Improve athletic performance and sleep through nasal breathing with Patrick McKeown


Key Takeaways:

1. Nasal versus mouth breathing. Learning how to nasal breath is important to daily performance and health
2. Benefits of nasal breathing for sleep. Nasal breathing will help decrease stress, prevent snoring and retain hydration
3. Bolt score and breathlessness. The Body Oxygen Level Test measures how efficient your body produces and uses oxygen and carbon dioxide.
4. Improving athletic performance through breathing. Shallow, fast breathing means athletes are likely to gas out quicker during an event or during training.
5. Be present. Drop the social media, find stillness and encourage yourself to listen to your body.

Podcast Summary

Breathing is a necessity in life one cannot live without. It’s something as humans we do 24/7 unconsciously throughout the day. However, how efficiently do you breathe and how does it affect your day to day activities?

Patrick Mckeown of Oxygen Advantage speaks to DTS Fitness Education Director of Education Ben McDonald about how nasal breathing should be the norm and how athletes and regular people can perform better on the daily tasks and activities.

1) Nasal versus mouth breathing

The simple task of breathing through your nose will automatically increase oxygen uptake, allowing the oxygen to get deeper and the nitric oxide to flow from your nose to the lungs. The nitric oxide redistributes the oxygen through the lungs and nasal breathing redistributes the air through the lungs.

The gas exchange and the amount of oxygen that is passed through the blood, the pressure increases about 10-15% just by nasal breathing, which was first noted in 1988, explains McKeown.
“A lot of people talk about nose breathing versus mouth breathing during running and they’ll say I’ll never do that because the air hunger is going to be too much but if you stick with it while doing physical activity, your fitness will surpass its current state in six to eight weeks,” says McKeown. “In terms of ventilation, a paper last year stated that there is 22 percent less ventilation so that’s 22% less energy expended to support your muscles if you breathe through your nose. So your breathing is slower and you don’t need as much air to attain a given intensity.”

That said, he points out nose breathing is a sustained practice. A group of athletes not used to nose breathing will see it as an impediment to their training until the body gets used to the learning curve.

“The body has to get used to the changes in the gases and the increase of the CO2 but after a few weeks it does. That’s when exercise intensity and endurance increase. It’s great for exercise endurance because if you can get by with 22% less ventilation, your breathing muscles are less prone to fatigue, you’re not wasting as much energy supporting the fatigued muscles and recovery and everything else is a lot better,” says McKeown.

Other benefits from nasal breathing include: slower breathing, activating the diaphragm, activating diaphragmatic breathing is essential for functional breathing and functional breathing is essential for functional movement.

When one is using upper chest for breathing, their functional movement will be impacted and, of course, if the functional movement is impacted, there is a greater risk for injury.

2) Benefits of nasal breathing for sleep

Children especially would benefit from nasal breathing to help reach their full potential. Children typically suffering from stuffy noses or are mouth breathing will see their sleep impacted from snoring or difficulty sleeping.

“As a result their concentration the next day is very much affected, including their academic ability and the ability to focus and concentrate,” says McKeown. “If the child is sleepy, they’ve got 10 times the amount of learning difficulties. These kids who have difficulty concentrating, people might say they’ve slow on the uptake, but these kids might not be slow at all – they might just be mouth breathers and they’re not getting quality sleep. Anyone who doesn’t get good quality sleep, it’s the first thing you notice. It seldom gets mentioned.”

Though sleep hygiene has become an important topic of conversation recently, most of the talk revolves around how many hours of sleep do you get, is there a lot of noise, are you sleeping in total darkness, is your bedroom cold, and so forth. The topic of nasal breathing is rarely talked about.

“It’s been shown that if you breathe through your mouth your sleep a lot later, you’re more likely to wake up, there’s greater sleep turbulence, sleep apnea, and the resistance of breathing is 2-3 times greater when you breathe through your mouth than your nose when you sleep,” explains McKeown. “If a child is diagnosed with sleep disordered breathing but untreated by the age of 5, they can have about a 20 percent reduction in permanent mental capacity. Most of these kids are undiagnosed but if they are diagnosed, they’re put on medication and the breathing isn’t addressed.”

One solution is to try and tape your mouth before you go to bed to assist with nasal breathing.

So what’s the simplest way to get rid of a congested nose?

“Take a normal breath in through your nose, a normal breath out through the nose then start walking around while holding your breath until you have medium to high air hunger, then let go and breathe in through the nose,” coaches McKeown. “Wait 30 seconds, do it again, then do it five to six times and your nose will be free.”

He adds this exercise is not suitable for females who are pregnant or people with serious medical conditions.

3) BOLT score and breathlessness

The Body Oxygen Level Test (BOLT) score looks at someone’s breath total time after exhalation.

“You take a normal breath in and out through your nose, pinch your nose with your fingers and you time it in seconds until you feel the first definitie desire to breathe or the first involuntary movement of your breathing muscles,” says McKeown. “You’re timing it to see how long does it take for the brain to react to the breath hold. It’s the first distinct reaction of the brain. It measures the sensitivity of the body to the build-up of CO2. Carbon dioxide is coming from cells into the blood and carbon dioxide is the primary drive to breathe.”

McKeown notes that the stimulus to breathe isn’t the change of oxygen in the blood that’s driving our each breath but it’s an increase or accumulation of carbon dioxide.

“If you think of it this way, if we go for a run and your cells are producing a lot more carbon dioxide, if you’ve got a strong sensitivity to the build-up of CO2, your breathing is going to be harder, so you’re going to be breathless.,” says McKeown. “There’s going to be a disproportion of breathlessness for a given intensity or duration of exercise. So your breath total time will give you feedback on how soon you get breathless during physical exercise and how breathless are you over a course of physical exercise.”

The test can also measure and provide feedback on breathing functionality for a person. The cutoff point is 25 seconds. If results are less than 25 seconds, there is likely a chance for breathing dysfunction, therefore disproportionate breathlessness and the person is wasting oxygen unnecessarily.

Dysfunctional breathing is linked to greater risk of injury, notes McKeown.

4) Improving athletic performance through breathing

For all their achievements, up to 50 per cent of athletes can experience diaphragmatic fatigue.

“We see athletes of all levels and their breath total time is 12 seconds and in the back of my mind I’m thinking, ‘How on earth did they get a medal?’” says McKeown. “One guy in particular got a medal and I was thinking in order to have achieved that medal he would have had to have pushed his body to a level of fitness to the extremes because your physical training isn’t necessarily going to affect your breathing.”

Training can only assist output to a degree, but breathing is an everyday necessity so it will affect physical training as the lungs often have a set limit.

“The diaphragmatic muscle gets tired due to being overworked. When that happens, blood is taken from the legs to feed the diaphragm,” he says, adding this is why sports masks help to create resistance in oxygen deprivation while training.

Breathing efficiency is increased drastically by breathing slower and deeper. By changing one’s respiratory rate from 12 breaths per minute to six breaths at rest, efficiency can increase by 22 per cent.

A prime example of an athlete in his prime is Connor McGregor. McKeown points out his breathing during his interviews, not after a fight, his breathing is fast upper chest breathing which will translate during physical exercise.

“It’s no coincidence that he’s gassing out so soon,” notes McKeown.

McKeown noted a paper in 2018 tested the repeated sprint ability of rugby union players.

“These guys were 21 years of age and in peak season. They gave them a breath holding test – normal breath in, normal breath out, pinch your nose hold and sprint for 40m with the breath held. Take a 30 seconds recovery repeat, 30 seconds repeat, 8 reps, two sets a week,” says McKeown. “In four weeks their repeated sprint-ability increased from 9 to 14. Which is around a 30 per cent increase. The control group has no improvement. These are top athletes and in team sports repeated sprint ability is a great indicator of performance with team sports.”

In the short term, he does point out most athletes don’t want to change their routine too much from what they’re used to doing successfully.

“If I’m looking at somebody I’m going to ask them how they’re doing their warm up, what can we do there? What do you do during your practice session, what can we do there? Your recovery. How can you bring this into your everyday life?” asks McKeown. “You breathe 24/7 so let’s pay attention to it.”

5) Be present

Ultimately, McKeown says both trainers and clients need to be aware of nasal breathing inside and outside a training session.

Start your warm ups with nasal breathing and ensuring you build a habit right from the beginning.

“If your attention is on the breath you’re not going to be thinking and focusing on the breath. There is a likelihood you are focusing on your breath and your mind wanders and that’s always a start; you bring your attention back and your mind wanders, it’ll take practice,” he says. “You start to notice gaps in between thoughts and your stillness improves. It’s almost as if there is a muscle in the brain and you can tap into that just by bringing your attention into it.”

Nasal breathing should be practiced daily to help bring oneself to self-awareness. People need to reconnect with life and not get stuck in their heads or social media.

“If you’re going around with yourself stuck in your head, you’re not living your life. How many people walk down the street preoccupied in their own thoughts? We’re giving the tools to think in school, but we’re not given the tools to stop thinking,” says McKeown.

Everyone needs to find stillness in their minds.

Resources and References from the Podcast

Oxygen Advantage Website –

SportsMask –