Diagnosis: Email Apnea?
I've just opened my email and there's nothing out of the ordinary there. It's the usual daily flood of schedule, project, travel, information, and junk mail. Then I notice. I'm holding my breath. 
As the email spills onto my screen, as my mind races with thoughts of what I'll answer first, what can wait, who I should call, what should have been done two days ago; I've stopped the steady breathing I was doing only moments earlier in a morning meditation and now, I'm holding my breath.
And here's the deal: You're probably holding your breath, too.
I wanted to know -- how widespread is email apnea*? I observed others on computers and BlackBerries: in their offices, their homes, at cafes. The vast majority of people held their breath, or breathed very shallowly, especially when responding to email. I watched people on cell phones, talking and walking, and noticed that most were mouth-breathing and hyperventilating. Consider also, that for many, posture while seated at a computer can contribute to restricted breathing.
Does it matter? How was holding my breath affecting me?
I called Dr. Margaret Chesney, at the National Institute of Health (NIH). Research conducted by Dr. Margaret Chesney and NIH research scientist Dr. David Anderson demonstrated that breath-holding contributes significantly to stress-related diseases. The body becomes acidic, the kidneys begin to re-absorb sodium, and as the oxygen (O2), carbon dioxide (CO2), and nitric oxide (NO) balance is undermined, our biochemistry is thrown off.
Breath holding and hyperventilating disturb our body's balance of oxygen, CO2, and NO. Nitric oxide, not to be confused with the nitrous oxide used in dental offices, plays an important role in our health. From a briefing document prepared for the Royal Society and Association of British Science Writers, Pearce Wright explains, "The immune system uses nitric oxide in fighting viral, bacterial and parasitic infections, and tumours. Nitric oxide transmits messages between nerve cells and is associated with the processes of learning, memory, sleeping, feeling pain, and, probably, depression. It is a mediator in inflammation and rheumatism."
As I researched the literature, and spoke with physicians and researchers about breath-holding, a relationship to the vagus nerve emerged. The vagus nerve is one of the major cranial nerves, and wanders from the head, to the neck, chest and abdomen. Its primary job is to mediate the autonomic nervous system, which includes the sympathetic ("fight or flight") and parasympathetic ("rest and digest") nervous systems.
The parasympathetic nervous system governs our sense of hunger and satiety, flow of saliva and digestive enzymes, the relaxation response, and many aspects of healthy organ function. Focusing on diaphragmatic breathing enables us to down regulate the sympathetic nervous system, which then causes the parasympathetic nervous system to become dominant. Shallow breathing, breath-holding and hyperventilating trigger the sympathetic nervous system, in a "fight or flight" response.
The activated sympathetic nervous system causes the liver to dump glucose and cholesterol into our blood, our heart rate to increase, our sense of satiety to be compromised, and our bodies to anticipate and resource for the physical activity that, historically, accompanied a physical fight or flight response. Meanwhile, when the only physical activity is sitting and responding to email, we're sort of "all dressed up with nowhere to go."
Some breathing patterns favor our body's move toward parasympathetic functions and other breathing patterns favor a sympathetic nervous system response. Diaphragmatic breathing, Buteyko breathing (developed by a Russian M.D., http://en.wikipedia.org/wiki/Buteyko_method), some of Andy Weil's breathing exercises, and certain martial arts and yoga breathing techniques, all have the potential to soothe us, and to help our bodies differentiate when fight or flight is really necessary and when we can rest and digest.
Now I want to know: Is it only the Big Mac that makes us fat? Or, are we more obese and diabetic because of a combination of holding our breath off and on all day and then failing to move when our bodies have prepared us to do so? Can 15 minutes of diaphragmatic breathing before a meal tune us in to when we're full? If, when we're doing sedentary work, and O2, CO2, and NO are optimally balanced, through healthy breathing, will we escape the ravages of an always-on sympathetic nervous system? Can daily breathing exercises contribute to helping reduce asthma, ADD, depression, obesity, and a host of other stress-related conditions?
I predict, within the next five-to-seven years, breathing exercises will be a significant part of every fitness regime. In the meantime, why not breathe while doing email? Awareness is the first step toward wiping out email apnea!
*Email apnea - a temporary absence or suspension of breathing, or shallow breathing, while doing email (Linda Stone, February 2008).
(originally published on The Huffington Post)
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Thanks, Deva. One of my fact-checkers for the piece is an Indian physician. We absolutely reviewed both scientific research on various pranayama practices as well as popular literature. Some of the these techniques HAVE been researched and some have not. The way we breathe -- or do not -- fundamentally impacts our health and resilience. That we unintentionally compromise this when we engage with technology is a good thing to know -- it means that we can INTENTIONALLY shift toward what would serve us better.
I lived in New Zealand for a while and the physiotherapists there have built up an understanding of the phenomenon you describe.
Patients present to them with painful chest and back muscles brought about by prolonged mild hyperventilation. The worst of it all is that you don't notice when you are hyperventilating. You are coping after all. It is the syndrome of a frog in water brought slowly to boiling point. Your partner won't notice either because it happens so slowly. It takes a stranger who is looking out for it because they have seen it so often.
I don't have a link to NZ physios but I could find one if you wanted it.
Great post
Hey linda,
What you've mentioned is something we all experience but are not cognizant of the side effects it may lead to.
Do try Prayanam, twenty mins a day is effective enough to show you results.
Thanks for the good post!
If our devices and applications (computers, cell phones, PDAs, etc.) potentially contribute to shallow breathing and an activated sympathetic nervous system, I have to wonder if we will come up with ways that our devices will counteract these responses. I think of an iPhone app that has some kind of biofeedback mechanism, or cell phone that helps me calm down. If we must use these devices so much, then we must harness their potential power to calm us down.
so just how sick is one when in days of desperatly looking for something or trying to fig out why some other application isnt doing what i claims /one finds one self literely crashing out at pc screen like nodded off to find curser totaly zipped accross and lost norwithstanding hitting on something on its way out! , a frequent occurence of mine, including not doing house work ,hovering washing up linen change,laundry posting letters written a week ago , takeing out rubbish, hair wash, even shopping,makeing phone calls loesing list of things to do ,my friend said get a computer it/ll save you time endless infomation etc yer right pitty it cant sort out the foresaid eh.
I have also noticed the same thing a few months ago. However, I wasn't checking my mail when I discovered it. I realized I hold my breath while exercising, watching a certain program on television. Sometimes, I hold my breath while putting on make-up. And the strangest thing of all is that I never really noticed it before. Even when I finally did. I would still catch myself holding my breath. I used to wonder why and now I have a better understanding of it. Thanks for sharing!
Jen, An inhale and short breath hold is not uncommon when we are in a state of anticipation. Following it with an exhale, keeps us in "balance." Inhales without much exhaling, constant shallow breathing, and constant (and frequent, long duration) breath holding appears to stress our bodies. The great thing about this is that, with intention, we can shift the behavior -- we can learn a breathing technique, we can catch ourselves and do more diaphragmatic breathing, we can exercise, then enjoy the parasympathetic response that follows that, we can get an adjustable desk and stand some (standing posture better supports healthy breathing patterns) and sit some when we work....
I don't think it's just email. My wife has long commented on my tendency to breath oddly when I write, even long-form essays or fiction. I breath in cadence with my thought processes, with the speed and demands of the piece, and have these odd little pauses and gasps all throughout.
Targetting email is cheap and easy, but it's not the whole of the story. There's something about the act of typing thoughtfully that makes one forget to do less important things, like breathing.
ADD (and ADHD) are not stress related disorders. They are neurological disorders.
From your description and my 10 minutes of experimentation) I think a more accurate term would be "poor breathing control while processing information," but e-mail apnea sounds so much more lyrical (and medical-sounding)!
http://blog.renewlab.com/2008/02/email-apnea-poor-breath-control-while.html
Elf -- correct. Not just email. I chose to focus on email because so many of us do it and once alerted, would be likely to notice whether or not we breathe optimally, and if not, improve our posture, improve our breathing or do some follow on activity that that supports healthy breathing. A bonus if we notice, in some other aspect of our life, we might also apply this information.
Sacha -- I used dictionary.com to help me come up with a more memorable and less awkward phrase than, "breath holding while doing email," which is where I started.
Dave -- I'm not an expert on ADD. I do believe, after doing months of research on this, that "healthy" breathing can probably contribute in a positive way to just about anyone in any condition.
The following link is in a collection of articles published by Reader's Digest in 1951 called Keys To Happiness.
Hi Linda,
I have watched and listened to your presentations since "discovering" you on IT Conversations some years back.
I'm a psychologist who specialises in anxiety, especially fear of flying (flightwise.com.au). But I also teach psychologists about trends in technology and how they may affect their practices and so of course have included info on Continuous Partial Attention and reference to your talks.
But I read your recent article on email apnea and have used the print out to give to my patients when it comes time to introduce them to the concept of Heart Rate Variability (HRV), and how raising it through Diaphragmatic Breathing exercises, using biofeedback, can help moderate anxiety and depression, and numerous psychosomatic complaints.
Your article was a most cogent distillation of how the ANS, SNS and PNS work in synch. I talk about Formula 1 racing car drivers (The Australian Grand Prix is held a mile or two from my practice) using a deft combination of brake and accelerator to eke maximum speeds around corners, compared to suburban drivers who just shift their right foot from brake to accelerator.
The putative link between breathing and obesity is a curious one. There is some discussion in the literature also of oxygen stress and more talk about neurocardiology, the link between the heart and brain mediated by the vagus nerve. No surprise, I also give workshops to psychologists here in Melbourne, on HRV and the technologies to measure it, and use Apple's Keynote to make the workshops engaging and interactive.
BTW, the HRV equipment I use comes from the US, from heartmath.org and I get a very good response from IT pros who come to me as patients and see the data displayed on my wall via a data projector. Very effective tool for those less aware of the power of the affective system to influence health and behaviour.
Many thanks again for your article,
best wishes
Les Posen
Fellow, Australian Psychological Society
President, internet Macintosh User Group, Melbourne.
Hi Linda,
are there any good sources about "holding breath"? It seems you went to a great length and looked for information everywhere. I am an IT professional (currently working as a Problem Manager) and at the same time certified masseur and therapist.
I will finish the first level of studies as a Yoga instructor in few months and I would like to focus my dissertation at problems typical to IT folks.
Les Posen touched "ANS, SNS and PNS working in synch", in other words, Autonomic Nervous System. I learned about relations between ANS, physical and mental exercise during anatomy lessons, but any good information source would be a great help.
Thank you very much for the perfect article. I am supposed to write the document in Czech language, but If you would be interested in reading it, I will ask about possibility of writing it in English at school.
Best regards,
Jakub
An interesting post. Yes, having read this post I realise I do tend to hold my breath while reading e-mails.
I guess the brain is very busy quickly scanning the subject lines trying to sort the wheat from the Spam !
A company I once worked for once tried e-mail free days. It didn't work. The face to face contact created more HR issues than you would believe. I suspect e-mail was invented for engineers so they didn't have to speak to people :)
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Deva Hazarika [02.12.08 10:45 AM]
Linda, you should do some reading on Pranayama, a yoga breath control technique.
http://en.wikipedia.org/wiki/Pranayama
There have been a wide range of claims made in India about the benefits of these techniques, ranging from some that have been well documented and researched to others that are somewhat outlandish.
http://www.yogapranayama.com/ is one prominent yogi focusing on these techiques.