Small Pause, Big Clues: Understanding Breathing Efficiency & the BOLT Score.

Understanding the Control Pause, BOLT Score & Your Breathing Efficiency!

At Funny Face Myo, we talk a lot about nasal breathing.

But how do we actually measure breathing efficiency?

Two simple tools we use to assess functional breathing patterns are:

• The Control Pause (CP)

• The BOLT Score (Body Oxygen Level Test)

These are gentle, non-stressful ways to understand how well the body tolerates carbon dioxide, which is a key marker of breathing efficiency.

Let’s break it down.

First: Why Carbon Dioxide Even Matters

Most people think breathing is all about oxygen.

But efficient breathing is actually about balance.

Carbon dioxide (CO₂) is not just a waste gas, it helps:

• Release oxygen from hemoglobin to tissues

• Regulate blood pH

• Support calm nervous system function

• Influence airway tone

  
  

When someone chronically over breathes (even subtly), CO₂ tolerance drops.

And that can show up as:

• Mouth breathing

• Frequent sighing

• Snoring

• Anxiety or restlessness

• Poor sleep quality

• Cold hands and feet

• Exercise intolerance

This is where the Control Pause and BOLT score come in.

All the information collected and written about today has been studied and published by The Oxygen Advantage & The Buteyko Method Clinic. Two GIANTS in airway and functional breathing.

What Is the Control Pause (CP)?

The Control Pause is a simple breath-hold test done after a normal exhale.

It measures how long someone can comfortably pause / hold their breath before the first natural urge to breathe.

Not a max hold.

Not pushing.

Just the first gentle desire to inhale.

It gives insight into:

• CO₂ tolerance

• Breathing volume habits

• Nervous system regulation

  
  

How It’s Done (Simplified Version)

1. Sit upright and breathe normally for 1–2 minutes.

2. Take a normal inhale.

3. Take a normal exhale.

4. Pinch the nose and hold.

5. Stop timing at the first sign of:

   • Swallowing

   • Neck tension

   • Diaphragm movement

   • Urge to breathe

   
   

Then resume calm nasal breathing.

That time (in seconds) is your Control Pause.

What Is the BOLT Score?

The BOLT score (Body Oxygen Level Test) is a standardized version of the Control Pause developed by Patrick McKeown, founder of the Oxygen Advantage® method.

It follows the same principle, measuring the functional breath-hold after a relaxed exhale, without strain.

The key difference:

The BOLT score is specifically interpreted as a marker of functional breathing efficiency and CO₂ tolerance.

What Do the Numbers Mean?

For adults and children (general guideline):

40+ seconds

• Excellent breathing efficiency

• Good CO₂ tolerance

• Typically quiet nasal breathing

20–30 seconds

• Functional but room for improvement

• May have mild symptoms (snoring, occasional mouth breathing)

10–20 seconds

• Reduced CO₂ tolerance

• Likely habitual mouth breathing

• Possible sleep-disordered breathing patterns

Under 10 seconds

• Significant breathing inefficiency

• Often associated with:

  • Chronic mouth breathing

  • Snoring

  • Restless sleep

  • Airway concerns

For children, we ideally want to see a BOLT score moving toward 20+ seconds and improving over time.

Why This Matters in Myofunctional Therapy

At Funny Face Myo, we don’t just look at tongue strength and lip seal.

We look at the whole breathing system.

If a child / teen / adult:

• Has a low BOLT score

• Mouth breathes at night

• Snores

• Has a narrow palate

• Struggles with endurance

Then breathing retraining becomes part of the plan.

Because strengthening the tongue without addressing breathing patterns is like fixing the roof while the foundation is unstable.

Can the BOLT Score Improve?

Yes, and that’s the exciting part.

With:

• Consistent nasal breathing

• Proper tongue-to-palate rest posture

• Reduced over breathing

• Gentle CO₂ tolerance training

• Habit elimination

• Collaborative airway referrals when needed

We often see BOLT scores gradually increase over weeks to months.

And as they improve, we may also see:

• Better sleep

• Improved focus

• Less snoring

• Calmer nervous system patterns

Important Notes

The Control Pause and BOLT score:

• Are not diagnostic tools

• Do not replace medical evaluation

• Should not be pushed or forced

• Should never create distress

They are simply functional indicators that help guide therapy decisions.

Breathing Is Foundational

If the breath isn’t efficient, everything else works harder.

Jaw development, tongue posture, sleep, even behavior.

Sometimes the smallest pause (measured in seconds) tells us the biggest story.

If you’re curious about your child’s breathing efficiency or want to explore airway-focused myofunctional therapy, I am here to guide you gently and thoroughly.

Because better breathing isn’t about holding longer or ONLY about the inhale.

It’s about breathing smarter, less and more intentional.

Thanks for your time reading :)

-Ashley

Funny Face Myofunctional Therapy 🤍