain that it's safe, eg safe to fall asleep. The contrast between the length of inhale and exhale in 4-7-8 breathing must surely be ideal for creating calm? Not necessarily. Put your fingers on your neck again and do the exercise: inhale for 4, hold for 7 and release for a count of 8. You may notice that the slower heart rate only happens on the exhale. For 11 seconds of this exercise (assuming your count was in seconds) your body was tipped slightly into the stress mode. A breathhold on the inhale is a continuation of the inhale thus prolonging the slightly faster heart rate and so for some of us, this exercise just doesn't deliver the hoped-for sleep-inducing calming effects. It may even keep us midly stressed.

But that's not all. A high proportion of insomnia sufferers are likely to have sub-optimal breathing, in fact this is an incredibly widespread problem in our pressurised world. Sub-optimal breathing is characterised in various ways with over-breathing being chief among them. This is a form of hyperventilation albeit not at the sharp end where a full on panic attack ensues. It's typically 'normal' enough to go unnoticed but the individual affected by it consistently breathes a little too much for their metabolic needs (and yet may frequently feel they're not getting enough air). This matters. The downstream effects interfere with oxygen delivery to muscles, tissues and organs, they amplify anxiety and cause sleep disturbances in many people to say nothing of the associated breathlessness that can make physical exercise unappealing. For such people this 4-7-8 breathing exercise is likely to reinforce or even worsen the over-breathing that's already potentially robbing the individual of their peace and better health. Why? Because to achieve the breathhold plus the long exhale, a large inhale is needed: 15 seconds without an inhale is a big deal for a person who is oversensitive to the build up of carbon dioxide (the biochemical trigger for over-breathing) so to compensate, more air is inhaled than the body needs thus serving as further ‘training’ for this unhelpful pattern of over-breathing.

Is there an alternative?

Yes. First and foremost slow your breathing, ideally making the exhale a little longer than the inhale, and definitely through your nose, in and out. Don't worry about a specific count, your way of doing it needs to suit you and not correspond to a predetermined formula. If you can also breathe a little bit lighter you're likely to experience almost immediate calming whilst ensuring there's no further ‘over-breathing’ to worsen any breathing pattern that may already be adversely affecting you. 

Counting can be useful when you need to give your mind a mundane task that helps to keep rumination at bay. But instead of counting seconds, count your breaths … backwards. As a rough guide (because we're all different) maybe start at say 40 i.e. inhale 40, exhale 40, inhale 39, exhale 39 and so on. You may find you fall asleep before you get to 1 in which case, great. But sometimes, sleep may still not happen however many rounds you do, so I recommend you take heart as you continue breathing slowly and lightly because you're likely to be producing Melatonin¹, cleaning your brain² and toning your Vagus Nerve³ to contribute to a better regulated nervous system. You can literally achieve some of the benefits of good quality sleep while you're awake.

If you can't sustain the focus on your breathing (which is not at all unusual in the small hours of the morning when worries sometimes loom larger than they actually are), be sure to have your phone on flight mode and a suitable guided meditation at the ready. There are several here by Patrick Mckeown, my trainer, and they're all free to download. 

I wish you better sleep, happiness and health.

~ Annette Henry 

¹ When You Really Cannot Sleep (blog post)

² Your Brain & CO² (blog post)

³ Cell Danger Response (blog post)

The above listed blog posts all include scientific references which may support your understanding and conviction to keep going.

If you think one to one help might be useful, do consider getting in touch and we can arrange a 20 minute exploratory zoom call.