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The Impact of Breathing & Low CO2 On Cognition | Link to Dementia

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In this blog we will explore how poor breathing, leading to CO2 depletion, can lead to cognitive dysfunction. Learn about the underlying mechanisms and the importance of early prevention and management. The content can be a bit dense with technological terms, but it is worth knowing how the way you breathe alters chemical reactions in your brain and ultimately your brain's health.

Common Cognitive Symptoms of Low CO2 Levels

When you breathe too much or too fast for too long, due to learned behaviors of breathing, you body loses too much carbon dioxide (CO2) and this affects the way your brain functions.

Do You Experience Any Of These Cognitive Symptoms?

  • Brain fog and sluggish thinking
  • Memory lapses and difficulty recalling information
  • Dizziness or lightheadedness
  • Short attention span and poor concentration
  • Chronic stress, anxiety, or panic attacks
  • Mental fatigue and difficulty processing information
  • Progressive mental decline following a surgical procedure

An ongoing heightened central nervous system hijacked by a state of hypervigilance or survival will create the perfect storm that will yield thought patterns that are destructive and negative. These patterns can perpetuate and exacerbate with more stress, creating true pathological conditions as mental health disorders.  Your sense of ease, motivation, and confidence can be negatively affected by the way you breath. CO2 depletion can cause the following states:

  • Disorganized thinking
  • Confusion
  • Anxiety
  • Worry
  • Catastrophic thinking
  • Disorientation
  • Feelings of unreality
  • Panic
  • Depression
  • Phobias
  • Hallucinations
  • Inappropriate pseudo calmness (alcohol, sugar, drugs, cravings)

How Low CO2 Affects Your Brain

The brain needs oxygen and blood flow to thrive. It is common to think that the way you breathe can affect your brain function. Breathing dysfunction can lead to CO2 depletion, resulting in impaired oxygen delivery, and decreased blood flow to the brain and all organs and systems in the body.

Carbon dioxide (CO2) is often perceived merely as a waste product of respiration. However, maintaining appropriate CO2 levels is crucial for various bodily functions, including oxygen transport, blood flow, and decreased inflammation.

Mechanisms Linking Low CO2 levels to Dementia

The connection between low CO2 levels and dementia may involve several mechanisms:

1. Decreased Blood Blow To The brain

Low CO2 makes your blood vessels tighten, reducing blood flow. WHY IT MATTERS: Your brain gets less blood volume and less oxygen. This can make you feel dizzy, tired, foggy, or like your thinking is slower than usual. Decreased blood flow is also referred to as cerebral hypoperfusion, and this is a known risk factor for vascular dementia.

2. Poor Oxygen Delivery (Bohr Effect)

Low CO2 makes it harder for red blood cells to release oxygen. WHY THIS MATTERS: Oxygen is not available when you have low CO2 levels. You can attempt to breathe deeper trying to get enough oxygen, but your brain can't use the oxygen effectively.

3. Neurotransmitter Imbalance

A neurotransmitter imbalance means the brain's chemical messengers are not working correctly.

WHY IT MATTERS: A neurotransmitter is a small chemical messenger that helps brain cells talk to each other.

For those who are interested in science, let me provide a brief explanation of what exactly happens when breathing dysfunction causes low CO2 levels and brain chemical imbalance.

Imbalance occurs when some messengers are too high or too low. This can affect how you feel, think, sleep, and handle stress. For example, neurotransmitters that are too high can cause brain cells to get over-stimulated. This can cause anxiety, restlessness, mind racing, trouble sleeping, or feeling "on edge." Conversely, if there are too few messengers (too low) communication between the cells slow down. This can lead to tiredness, sadness, or brain fog.

Hypocapnia, low CO2 levels, can alter the balance of glutamate and gamma-aminobutyric acid (GABA), which are critical for cognitive processes. Essentially, glutamate speeds things up in your thinking. The brain cells in your brain get more active. On the other hand, GABA slows things down, and this can help you feel calm and focused.

When CO2 levels are too low from over-breathing or stress, the brain gets too much glutamate and not enough GABA. That means your brain stays in "go-go-go" mode, making it hard to relax, sleep, or feel steady. Disruptions in these neurotransmitters have been implicated in various forms of dementia.

4. Cell Damage - Oxidative Stress

Low CO2 can interfere with how cells use oxygen, creating harmful molecules called free radicals. Essentially, oxidative stress happens when your body has too many harmful molecules (free radicals) and not enough defenses to clean them up.

WHY IT MATTERS: This can result in damage to the cells. It is like your cells are getting "rusty" or damaged inside and very little to no repair process.

Lowered CO2 levels causes the oxygen to not be available to nourish the cells. The cells in your brain cannot use oxygen properly, leading to neuronal damage and contributing to the onset of neurodegenerative diseases like dementia and Alzheimer's disease.

5. Low Brain Energy (Mitochondria Dysfunction)

Mitochondria are the energy factories in your cells and they need balance CO2 to work well. Low CO2 affects the release of oxygen from red blood cells. The oxygen is not available to combine with glucose to produce ATP (Cellular energy) in the cells.

WHY THIS MATTERS: Low CO2 results in mitochondria dysfunction. Without enough CO2, your brain makes less energy, which can lead to fatigue, poor memory, confusion, disorientation, and depersonalization.

6. Inflammation and Immune Stress

Low CO2 can trigger inflammation in the brain and body. Low CO2 confuses the brain into thinking there is a problem. It is like the smoke alarms are triggered even if there is no real fire. The smoke alarm sends out inflammation signals, just like calling firefighters, but the alarms keep going off for no reason long after the firefighters cleared the area. Low CO2 caused by breathing dysfunction will keep setting off false alarms in your brain, creating more inflammation and causing more cell damage to the brain.

Clinical Observation and Preventative Measures

Clinical reports have documented cases where patients with hyperventilation syndrome (HVS), characterized by chronic hyperventilation and resultant low CO2, presented with cognitive impairments. With the proper treatment aimed at normalizing breathing patterns and CO2  levels, the patient’s cognitive functions can improve, suggesting a reversible component of CO2 related cognitive impairments. In other words, the treatment aims at restoring blood supply, oxygen delivery, and decreasing inflammation.

Recognizing the impact of CO2 levels on cognitive health underscores the importance of proper breathing techniques and respiratory health in preventing cognitive decline. Interventions may include:

  • Breathing Retraining: Teaching individuals to adopt appropriate breathing patterns can help maintain optimal CO2 levels, potentially mitigating cognitive risks associated with hypocapnia.
  • Anxiety Management: Since anxiety can lead to hyperventilation, addressing anxiety through therapeutic approaches may prevent exacerbation of disordered breathing and its cognitive consequences.
  • Regular Monitoring: For individuals with respiratory disorders, regular monitoring of CO2  levels could aid in early detection and management of potential cognitive impairments.

Conclusion

Low CO2 isn't harmless. It is a hidden stressor in the brain.

Maintaining balanced CO2 levels is essential not only for respiratory function but also for cognitive health.

Hypocapnia, often resulting from hyperventilation, can lead to significant cognitive impairments and may contribute to the development or exacerbation of dementia.

Awareness of this connection is crucial for both prevention and management, highlighting the need for proper respiratory practices and addressing underlying causes of hyperventilation.

Restoration of CO2 balance is a critical component of physiological rehabilitation, which can lead to predictable recovery or improvement of symptoms.


If you struggle with brain fog, memory lapses, difficulty concentrating, dizziness, or chronic stress, your breathing habits could be the missing link. Correcting dysfunctional breathing and restoring CO2 balance may be the key to protecting your brain health and cognitive longevity.

At Respiras, we specialize in scientific breathing retraining and pulmonary and neurological occupational therapy to restore CO2 balance, improve brain function, and prevent cognitive decline.

By understanding and addressing the role of CO2 in cognitive function, we can take proactive steps toward preserving cognitive health and potentially reducing the risk of dementia

Book a consultation today

Medical References

Laffey JB, Kavanaugh BP. Hypocapnia. New England Journal of Medicine 2002; Vol 47.

Beaudin, A. E., Raneri, J. K., Ayas, N. T., Skomro, R. P., Smith, E. E., & Hanly, P. J. (2022). Contribution of hypercapnia to cognitive impairment in severe sleep-disordered breathing. Journal of Clinical Sleep Medicine, 18(1), 245-254.

Shigematsu, K., & Kaga, K. (2019). Hyperventilation syndrome in an aged male patient: A case report. Clinical Case Reports, 7(3), 554-557.Â

Gardner WN. The Pathophysiology of Hyperventilation Disorders. CHEST 1996; 109:516-34.

Fraser MB, MRCP. Hyperventilation Attacks: A Manifestation in Hysteria. British Medical Journal 1938; Vol. 378.

Lum LC Hyperventilation: The Tip of the Iceberg. Journal of Psychsomatic Research 1975; 19:375-383.

Gilbert, C. Better chemistry through breathing: The story of carbon dioxide and how it can go wrong. Biofeedback 2005, 33(3),100–104.

Alireza Farnam. pH of soul: how does acid-base balance affect our cognition? BioImpacts, 2014, 4(2), 53-54

Xie, Z., Moir, R. Hypocapnia induces Caspase-3 activation and increases Aᵦ production. Neurodegenerative Dis. 2004; 1:29-37. Genetics and Aging Research, Harvard Medical School, Charlestown, Mass., USA.

Fan, J. L., Burgess, K. R., Thomas, K. N., Lucas, S. J., & Ainslie, P. N. (2019). Isolating the independent effects of hypoxia and hyperventilation-induced hypocapnia on cerebral haemodynamics and cognitive function. The Journal of Physiology, 597(4), 1105-1118.

Joseph R. Neurological Manifestations of the Hyperventilation Syndrome. Journal of the Royal Society of Medicine 1986; Vol. 79.

Courtney L. The functions of breathing and its dysfunctions and their relationship to breathing therapy. International Journal of Osteopathic Medicine 12 (2009) 78-Australia.


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