The Human Operating Manual

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Breathing Resources

The references that informed the Breathing section, organized by type. This isn’t a comprehensive bibliography (the academic literature on respiration is vast), but it represents the core sources the manual draws on, and gives you a starting point for going deeper into any specific area.

Where appropriate, citations include both the primary research papers and the practitioners or popularizers who’ve made that research accessible. Both have their place. Primary research is where the evidence actually lives. Popularizers and synthesizers are sometimes more accessible entry points, but should be cross-checked against the underlying papers.

Foundational Physiology

  • West, J.B. (2012). Respiratory Physiology: The Essentials (9th ed.). Lippincott Williams & Wilkins. — The standard textbook treatment. The reference for Bohr/Haldane chemistry, gas exchange, and ventilatory mechanics.
  • Bohr, C., Hasselbalch, K., & Krogh, A. (1904). Über einen in biologischer Beziehung wichtigen Einfluss, den die Kohlensäurespannung des Blutes auf dessen Sauerstoffbindung übt. Skandinavisches Archiv für Physiologie, 16(2), 402–412. — The original Bohr effect paper.
  • Brian, J.E. (1998). Carbon dioxide and the cerebral circulation. Anesthesiology, 88(5), 1365–1386. — The CO2-cerebral blood flow relationship that underlies the hyperventilation discussion.


Brainstem and Neural Substrate

  • Smith, J.C., Ellenberger, H.H., Ballanyi, K., Richter, D.W., & Feldman, J.L. (1991). Pre-Bötzinger complex: a brainstem region that may generate respiratory rhythm in mammals. Science, 254(5032), 726–729.
  • Yackle, K., Schwarz, L.A., Kam, K., Sorokin, J.M., Huguenard, J.R., Feldman, J.L., Luo, L., & Krasnow, M.A. (2017). Breathing control center neurons that promote arousal in mice. Science, 355(6332), 1411–1415.
  • Li, P., Janczewski, W.A., Yackle, K., Kam, K., Pagliardini, S., Krasnow, M.A., & Feldman, J.L. (2016). The peptidergic control circuit for sighing. Nature, 530(7590), 293–297.
  • Zelano, C., Jiang, H., Zhou, G., Arora, N., Schuele, S., Rosenow, J., & Gottfried, J.A. (2016). Nasal respiration entrains human limbic oscillations and modulates cognitive function. Journal of Neuroscience, 36(49), 12448–12467.


Autonomic Regulation and HRV

  • Lehrer, P.M. & Gevirtz, R. (2014). Heart rate variability biofeedback: how and why does it work? Frontiers in Psychology, 5, 756. — The foundational synthesis on resonance frequency breathing.
  • Bernardi, L., Sleight, P., Bandinelli, G., Cencetti, S., Fattorini, L., Wdowczyc-Szulc, J., & Lagi, A. (2001). Effect of rosary prayer and yoga mantras on autonomic cardiovascular rhythms: comparative study. BMJ, 323(7327), 1446–1449. — The cross-cultural convergence-on-six-breaths-per-minute paper.
  • Russo, M.A., Santarelli, D.M., & O’Rourke, D. (2017). The physiological effects of slow breathing in the healthy human. Breathe, 13(4), 298–309.
  • Zaccaro, A., Piarulli, A., Laurino, M., et al. (2018). How breath-control can change your life: a systematic review on psycho-physiological correlates of slow breathing. Frontiers in Human Neuroscience, 12, 353.


Specific Breathing Interventions and RCTs

  • Balban, M.Y., Neukirchen, E., Spiegel, D., Deisseroth, K., & Huberman, A.D. (2023). Brief structured respiration practices enhance mood and reduce physiological arousal. Cell Reports Medicine, 4(1), 100895. — The physiological sigh study.
  • Kox, M., van Eijk, L.T., Zwaag, J., et al. (2014). Voluntary activation of the sympathetic nervous system and attenuation of the innate immune response in humans. PNAS, 111(20), 7379–7384. — The Wim Hof Method endotoxin study.
  • Bowler, S.D., Green, A., & Mitchell, C.A. (1998). Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Medical Journal of Australia, 169(11–12), 575–578.
  • Cowie, R.L., Conley, D.P., Underwood, M.F., & Reader, P.G. (2008). A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respiratory Medicine, 102(5), 726–732.
  • Santino, T.A., Chaves, G.S., Freitas, D.A., Fregonezi, G.A., & Mendonça, K.M. (2020). Breathing exercises for adults with asthma. Cochrane Database of Systematic Reviews, (3), CD001277.
  • Brown, R.P., & Gerbarg, P.L. (2005). Sudarshan Kriya yogic breathing in the treatment of stress, anxiety, and depression: Part II — clinical applications and guidelines. Journal of Alternative and Complementary Medicine, 11(4), 711–717.
  • Seppälä, E.M., Nitschke, J.B., Tudorascu, D.L., et al. (2014). Breathing-based meditation decreases posttraumatic stress disorder symptoms in U.S. military veterans: a randomized controlled longitudinal study. Journal of Traumatic Stress, 27(4), 397–405.


Nasal Breathing and Nitric Oxide

  • Lundberg, J.O., Settergren, G., Gelinder, S., Lundberg, J.M., Alving, K., & Weitzberg, E. (1996). Inhalation of nasally derived nitric oxide modulates pulmonary function in humans. Acta Physiologica Scandinavica, 158(4), 343–347.
  • Lundberg, J.O. (2008). Nitric oxide and the paranasal sinuses. The Anatomical Record, 291(11), 1479–1484.
  • Weitzberg, E., & Lundberg, J.O. (2002). Humming greatly increases nasal nitric oxide. American Journal of Respiratory and Critical Care Medicine, 166(2), 144–145.
  • Dallam, G.M., McClaran, S.R., Cox, D.G., & Foust, C.P. (2018). Effect of nasal versus oral breathing on Vo2max and physiological economy in recreational runners following an extended period spent using nasally restricted breathing. International Journal of Kinesiology and Sports Science, 6(2), 22–29.


Clinical Respiratory Medicine

  • Thomas, M., McKinley, R.K., Freeman, E., & Foy, C. (2001). Prevalence of dysfunctional breathing in patients treated for asthma in primary care: cross sectional survey. BMJ, 322(7294), 1098–1100.
  • Boulding, R., Stacey, R., Niven, R., & Fowler, S.J. (2016). Dysfunctional breathing: a review of the literature and proposal for classification. European Respiratory Review, 25(141), 287–294.
  • van Dixhoorn, J., & Folgering, H. (2015). The Nijmegen Questionnaire and dysfunctional breathing. ERJ Open Research, 1(1).
  • Senaratna, C.V., Perret, J.L., Lodge, C.J., et al. (2017). Prevalence of obstructive sleep apnea in the general population: a systematic review. Sleep Medicine Reviews, 34, 70–81.
  • Guilleminault, C., & Sullivan, S.S. (2014). Towards restoration of continuous nasal breathing as the ultimate treatment goal in pediatric obstructive sleep apnea. Enliven: Pediatrics and Neonatal Biology, 1(1), 001.
  • Mayer, A.F., Karloh, M., Dos Santos, K., de Araujo, C.L.P., & Gulart, A.A. (2018). Effects of acute use of pursed-lips breathing during exercise in patients with COPD: a systematic review and meta-analysis. Physiotherapy, 104(1), 9–17.
  • McCarthy, B., Casey, D., Devane, D., Murphy, K., Murphy, E., & Lacasse, Y. (2015). Pulmonary rehabilitation for chronic obstructive pulmonary disease. Cochrane Database of Systematic Reviews, (2), CD003793.
  • McEvoy, R.D., Antic, N.A., Heeley, E., et al. (2016). CPAP for prevention of cardiovascular events in obstructive sleep apnea. New England Journal of Medicine, 375(10), 919–931. — The SAVE trial.
  • Lee, Y.C., Lu, C.T., Cheng, W.N., & Li, H.Y. (2022). The impact of mouth-taping in mouth-breathers with mild obstructive sleep apnea: a preliminary study. Healthcare, 10(9), 1755.


Craniofacial Development and Myofunctional Therapy

  • Harvold, E.P., Tomer, B.S., Vargervik, K., & Chierici, G. (1981). Primate experiments on oral respiration. American Journal of Orthodontics, 79(4), 359–372.
  • Yoon, A., Zaghi, S., Weitzman, R., Ha, S., Law, C.S., Guilleminault, C., & Liu, S.Y. (2017). Toward a functional definition of ankyloglossia: validating current grading scales for lingual frenulum length and tongue mobility in 1052 subjects. Sleep and Breathing, 21(3), 767–775.


Lung Function and Mortality

  • Mandsager, K., Harb, S., Cremer, P., Phelan, D., Nissen, S.E., & Jaber, W. (2018). Association of cardiorespiratory fitness with long-term mortality among adults undergoing exercise treadmill testing. JAMA Network Open, 1(6), e183605.
  • Beaumont, M., Forget, P., Couturaud, F., & Reychler, G. (2018). Effects of inspiratory muscle training in COPD patients: a systematic review and meta-analysis. The Clinical Respiratory Journal, 12(7), 2178–2188.


Interoception and Predictive Processing

  • Critchley, H.D., & Garfinkel, S.N. (2017). Interoception and emotion. Current Opinion in Psychology, 17, 7–14.
  • Barrett, L.F. (2017). The theory of constructed emotion: an active inference account of interoception and categorization. Social Cognitive and Affective Neuroscience, 12(1), 1–23.
  • Friston, K. (2010). The free-energy principle: a unified brain theory? Nature Reviews Neuroscience, 11(2), 127–138.


Air Quality

  • Allen, J.G., MacNaughton, P., Satish, U., Santanam, S., Vallarino, J., & Spengler, J.D. (2016). Associations of cognitive function scores with carbon dioxide, ventilation, and volatile organic compound exposures in office workers: a controlled exposure study of green and conventional office environments. Environmental Health Perspectives, 124(6), 805–812.


Free-Diving and Apnea Physiology

  • Schagatay, E. (2009). Predicting performance in competitive apnoea diving. Part I: static apnoea. Diving and Hyperbaric Medicine, 39(2), 88–99.


Books and Practitioner Sources

  • McKeown, P. (2015). The Oxygen Advantage. Little, Brown Book Group. — The most rigorous popularization of Buteyko-tradition breathing for general and athletic audiences.
  • Nestor, J. (2020). Breath: The New Science of a Lost Art. Penguin. — Popular synthesis. Mostly accurate on physiology; some specific claims and self-experiments overstate.
  • Hof, W. (2020). The Wim Hof Method: Activate Your Potential, Transcend Your Limits. Random House. — The practitioner’s own treatment. Read alongside the Pickkers/Kox 2014 PNAS paper for the actual research.
  • Severinsen, S.A. (2010). Breatheology. — Popular treatment of competitive freediving physiology applied to general practice. Good on breath-hold training, less rigorous on broader claims.


Practitioners and Ongoing Conversations

  • Beck, F. Optimal Health Model — optimalhealthmodel.com. Practitioner perspective and ongoing conversations that have shaped how the manual structures the breathing material.