Thread by @ErwanLeCorre

IMO breathing through a mask will lower oxygen saturation in most people but not for the reason most people believe it does. Looks like this needs a thread...

https://twitter.com/jd3141592/status/1318561151454646272

Healthy individuals - as in truly healthy not merely being temporarily not ill - naturally and consistently breathe gently through the nose at a slow pace (my respiratory rate is 6 breaths per minute as I’m typing this in a rested state), day and night.

Their blood oxygen level is continuously high (98-99%, 95% at the lowest) and they have a good CO2 tolerance (also because they’re physically active).

Breathing through a mask is not going to make any difference in such individuals.

They’ll keep continuously breathing through the nose, at a slow rate, with the exact same levels of blood oxygen level.
What about not so healthy individuals and who are they?
Answer: it’s just the VAST majority of modern mankind living an artificial, unhealthy lifestyle.

A mask is going to act as a slight extra obstacle to the already weak and inefficient breathing of modern mankind. Inhalation gets slightly slower, and the mask creates a thin pocket of stale air we inhale through.
How’s that going to impact most people?

Well, whereas everyone checks out how they externally look several times a day, most people know very little about their own body, the physiological needs and mechanisms of its biology; starting with the difference between ventilation and respiration and their connection.

Ventilation is the actual breathing movement of your respiratory muscles as well as the movement of the air flowing into and out of your lungs as you inhale and exhale. It’s the “biomechanical” part of it.

Respiration is the exchange of oxygen and carbon dioxide within your tissues, starting in the lungs, through the blood and cells.

So back to the original point, how’s breathing through a mask going to impact both ventilation and respiration in unhealthy people (i.e most people)?

As they breathe through the mask, ventilation, inhalation especially, is slightly bothered. Most people are fast breathers and breathing slowly makes them uncomfortable because it temporarily raises CO2 levels which they already have a low tolerance for.

As a result they feel like breathing “more” typically by breathing through the mouth (if they weren’t already). They’ll get more air faster in their lungs but also faster out. Now starts a cascade of negative effects but mainly the respiratory rate get even faster.

They breathe more volume of air and they do it faster as a result of their low CO2 tolerance, thinking they need that to get enough oxygen. What happens is the exact opposite, they get less oxygen, not because they don’t breathe enough, but because they breathe way too much.

This is already an issue in most people even when who do not wear a mask, and wearing a mask only makes it worse. So that’s what happens from a ventilation perspective. Now what happens at a cellular respiration level (gas exchange in the body)?

By breathing hard (too much, too fast) CO2 levels lower abnormally. Which should be good for those with low CO2 tolerance right? Except that because of the Bohr effect less blood CO2 means less oxygen delivered to the cells even when you’re inhaling enough air.

Enter “hypoxemia”, i.e low levels of O2 in the blood. Ultimately, with too little CO2 in the blood, you’ll end up with too little O2 in your tissues. Without enough CO2, oxygen “sticks hard” to hemoglobin, the protein transporting O2 to your tissues and carrying CO2 back out.

It’s also important to mention that heavy mouth breathing deviates air intake from the nasal cavities to the mouth, preventing the nasal cavities from fulfilling their normal functions of cleaning air and producing nitric oxide. “NO” is extremely important for oxygenation.

So is the mask negatively impacting blood oxygenation? Yes but not because it is a physical barrier that prevents ventilation but because people aren’t healthy and don’t know how to breathe. In most people it impacts ventilation just enough to impact respiration very negatively.

Even the psychological impact cannot be dismissed, because people with already inefficient breathing get even more tense and worried about their breathing the moment they put the mask on.

When you study breathing and breathholding, you realize that this mental aspect and how it alters physiology- positively or negatively - is extremely important. This principle is called “psychophysiology” and explains how you think can trigger or modify physiological processes.

So what’s the fix?
Knowledge, first. Then patience and composure. When you put the mask on, you know that you’ll have to be extra attentive to how you breathe. It’s a great opportunity to practice and improve both your ventilation and respiration as a matter of fact.

Do this:

-see it as a beneficial practice.

-be patient and attentive.

-relax mentally and physically.

-close your mouth and systematically breathe through the nose, slowly and gently.

As you do that, consider that:

-you’re always breathing enough oxygen.

-the feeling of air “hunger” is not due to a lack of oxygen, but to a slight build up of CO2.

-that CO2 build up in your blood is PRECIOUS: it actually helps your tissues to get optimum oxygen!

You just need to tolerate the feeling of a little extra CO2 (a very mild “hypercapnia”) for a moment, so be patient. Remember that, as you commit to handle this slight, temporary discomfort, O2 starts flowing to all your tissues (thank you Bohr effect).

If you revert to a faster, heavier breathing, or mouth breathing, it’s all right, take that “break” and resume practicing as described above as often as possible...that you’ve got a mask on or not needless to say.

If you want to go even a little further and become increasingly more comfortable breathing, do short breath holds of just a few seconds intermittently: far from depriving you from O2, it will slightly build CO2 enabling more oxygen to be delivered to your tissues.

As you’re improving CO2 tolerance that way, and increase nitric oxide by breathing nasally, your blood oxygen goes up, with or without a mask.
It also quiets the mind, reduces anxiety and so many other beneficial health effects.

Breath is a door to your soul...