Why Singers Die Early: Changes in Breathing and Body O2

Thousands of singers die much earlier than the average life expectancy. Here are just a few famous names with their life span:
- Whitney Houston, 48
- Amy Winehouse, 27
- Michael Jackson, 50
- Elvis Presley, 42.

It is possible to notice that, among different groups of singers, typical life expectancy of opera signers is greater. However, many of them still had reduced life expectancy.
- Luciano Pavarotti, 71
- Elizabeth Connell, 65.

While there were many opera singers who lived up to their 80s and even 90s, the general situation with signers is horrible. There were dozens of famous singers who died in their 20s:
- Darby Crash (aka Bobby Pyn) 22
- Selena 23
- Andrew Wood 24
- Tammi Terrel 24
- Johnny Ace 25
- Tupac Shakur 25
- Gram Parsons 26
- Kurt Cobain 27
- Jim Morrison 27
- Jimi Hendrix 27
- Janis Joplin 27
- Big Pun 28
- Tim Buckley 28
- Bradley Nowell 28
- Shannon Hhoon 28
- Hank Williams 29.

And some singers died even in their teens:
- Bethany Durose, 17
- John Spence, 18.

Why do singers die early? Some researchers suggested that singers have stressful lives, and being famous is a negative factor that makes them prone to chronic diseases, addictions, suicides, and poor health. This idea is not correct since dozens of music conductors had very long lives. Here are some famous names:
- Arturo Toscanini, 89.
- Nadia Boulanger, 90
- Leopold Stokowski, 95
- Pablo Casals, 96
- Blanche Honnegger Moyse, 101.

Obviously, conductors have no less stress than singers and often even more responsibility in their work.

The most likely cause of poor health of singers lies in physical causes that relate to their professional work (i.e., singing). Singers often spent up to 4-5 hours daily with signing, and this produces a profound negative effect on their basal breathing patterns. The physiological effects of singing that we are going to consider here will explain development of chronic diseases and addictions.

Firstly, note that chronic diseases and addictions are always accompanied by low body-O2 levels and reduced brain O2 content. For many diseases, low body O2 content is the main driving force. We can consider many serious health problem like heart disease, cancer, diabetes, and asthma. There are dozens of studies that testify that low O2 in cells is the key cause for development of these diseases.

Hence, in order to solve the puzzle of early deaths in singers, we need to analyze effects of singing on basal breath patterns and body O2. Singers are commonly taught to sing with abdominal breathing to improve the quality of voice. This is a positive factor since chest breathing that is present in most modern people dramatically reduces blood O2. However, singing requires increased flow of air or ventilation.

The medical norm for minute ventilation is nearly 6 L/min at rest for a sitting 70-kg person. Such breathing ensures nearly ideal blood O2 (nearly 98 %) and normal arterial CO2 (nearly 40 mm Hg). Since singing takes place in a standing posture, the norm for ventilation would be slightly higher or about 7 L/min. Hours of singing are done with much greater ventilation ranging from about 12 up to 20 L/min. This hyperventilation (breathing much more than the medical norm) resets the breathing center to increased ventilation days and nights. Our next step is to consider effects of hyperventilation on body O2.

Hyperventilation could not boost blood O2. One could breathe in also two times below the healthcare standard, or 5 fold more, nonetheless in all these circumstances O2 content in the arterial blood is going to be practically at the highest amount (roughly 97-98 %). In actual living, blood oxygen amount will be approximately exactly the same.

On the other hand, hyperventilation minimizes alveolar carbon dioxide levels together with blood carbon dioxide quantity. This loss triggers constriction of blood vessels and the reduced Bohr effect. Therefore, hyperventilation becomes the crucial reason for lessened oxygen concentrations in body tissues.

Obviously, low body O2 also means low brain O2. Moreover, in conditions of hyperventilation, apart from lack of O2, the brain suffers from low CO2 that is another crucial chemical for normal function of nerve cells. This effect takes place due to low arterial CO2 levels. With reductions in brain CO2, nerve cells become over-excited. That leads to "spontaneous and asynchronous firing of neurons" (see medical references for CO2 effects below). In other words, low arterial CO2 causes appearance of problems with sleep, mood swings, anxiety, panic, and addictions. It has been known for many decades that hyperventilation is the foundation for nearly all psychological, psychiatric and neurological problems.

Of course, not all signers acquire heavy basal breathing patterns, diseases and addictions. There are tens of other factors that influence breathing, including exercise, sleep, diet, posture, and many others. Most influential negative factors are individual, and they include exercise with mouth breathing, supine sleep, poor posture, poor diet and many others. Generally, only some people are able to successfully counteract negative effects of hours of hyperventilation on body-O2 content.

With developing hyperventilation, people get reduced results for the DIY body oxygen test. Chronic diseases, such as cancer, heart disease, and asthma develop when a singer has genetic predisposition to a particular disease and less than 20 seconds for body-O2 test, while the normal value is about 40 seconds. This happens when this singer breathes over 2 times more than the medical norm. If body O2 drops below 10 seconds, there is an immediate danger of heart attack, stroke, seizures, asthma attack, or some other severe exacerbation.

The solution to this problem of early deaths in singers is to keep body O2 over 20 seconds 24/7. This is the minimum level that guarantees ordinary health levels. With application of breathing techniques, it is possible to achieve normal minute ventilation and normal O2 values in tissues. Furthermore, high body O2 and CO2 values profoundly improve quality of voice in singers due to relaxation and expansion of smooth muscles of airways. This graph below provides some clues why singers of the first half of the 20th century had more melodic voices.

In general, due to varieties of factors, people used to breathe almost 3 times less. This tendency should be also present in signers living several decades ago.

Among most effective techniques for higher body O2 are the Frolov breathing device (Breathslim is an American version of this Russian device), Amazing DIY breathing device and lifestyle factors related to the Buteyko breathing method.

On a practical note (since I taught breathing retraining to some singers), too much singing can prevent a person from getting over 30 s for the body oxygen test or be a hindrance even at lower numbers. For many people with up to 2-4 hours of daily singing, it is best to take a break for some weeks and get 30+ or even higher body O2 numbers. Later the same person will be surprised by a greatly improved quality of his or her voice.

Lifestyle factor:	Body oxygen < 30 s	Body oxygen > 50 s
Energy level	Medium, low, or very low	High
Desire to exercise	Not strong, but possible	Craving and joy of exercise
Intensive exercise with nose breathing	Hard or impossible	Easy and effortless
Typical mind states	Confusion, anxiety, depression	Focus, concentration, clarity
Craving for coffee, sugar and junk foods	Present	Absent
Addictions to smoking, alcohol, and drugs	Possible	Absent
Desire to eat raw foods	Weak and rare	Very common and natural
Correct posture	Rare and requires efforts	Natural and automatic
Sleep	Often of poor quality; > 7 hours	Excellent quality; < 5 hours naturally

Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours

References: pages about CO2 effect:
- Vasodilation: CO2 expands arteries and arterioles facilitating perfusion (or blood supply) to all vital organs
- The Bohr effect: How and why oxygen is released by red blood cells in tissues
- Cell oxygen levels: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.

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