Breathing rhythms, resonance between the lungs and heart and modulation of the Heart Rate Variability, applications to brain and aging

1. Brain Bonanza
Unit 2.2. Breathing Rhythms
Eric Serejski
eric@serejski.com

2. Unit 2.2
Breathing – Functional Approach
© 2019. Eric Serejski

4. David Petrucci
Jeff Lessans
Luke Markey
Eric Serejski
WHO
Sean Moore

5. A word of gratitude
The Experts
Hugh Gordon Eric Johnson
Frederic County
Association of Realtors
Audio-Video Group
Johnson Tien
Social Media Koi Agency
And all of you making this possible.

6. Disclaimer
All graphics not created by me are, to the best of my knowledge, public domain and used for sole
purpose of education. Should one not fall in the public domain category, or should proper credit
be missing, please notify me so that the issue can be corrected immediately.

7. Find us at:
https://www.facebook.com/abrainbonanza
https://www.brainbonanza.org/

8. Brain Health

9. Where are we?

10. Brain - Community
Eating
Supplements
Breathing
Diet
Interacting
Nootropics
Da Vinci
Pairing
Structures
Coupling 1
Breathing
Heart-Lung
HL Resonance HRV
Coupling 2
Heart-Lung-
Autonomic
Nervous System

11. Review
The Three Breathing Units

12. The three breathing units
1
6
3
2
Upper
Middle
Lower

13. Breathing in Breathing out
chest
expands
ribs
diaphragm
diaphragm
contracts
chest
contracts
lung
diaphragm
relaxes
Complete breathing

14. Complete breathing
Inhale Exhale
1. Belly out
2. Chest out
3. Chest up
1. Belly in
2. Chest in
3. Chest down1
2
3
1
2
3
Sequence SequenceRatios 3:2:1 Ratios 3:2:1

15. Resonance
Heart and Lungs

16. The Lung Frequency
Total lung
capacity
Vital
Capacity
Tidal Volume
(Normal breathing)
10%
Residual
Volume
• Slower
• Fuller
• More efficient
• Awareness of Heart Rate Variability
RR = 16/min

17. The Heart Frequency

18. Heart-Lung Resonance
RR = 16
HR = 70
RR = 6
HR = 70
RR = Respiratory rate (/min.); HR = Heart rate (/min.).

19. Heart-Lung Resonance
=
Optimal Heart Rate Variability

20. What is Heart Rate Variability?
— HRV —

21. Heart Rate Variability
=
Fluctuations between heart beats

22. HRV Illustrated
(1)
(2)
(1) Constant Heart Rate; (2) Heart Rate with Variability
Heart ‘Rate’ = Eight Beats

23. HRV – The amazing biomarker

24. An aggregate view
Heart Health
Diabetes
Sudden infant death syndrome
Premature babies’ survival
Emotional arousal
Anxious depression
Anxiety
Worry
PTSD
Cancer survival
Parkinson Disease
Emotional strain
Dementia
Mild cognitive impairment
Major depression
Liver
Kidney

25. How is HRV computed?

26. HRV Measurements
• Many computing methods
• Highly individual
– Generally: High values are good
• Learn to know trends rather than numbers
• Use modern technology with HRV:
– Portable devises (rings, bracelets)
– Smart phones applications

27. Examples
• Oura Ring (IOS and Android)
– ouraring.com
• ECG for Everybody (IOS and Android)
– ecg4everybody.com
• Metronome

28. Now let’s resonate

30. The three breathing units
1
6
3
2
Upper
Middle
Lower

31. Breathing in Breathing out
chest
expands
ribs
diaphragm
diaphragm
contracts
chest
contracts
lung
diaphragm
relaxes
Complete breathing

32. Complete breathing
Inhale Exhale
1. Belly out
2. Chest out
3. Chest up
1. Belly in
2. Chest in
3. Chest down1
2
3
1
2
3
Sequence SequenceRatios 3:2:1 Ratios 3:2:1

33. Things to come

34. Next
Structures
Parts involved
Coupling 1
Aging
Coupling 2
Breathing
Breathing
Heart-Lung
HL Resonance
HRV
Heart-Lung-
Autonomic
Nervous System
Tick Tock
2–4 hours

35. Find us at:
https://www.facebook.com/abrainbonanza
https://www.brainbonanza.org/

36. References
https://brainbonanza.org
58 references

37. References
• Alonso, Alvaro, Xuemei Huang, Thomas H. Mosley, Gerardo Heiss, and Honglei Chen. 2015. “Heart
Rate Variability and the Risk of Parkinson Disease: The Atherosclerosis Risk in Communities Study.”
Annals of Neurology 77 (5): 877–83. https://doi.org/10.1002/ana.24393.
• “Applications: Oura Ring.” n.d. Oura Ring. Accessed June 4, 2019. https://ouraring.com/.
• Ask, Torvald F., Ricardo G. Lugo, and Stefan Sütterlin. 2018. “The Neuro-Immuno-Senescence
Integrative Model (NISIM) on the Negative Association between Parasympathetic Activity and
Cellular Senescence.” Frontiers in Neuroscience 12: 726. https://doi.org/10.3389/fnins.2018.00726.
• Ates, Fehmi, Ergun Topal, Feridun Kosar, Melih Karincaoglu, Bulent Yildirim, Yuksel Aksoy, Murat
Aladag, et al. 2006. “The Relationship of Heart Rate Variability with Severity and Prognosis of
Cirrhosis.” Digestive Diseases and Sciences 51 (9): 1614–18. https://doi.org/10.1007/s10620-006-
9073-9.
• Bhagat, Om Lata, Chhaya Kharya, Ashok Jaryal, and Kishore Kumar Deepak. 2017. “Acute Effects on
Cardiovascular Oscillations during Controlled Slow Yogic Breathing.” The Indian Journal of Medical
Research 145 (4): 503–12. https://doi.org/10.4103/ijmr.IJMR_830_15.
• Bhargav, Hemant, H. R. Nagendra, B. N. Gangadhar, and Raghuram Nagarathna. 2014. “Frontal
Hemodynamic Responses to High Frequency Yoga Breathing in Schizophrenia: A Functional near-
Infrared Spectroscopy Study.” Frontiers in Psychiatry 5: 29.
https://doi.org/10.3389/fpsyt.2014.00029.
• Bowser, Andrew. 2018. “Heart Rate Variability May Be Risk Factor for Depression, Not a
Consequence.” May 16, 2018.
https://www.mdedge.com/psychiatry/article/165900/depression/heart-rate-variability-may-be-
risk-factor-depression-not.

38. References
• Brunoni, Andre Russowsky, Andrew H. Kemp, Eduardo M. Dantas, Alessandra C. Goulart, Maria Angélica Nunes,
Paulo S. Boggio, José Geraldo Mill, Paulo A. Lotufo, Felipe Fregni, and Isabela M. Benseñor. 2013. “Heart Rate
Variability Is a Trait Marker of Major Depressive Disorder: Evidence from the Sertraline vs. Electric Current Therapy
to Treat Depression Clinical Study.” International Journal of Neuropsychopharmacology 16 (9): 1937–49.
https://doi.org/10.1017/S1461145713000497.
• Burr, Robert L., Sandra A. Motzer, Wan Chen, Marie J. Cowan, Robert J. Shulman, and Margaret M. Heitkemper.
2006. “Heart Rate Variability and 24-Hour Minimum Heart Rate.” Biological Research for Nursing 7 (4): 256–67.
https://doi.org/10.1177/1099800405285268.
• Cabanas-Grandío, Pilar, Felipe Bisbal, Esther Guiu, Lluís Mont, and Antonio Berruezo. 2015. “Deep Breathing-
Triggered Atrial Fibrillation: An Unusual Mechanism Terminated by Focal RF Ablation.” Indian Pacing and
Electrophysiology Journal 15 (4): 199–201. https://doi.org/10.1016/j.ipej.2015.09.006.
• Dick, Thomas E., Joseph R. Mims, Yee-Hsee Hsieh, Kendall F. Morris, and Erica A. Wehrwein. 2014. “Increased
Cardio-Respiratory Coupling Evoked by Slow Deep Breathing Can Persist in Normal Humans.” Respiratory
Physiology & Neurobiology 204 (December): 99–111. https://doi.org/10.1016/j.resp.2014.09.013.
• Farnsworth, Bryn. 2017. “Heart Rate Variability - How to Analyze ECG Data.” IMotions. July 25, 2017.
https://imotions.com/blog/heart-rate-variability/.
• Garcia, Alfredo J., Jenna E. Koschnitzky, Tatiana Dashevskiy, and Jan-Marino Ramirez. 2013. “Cardiorespiratory
Coupling in Health and Disease.” Autonomic Neuroscience: Basic & Clinical 175 (1–2): 26–37.
https://doi.org/10.1016/j.autneu.2013.02.006.
• Gillie, Brandon L., Michael W. Vasey, and Julian F. Thayer. 2014. “Heart Rate Variability Predicts Control over
Memory Retrieval.” Psychological Science 25 (2): 458–65. https://doi.org/10.1177/0956797613508789.

39. References
• ———. 2015. “Individual Differences in Resting Heart Rate Variability Moderate Thought
Suppression Success.” Psychophysiology 52 (9): 1149–60. https://doi.org/10.1111/psyp.12443.
• Godfrey, Kathryn M., Adrienne Juarascio, Stephanie Manasse, Arpi Minassian, Victoria Risbrough,
and Niloofar Afari. 2019. “Heart Rate Variability and Emotion Regulation among Individuals with
Obesity and Loss of Control Eating.” Physiology & Behavior 199 (February): 73–78.
https://doi.org/10.1016/j.physbeh.2018.11.009.
• Goessl, V. C., J. E. Curtiss, and S. G. Hofmann. 2017. “The Effect of Heart Rate Variability
Biofeedback Training on Stress and Anxiety: A Meta-Analysis.” Psychological Medicine 47 (15):
2578–86. https://doi.org/10.1017/S0033291717001003.
• “Heart Rate Variability.” 2019. In Wikipedia.
https://en.wikipedia.org/w/index.php?title=Heart_rate_variability&oldid=892706466.
• Hsia, Connie C. W., Anke Schmitz, Markus Lambertz, Steven F. Perry, and John N. Maina. 2013.
“Evolution of Air Breathing: Oxygen Homeostasis and the Transitions from Water to Land and Sky.”
Comprehensive Physiology 3 (2): 849–915. https://doi.org/10.1002/cphy.c120003.
• Jovanov, E. 2005. “On Spectral Analysis of Heart Rate Variability during Very Slow Yogic Breathing.”
Conference Proceedings: ... Annual International Conference of the IEEE Engineering in Medicine
and Biology Society. IEEE Engineering in Medicine and Biology Society. Annual Conference 3: 2467–
70. https://doi.org/10.1109/IEMBS.2005.1616968.
• Kircanski, Katharina, Leanne M. Williams, and Ian H. Gotlib. 2019. “Heart Rate Variability as a
Biomarker of Anxious Depression Response to Antidepressant Medication.” Depression and Anxiety
36 (1): 63–71. https://doi.org/10.1002/da.22843.

40. References
• Kloter, Evelyne, Katja Barrueto, Sabine D. Klein, Felix Scholkmann, and Ursula Wolf. 2018. “Heart Rate Variability as
a Prognostic Factor for Cancer Survival – A Systematic Review.” Frontiers in Physiology 9 (May).
https://doi.org/10.3389/fphys.2018.00623.
• Koenig, Julian, Daniela Falvay, Annika Clamor, Julia Wagner, Marc N. Jarczok, Robert J. Ellis, Cora Weber, and Julian
F. Thayer. 2016. “Pneumogastric (Vagus) Nerve Activity Indexed by Heart Rate Variability in Chronic Pain Patients
Compared to Healthy Controls: A Systematic Review and Meta-Analysis.” Pain Physician 19 (1): E55-78.
• Koester, Mark. 2017. “Heart Rate Variability: The Amazing Biomarker for Understanding Our Body, Health and
Fitness - Minding the Borderlands.” May 16, 2017. http://www.markwk.com/hrv-for-beginners.html.
• Kromenacker, Bryan W., Anna A. Sanova, Frank I. Marcus, John J. B. Allen, and Richard D. Lane. 2018. “Vagal
Mediation of Low-Frequency Heart Rate Variability During Slow Yogic Breathing.” Psychosomatic Medicine 80 (6):
581–87. https://doi.org/10.1097/PSY.0000000000000603.
• Laborde, Sylvain, Philip Furley, and Caroline Schempp. 2015. “The Relationship between Working Memory,
Reinvestment, and Heart Rate Variability.” Physiology & Behavior 139 (February): 430–36.
https://doi.org/10.1016/j.physbeh.2014.11.036.
• Laborde, Sylvain, Thomas Hosang, Emma Mosley, and Fabrice Dosseville. 2019. “Influence of a 30-Day Slow-Paced
Breathing Intervention Compared to Social Media Use on Subjective Sleep Quality and Cardiac Vagal Activity.”
Journal of Clinical Medicine 8 (2). https://doi.org/10.3390/jcm8020193.
• Laborde, Sylvain, Emma Mosley, and Alina Mertgen. 2018. “A Unifying Conceptual Framework of Factors
Associated to Cardiac Vagal Control.” Heliyon 4 (12): e01002. https://doi.org/10.1016/j.heliyon.2018.e01002.
• Lake, James. 2018. “Heart Rate Variability (HRV) Biofeedback for Anxiety.” Psychology Today. October 24, 2018.
https://www.psychologytoday.com/blog/integrative-mental-health-care/201810/heart-rate-variability-hrv-
biofeedback-anxiety.

41. References
• Langer, Daniel, Noppawan Charususin, Cristina Jácome, Mariana Hoffman, Alison McConnell, Marc Decramer, and
Rik Gosselink. 2015. “Efficacy of a Novel Method for Inspiratory Muscle Training in People with Chronic Obstructive
Pulmonary Disease.” Physical Therapy 95 (9): 1264–73. https://doi.org/10.2522/ptj.20140245.
• Li, Changjun, Qinghua Chang, Jia Zhang, and Wenshu Chai. 2018. “Effects of Slow Breathing Rate on Heart Rate
Variability and Arterial Baroreflex Sensitivity in Essential Hypertension.” Medicine 97 (18).
https://doi.org/10.1097/MD.0000000000010639.
• Lin, I. M., L. Y. Tai, and S. Y. Fan. 2014. “Breathing at a Rate of 5.5 Breaths per Minute with Equal Inhalation-to-
Exhalation Ratio Increases Heart Rate Variability.” International Journal of Psychophysiology: Official Journal of the
International Organization of Psychophysiology 91 (3): 206–11. https://doi.org/10.1016/j.ijpsycho.2013.12.006.
• Mani, Ali R., Sara Montagnese, Clive D. Jackson, Christopher W. Jenkins, Ian M. Head, Robert C. Stephens, Kevin P.
Moore, and Marsha Y. Morgan. 2009. “Decreased Heart Rate Variability in Patients with Cirrhosis Relates to the
Presence and Degree of Hepatic Encephalopathy.” American Journal of Physiology - Gastrointestinal and Liver
Physiology 296 (2): G330–38. https://doi.org/10.1152/ajpgi.90488.2008.
• Matei, Daniela, C. D. Popescu, B. Ignat, and R. Matei. 2013. “Autonomic Dysfunction in Type 2 Diabetes Mellitus
with and without Vascular Dementia.” Journal of the Neurological Sciences 325 (1–2): 6–9.
https://doi.org/10.1016/j.jns.2012.11.001.
• Nuckowska, Magdalena K., Marcin Gruszecki, Jacek Kot, Jacek Wolf, Wojciech Guminski, Andrzej F. Frydrychowski,
Jerzy Wtorek, Krzysztof Narkiewicz, and Pawel J. Winklewski. 2019. “Impact of Slow Breathing on the Blood
Pressure and Subarachnoid Space Width Oscillations in Humans.” Scientific Reports 9 (April).
https://doi.org/10.1038/s41598-019-42552-9.
• Penzel, Thomas, Alberto Porta, Aneta Stefanovska, and Niels Wessel. 2017. “Recent Advances in Physiological
Oscillations.” Physiological Measurement 38 (5): E1–7. https://doi.org/10.1088/1361-6579/aa6780.

42. References
• Resenja, Svezdrav. n.d. “Applications: ECG for Everybody.” Accessed June 4, 2019.
http://www.ecg4everybody.com/.
• Rochet-Capellan, Amélie, and Susanne Fuchs. 2014. “Take a Breath and Take the Turn: How Breathing Meets Turns
in Spontaneous Dialogue.” Philosophical Transactions of the Royal Society B: Biological Sciences 369 (1658).
https://doi.org/10.1098/rstb.2013.0399.
• Russell, Matthew E. B., April B. Scott, Ian A. Boggero, and Charles R. Carlson. 2017. “Inclusion of a Rest Period in
Diaphragmatic Breathing Increases High Frequency Heart Rate Variability: Implications for Behavioral Therapy.”
Psychophysiology 54 (3): 358–65. https://doi.org/10.1111/psyp.12791.
• Saoji, Apar Avinash, B. R. Raghavendra, and N. K. Manjunath. 2019. “Effects of Yogic Breath Regulation: A Narrative
Review of Scientific Evidence.” Journal of Ayurveda and Integrative Medicine 10 (1): 50–58.
https://doi.org/10.1016/j.jaim.2017.07.008.
• Servant, D., R. Logier, Y. Mouster, and M. Goudemand. 2009. “[Heart rate variability. Applications in psychiatry].”
L’Encephale 35 (5): 423–28. https://doi.org/10.1016/j.encep.2008.06.016.
• Shaffer, Fred, and J. P. Ginsberg. 2017. “An Overview of Heart Rate Variability Metrics and Norms.” Frontiers in
Public Health 5: 258. https://doi.org/10.3389/fpubh.2017.00258.
• Silva, Vanessa Pereira da, Bruno Ribeiro Ramalho Oliveira, Roger Gomes Tavares Mello, Helena Moraes, Andrea
Camaz Deslandes, and Jerson Laks. 2018. “Heart Rate Variability Indexes in Dementia: A Systematic Review with a
Quantitative Analysis.” Current Alzheimer Research 15 (1): 80–88.
https://doi.org/10.2174/1567205014666170531082352.
• Stankovski, Tomislav, Spase Petkoski, Johan Raeder, Andrew F. Smith, Peter V. E. McClintock, and Aneta
Stefanovska. 2016. “Alterations in the Coupling Functions between Cortical and Cardio-Respiratory Oscillations
Due to Anaesthesia with Propofol and Sevoflurane.” Philosophical Transactions of the Royal Society A:
Mathematical, Physical and Engineering Sciences, May.
https://royalsocietypublishing.org/doi/abs/10.1098/rsta.2015.0186.

43. References
• Struhal, Walter, Christoph Mahringer, Heinz Lahrmann, Christoph Mörtl, Peter Buhl, Mario Huemer, and Gerhard
Ransmayr. 2016. “Heart Rate Spectra Confirm the Presence of Autonomic Dysfunction in Dementia Patients.”
Journal of Alzheimer’s Disease: JAD 54 (2): 657–67. https://doi.org/10.3233/JAD-160084.
• Tan, Gabriel, Tam K. Dao, Lorie Farmer, Roy John Sutherland, and Richard Gevirtz. 2011. “Heart Rate Variability
(HRV) and Posttraumatic Stress Disorder (PTSD): A Pilot Study.” Applied Psychophysiology and Biofeedback 36 (1):
27–35. https://doi.org/10.1007/s10484-010-9141-y.
• Tan, Jason Por How, Jessica Elise Beilharz, Uté Vollmer-Conna, and Erin Cvejic. 2019. “Heart Rate Variability as a
Marker of Healthy Ageing.” International Journal of Cardiology 275 (January): 101–3.
https://doi.org/10.1016/j.ijcard.2018.08.005.
• Thio, Christian H. L., Arie M. van Roon, Joop D. Lefrandt, Ron T. Gansevoort, and Harold Snieder. 2018. “Heart Rate
Variability and Its Relation to Chronic Kidney Disease: Results From the PREVEND Study.” Psychosomatic Medicine
80 (3): 307–16. https://doi.org/10.1097/PSY.0000000000000556.
• Ticcinelli, Valentina, Tomislav Stankovski, Dmytro Iatsenko, Alan Bernjak, Adam E. Bradbury, Andrew R. Gallagher,
Peter B. M. Clarkson, Peter V. E. McClintock, and Aneta Stefanovska. 2017. “Coherence and Coupling Functions
Reveal Microvascular Impairment in Treated Hypertension.” Frontiers in Physiology 8.
https://doi.org/10.3389/fphys.2017.00749.
• Tsai, H. J., Terry B. J. Kuo, Guo-She Lee, and Cheryl C. H. Yang. 2015. “Efficacy of Paced Breathing for Insomnia:
Enhances Vagal Activity and Improves Sleep Quality.” Psychophysiology 52 (3): 388–96.
https://doi.org/10.1111/psyp.12333.
• Vesterinen, V., K. Häkkinen, T. Laine, E. Hynynen, J. Mikkola, and A. Nummela. 2016. “Predictors of Individual
Adaptation to High-Volume or High-Intensity Endurance Training in Recreational Endurance Runners.”
Scandinavian Journal of Medicine & Science in Sports 26 (8): 885–93. https://doi.org/10.1111/sms.12530.

44. References
• Wang, Shu-Zhen, Sha Li, Xiao-Yang Xu, Gui-Ping Lin, Li Shao, Yan Zhao, and Ting Huai Wang. 2010. “Effect of Slow
Abdominal Breathing Combined with Biofeedback on Blood Pressure and Heart Rate Variability in
Prehypertension.” Journal of Alternative and Complementary Medicine (New York, N.Y.) 16 (10): 1039–45.
https://doi.org/10.1089/acm.2009.0577.
• Weinschenk, Stefan W., Reinhard D. Beise, and Jürgen Lorenz. 2016. “Heart Rate Variability (HRV) in Deep
Breathing Tests and 5-Min Short-Term Recordings: Agreement of Ear Photoplethysmography with ECG
Measurements, in 343 Subjects.” European Journal of Applied Physiology 116 (8): 1527–35.
https://doi.org/10.1007/s00421-016-3401-3.
• Wilhelm, Frank H., Paul Grossman, and Michael A. Coyle. 2004. “Improving Estimation of Cardiac Vagal Tone
during Spontaneous Breathing Using a Paced Breathing Calibration.” Biomedical Sciences Instrumentation 40: 317–
24.
• Zaccaro, Andrea, Andrea Piarulli, Marco Laurino, Erika Garbella, Danilo Menicucci, Bruno Neri, and Angelo
Gemignani. 2018. “How Breath-Control Can Change Your Life: A Systematic Review on Psycho-Physiological
Correlates of Slow Breathing.” Frontiers in Human Neuroscience 12: 353.
https://doi.org/10.3389/fnhum.2018.00353.
• Zelano, Christina, Heidi Jiang, Guangyu Zhou, Nikita Arora, Stephan Schuele, Joshua Rosenow, and Jay A. Gottfried.
2016. “Nasal Respiration Entrains Human Limbic Oscillations and Modulates Cognitive Function.” The Journal of
Neuroscience 36 (49): 12448–67. https://doi.org/10.1523/JNEUROSCI.2586-16.2016.
• Zhou, Guangyu, Gregory Lane, Torben Noto, Ghazaleh Arabkheradmand, Jay A. Gottfried, Stephan U. Schuele,
Joshua M. Rosenow, Jonas K. Olofsson, Donald A. Wilson, and Christina Zelano. 2019. “Human Olfactory-Auditory
Integration Requires Phase Synchrony between Sensory Cortices.” Nature Communications 10 (March).
https://doi.org/10.1038/s41467-019-09091-3.
• Zhou, Xin, Zhaolai Ma, Lingfu Zhang, Shuzhe Zhou, Jilian Wang, Bingyan Wang, and Wei Fu. 2016. “Heart Rate
Variability in the Prediction of Survival in Patients with Cancer: A Systematic Review and Meta-Analysis.” Journal of
Psychosomatic Research 89 (October): 20–25. https://doi.org/10.1016/j.jpsychores.2016.08.004.