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Q: Are there any differences between the two editions of your book?

A: No there are no differences. The book is published by two different publishing houses in the USA and UK – hence the different cover art.


Q: Which snoring strap do you recommend?

A: I don’t recommend the snoring strap anymore. The strap may pull the jaws inwards, thereby reducing airway size and increasing the risk of collapse of the airways during sleep. Instead we use tape www.buteykoclinic.com/myotape/  


Q: Have you any advice for someone with a deviated septum attempting nasal breathing? In your opinion do you think surgery is necessary?

A: 60% of the population have a deviated septum. In the vast majority of individuals continued and comfortable nasal breathing is possible. If your nose feels stuffy, practice the nose unblocking exercise. https://www.youtube.com/watch?v=tgmKIwUqhkg

Try the exercise six times. If you can breathe through your nose for one minute you can do so for life.


Q: I’m not sure I understand what the Bolt score is?

A: The BOLT score is generally a measure of chemosensitivity to carbon dioxide, or a measure of breathlessness. That’s it.


Q: When measuring my BOLT score I get confused as to what is meant by “the first desire to breathe”. Could you please clarify what this means?

A: It means the first distinct sensation to resume breathing. Or the first involuntary contractions of the breathing muscles. Your breath at the end of the measurement should be fairly normal.


Q: When is the best possible time to measure your BOLT score?

A: The most accurate time is first thing in the morning, soon after waking.


Q: Generally I have a comfortable BOLT score of around 40 seconds. But on some days I have observed that it is very hard to do and I gasp for air after 30 seconds. What could be the reason?

A: Yes, it is normal that BOLT score fluctuates. This depends on how much you are talking, your diet, amount of exercise etc. Most important BOLT score is measured first thing in morning.


Q: What are the differences between the Oxygen Advantage and Wim Hof Methods?

A: My opinion of both methods is explained on this page: www.oxygenadvantage.com/wim-hof/

I explain that the WHM is a stressor to cause adaptations. After practising WHM, then slow down your breathing. Adopt functional breathing patterns for the rest of the day.


Q: I purchased your online course and think it is great, but I do have a question for you. When practicing to achieve air hunger and cadence breathing: is the whole point to minimize volume of air during this time? The reason I ask is that you say to breath LSD (light, slow, and deep). But when I try to breath light/slow during the 4 seconds in/6 seconds out it seems like I cannot take as deep of a breath – I don’t feel as much movement of the first two ribs. (maybe that’s the point?). I was wondering if changing to a count of 6/7 seconds in and 8/9 seconds out would be a good idea where I can still breath really light/slow, achieve air hunger and take a much deeper breath (really feel the expansion of the first two ribs)? Any thoughts on doing this?

A: In a way, they are three different exercises:

Breathe light- biochemistry  (focus is on air hunger)

Breathe light- biomechanics   (focus is on breathing with greater use of the diaphragm)

Breathe light – cadence (focus is on six breaths per minute)

The main thing is when doing biomechanics and cadence breathing, than one does not overbreathe. This is common problem. People breathe low, but in the process take full big breaths which disrupts biochemistry. It is a balance. You don’t need air hunger while doing biomechanics and cadence.  But light hunger would ensure that you are not overbreathing.


Q: When practicing breath holds as part of my Oxygen Advantage training, what should the target be for Heart Rate Variability (HRV)? I did 6 sessions x 10 mins on a treadmill to change the types to see my body’s reaction (HRV vs Breath hold). I am new to this HRV thing and want to understand more by combining Oxy Adv.

A: HRV – I don’t have ideal measures for HRV. HRV is improved by cadence breathing of 6 breaths per minute. The Oxygen Advantage is more about changing the biochemistry and biomechanics of breathing. This in turn will slow down breathing leading to increased HRV.


Q: Can diaphragmatic breathing happen without air volume? Can we expand our stomach without breathing? Does that not stretch the diaphragm?

A: Yes, we emphasize deep, slow and light breathing. During inhalation, the diaphragm moves downwards and there is lateral expansion of the lower two ribs.


Q: What about breathing for swimming – does breathing through the mouth affect performance?

A: Mouth breathing during swimming is fine. Take a breath every five strokes. Work on increasing your BOLT score. This will help with swimming.


Q: I’ve been practicing breath holding and nose breathing while exercising (HIIT and running) for the past 2/3 weeks, and at an 8km race two days ago I could sustain nose breathing for the whole race with a heartbeat at +190-200bpm without difficulties! Truly amazing! Patrick, I wonder, can we overdo it with the breath-holds? (maybe with the blood pH balance?)

A: That’s great. Yes, adaptations do take place. Breath holds should not cause too much stress. We teach people to hold the breath after an exhalation until moderate to strong air hunger. But never to extreme. Always recover in a couple of breaths. 5 reps twice daily are enough.


Q: Is it okay if I tape one nostril all the time even in bed to reduce my breathing volume?

A: I wouldn’t advise taping one nostril during sleep. The reason being it could cause increased negative pressure in the throat. This is due to Starling resistor model. If you want to keep breathing calm during sleep, then wear a buteyko belt.


Q: I compete in MMA and am currently trying to make the switch to nasal breathing and high altitude simulation…so far so good (have already after a couple of weeks noticed improvements in cardio and composure)! I have a question relating to the format of MMA competitions; with the rounds being 5 mins with 1 min rest in between – what is the best way to breathe during that one min rest interval to recover? Am I right in thinking despite the urge to rapidly breathe that I should try and slow this down and nasal breathe as much as possible? Many thanks for your insight! Its changing my game!

A: First few weeks of nose breathing will be tough. But this is where the body makes adaptations. One needs to be persistent during training, spending as much time breathing through the nose. Never wake up with a dry mouth. Mouth must be closed at night with paper tape. Then sleep is deeper and focus is better. Before competition, do five strong breath holds. During the rounds, take slow and deep breaths. Take fuller breaths but less of them. Also, make sure your BOLT (40 seconds) and MBT score (80 paces) is decent enough. See both tests on oxygenadvantage.com


Q: To what extent should one hold their breath?

A: It depends on the person. If you are suited to the breath holds, then hold breath until a moderate to strong air hunger.


Q: If one produces more red blood cells, isn’t there a risk that blood becomes thicker?

A: Yes, higher Hct – the risk is when Hct is over 50%. Breath holding unlikely to do this.


Q: Does EPO help with general performance for those who are not competing and just want a boost to workout in gym or running distance?

A: Yes, EPO increases O2 carrying capacity. However, there are many other benefits as well from doing the OA exercises.


Q: For athletes that are injured or about to go into surgery and can’t really go out and run. What breath holding techniques could help maintain the level of endurance?

A: For injured athletes, I would do all the techniques. Functional breathing and breath holding. They are all explained in the book and masterclass. Also nose breathing during wakefulness, exercise and sleep. As long as you can maintain a good BOLT, you will find it easier to get back into training.


Q: Just to clarify before competition should I hold my breath? For how long and how many times in order to boost EPO?

A: EPO – 3 days to mature. Breath holding should be done every day. 5 reps by twice daily.


Q: Is there an Oxygen Advantage App?

A: It is under development and we will announce it when available.


Q: Do you have any practice for getting rid of nasal congestion without using medication?

A: Yes, as long as you are in reasonably good health- do the MBT from the homepage of oxygenadvantage.com. Repeat five times.


Q: Why does my blood oxygen drop during and after these exercises? My oxygen goes to 93/95 %. My heart rate goes to 53bpm. That’s not healthy right? I believe it’s only temporary. Is the goal to get my body and brain used to this volume of breathing?

A: During reduced volume breathing (breathe light to breathe right), blood oxygen saturation might drop a little. That is fine. As long as you are not stressed. If in doubt, please stop practicing the exercises. Seek out an instructor who can help you.


Q: What’s your best tip to do a breath hold without using hands to pinch the nose, for example when walking in public? Is a no-hands breath hold even worth trying?

A: Yes, just hold the breath. No need to pinch the nose.


Q: I am trying desperately to nose breath whilst jogging (even very slowly in HR z1) but my nose starts to run after about a minute so I just can’t keep it up and revert to mouth breathing. Any advice?

A: Yes, this is normal. Bring a tissue with you. It does dry up in time. But even in cold air, the nose will run. See the benefits of running with mouth closed: https://oxygenadvantage.com/nasal-breathing-running/


Q: Would L-Arginine and L-Citrulline supplementation be useful to help increase Nitric Oxide levels?

A: I’m not sure if this increases NO in the nose. It will increase production of NO in blood. It is NO in the nasal airway that we want to harness during this time.


Q: Is breathing in through the nose and out through the center of your lips discouraged? It seems effective for relaxing mouth, face and head tension. Also it increases or prolongs out breath capacity.

A: Slow breathing through the nose also does the same thing. Allow a prolonged relaxed exhalation. It also retains moisture and heat in the body.


Q: That’s interesting you mention nostril size, does that mean those that have larger nostrils are at an advantage with breathing?

A: Yes, in terms of maintaining nasal breathing during physical exercise.


Q: Are there any videos demonstrating the advanced high altitude training techniques as I’m not sure how to do them going by the book?

A: There are no videos available. Some content I make available from our live online class where I teach people the techniques.


Q: I thought the production of NO in the nasal area was for the purpose of building NO levels in the blood?

A: No. I don’t think the NO in the nose reaches circulation. It is likely that the effects of NO from the nose are isolated to the lungs.


Q: Why is it easier to do breath hold exercises while walking or jogging than while sitting down?

A: Yes, generally it is easier to hold the breath while walking or jogging. It is probably due to the distraction. The body can cope better with air hunger during movement.


Q: Is breathing in through the nose in out through the nose essential? It seems to me that breathing out through the mouth is more economical, because you spare more NO in the nose?

A: Breathing out through the nose is advisable. Exhalation through the nose traps heat and moisture. Mouth breathing causes 42% greater moisture loss from the body.


Q: Can Oxygen Advantage exercises be used with children / teenagers?

A: Please see our recommended children’s breathing re education program at www.buteykoclinic.com/buteykochildren/

This is available for free.