The Oxygen Advantage by Patrick McKeown, published by HarperCollins, (2015)
This fascinating book introduces us to the concept of chronic overbreathing. Based on the work of Russian physician Dr. Konstantin Buteyko, the author reviews with us the physiology of breathing and how the body extracts oxygen from the air that we breathe. He reminds us that how much oxygen the body can use is actually dependent on the amount of carbon dioxide in the blood. He shows us that the common practice of breathing with the mouth open, especially during exercise, does not allow the proper amount of carbon dioxide to accumulate in the blood, hence we are not able to extract the optimum amount of oxygen from the air we are breathing.
I believe that this may affect many patients with chronic conditions, and that by following some of the simple breathing techniques outlined here, can be significantly improved.
First, the author emphasizes that one should breathe, as much as possible, even while asleep, through the nose. Practicing this, alone, may be helpful. To get a quick measure of how well you are breathing (in terms of extracting oxygen from that air), he outlines the BOLT (Body Oxygen Level Test) test: take a normal breath in through your nose, and allow a normal breath out through your nose. Hold your nose with your fingers, and time the number of second suntil you feel the first definite urge to breathe. A score of less than 20 seconds implies a significant difficulty with breathing properly.
The author then outlines a series of simple exercises to improve this, which presumably would improve oxygenation for all of the tissues and he goes into detail about all of the health benefits that could ensue.
I was quite impressed with the science behind this concept, and began to do one of the basic exercises every day, finding that within one week, my breathing had become noticeably better. Keeping in mind that for patients with porphyria, it is postulated that a low carbon dioxide level predisposes for porphyric conditons, so this might be a great way to approach those patients.
Half of this book is designed to simply improve health, and the second half is designed to help athletes improve their performance. I think there is much to be learned here and I highly recommend this book.