In This Article
Do You Have Email + Texting Apnea?
Next time you are pounding out a text thread or deeply focused on an email response, stop and see if you are breathing. Back in 2008, the Huffington Post coined the phrase email apnea, a condition affecting 80% of us.12,13
What is apnea? This common affliction is chronic shallow or interrupted breathing, which plays a contributing role in numerous stress-related health concerns. During sleep apnea, email apnea, texting apnea, or screen apnea, our levels of oxygen, carbon dioxide, and nitric oxide fall out of balance, making the body chemistry more acidic. The kidneys begin to reabsorb sodium, and as the oxygen, carbon dioxide, and nitric oxide (NO) balance is undermined, our biochemistry is thrown off.12,13
As with sleep apnea, in screen apnea, there is a spontaneous breath hold followed by a large gasp when you finish the text, email, or task. During the breath hold, you rob yourself of nitric oxide. NO is a Noble Prize-winning panacea molecule produced in the paranasal sinuses ONLY during nose breathing (not mouth breathing)!14 The mouth-breathing gasp that typically follows the apnea is a form of hyperventilation, inhaling too much oxygen and exhaling too much carbon dioxide.

These gas imbalances can cause a host of health concerns, from heart disease to compromised immunity, as well as issues with learning, memory, distorted pain sensation, depression, inflammation, and joints. The stress induced from daytime apnea can easily be measured with heart rate variability (HRV) devices that clip to your ear or finger.12,13 Heart rate variability measures the time between each heart beat. The more exact the time from beat to beat, the more stressed you are. The more variable the rhythm between beats, the more relaxed you are.
We recommend "Are You an Overbreather? Balance CO2 + O2 for Mood Support": https://lifespa.com/overbreathing/
Treating Email Apnea with Breath Awareness
Inhalation Training
I have written about the well studied benefits of a medical breathing technique called inspiratory breathing training (IMT), used for decades for heart-, lung-, and heartburn-related concerns, recently approved for supporting recovery from COVID.
A strong diaphragm—the primary muscle of inspiration—is critical for optimal respiration health, immunity, and recovery.1 The Ayurvedic breathing technique pratiloma is similar to IMT techniques used in hospitals worldwide.2
Learn how to perform pratiloma pranayama here.

Exhalation Training
While much medical research on breathing has been on the benefits of strengthening the diaphragm for inhalation, little has been done on strengthening the muscles of exhalation. Because of the natural elasticity of the ribcage, called elastic recoil, exhaling is considered passive, requiring little effort.
That said, the secondary muscles of breathing are the abdominals, which play an important role in expiration. The abdominals involved include the rectus abdominis, internal and external obliques, and transversus abdominis, which work to push the diaphragm back up, helping to drive air out of the lungs during expiration. The internal intercostal muscles also assist with exhalation.3
Studies on expiratory muscle training (EMT) have been shown to decrease respiratory fatigue. Premature respiratory fatigue results in shallow overbreathing, causing an imbalance in oxygen-carbon dioxide ratios, along with overstimulating the fight-or-flight sympathetic nervous system.4,5
The Relaxator for Email Apnea + More
In my quest for understanding the science of breathing, I interviewed breathing expert, Anders Olsson, who wrote book called Conscious Breathing. He designed a breathing device called the Relaxator, which strengthens the muscles of exhalation.
The device sits in your mouth while you’re at your computer, out and about, or exercising. It can be adjusted to make exhaling more or less difficult, delivering the precise amount of expiratory muscle training (EMT) you need.
Once of the most beneficial side effects of using this device is that it makes you 100% aware of your unconscious breathing in states of email, screen, or texting apnea. The device forces you to exhale through the mouth and inhale through the nose. You can increase the expiratory tension that makes it more more difficult to exhale which naturally extends the exhale and slows down the breathing. Your new longer slower breath keeps you breathing halting email or texting apnea’s. In addition to being an expiration trainer, it is a breathing awareness tool.
If you slip into an apnea, the Relaxator alerts you to the disturbed rhythm by increasing breathing awareness. I highly recommend this practice because most of us are not aware of holding our breath during certain tasks, and even less aware of the dangers.

Regular pranayama practice will also curb unconscious breathing and task apnea. Learn my favorite breathing exercise here.
The King of EMT: Dr Carl Stough
From the 1940s to the 1970s, Dr. Carl Stough perfected the art of exhalation. He was famous for working with singers and dancers for decades in New York, but reached international fame when he trained track athletes at Yale and on the 1968 Olympic team that competed at altitude in Mexico City. Under Dr. Stough’s tutelage, the 1968 US Olympians won 12 medals and broke five world records. Lee Evans, who won gold in the 400 meters and 400 meter relay, was most remembered for wearing a black beret with his fist high during the podium ceremony, in support of social justice.15
Dr. Stough’s technique, as described in James Nestor’s book Breath, includes deep expiratory muscle training. The exhalation is trained to be maximal. James was asked to breathe all the way out while counting to 10 slowly. Then, when there was no more air left to vocalize, he was asked to count to 10 again slowly, under his breath, followed by an inhalation that would be surprisingly easier each time. The emphasis was on the depth of the exhale rather than the inhale in this technique. This practice was repeated several times—designed to free the diaphragm through maximal EMT or expiratory muscle training.15
Respiratory diaphragmatic fatigue is extremely common. In one study on elite athletes, half of the group experienced premature respiratory diaphragmatic fatigue. If the best athletes are inefficient breathers, most of us probably are, too!6,7
We recommend "3-Step Breathing for Diaphragm + Lung Strength": https://lifespa.com/diaphragm-lung-breath/
The Importance of Full Breathing
In a meta-analysis of nine studies on the effects of expiratory muscle training, researchers concluded that EMT significantly increased maximum expiratory pressure, making it easier to fully exhale.

Studies suggest the combination of IMT and EMT significantly increases respiratory muscle strength and endurance, decreases sensations of dyspnea (labored breathing) at rest and during exercise, and tends to improve functional exercise capacity.11 Studies find regular EMT practice supports heart, lung, and nervous system function.9,10
Only when and if the lungs are fully emptied can there be a full and efficient inhalation, which is dependent on maximal contraction of the diaphragm. The prevalence of diaphragmatic fatigue is in part due to expiratory muscle fatigue, suggesting the need for both inspiratory and expiratory muscle training.8
Take a few minutes the next time you email, text, or engage with a screen, and notice your breathing. Do you have moments of holding your breath? If so, it could be affecting your heart, lungs, and nervous system, keeping you in a stressed state.
The first step to addressing this common problem is awareness. The next step is strengthening your breathing muscles using practices such as pratiloma pranayama, inspiratory muscle training, expiratory muscle training, or using a device such as the Relaxator. If you try some of these exercises, let us know what you find in the comments below.
Expiration is always done by the nose or when is done by the mouth? What is the best for sleeping and when awake during the day?
Does breath holding negatively impact high blood pressure condition?
Hello Dr. John: Does Kapalbhati help EMT since it uses the abdomen exhale forcefully?