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When an athlete walks in and I assess their breathing pattern, it more or less immediately tells me a lot of information about how their training feels, how well their body is coping, and where their overall health is. I can see how much tension they are carrying, how stressed their nervous system is, and whether they are breathing in a way that is going to support or limit performance over time. Working as a breathwork coach/breathing instructor, that first assessment is often more revealing than people expect.
Recently, a review published in The Lancet by Eric Harbour, Camilla Rønn Illidi, and Dr James Hull asked a simple question: “Breathing in sport: can we make breath work better?” I smiled when I read that, because my own tagline has long been that breathwork isn’t work, it’s freedom. Science is now catching up with something many of us working in this space see every day. When breathing is trained properly, it stops feeling like effort and starts becoming an advantage.
What struck me reading the review was how closely the science mirrors what I see every week working with athletes. It highlights that breathing in sport is not just background physiology ticking along automatically. Under pressure, at high intensity, and over long training blocks, breathing patterns and respiratory load can become real limiting factors.
Although the review focuses on sport, the physiology does not switch off when someone leaves the training ground. The same breathing patterns that shape performance also shape how people respond to stress and anxiety, how well they recover from long days, and how clearly they think under pressure. This is why breathwork now sits not only in sport but also in workplaces and institutions where the goal is sustained performance rather than medals and success at the highest levels.
For example, I recently worked with an elite endurance athlete who felt breathless despite solid training programming. Their resting breathing rate (RR) was high, their recovery breathing between efforts was slow, and they were over-breathing and mouth-breathing early in low intensity sessions. Within weeks of focused breathing training, their breathlessness (dyspnea) reduced significantly, their recovery improved, their pacing felt more controlled, and they reported greater efficiency as intensity rose.
Harbour, Illidi, and Hull describe how the respiratory system can influence performance more than many coaches realise, especially when exercise intensity is high or when athletes are dealing with airway issues, poor breathing control, or respiratory muscle fatigue. Their work frames breathing as something that can be trained and refined, rather than simply left to run on autopilot. Breathing is autonomic, and many people pay little or no attention to it, but it can be trained just like anything else.
That perspective is important because many athletes are incredibly well-conditioned from a cardiovascular and muscular point of view, yet still struggle with dyspnea, control, and recovery. Science is starting to catch up with what many breathing coaches have been observing for years, that the way someone breathes under load can shape how hard they can push and how well they recover.
In practice, the patterns I see are very consistent. I regularly work with athletes who over breathe without realising it, who rely heavily on upper chest breathing instead of using, strengthening and conditioning the diaphragm, lower/upper rib activation and intercostal muscles efficiently, and who lose rhythm/control as soon as exercise intensity rises. As carbon dioxide builds in the system, breathing speeds up, control drops, and the sensation of dyspnea starts to drive physiological and psychological behaviour.
Mouth breathing often appears early, often as soon as they leave the door for a run even at lower heart rates where nasal breathing would still be possible. When an effort stops, recovery breathing is shallow and fast, which affects recovery between reps, between sets, and across sessions. These patterns influence how hard an athlete feels they can push and how well they recover from hard intensity work.
Although I see this most clearly in sport, the same over-breathing patterns show up day to day in people dealing with stress, anxiety, and high cognitive load at home and in the workplace, where breathing control influences focus, emotional regulation, and recovery from pressure in very similar ways.
One of the more established areas highlighted in the review is respiratory muscle training (RMT). This is something I use regularly in my work as a breathwork coach with endurance and repeat effort athletes, with the Isocapnic BWB device being my tried and tested favourite. When breathing muscles become stronger and more fatigue-resistant, athletes often describe hard efforts as feeling more manageable because their breathing is working with them rather than against them. The respiratory muscles, as well as the bodies respiratory centre, are being trained just like you would train your legs. Athletes are less likely to tip into a panicked over-breathing, high sympathetic response, which helps them stay composed and make better decisions deeper into sessions and races. Staying calm under pressure is a key component of athletic performance.
The science discussed by Harbour and colleagues supports the idea that respiratory muscle fatigue can influence overall exercise tolerance. In the coaching room, that translates into athletes who can repeat hard efforts more consistently and recover more effectively between them when their breathing strength and control improve. Those same benefits apply to professionals under pressure, where sustained focus and recovery between high-stress moments matter just as much.
The review also discusses breathing control and slower breathing strategies, not as relaxation tools, but as ways of improving regulation. As a breathing instructor, I frame slow breathing as control under pressure. Many athletes I assess have resting breathing rates well above what we would consider efficient (15+). Very few naturally sit in a calm, controlled range (6-10).
If someone cannot slow their breathing down at rest and when requested, they do not really control it and it controls them. Slower, more efficient breathing builds awareness and regulation, which then supports performance when intensity increases. It gives athletes a way to shift their nervous system state, helping them understand how to oscillate between high stress and recovery more effectively. That same skill set is now being used in corporate environments where breathing control supports decision making, creativity, and resilience.
Carbon dioxide tolerance is another area where science and coaching meet. The review highlights how the respiratory system responds to the stress of exercise, and in practical terms, in my opinion, this often comes down to how sensitive someone is to the feeling of air hunger. If that sensation feels threatening, breathing becomes reactive and chaotic.
When we train carbon dioxide tolerance, athletes become more comfortable with that rising urge to breathe. They do not feel breathless as quickly, they stay calmer under pressure, and they can hold their form and pacing for longer. This links directly to fatigue and that burning sensation athletes talk about. When breathing control is poor and sensitivity to carbon dioxide is high, mechanics drop off sooner and effort feels overwhelming due to blood-stealing (metabaroreflex). As breathing control improves, athletes can stay efficient deeper into sessions and competitions. In their review, they refer to this as lactate buffering rather than carbon dioxide tolerance. Lactate and lactate buffering play an essential part in performance and can be controlled by breathing training through intermittent hypoxic hypercapnic training.
Harbour Illidi, and Hull emphasise that breathing issues in athletes are often missed. I see this constantly. In my assessments as a breathwork coach, I take a detailed consultation and data collection to look at the athlete's full health, habits and goals. I look at breathing rate, nasal versus mouth breathing, lateral lower and upper rib expansion measurements, diaphragm awareness, strength control and phrenic nerve signalling, mobility through the thoracic cavity, spirometry testing and carbon dioxide tolerance using tools like the BOLT score. I also include maximal breath holds on the inhale and exhale.
Learn more about how I assess breathing mechanics here.
Mouth breathing, over breathing, low tolerance to carbon dioxide, poor mechanics, and a lack of breathing awareness are all red flags. Yet many athletes have never been screened in this way, even though breathing plays a role in how they train, recover, and perform. The same is true in high-stress workplaces, where breathing patterns often reflect chronic tension and nervous system overload.
Breathing patterns are habits built over years. In my coaching, I tell athletes that meaningful change takes at least six weeks, and deeper, more stable changes often take months. Consistency and awareness are what make new breathing patterns stick. Athletes practise in low stress situations first, then gradually bring those skills into higher-intensity training and competition settings. Professionals follow the same path, integrating breathing control into daily routines and high-pressure moments at work.
At The Breath Coach, we see it as a way of giving people an edge when margins are small. It improves awareness, strengthens breathing mechanics, builds carbon dioxide tolerance, and gives athletes real control under pressure. Performance improves, but so does the bigger picture. People often report feeling less stressed, less anxious, and more capable of shifting between high-intensity effort and deep recovery. That affects sleep, resilience, and long-term health as well as performance.
Breathing also connects to areas that influence training consistency, from exercise-induced airway issues and frequent respiratory infections to neck and shoulder tension and movement efficiency. When breathing improves, movement often improves too. The work of Harbour, Illidi, and Hull helps move this conversation forward by framing breathing in sport as something trainable and measurable. As a performance breathing coach working internationally, both in person and online, with athletes and high-performing teams across the UK, Europe, North America, and beyond, that is exactly how I see it.
A breathwork coach assesses how an athlete breathes at rest and under load, then provides breathing training to improve mechanics, control, recovery, and tolerance to high-intensity effort to boost performance.
Breathing training can improve breathing efficiency, reduce unnecessary over-breathing, and help athletes stay composed at higher intensities, all of which support endurance performance.
Higher carbon dioxide tolerance helps athletes feel less breathless at a given intensity, maintain control of their breathing, and delay the point where mechanics and pacing begin to break down. Syncing breathing with movement is a key driver of efficiency, particularly in endurance sports. This synchronisation between breath and movement is referred to in the literature as locomotor–respiratory coupling, and can be seen when a runner matches their inhale and exhale to foot strikes, a cyclist times their breath with pedal revolutions, a swimmer coordinates breathing with stroke cycles, or a rower links the inhale to the recovery and the exhale to the drive phase of the stroke.
Yes. Reviews such as the one by Harbour, Illidi, and Hull in The Lancet show growing scientific interest in how breathing patterns and respiratory muscle function influence exercise performance. The review itself points toward research on respiratory muscle training, breathing control and slow-paced breathing, hypoventilation training, nasal breathing, and locomotor–respiratory coupling, all areas where breathing mechanics and regulation appear to influence how athletes better tolerate high-intensity work and perform under pressure. See the referenced papers below.
Yes. The same breathing patterns that influence endurance and recovery in sport also affect stress levels, emotional regulation, and mental clarity in daily life. This is why breathwork coaching is now used in workplaces and institutions as well as in sport.
No. While much of this article focuses on athletic performance, breathing training is equally valuable for professionals, teams, and organisations who want to improve focus, resilience, and recovery from stress.
Yes. I work with athletes, teams, and organisations both in person and online, supporting clients across the UK, Europe, North America, and other international locations.
Whether you are an endurance athlete looking to improve performance, a professional managing high levels of stress, or part of a team that needs better focus and recovery, breathing can be trained just like strength or endurance. The difference is that it affects everything at once: how you perform, how you recover, and how you feel day to day.
If you want to understand how your breathing is affecting your performance or wellbeing, the first step is a simple assessment. From there, we build a tailored breathing program that fits around your training, work, and life.
You can get in touch by clicking the blue 'free consultation' button or through the contact page to arrange an initial conversation or breathing assessment. I work with individuals and teams both in person and online, supporting clients across the UK, Europe, North America, and beyond. I would love to hear from you.
Thomas
Breathing in sport: can we make breath work better?
Harbour ER, Illidi CR, Hull J – The Lancet
Is the healthy respiratory system built just right, overbuilt, or underbuilt to meet the demands imposed by exercise?
Dempsey JA, La Gerche A, Hull JH – Journal of Applied Physiology
Breath Tools: A synthesis of evidence-based breathing strategies
Harbour E – Frontiers in Physiology
Exercise-induced laryngeal obstruction (EILO) – Overview
StatPearls – National Center for Biotechnology Information
Exercise-induced laryngeal obstruction in athletes
Sandnes A et al. – BMJ Open Sport & Exercise Medicine
Distinguishing science from pseudoscience in respiratory interventions
Illidi CR & Williams – PubMed Central
Rehabilitation of respiratory disorders in athletes
Allado E et al. – Annals of Physical and Rehabilitation Medicine
