THE ROLE OF BREATHING FOR BETTER COGNITION

Medically Reviewed by Dr. Rosmy Barrios - October 10, 2024

Of all organs, the brain requires the most oxygenation since it can use up to 20% of the oxygen that we breathe in^[1]. In light of this, it is not surprising that optimal respiration is vital to cognitive function.

The following discussion takes a closer look at how breathing boosts brain function and how this serves to improve many aspects of health, well-being, and quality of life. 

Breathing Affects and is Affected by Everything We Do

Breathing is involuntary and often subliminal, yet it has a massive impact on overall health and quality of life. Focusing on promoting better cardiovascular health is a major determinant of overall well-being and vitality and breathing contributes largely towards maintaining cardiovascular health.

Often, subconsciously, everyday activities uniquely affect how we breathe, thus affecting our ability to think and feel. Changes in body position, wakefulness, types of activity (mental or physical), emotional state, and speech engagement all change the rate and way in which we breathe. This ultimately impacts the brain and body in a way that affects how we think as well as how we perceive our lived experiences.

How Mindful Breathing Enhances Cognition

Controlled breathing has been shown to have dramatic effects on cognitive function and life quality, as described briefly below.

Improves Brain Oxygenation. Mentally demanding tasks are known to increase the respiration rate and brain oxygen consumption^[2], which deep breathing can help to improve. The brain areas required for these tasks also appear to consume the highest amounts of brain oxygen to meet their energy requirements. Cognitive function, as seen in studies testing for memory recall and object recognition abilities, appears to increase upon inhalation and decrease upon exhalation, likely to fall in tandem with brain oxygenation.

Brain Electrical Coherence. The breathing centers of the brain are connected to multiple brain areas, the neural oscillations of which are ultimately entrained into the rhythm of every breath we take. The neural oscillations of every brain area are vitally important for mediating different states of consciousness, arousal, and behavior. For each of these, we exhibit a unique pattern of breathing. Many respiration-entrained brain regions connect the brain to the body and are actively involved in coordinating muscle groups involved in respiration, blood circulation, body oxygenation, nutrient-loading, waste removal, metabolic processes, and more.^[3]

Heart Rate Variability and Cognition. Breathing is also central to conscious control of the heart rate. Studies have suggested that increased HRV, often achieved through mindfulness practices and slow-paced breathing, can positively impact cognitive function and enhance emotional control.^[4]

Respiration and the Olfactory Bulb. The olfactory bulb appears to play a central role in syncing breathing and brain activity, which is likely why nasal breathing has a far more profound effect on cognition than oral breathing. When the olfactory bulb and/or nose are not working as well, it has been shown to increase the risk of mental and neurological diseases such as dementia.

Better Emotional Regulation. Optimal breathing shares a direct relationship with one’s mood, stress levels, and cognitive ability. Stress tends to detract from the ability to think and regulate emotion, likely by activating the breathing centers in the brainstem and elevating the respiration rate. Breathing difficulties are also indicative of an elevated respiratory rate and have been shown to increase the risk for mood disorders, including anxiety disorders, PTSD, and depression. Controlled breathing has been shown to activate respiration-related areas in the brainstem, which in turn are able to positively affect several brain areas, including those involved in regulating stress and emotion. An interesting study on mice highlights how the vagus nerve becomes active in between inhalation and exhalation, indicating that holding the breath for longer after both breathing in and out helps to further reduce stress, promote emotional regulation, and may even support immune function.^[5]

Reduced Pain Perception. Following on from stress regulation and emotional control, slow deep breathing and controlled breathing practices are often used to alleviate pain. Studies reveal that pain is linked with a higher respiration rate.^[6] Slow breathing can help to increase awareness of pain, lower the perception of pain intensity^[7] and increase one’s ability to cope. This suggests that optimal breathing serves to keep cognition balanced and well-maintained, even during painful conditions. Pain is capable of reducing cognition, yet a cognitively demanding task can help to shift focus away from pain and lower its intensity, which can be complemented by deep breathing.^[8]

Sustained Attention and Focus. Deep breathing exercises have been shown to promote sustained attention and focus, as well as reduce cortisol levels across study participants.^[9] These techniques may help those with ADD/ADHD to focus better^[10], especially with respect to nasal breathing practice. Children with ADD/ADHD are at a higher risk for sleep apnea and mouth breathing^[11], which has correlated to worse symptoms.

Neurogenesis and Neuroplasticity. Optimal respiration, particularly through the nose, is known to enhance brain connectivity which is conducive to neuroplasticity and flexible or adaptive cognition. Few studies have assessed whether respiration might affect neurogenesis. Of these, it has been shown that patients with sleep apnea affected by lower levels of oxygen during sleep were shown to have compromised neurogenesis, lower hippocampal function, and reduced cognition in terms of memory and learning^[12]. In those recovering from stroke and brain injury, deep breathing practices improved their ability to re-learn lost cognitive and motor skills through enhancing neurogenesis^[13]. Similar results can be seen in the elderly,^[14] who are prone to cognitive decline and an increased risk of acquiring neurodegenerative disorders. Controlled breathing potently lowers stress by changing brain activity and stimulating the vagus nerve, which is also conducive to optimizing neurogenesis and neuroplasticity.^[15]

Effects of Different Breathing Techniques: Nasal vs Oral Breathing

We use both the mouth and nose to breathe optimally, usually with a greater reliance on nasal breathing than oral breathing. The effects of each are briefly reviewed below:

Oral breathing may not be as healthful as nasal breathing. Several studies have highlighted the importance of the nostrils in filtering the air as well as ensuring it remains moist and at the right temperature for optimal lung function. Oral breathing can interfere with this process and detract from respiration. Other effects of oral breathing include:

• Reduced Cognition. Oral breathing is linked to lower brain oxygen levels^[16], which has been proven to promote reduced cognitive ability and memory function in healthy adults and in children with mouth breathing syndrome. Breathing through the mouth lowers brain wave activity in the alpha and theta ranges which has been shown to lower overall brain function during cognitive tasks compared to nasal breathing^[17]. This has also been associated with increased asymmetrical connectivity between multiple brain regions as opposed to optimal symmetrical brain activity^[18].
• Negative Impact on Posture. Prolonged oral breathing is known to deform neck posture, as seen in individuals with sleep apnea. It is additionally associated with poor dental health, a dry mouth, congestion, and lower saliva production.^[19]
• Activates Brain Regions Connected with Speech. We breathe naturally through the mouth when speaking or singing. When coupled with inhalation via the nose, expiration from the mouth appears to engage and connect several additional brain regions associated with language processing, speech, and sound. This indicates that mouth breathing does have an appropriate use which serves to enhance cognition when nasal breathing is not impaired, and deep breathing is emphasized. 

Nasal breathing is associated with better outcomes compared to oral breathing. Unlike oral breathing, nasal breathing encourages deeper breathing that allows for greater oxygen uptake, as well as for more brain stem and cardiorespiratory input. Its greater effect with respect to enhancing brain oxygenation is able to enhance cognition in a variety of ways:

• Regulates Brain Networks Relevant to Consciousness, Arousal, and Perception. It appears to strengthen connectivity in the default mode network (DMN) of the brain. The DMN encompasses many higher-order brain regions that sustain social and emotional processing, perception, self-reflexivity, empathy, and the rational mind^[20], suggesting that nasal breathing is capable of helping to regulate these brain areas.
• Improves Memory Recall and Learning Ability. It has also been shown to enhance connectivity in the hippocampus, which governs the ability to learn and recall information. Additionally, many of the cognitive-enhancing benefits of breathing described above can be attributed largely to nasal breathing.
• Better Neurologic Coordination of Physical Movement. Adults that performed nasal breathing have improved connectivity and higher activity in the cerebellum, which was reflected in an increased ability to perform physical tasks involving muscle memory and coordination.^[21]

Other Factors That Impact Respiratory Function

Aside from whether one breathes more through the nose or mouth, the following factors are also known to impact respiratory function:

Cardiovascular Health. The functioning of the cardiovascular system affects lung health and vice versa. If the blood cells are unable to take up oxygen optimally, it will ultimately impact lung and heart function as well as the vitality of many other bodily tissues. Diminished blood flow and reduced tissue oxygenation tend to promote fast, shallow breathing and are associated with more tissue inflammation and nasal congestion.

Posture. It has been observed that reduced respiratory function occurs with bad posture when the head slouches forward, as this places pressure on the diaphragm and the lower portion of the lungs, which promotes shallow breathing.^[22] A good upright posture, especially of the head and neck, is conducive to optimal breathing and cognition.

Energy Metabolism. Overall metabolic health influences how well one can breathe by regulating tissue oxygenation, inflammation, and cardiorespiratory health. Metabolic health is governed by energy production at the cellular level, which requires optimal oxygen uptake, fats, and glucose, as well as vital amino acids. Too much or too little of any of these can cause energy metabolism to become over or underactive, which may lead to cardiovascular inflammation and breathing issues. It is important to note that vital amino acids contribute towards breathing through forming the building blocks for vascular antioxidants like glutathione and vasodilators such as nitric oxide that regulate vascular inflammation, blood cell oxygen uptake, and whole-body oxygenation. Amino acid disturbances, alongside other metabolic deficits, are known to promote respiratory disease.^[23]

Air Pollution. Optimal respiration requires good air quality. Volatile compounds in polluted air can increase respiratory inflammation, interfering with the lung’s ability to process oxygen as well as the blood’s ability to take up oxygen.^[24]

Stress. Chronic stress and emotional states associated with it, including anger and sadness, have been linked with a decline in lung function throughout aging as well as the presence of asthma at all ages.^[25]

Tips for Improved Breathing

The below suggestions can greatly help to improve breathing, cognition, and mood.

Keep Hydrated. Moisture and electrolytes are critical to respiration, as they allow for optimal gaseous exchange in the membranes of the lung. A large part of our electrolyte intake is derived from the water we drink, as well as from fruits, vegetables, and small amounts of salt. Keeping hydrated also allows for optimal circulation of bodily fluids, which serves to enhance the health of supportive systems and organs, such as the cardiovascular system, the kidneys, and the digestive tract. The digestive tract and kidneys regulate protein metabolism and correspondent blood cell function, vasodilation, and tissue oxygen uptake.

Eat a Nutrient-Dense Diet that Promotes the Health of the Blood. All the components of a nutritionally balanced wholefood diet support cardio-respiratory function as well as optimal cognition. A plant-based wholefood diet holds a wealth of nutrients that support bodily oxygenation, such as antioxidants, sulfur, essential amino acids, iron, and prebiotic fibers.

Practice Breathing. Deep breathing has been shown to improve respiratory function as well as aspects of cognition. Many of these benefits can be attributed to lowering bodily stress and blood pressure as well as improving blood oxygenation. Pranayama is a specific type of yoga that encompasses numerous kinds of deep breathing techniques that may be useful for those wishing to enhance their breathing. In a small study conducted on healthy young women, yogic breathing exercises have proven to enhance postural control and improve spinal mobility in a similar way to physical exercise.^[26] Deep breathing can also be practiced throughout the day during speech, exercise, and any activities.

Frequently Clearing the Nasal Passage and Preventing Sinus Issues. Keeping the nasal passages clear of mucus and other obstructions helps to preserve respiratory function. Those that suffer from allergies, sinus, or congestion that promote mouth breathing ought to make an effort to keep the nose clear and practice breathing through it, even more so than individuals without sinus obstruction. The risk for nasal obstruction can increase due to air pollution, consuming an unbalanced diet, allergies, or a congenital malformation of the nasal cavity (for which corrective surgery may be advisable in severe cases). Investing in air purification systems and a healthy plant-based wholefood diet can greatly help to alleviate sinus issues and improve respiratory function.

Exercise helps to improve breathing by enhancing blood flow, heart strength, and muscles conducive to both breathing and postural control^[27]. This encompasses stretching, aerobic and weight-bearing exercises, as well as resistance training. All forms of muscle-building exercise ought to be carried out with an emphasis on good posture to ensure muscles form in alignment with breathing. In light of the effects of breathing on muscle control, heart rate, and neural coordination, focused nasal breathing during exercise can also enhance a workout while boosting the respiratory and cognitive benefits.

Conclusion

Our breathing closely mirrors the state of our minds and our hearts, both physiologically and perceptually. Respiration is central to brain and body oxygenation, allowing for more to be accomplished when adequately meeting the brain’s high oxygen demands. Over and above oxygen metabolism, the rhythm of the breath is able to set the pace of the heart as well as the oscillations of the neurons in the brain. This effect is greatly enhanced through nasal breathing, emphasizing the importance of keeping the nasal passages clear. Nasal breathing further encourages deeper respiration, more oxygen uptake, and better brain connectivity, resulting in optimal cognition and emotional regulation. Practicing deep nasal breathing exercises helps to strengthen the benefits of breathing, as does leading a healthy lifestyle.

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