Felix Strobl, pneemo: 0:00

If you are aware of your breath and you start being aware of your breath, you can see, I would say, the power of the breath.

Alex, X-Health.show: 0:11

Hi, i'm Alex and welcome to the X-Health. show, where I talk to visionaries behind the latest innovations in healthcare. For the eXtra health of the future. We're in the center of Basel, Switzerland, with a theatre across the street and a high street that stays awake until late on the other side. My guest today is Felix Stroble, Medical and Scientific Director at pneemo. A neuroscientist specializing in the effect of breathing on the autonomic nervous system, but also a trained paramedic and a tenor. pneemo, a breathing metronome strikingly differs from the devices we've covered so far. It's as simple as your electric toothbrush, yet there's a plethora of super interesting neuroscientific research behind it. So we'll hear today about panic attacks, breathing exercises for anxiety, breathing for singing, for public speaking, for pain relief. We'll try some breathing techniques together and, of course, you'll hear Felix singing. What's more important in breathing, i nhaling or exhaling?

Felix Strobl, pneemo: 1:15

What a great question at the beginning. What do you mean exactly by inhaling, exhaling" gt; breathing is essential to life. As you know, we can survive without water and food for several days, even a month, but we cannot survive maybe up to five minutes or four minutes without the breath. So, coming back to your question, inhaling and exhaling is like this process The inhale, where you take, like this, oxygen and this effect of oxygen and carbon dioxide. We need to define and go further, I think, with the question, because it depends what you want to do. If you want to do like the learning and memory, or for the concentration, or to fight anxiety, panic, then it depends what is more important The inhaling part to getting more energy, maybe more concentration, or you are stressed, high stressed, you're anxious, then the exhaling part is more important.

Alex, X-Health.show: 2:18

We'll get to that. I'm asking this question because it's apparently a tricky question. I think if we ask people, everyone might say something different. I was actually asked this question by Chuck Miller, a yoga teacher, at an Ashtanga yoga workshop. Someone actually said exhaling, and I was like: both. I was speaking not from yoga perspective, I was speaking from a perspective of a scuba diver.

Felix Strobl, pneemo: 2:45

You're a diver, w ow, that's interesting. So it's linking diving and the breath.

Alex, X-Health.show: 2:52

For me, breathing was like you need to have the same amount of breathing in as you out, inhaling- exhaling, especially when you're going up, because otherwise you may, basically, die if you hold breath and go up.

Felix Strobl, pneemo: 3:08

And, as you know, it depends on the activity we're doing. As I mentioned, if we are hyperstressed, then the exhaling, because then you can calm down the nervous system. But if you need a bit of motivation or lack of energy, then the inhaling like this, taking air in the lungs to activate the nervous system. Then it's to focus more on the: inhale.

Alex, X-Health.show: 3:33

Can we breathe in the wrong way?

Felix Strobl, pneemo: 3:36

In the wrong way, I would say yes, we can breathe improperly, just as taking shallow breaths, not deeply, and holding our breath. Or we are breathing too quickly or too slowly, and it can lead to symptoms such as dizziness, fatigue or shortness of breath. But there are good news. Now There are ways we can breathe in a healthy or good way, and the breathing can tremendously, in my opinion, improve the quality of life of people, and I have mentioned just some examples. For example, reducing stress and anxiety In our overstressed society. We can manage our breath, we can control our breath, we can drop down the anxiety level. The same way is to improve the cardiovascular function throughout the breath And we can enhance the cognitive performance. We want all we want to perform. We need to perform. It's in the workplace, in schools, in institutions, universities, and there are tricks and techniques how we can improve the cognitive performance.

Alex, X-Health.show: 4:48

Let's come back to this, but before that, is there anything like a normal breathing, or is there anything like the range of how we humans breathe?

Felix Strobl, pneemo: 5:00

So if we say the normal breathing normal breathing, then we should define what is normal.

Alex, X-Health.show: 5:06

I hate that word too.

Felix Strobl, pneemo: 5:08

What is the norm? first of all, We can say there are some characteristics of a breathing rate. In adults, The normal breathing rate is around 12 to 16 or even 20. Then we are not talking about the healthy way now, That's later And the death of the breathing. If we go for the gas exchange the breathing.

Alex, X-Health.show: 5:33

So it's like 20 inhales and exhales, or is it? how do you count that? Yeah, exactly.

Felix Strobl, pneemo: 5:40

So yeah, immediately we go to reply to it. It's like the four, six, we come later, you take four in, six out, then it's like this 10, and we have 60 seconds per minute. So it's like six breathing for the breathing rates, for the frequency, which is very healthy. Coming back, the breathing rhythm What is the breathing rhythm? Like? the interdependence between the inhalation and the exhalation, which is really good, and the breathing pattern. How do we breathe? What do we use? the diaphragmatic breathing, our muscle, intercostal muscles? or do we breathe just with the shallow breathing? not healthy. So that's what it's, a terminology already, normal breathing.

Felix Strobl, pneemo: 6:32

Yeah there are some characteristics for humans.

Alex, X-Health.show: 6:35

Do women and men breathe differently?

Felix Strobl, pneemo: 6:39

What a question. Now, i don't talk about this. I tend to discuss and say yes, there are differences. Why? Because of physiology, i think the lungs of men they can take in more air, for sure, but I don't know exactly. But I did not study the difference and I have done the study I can rely on. So I think just it's our physiology, there are differences, yes, and for the gas exchange, taking air in and out, i think there are differences.

Alex, X-Health.show: 7:15

I'm just thinking because, like going back to scuba diving, i was usually more efficient in using the air tongue than people who are basically bigger, with bigger lungs. And I'm thinking it's not about how big your lungs are, how you breathe in and out, so how efficiently you're breathing.

Felix Strobl, pneemo: 7:39

Exactly, and I think breathing, when we talk about the mechanism of breathing, we have this mechanism and then the chemistry as well in breathing, and the mechanism is like a muscle work. As I mentioned, this diaphragm, the muscle below our chest, is so important to use for the corrective, i would say the healthy breathing, and then the intercostal and then the coming, the lungs, and how you use the muscles for the correct or the healthy breathing. I think what you mentioned it led to the better performance because it was a training, because, i would say, as a singer as well, a good breathing training enhances improvements to the voice performance because singers are athletes at Lunds.

Alex, X-Health.show: 8:28

Definitely What's healthy breathing you mentioned.

Felix Strobl, pneemo: 8:34

So healthy breathing is like it depends, again, the situation. If I'm anxious or I have a panic attack, definitely the healthy breathing is like the slow pace breathing, Which means, like the name says, the slow pace breathing I take in, for example, i breathe in for four seconds to inhale and I exhale for six seconds. What happens in the body? Through the extended exhale? I'm triggering my nervous system, the parasympatheticus, which is the rest, and I just nerf and it relaxes me as a person. So if I do a training, if I control my breath and I take the air in for four seconds and exhale for six, then after three minutes, after five minutes, after ten minutes, i'm a bit more stress-relief because when you're measuring the heart rate variability you can see a synchronization of the body and the brain and it's a healthy way.

Alex, X-Health.show: 9:46

So we met at future health battle conference early in the morning.

Felix Strobl, pneemo: 9:51

Yes, early in the morning.

Alex, X-Health.show: 9:56

And then you told me about how actually the Pneimo story began. So there was this professor, thomas Leu, who called a dental care company and he said like you need to make that breathing device. Why would a dental company say yes to such an offer?

Felix Strobl, pneemo: 10:21

I would say why not? That's like a big question. First of all, dental care is as well. It's linking to the overall health, because a good overall health starts in the mouth. We could talk about hours now got the gut microbiome and the interconnectedness, but we don't have the time. It will be a next episode, maybe.

Felix Strobl, pneemo: 10:42

Yeah, first of all, it was this idea because when you brush your teeth, usually two or three times per day in the morning, it would be helpful to do a breath exercise, because we do. We take care of our teeth every day, which is good, which is important, but the same way, we should take care of our psycho hygiene, of our mental states, in a healthy way. Mental health is a big issue, and so to connect it and say, like this message okay, this is a dental care business, but we bring in, like a breath device, this is fantastic. So that's why we talk to people Yeah, in the morning, usually it's good to brush your teeth three minutes, four minutes, five minutes, and then maybe, if you have the time, you should grade it up earlier anyway, which is better. Then take the three or five minutes to do some breath work.

Alex, X-Health.show: 11:38

I already kind of started that because I started, like a few months ago, mindfulness, so I can already say that these 10, 15, 18 minutes of just well, basically you're just sitting and concentrating on what's around you, what's in you, what's your breathing, like this morning It seriously it's getting you ready for the day in a more calm way, i'd say.

Felix Strobl, pneemo: 12:09

It's much more better because you can say I start my day, i act it or I react it, you know, and if you get up in the morning, your cortisol level, the stress on one, is really high, oh yes, so it's like a spike. And so you should really have like these techniques, like, as you mentioned, mindfulness in the morning, meditation. You could exercise. But high exercise in the morning is really healthy breath work healthy to come into a good state of mind, to be ready, because there will be a lot of external factors traffic jam, you miss the bus and so many stressors.

Felix Strobl, pneemo: 12:48

But I think the most important part you should know is, like you are the CEO of your body, you are the CEO of your brain and brain. If you started to act, then you control your breath And which is so fantastic. The breath is the bridge between the conscious and the subconscious mind, because it's going all the time. We're breathing 70, 20,000 times per day and how many times you are aware of your breath. But if you are aware of your breath and you start speaking aware of your breath, you can see, i would say, the power of the breath, with all the positive effects we mentioned at the beginning.

Alex, X-Health.show: 13:24

So we're speaking of it to different things now. So I'm speaking about the. You're observing the breath and you're speaking about controlling the breath. Tell me, then, about the device, about Nemo. Right, we have it with us here.

Felix Strobl, pneemo: 13:38

Right.

Alex, X-Health.show: 13:38

And so it's like 7.5 centimeters long, 4 centimeters wide and like 2 centimeters deep. Let's say It's not too big, not too small. You know it fits into the hand and it is for controlling the breath, Right.

Felix Strobl, pneemo: 13:55

Exactly, yeah, we just did it before the recording a short Nemo session. Right, It's simple and it's immediate use. It's a device, it's low tech, yeah, and I would say, as mentioned on the website, it's simplicity that works and it over stimulated and, yeah, world with a lot of advertisement connection screens. It's exactly what we need. A lot of people are in need. We actually, we realized. So it's a very simple device and that guides you breathing to follow a rhythm. Yeah, it's like in the music. You can if you have your body as an orchestra, and sometimes your body is out of tune or not in the right rhythm. So you need like a conductor or you need like a device that is scientifically proven to improve your health.

Alex, X-Health.show: 14:52

Why it is four seconds inhale and six seconds exhale. Why not like a different rate?

Felix Strobl, pneemo: 15:00

So it's four six because our mentor, professor Leuwe, who is a chief medical officer at the University Hospital in Rheingsburg. he conducted a lot of studies with the breath for over 30 years now And he told us with his published studies that the four six is the best way to synchronize the body.

Alex, X-Health.show: 15:27

What did he measure?

Felix Strobl, pneemo: 15:28

Professor Leuwe measures the heart rate where I believe it's the measure of the variation of the time between the intervals of the successive heartbeats And also known as RR intervals that occur during normal breathing. And this variability reflects the ability of the autonomic nervous system, which controls the heart rate, and to respond to changes in the internal and external stimuli. So with this measure, he measured with, he measured with patients and he said okay, we do five inhales and then seven exhales, or six inhales, eight exhales, and he measures all the time the heart rate variability.

Alex, X-Health.show: 16:13

So he was measuring different intervals and exhales exactly.

Felix Strobl, pneemo: 16:18

And then he saw this heart rate variability. He monitored it and he saw like and the results are really stunning, astonishing, And he said okay, the four, six, four inhales and six exhales are really the healthiest way. What he can see with this measure of the heart rate variability And heart rate variability is really to feel less stress, less panic, and it's nearly impossible, as we say with Pneimo, to feel stress After 10 minutes of doing Pneimo and being to synchronize the body, the brain and coming in this calm state and feeling more relaxed.

Alex, X-Health.show: 17:00

So you obviously got some feedback already from Pneimo users. Could you tell a bit more about that, like what people say basically, who use it?

Felix Strobl, pneemo: 17:26

We, yeah. after we went on the market now with this medical device, Pneimo, we got a lot of good feedback And we realized, yeah, it's a problem, It's a challenge in our society. They told us, yeah, it's better to manage my stress and anxiety, my panic attacks, So I can control my breath again with this device. the fear of flying, which is a big issue apparently. Gondola rides when you like, skiing when you like, really beautiful Switzerland, we like in the mountains, but you are afraid of taking the gondola. So we have one really impressive video from a neurofeedback therapist where she used with a friend. she has impressive fear of gondola rides and it worked.

Alex, X-Health.show: 18:15

Yeah, i saw that video, you know, and it's really like you can see, the person is seriously stressed when entering the gondola And then she's quite happy. you know at the top that she's made it And it helped her compose herself, basically. So it's. I mean, it sounds like a huge thing that you may control your panic attack with bluish box holding in your hand with some vibration. Because, that's what's it. I mean, there's nothing more into it, right.

Felix Strobl, pneemo: 18:51

Yeah, that's astonishing because it's so simple but it's so effective.

Felix Strobl, pneemo: 18:55

And it's low cost therapy and it's no medication, so we adjust. to mention, the list is long. it helps what we for people. they got the feedback for sleeping improved sleep because when you do like a breathing exercise with Pneimo before you fall asleep it helps because it's calms and nervous system coming in this rest and digest and calm state to improve your quality of sleep. And the same is for stage fright people afraid talking from the big audience or just in school or universities, So you can really use it in different settings But the effects results are impressive.

Alex, X-Health.show: 19:35

Yeah. So now for you guys listening, there's some full disclosure from me. So I borrowed the Pneimo to use it before our recording, you know, just to basically test it, and I promised to bring it back and I did. You know, i have it with me. The thing is I just bought it. So I just bought it before the our recording. I got a nice 20% discount. It costs on their website 49 euros. Because I actually use it, you know, except for or despite the fact that I'm doing these mindfulness meditations, i found it very useful before the recording, so before I record interviews, to relax a bit, also myself, but also my vocal cords. It helps me to work, to prepare my voice for the recording. So now you know that, okay, i owned the device, but I was just thinking like Felix, can we try the Pneimo together? Yes, yeah, and you guys listening like, if you want to try it, like how long? because six seconds for exhaling might feel a bit long, especially at the beginning. So would you, would you like to lead the breathing?

Felix Strobl, pneemo: 21:07

with Pneimo.

Alex, X-Health.show: 21:08

Yes, And you may join us guys right.

Felix Strobl, pneemo: 21:12

Yeah, for sure. So if you have the Pneimo in your hand, then the best way is you sit on the chair, on the floor. It's easier to sit upright in upright position, but you can also lie down. You, when you are in the train, in a bus, you can use it everywhere. Yeah, which is so great, you know. You can either close your eyes or you can keep them open. Many people like to relax their eyes, so they are half closed because there's a lot of visual stimuli coming in. So feel free What's the best for you And you don't have to concentrate on anything. With practice, you can be reading the newspaper or driving, even to use the Pneimo if you are a bit stressed in the traffic. So it's important to feel and listen to your breath and Pneimo's gentle vibrations, because you, yeah, So we press the button, yeah and we exhale on the vibration right.

Felix Strobl, pneemo: 22:13

Exactly Now we are taking the Pneimo in our hand, you know with us. Hold it lightly and place your thumb on the band of the belt side. Underneath the band is the power button. You press the power button, pneimo starts to operate, lasting for six seconds, before pausing for four seconds. And then we are coming back, as mentioned before, in this four, six slow paced breathing. You inhale for four seconds and exhale on the vibration signal for six seconds. And trust me, dear listeners here with us in this Pneimo breath exercise, it will take some time. If you're an experienced breath people yoga then it's maybe quicker. If you're new, it takes some time to be in the pace and in this rhythm of the Pneimo. So, on the vibration signal, breathe out and then breathe in.

Alex, X-Health.show: 23:54

I think it's already like four to five breaths It actually. You know, you already can feel the difference if you're not like very stressed, like you know.

Felix Strobl, pneemo: 24:04

I can, imagine.

Alex, X-Health.show: 24:05

We are now not too stressed.

Felix Strobl, pneemo: 24:07

Not too.

Alex, X-Health.show: 24:08

Yeah.

Felix Strobl, pneemo: 24:10

So, yeah, this exactly, and it takes time and I like this, like in music, if you are listening to an orchestra and you want to play an instrument, and it takes some time, you listen to the rhythm of the music and then you're sitting at the piano or you have your instrument or you're singing and then you are in the right rhythm. That's the same, this connection to the breath and this with this device. Yeah, so conducting to lead there and to be with this device in the right rhythm. So this rhythm will repeat for 15 minutes. So, even if you're falling asleep that's which is great It's not connected, there's no screen You can fall asleep with the device, which helps a lot to improve the quality of sleep. And yeah, it takes time when you start breathing with Pneimo, but then after three minutes, five minutes, 10 minutes usually, you feel the effects.

Alex, X-Health.show: 25:07

Yeah, on Pneimocom website you say that Pneimo could help in fear, panic, stress, mild hyperattention, lung disorders, concentration, long COVID sleep problems, addiction, perimenopause, labor and childbirth. I mean that's quite a range. Are there any like no go zones or is there anyone who shouldn't really use this four by six breathing?

Felix Strobl, pneemo: 25:36

So, first of all, i think it's not harming if you're doing the four, six breathing. Yeah, if you're already by nature really relaxed or with fatigue maybe, then it's not the right breathing exercise. You need other ones. But this device is great because it's not harming And the effects you're doing if you do the deep breathing like deep breathing means with a diaphragm If you do the deep breathing it increases and improves the lung function And I think the effects then on the brain and on the tissues and the cellular level it's tremendous. So I would say there is no, no zones or, as you mentioned it before, because it's something natural And a lot of diseases or diseases are linked to the breath And, for example, mild hyper tension.

Felix Strobl, pneemo: 26:30

If you do, for example, with the Pneimo, the straining, breathing, training and you're using really your diaphragm. So we don't have the visuals now, but we can explain it, because if you inhale, your diaphragm goes down or your belly goes out, which is the good way of breathing, and then when you exhale, your belly goes in, what happens? The diaphragm below your chest goes down And there's more space for the heart to pump, which is healthy. So there's a lot of interconnection you can make And, yes, the list is long. Childbirth, yeah, labor. If you do the breath work, if you control pain relief, pain management and asthma, for sure, there's a lot of positive benefits and effects.

Alex, X-Health.show: 27:30

I just wanted to say that, guys, if you have any of the problems mentioned here or any other problems, i mean definitely you should visit your doctor first, right? So I mean Nimo helps, but then, yeah, just go and ask for advice, for medical advice from your medical doctor Now. So Nimo is already available on the website, so you sell it through the website. What's your selling strategy? So you want to sell it to individuals only?

Felix Strobl, pneemo: 28:06

Not only, but yes, we have a lot of orders from individuals now On the website. It's available. It's in the German, the E, the dot com, the webpage, switzerland, in Austria, but everywhere. We have an NGO. In Norway they sell it already. We're fighting panic attacks. They're going on festivals. So yeah, we have.

Alex, X-Health.show: 28:30

Well, tell me a bit more about that. What's that NGO and why would they want the Nimo?

Felix Strobl, pneemo: 28:38

They're already there on our webpage on the first day. It's the NGO Metalheads, yeah, and they support people in their fight against bullying and other difficulties in life And they are a lot of presence on festivals and they resell already Nimo no So in Norway. So our strategy at the moment is to individuals therapists, speech therapists, neurofeedback therapists. Now we have a combatant center, a showress, here in Basel and Zurich. They use it in the curriculum when they educate their students. They use the Nimo because the effects are incredible.

Alex, X-Health.show: 29:17

Like how do they use it?

Felix Strobl, pneemo: 29:18

They use it when you do a neurofeedback session biofeedback. They have EG, this cup you're wearing on your head.

Alex, X-Health.show: 29:27

With wires. Is it the one?

Felix Strobl, pneemo: 29:28

Yeah, exactly EG. And then it happens to the client's patients. They're looking at the screen so it's visual And what they forgot? usually when they're fighting with stress, burnout, concentration, they're forgetting to breathe. So now she said, the owner, the therapist, we have the results and we have data now during the feedback sessions And they said it's incredible They restore with PNimo and without PNimo. And it was so incredible because without PNimo, the sympathetic, it's nothing to do with sympathy, just like this fight or flight.

Alex, X-Health.show: 30:08

Yeah, it's a tricky name.

Felix Strobl, pneemo: 30:09

really It's a tricky name parasympathetic and parasympathetic nervous system, This versus or with or against. So the sympathetic part is really active And when they do the neurofeedback session they're looking at the screen with the EG cap and then they hold the PNimo in their hand and it's like hand in hand. So they do neurofeedback, biofeedback session and at the same time it's a breathing And they had before like something acoustic signal, but now they have with this tactile because of this vibration, And they have really good results. So we see, like then with PNimo, while sympathetic activation is lower, is decreasing, So the parasympathetic is like the way it should be to be in a relaxed state. So, yeah, they ordered a lot of PNimo's for all their students and they will resell it And they said they put it already in the curriculum So to teach it. Ok, they do the sessions And then what we mentioned before, the heart rate variability, and they come in this 4-6 and they see incredible results.

Alex, X-Health.show: 31:25

What are the results? What results are we speaking about? Are we speaking about like they are calmer? Are we speaking? about like they can learn better.

Felix Strobl, pneemo: 31:33

The smoothness. You see, it's like we have all these results, you have all the scientific results and you see the smoothness, green, boom, the spike, so it's positive. You have a lower sympathetic activation, so it's decreasing the sympathetic fight or flight, so they are more calm. So, yeah, if it's I don't know what's the diagnosis or symptom but if it's like lack of concentration, stress, and you activate the parasympathetic nervous system and you learn again to control your breath and you control it in the 4-6, in the extended exhale, then it's really good, healthy. And yeah, we are looking forward to collaborate with other institutions, hospitals, because, as you mentioned, the other strategy, hospitals, emergency services, schools, universities The list is long. The market is huge. Yeah, we are targeting at the moment, Yeah, it's a lot of B2B, but B2C as well. So, yeah, we are looking forward to, hopefully, a bright future.

Alex, X-Health.show: 32:42

This episode is brought to you by The Ex-Holes Show and me. So if you like this podcast, be generous, hit, follow, leave a review. That'll help me invite more such amazing guests for you. Thank you. You mentioned to me that you are launching a pilot with emergency unit paramedics in Bula And you are also a paramedic right.

Felix Strobl, pneemo: 33:06

Yes.

Alex, X-Health.show: 33:07

Tell me a bit more about that.

Felix Strobl, pneemo: 33:09

Yeah, in the past I became a paramedic. I was after high school yeah and I started for a year. It's like a social year service. yeah, Yeah, we did in Germany, but then I like a military service.

Felix Strobl, pneemo: 33:22

Military service, exactly, but I'm a pacifist, yeah, So I've used weapons and so on. So, yeah, I did became a paramedic and it was an incredible experience. It was an experience from the human side. I saw the societal level. you see everything. You see tragedy, you see happiness, you see what it is to real life, yeah, and what it is to appreciate life if you are healthy. And I like it very much because you learn. from the medical point of view, you have this knowledge. I learned from the human level. It was, as I mentioned, incredible Because, yeah, we learned to manage, for example, now, the breathing stress, shortness of breath, but we do not have a device like this, a simple and effective device. So, yeah, we're approaching this pilot with Rettungsdienstbühler, close to the airport Zurich, and we're really looking forward. If the emergency service, you want to see, first of all, the stress level of the paramedics, we did a survey so they will fill out the survey. It's an online survey the stress level and paramedics, they have a high stress.

Alex, X-Health.show: 34:42

Well, I thought they actually need Adrenaline to react quickly.

Felix Strobl, pneemo: 34:49

Yes, you need it And usually if you do this profession, you like it because you never know, you have maybe an indication heart attack or stroke. okay, then you prepare already. what's the algorithm?

Alex, X-Health.show: 35:01

CPR or yeah, but Yeah, you're high on Adrenaline, right.

Felix Strobl, pneemo: 35:06

Yeah, you're high And, as we know, all the time Adrenaline it's not healthy as well And after years and years sometimes it drops a bit, but it's sometimes kind of, yeah, exciting and the Adrenaline level. But it's high stress because they have more and more emergencies coming up. People are calling too quickly the emergency service. Sometimes it's not necessary because that's another discussion about the education, the medical or health education of the society, and so they all the people have the training, so they call too quickly, so they have too many calls, emergency calls, and they need to go to the patients, which is a lot of stress. It's high stress.

Felix Strobl, pneemo: 35:55

Then the shift work, lack of sleep, not the best nutrition because you do not have time. So we talk about fast food and so on, and the list is long. And we want to see how they can implement it in the day. If you have smokers in the team, how you can maybe replace, because at the end of the day smoking is an extended exhale to bring you in this smoothness, calm state of mind, and so to make maybe two groups to the smokers, non-smokers, to find relaxation techniques through the breath, stress relief, and it will be a four weeks pilot program. Then we make. Initially, i need to mention, we make a training with the team. I will go there, train them simple breathing techniques And after this we will see what are the results.

Felix Strobl, pneemo: 36:47

And the next stage will be and it will be our goal and I see hopefully a high potential to bring on the emergency ambulance car. So in the next stage, the terraeumatical scene, the paramethics will use it actually in emergency situations. So, four patients, four patients, so in panic attacks or mild hypertension, medical symptoms where the breath is connected, or you're just you witnessed a car accident, you're not implicated but you witnessed it, and then you're high stress, panic, you're shocked, and maybe through a simple breath device you can manage it because at the end, yeah, it's the fear and the fear center in the brain, again, the migtala, which is important for survival but which is overactive, reactive, and so to calm down with this PNIMO breath device. And yeah, this is like the plan from September on and we are really looking forward to it.

Alex, X-Health.show: 37:58

Now you guys listening. Apart from being a neuroscientist and a paramedic, felix is also a tenor vocalist, so think Pavarotti. Right, that's the voice.

Felix Strobl, pneemo: 38:29

The voice. Yeah, yeah, yeah, i need to eat more pizzas, but I like but become more Pavarotti.

Alex, X-Health.show: 38:39

So in singing, inhaling, exhaling plays crucial role. Right, you also inhale quicker and then exhale slower. What's more into it?

Felix Strobl, pneemo: 38:55

Oh, maybe we could talk about this one hour about this topic, but we make it short. So, yeah, a good singer has a good breathing technique And I had a wonderful Italian opera singer, a mentor, a teacher. He told me Yeah, before we start singing, we start breathing correctly, properly. To manage again, manage and control the breath, because when you think about singing, it's like you exhale and you put your voice or the lyrics on it, like phrasing. Yeah, when you listen to an opera area, it's like this extended exhale, you're phrasing and you put your words on it on the exhale, but before it you need to train it.

Felix Strobl, pneemo: 39:42

Yes, singers are athletes. You mentioned scuba diving, performance capacity, increasing it. It's the same for singers And that's what is exciting to connecting the dots, as you mentioned, the breath in emergency situations, panic, anxiety. Yes, it's the spirit, medic part, then neuroscience, to understand the entire body, the brain, the function, the interrelation, the scientific point of view, reading the studies, what they like.

Felix Strobl, pneemo: 40:11

But this artistic component, yeah, breathing is a critical component of singing And the way you breathe can have a significant impact on the quality of your voice And your performance as a singer in your stage and you have several performance you need to control the breath. You need to work with the diaphragm, with the muscles, otherwise your vocal cords are tired And the act of singing is a coordination of the diaphragm and the vocal cords. You need to coordinate the vocal cords, the muscles of the throat, the mouth and all the muscles controlled by the brain. At the end it's the brain, because, as a singer or as an artist, there are emotions And we are human beings. We are, we have a lot of emotions, which makes life as well So interesting.

Alex, X-Health.show: 41:05

Sometimes, yeah, for the better, sometimes for the worse, right.

Felix Strobl, pneemo: 41:09

But it's like when you're happy, your breath changes. Yeah, when you're sad, your breath changes And that's the breath is connected to every emotion in your life. That's why it is such an interesting topic, yeah. But coming back to the singing voice, yeah, we just had, like this inter connection between the singing, the vocal cords, but as well, the state of mind. You know you need to have the right emotions or not the right emotions, but you'd be emotional Because if you interpret it opera area or a music piece without emotions, it's not that interesting As a listener.

Alex, X-Health.show: 41:53

It's wonderfully put. We spoke about the benefits of breathing on our health, and apparently singing can also impact positively our health. So a long a few years ago I interviewed Ursula Dudjak, a jazz vocalist and a cancer survivor, and basically she told me that her doctor recommended her to continue singing, and especially singing in high notes that she specializes in, to improve her health.

Felix Strobl, pneemo: 42:31

Yes, definitely So, when you sing, you feel better. You sing right or wrong, you sing, you express an emotion, you express a feeling. So, and we know that singing it has to be found in studies to stimulate the release of endorphins Yeah, Exactly.

Alex, X-Health.show: 42:48

So this actually because when she said that, i was like okay, a doctor said that, but there's actually research behind it. now, like, what are the benefits of singing?

Felix Strobl, pneemo: 43:00

You can eat chocolate, but you can sing or you can do both.

Felix Strobl, pneemo: 43:03

But even if chocolate, but yeah, but dark chocolate, yeah, that's important, end of it. But chocolate, just an advice for the listeners. Who wants to be a good performer on stage? Chocolate is not so good for your vocal chords. So this is another point as a singer, You eat what you eat and the way you breathe and how you breathe. It's so important, yeah, but coming back to end of it, it's natural painkillers And, for sure, if this is so wonderful what you just quoted in cancer survivor oncology, it's a natural painkiller and it reduces stress and anxiety. And it's so popular to sing in choir because the social component, yeah, to create like the sound and then to feel better, to live better and to reduce stress and anxiety. You know, after a day at the office and I already met a lot of people, right, they have different jobs and they go singing in the evening, which is wonderful, it's amazing, and you don't need an instrument because your instrument is your body, which is so fascinating.

Felix Strobl, pneemo: 44:12

Yeah, and our body is complex, the way it works And yeah. So singing and proper breathing, definitely just to summarize it Yeah, definitely can have positive effects on both on the brain and the whole body. Yeah, this is a holistic way of the singing and it can improve, it's a mood. It can improve mood, stress, anxiety reduction And it promotes a sense of relaxation and well-being. Yeah, and it's, it's already exists, the singing therapy. Yeah, so the art in health intervention in different settings, because all the positive effects, it's amazing.

Alex, X-Health.show: 44:56

I wonder if there are any studies related to the effects of listening to choir singing, Because I just listened to some choir singing over the weekend and it's also it's amazing how emotionally it impacts you just listening, And I know that you were singing in hospitals, So you know I'm sensing there is something into it.

Felix Strobl, pneemo: 45:27

Yeah, it was just to seal the reaction. It started again when we come to this paramedic story, when I was a paramedic And you know, in a lot of elderly homes there's a piano, and it's just now an anecdote of the past. The colleagues at some time they knew, okay, you are a musician, okay, so every time we saw a piano in hospitals, aldi home, they said, now it's time to play. Okay, i played, and they were wondering There are sometimes wonderful instruments, really, the sound, new. And I saw this grand piano and it was amazed. You know, even the uniform. And we just brought a patient that was transferred back from hospital back to the elder home And then we had some time. So I used the time wisely and went to the piano.

Felix Strobl, pneemo: 46:12

This was one moment There was, it was. It struck me, it was, i was at the piano, It was an elderly home, i was playing and then it was a guy, an older guy, who was in front of the elderly home in a wheelchair. He approached me, then I listened to the music and he said can you play, poor Elise Beethoven? And I said, yeah, he heard this melody, trust me, it was like another man. It was like this flower, like blooming. It was this live and he became alive And it's like, yeah, when you bring the science in choir singing, i don't know, but listening to music in general it's healthy for the brain Because when you're listening to music it's like more passive.

Felix Strobl, pneemo: 46:58

Yeah, when you're doing music, but already the effects, the results are there. If you're listening to music, stress relief, pain relief, you notice dentist, where you have like the headphones, you're listening to music while the treatment to do the stress and the anxious feelings, to relieve it, to reduce it, and yeah, it's, it's, it's amazing. So it's on the neural pathways, there's something that's a firework in the brain. Yeah, When you're listening to music it's. And you're not coming back to this old man in the elderly home. Yeah, it was like clearly a man with dementia, old, but he listened to music and the music it was like boom, it popped up and immediately he has. All the memories came back and he became emotional and he was like he remembered his daughter playing the music piece 60 years ago And this is incredible. But this would be a topic for another episode. Maybe music with Alzheimer's and dementia or brain health prevention.

Alex, X-Health.show: 48:04

There is a topic, definitely And I know there is an association that actually works on it bringing music to people in elderly homes.

Felix Strobl, pneemo: 48:16

Because you know, at the end of the day, it's something holistic, it's something natural and I think Music already babies. You know it's incredible the reaction of music. At the end of day, it's the holistic approach. We are humans, yeah, we have ratio where the cognition, but you have as well the feelings, which makes our behavior. And Music is something natural. The music is all around the world, it's a universal language and it's understood everywhere, in despite Health conditions, yeah, and it's so interesting because it's. It's emotional, this emotional. There's the memory, the expression and it could be both. If you're just listening Yeah, this more passive but still beneficial Approach or you're playing an instrument, then it's a complete firework in your brain and we, we, we know The health benefits of playing instrument could we I mean our listeners, and I have a taste of how You're singing.

Alex, X-Health.show: 49:19

I mean we could also do some you know exercises before, because we don't want to hurt your Vocal cords, right.

Felix Strobl, pneemo: 49:27

Yeah, we never start with a cold body or cold, yeah, vocal cords. You need to warm up. It's, it's like stretching like an athlete again before you on the marathon.

Alex, X-Health.show: 49:41

Yeah, I'd be happy to do these exercises.

Felix Strobl, pneemo: 49:42

Let's do it become a bit physical. We are sitting, we can. Now we can standing up.

Alex, X-Health.show: 49:47

Huh, okay, let's stand up then. Okay, and you guys listening? I mean, yeah, feel free to join if you, if you want to try it.

Felix Strobl, pneemo: 49:56

So first of all, before you start singing, you start with some breath exercise and let's do a breath exercise together. So you place your right hand on your chest and you place your left hand on your belly and now Breathe in for four, three, four and then you breathe out. So Ideally, as we mentioned before, when you inhale, the belly comes out And when you exhale, the belly comes in this process. So try it again right hand on your chest, your left hand on the belly, and just breathe naturally in as long as you want. Let's do together four, four again, four in and four out. And, yeah, feel the sensation like if belly with a diaphragm. That's important to to have like this support when it comes to singing. It's a good singer, good singing is a good breath, yeah, and then when we start it's important for the relaxation of the vocal chords. We can start a bit with humming.

Alex, X-Health.show: 51:46

I Can notice, you are also moving your jaw.

Felix Strobl, pneemo: 52:00

Yes, because you don't fix that. It's really important. It's then the best to the jaw relaxation Good, that's the next one. Thanks for the transition. So the jaw usually we are really tight. It's like when you're speaking or when you're sitting, and sometimes it's so Healthy to implement it in the day. Choreo relaxation, not as the warm-up just before singing. It's like you have a potato in your mouth And sometimes it looks a bit stupid.

Alex, X-Health.show: 52:31

Oh, it's like a big potato.

Felix Strobl, pneemo: 52:34

Yeah, jaw dropped down, dropped completely, and don't force it, just naturally Can you feel something. It's.

Alex, X-Health.show: 52:44

Yeah, i mean, at the beginning I was forcing it, so thank you for that, yeah, and then it's like so, like gently, and you can feel already, like The cheeks, that the muscles I mean they relax a bit.

Felix Strobl, pneemo: 52:58

Yeah. So that's, that's important, because if you're, all this is interconnected then on the vocal chords, and when you're, yeah, the vocal chords are tired here kind of, so don't force it too much natural then Lip, lip trills Let's get, and you know you have a good lip trill. Work with the diaphragm again. So remember again the inhale and exhale. Then, yeah, neck and shoulder relaxation, go gently to the right, go gently to the left, oh, and you hear sometimes Yeah, clicks, clicks and cracks and yeah, so That's as well.

Felix Strobl, pneemo: 54:00

If you're tight and a neck on the shoulder, there's an impact on the on the voice. Yeah, so that's just. And even if you're not seeing, sometimes before you start working a podcast, you can do again. The list, the humming Lip trills.

Alex, X-Health.show: 54:15

That's why I'm asking I'm asking quite selfishly, but I can imagine also like before public speaking, public speaking, speaking presenting before meeting or something like that.

Felix Strobl, pneemo: 54:25

Yeah, and then the deep breathing techniques. Yeah, like again, it should be done for three or five minutes really, like inhale, ideally through the nose, but it doesn't matter. If you don't have the capacity or of the physiology, then breathe into the mouth, it's better. Breathing in through the nose, it's healthier. Yeah, you have these little hairs, especially if you have the cold season out there, and so it's it's kind of a protection, and can you just, maybe me for you? I will do it now. We make now an experiment, dear listeners Once you breathe in through the mouth and out through the mouth, and then you breathe in through the nose and out through the mouth, and can you just Tell me the difference, maybe, how you engage with diaphragm and so first inhale through the mouth and inhale and exhale through the mouth.

Alex, X-Health.show: 55:22

And now through the nose and out through the mouth, yeah, yeah. Well, for me, it's just like I don't like inhaling through the mouth because I feel like I'm hurting my throat, basically, but I I also feel that through the nose I can inhale more. I have no idea.

Felix Strobl, pneemo: 55:46

Yeah, and if you breathe in through the mouth, and it's usually the same The mouth, and it's usually the shallow breathing, and then you're activating, like, for example, before the panne attacks. It's like hyperventilation, just rapid breathing, and uh yeah, usually in daily life It's the wrong breathing coming back at the beginning. Maybe you are like more in the chest, only not chest breathing, and then you activate again the fear, uh, fight and flight, the fear center in the brain and which leads to anxiety, which leads to stress.

Alex, X-Health.show: 56:19

Are you ready now? Oh. Wow, thank you, that was amazing. Thank you very much, felix. What was that?

Felix Strobl, pneemo: 57:09

That was, uh, an excerpt from the opera Xerxes, from geocphreid, the handle ombra mai fu, and you know this is exactly a Wonderful, perfect example of the extended exhale this beginning.

Alex, X-Health.show: 57:29

You're making a circle with your hand.

Felix Strobl, pneemo: 57:30

Yeah, for me now, because we are sitting here or standing in a studio, yeah, this is just to help me a bit, this dynamic, because singing is dynamic like a breathing dynamic. Yeah, and it's like you prepare your body with this good, the inhale, and then you're ready, your place. Yeah, that's a complex place in the mask, the voice, and on the exhale you put the lyrics and you sing on the exhale. So it's a good way of controlling the breath And then you put emotions in and it's complex. That's the instrument, the body, but which makes so mysterious and so interesting and also, you know, like, like my reaction.

Alex, X-Health.show: 58:14

I don't know about you guys listening, but I automatically started smiling, and smiling Wide, when Felix started singing. So that's like immediate, it's a packed. So thank you very much again.

Felix Strobl, pneemo: 58:29

It was a pleasure. It was a pleasure being your guest. Thank you so much.

Alex, X-Health.show: 58:34

Thank you And you guys. If you want to read a bit more about Pneimo, go to Pneimocom, which is P N E E M O dot com. Thanks again, i'm totally impressed by the audacity of researchers than startup founders, doctors, than old reprimands or ordinary parents turned healthcare innovators, people battling the battles that no one thought before for the extra health of the future. So if you see a startup posting on LinkedIn, show them some love, hit like comment. That's fabulous. If you have a couple drops more of that altruism, follow the x-hall show, leave a review here. I'll be able to bring more of these visionaries to you. So a big thank you. You're awesome. See you next week.

Speaker 3: 59:19

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