Summary
Brian Johnson of the Optimize podcast interviews Patrick McKeown, author of The Oxygen Advantage, in what Brian calls the most life-changing practice he has adopted. Brian shares that despite constantly optimizing his nutrition, mental training, and other fundamentals, learning to breathe properly from Patrick's work has had the single greatest impact on his life. He now does all high-intensity workouts exclusively through his nose and tapes his mouth shut every night. Patrick explains the basic physiology of breathing: oxygen is carried by hemoglobin, but the catalyst for releasing oxygen from hemoglobin to cells is carbon dioxide (the Bohr effect, discovered in 1904). Over-breathing depletes CO2, which paradoxically reduces oxygen delivery — this is why people feel lightheaded when they take big breaths. He explains that healthy breathing is nasal, diaphragmatic, light, quiet, and effortless with a gentle pause on the exhale. The BOLT score (how long you can comfortably hold your breath) indicates breathing efficiency and fitness. The conversation covers extensive ground on athletic performance (simulating high altitude training through breath holds, delaying lactic acid onset, improving respiratory muscle strength), children's health (50% of children are habitual mouth breathers, affecting facial development and airway size), sleep quality (mouth taping for nasal breathing during sleep), and concentration training (following the breath reduces neural excitability and improves attention span). Patrick discusses 16 clinical trials, including work with US Marines showing improved stress response after six weeks of breathing practice.
Key Points
- The Bohr effect (1904): carbon dioxide is the catalyst for releasing oxygen from hemoglobin to cells
- Over-breathing depletes CO2, paradoxically reducing oxygen delivery despite more air intake
- Healthy resting breathing is nasal, diaphragmatic, light, quiet, and effortless with a gentle pause on exhale
- Nose breathing provides 5-15% improvement in arterial oxygen uptake compared to mouth breathing
- 50% of children are habitual mouth breathers, affecting facial development and airway size
- The BOLT score (comfortable breath hold time) measures breathing efficiency and correlates with exercise capacity
- Breath holding exercises simulate high altitude training by dropping SpO2 into the 80s, triggering EPO production
- US Marines who practiced breathing exercises for 30 minutes daily were better able to cope with battlefield stress
Key Moments
Light breathing is king -- the paradox of breathing less for more oxygen
Patrick McKeown explains that light breathing ensures optimum oxygenation, while the more air we breathe into our lungs, the less oxygen gets delivered -- making the instruction to take a big breath incorrect, as it offloads CO2 and reduces oxygen delivery to cells.
"Conversely, if you went for a walk alongside someone who is very unfit and say they are carrying their suitcase, you'll notice that they are really kind of out of breath. We're like human beings, we should be like cars in a way. How efficient are we with our breathing? Light breathing ensures optimum oxygenation and conversely, the more air we breathe into our lungs,"
50% of children are habitual mouth breathers with lifelong consequences
McKeown reveals that nose breathing provides 5-15% better arterial oxygen uptake than mouth breathing, yet 50% of children are habitual mouth breathers, with 60% of facial structure formed by age 4 -- making early intervention critical for airway development and lifelong health.
"Nose breathing is responsible for a 5-15% improvement in arterial oxygen uptake in comparison to mouth breathing. Nose breathers, better oxygen uptake and better oxygen delivery than mouth breathers. And how many children are mouth breathing? 50%. So we have a car crash waiting to happen here."
Nitric oxide from nose breathing improves ventilation and kills pathogens
McKeown details how the paranasal sinuses produce nitric oxide which is carried into the lungs during nose breathing, acting as a natural bronchodilator, sterilizing incoming air, and improving ventilation perfusion by redistributing blood flow in the lungs.
"nitric oxide is released from the paranasal sinuses into the nasal cavity. And when we breathe through our nose, we carry this nitric oxide into our lungs. Nitric oxide opens up the airways. It's a natural bronchodilator. Nitric oxide also sterilizes the incoming air."
Mouth taping for sleep transforms energy and eliminates snoring
McKeown describes introducing mouth taping with small paper tape 15 years ago, explaining that getting the mouth closed during sleep makes sleep dramatically deeper, and that he still tapes every night -- finding that the tape becomes a conditioned cue for deeper sleep.
"I started taping up about 20 years ago and I haven't stopped it since I still tape now if I fell asleep somewhere on a plane for example My mouth is closed but the tape actually becomes a crutch that you put a small piece of tape in the mouth and instantly you you there's a connection there for sleep time"
