COVID-19 is in everywhere in the news. Many people were infected, and many others fear to be infected.

It is the first time in our lifetimes that we all had to adapt our lives in order to contain the spread of a virus. This virus is sneaky, because it is completely harmless for some of us, can have devastating consequences for others, leading to hospitalization, or it can be anywhere in the middle.

Like many people, I was in that large “somewhere in the middle” category.

The immediate symptoms of the infection on this category are not necessary really bad, but they can last for weeks or months, which can be quite anxiogenic. In particular, many people, including myself, experience difficulties breathing, as well as mood and sleeping disorders for several weeks or months. The chronic aspect of these symptoms is quite upsetting, and although we cannot do much about them from a medical point of view, conscious breathing exercises can surely help to recover physically as well as to manage the stress associated with those persistent symptoms.

Let me start with a bit of background on when the virus hit me: We had spent the first lockdown with my parents, and since my dad is severely ill, all our business projects cancelled and we had to take care of our son 7/7, it was a really stressful lockdown. In the summer, we achieved the digital transformation of our business by creating a series of webinars for corporate clients, and a self-paced online course. After being on pause for the first half of the year, we wanted to bring something meaningful to the world in 2020.

The course has been a great success, but the amount of work and self-imposed pressure was huge and combined with other sources of stress led me on the edge of a burnout. It is on that background that COVID-19 hit me.

I usually have a pretty strong immune system, but it is well-known that chronic stress is the biggest enemy of our immunity. I guess symptoms would have been milder if I had been less tired and stressed. My father-in-law caught it together with my wife and I (probably from our son’s school), and despite his 65+ age, he had almost no symptoms, which I explained by the fact that he was much less tired and stressed than us.

The first symptoms were quite intense: for 2 days, I could not work at all because of extreme tiredness and an unbearable headache. On top of that, I was feeling breathless from time to time in the day. It got better after a few days, and I felt the need to sleep a lot. Until then, that could have been a bad flue. The issue is that even after I was virus-free, some mild symptoms remained for weeks: feelings of breathlessness from time to time, some productive cough with a weird sound, and the feeling of having something caught in the throat permanently. From an emotional standpoint, I felt sometimes depressed without any particular reason, and I could not sleep for several nights in a row.

I have practiced breathing exercises and mindfulness for a decade, and I used them to help me recover and manage those symptoms. I am not claiming that they were a miracle cure, but I could feel that they really helped.

I would like to share 3 breathing exercises and cleaning practices that really helped me navigate this period and overcome it, both from a physical and an emotional standpoint.

1. Nose and throat hygiene:

The first step was to make sure my nose and throat hygiene were as good as possible. This involved 2 things: washing my nose using a simple device called a rhino horn (for pharmacists) or Neti pot (for Yogi), and gargling with salty water. The rhino horn is like a small version of a watering can, and you put its extremity on 1 nostril, bend your head, breathe through the mouth and let the water flow from 1 nostril to the other.

It is very important to add salt to the lukewarm water, to the point where you can taste that it is salty, although not as much as sea water. The reason for that is that if you rinse your nasal mucosa with water with a higher salt concentration than your blood (called hyperosmotic), some water will move from your tissues into your nose cavity for a few minutes after you washed your nose by a phenomenon called osmosis. This will happen for a few minutes after you wash your nose, and this is what will really clean it. This is way more efficient that using those nasal sea water sprays that your pharmacist will try to sell you, and it is extremely cheap since salt costs almost nothing. It is the same principle for gargling with sea water, and it really helps when you feel that your throat is congested or sore.

2. Fire Breath:

The first breathing exercise I used is called in Sanskrit Kapalabathi, or fire breath. You can google it to see a demonstration. It consists in exhaling forcefully from the abdomen and letting the air enter on exhale, pretty much like a bicycle pump. I normally do 60 such breaths at 1 breath per second, followed by 3 deep full breaths, and hold by breath with ¾ full lungs for about 1 min. I repeat this cycle 3 times, which takes around 10 min.

This practice has 3 main benefits:

• It of a great way to clear airways and exercise the diaphragm, the main muscle of breathing.
• It also alternates between an activation of the sympathetic nervous system (the arousing branch of the autonomous nervous system) when you perform the fast breathing part, and the parasympathetic nervous system (the calming branch) when you hold your breath. Therefore, it teaches your body to self-regulate between those 2 states: arousal and calm.
• Finally, maybe the most interesting part of this practice is the breath hold. After breathing fast for 1 min, it is quite easy to do a prolonged breath-hold (from 30s to 1,5 min). When you hold your breath, the blood CO2 increases since it accumulates. CO2 is far from being a waste product since it regulates blood flow and tissue oxygenation. During such a breath hold, your blood oxygen levels should not drop that much, because oxygen is linked with hemoglobin, so we usually have largely enough. However, if blood CO2 concentration increases, it will have 3 main effects:
  • Bronchodilatation : bronchioles will open up, meaning that more gas will be exchanged between the air in the lungs and the blood
  • Vasodilatation: capillaries will open up, meaning that more blood will get to the organs, including the lungs and the brain
  • Bohr effect: oxygen will dissociate from hemoglobin, leaving the bloodstream to get into the organs where it is needed

In other words, the increase in blood CO2 during breath holds will lead to higher oxygenation of the organs and opening up of the airways. This is very useful when you experience COVID symptoms, and a systematic daily practice really helped me to manage them. It is best to practice it in the morning on an empty stomach. It will wake you up and help you build focus. I would not recommend practicing in the evening, since it can lead to overarousal and prevent you from sleeping.

3. Alternate nostril breathing:

The second breathing exercise that I would like to mention is alternate nostril breathing. It consists in breathing alternatively through each nostril, and holding your breath with full lungs between inhale and exhale. The most important here is not so much alternating the nostril, but the breathing rhythm.

I usually advice my students to start with a 4-8-8 rhythm: inhale on 4 seconds from the belly, hold for 8 seconds, and exhale for 8 seconds. I like to practice with a 4-16-8 rhythm, but it takes a bit of practice, so please do it only if it feels good. When practicing alternate nostril breathing, I place a finger on 1 nostril to block it on inhale, I block both nostrils with 2 fingers during the breath hold, and I change the blocked nostril before exhaling. I then inhale through the same nostril and repeat. If this seems too complicated, you can simply breathe through both nostrils using the rhythm 4-8-8, or 4-16-8 if comfortable. The whole practice has to be performed with deep breathing, starting by filling the abdomen and then the chest.

This practice is the opposite of Kapalabathi because it is a deeply calming one. On top of benefiting from the effects of the breath hold mentioned previously, it activates the parasympathetic system (the calming branch) because exhale is longer than inhale.

It is great to deal with anxiety and stress. When we are sick with a virus that is every day on the headlines, a good part of the symptoms we experience are from psychological origin, and linked with the anxiety we are fed all day long. This is a great way to address that.

If you alternate both nostrils on top of breathing with this rhythm, it will add a balancing effect on both brain hemispheres.

These practices are great before going to bed, or when you feel overwhelmed. I recommend practicing for 10 min in a row.

4. Bumblebee breath:

Finally, the third practice I would like to talk about is called Bhramari in Sanskrit, or bumblebee breathing. This may sound funny, but I assure you that it makes a lot of sense from a scientific point of view. The idea behind the practice it to produce a humming sound with the mouth closed when exhaling.

Studies have shown that when you do that, you multiply by a 15-fold factor the quantity of Nitric Oxide (NO) produced in the sinuses. This is a very interesting gas because it has amazing properties:

• It has the same effects as CO2: bronchodilatation and vasodilatation, leading to opening of the airways and more oxygen reaching the organs
• It increases the secretion of mucus and the ciliary movements in the lungs, essential for their mechanical cleaning
• It has antibacterial, antiviral and anti-inflammatory effects. In other words, it is the first line of defense of our airways

Nitric Oxide is not produced when we breathe through the mouth, which is why it is very important to pay attention to breathe constantly through the nose.

Inhaled Nitric Oxide has a well-established use in newborns who are born with pulmonary hypertension to dilate their pulmonary arteries and save them. It is being tested with success in some hospitals in severe COVID-19 patients, in order to avoid having to ventilate them, and to speed up their recovery.

The great news is that we do not need medical treatment: we can produce it ourselves simply by humming. The best way to leverage that is to apply the 4-8-8 breathing rhythm, and simply produce a humming sound on exhale. When you hold your breath after the following inhale, you reap all the benefits of the NO produced during your last humming exhale. If you like complexity, you can even combine it with alternate nostril breathing :).

I would like to emphasize a crucial aspect of those breathing practices: we could call them conscious breathing practices, because it is not only about the mechanical aspects of the breath-modifying practices, but also about the mental focus when practicing. You should never practice those while driving, and you should avoid all mental distractions. Do not practice while watching TV, for example. You should sit with your back straight, your eyes closed, and bring your full attention to the practice. It is particularly important during breath holds. Because they increase oxygenation of the brain, they act as a magnifier for thoughts. If you let your thoughts wander during those breath holds, it will be hard to maintain the breath hold, and it will have a detrimental effect on your focus. In order to keep the focus, it is useful to count mentally to keep the breathing rhythm and keep your focus on the point between your eyebrows. Do not forget to relax your diaphragm (by letting your belly go out) and your shoulders during breath holds.

Of course, if you can practice in an environment with fresh unpolluted air, it is way better and will help your recovery.

I am not pretending that those practices are miracle treatments that will accelerate your COVID-19 recovery. The journey has been challenging for me from a physical and emotional standpoint, but they were a great help, and I could feel their effects. They were part of my life for over a decade, and they have been my anchor that helped me navigate tough times by keeping my mental and emotional balance. COVID-19 recovery was no exception, and they were even more relevant given the fact that this nasty virus affects airways. I encourage you to try those and pay attention to how you feel after the practice, both physically and mentally.