Show HN: I'm a doctor and made a responsive breathing app for stress and anxiety (lungy.app)
My background is as a junior surgical trainee and I started building Lungy in 2020 during the first COVID lockdown in London. During COVID, there were huge numbers of patients coming off ventilators and they are often given breathing exercises on a worksheet and disposable plastic devices called incentive spirometers to encourage deep breathing. This is intended to prevent chest infections and strengthen breathing muscles that have weakened. I noticed often the incentive spirometer would sit by the bedside, whilst the patient would be on their phone – this was the spark that lead to Lungy!
The visuals are mostly built using Metal, with one or two using SpriteKit. There are 20 to choose from, including boids, cloth sims, fluid sims, a hacky DLA implementation, rigid body + soft body sims. The audio uses AudioKit with a polyphonic synth and a sequencer plays generated notes from a chosen scale (you can mess around with the sequencer and synth in Settings/Create Music).
There are obviously lots of breathing and meditation apps out there, I wanted Lungy to be different - it's about tuning into your surroundings and noticing the world around you, so all the visuals are nature-inspired or have some reference to the physical world. I didn’t like other apps required large downloads and/or a wifi connection, so Lungy’s download size is very small (<50MB), with no geometry, video or audio files.
Lungy is initially a wellness app, but I’d like to develop a medical device version for patients with breathing problems such as asthma, chronic obstructive pulmonary disease (COPD) & long COVID. Thanks for reading - would love to hear feedback!
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[ 4.8 ms ] story [ 316 ms ] threadFor the first year or so it was self-developed and self-funded, and then in 2021 I won a couple of grants to develop the prototype for release. I don't suggest it directly to patients as there would be a conflict of interest, but I'm hoping it could be useful in both respiratory disease and stress/anxiety.
Never had an easier time porting UI to so many, different platforms.
Flutter alone saved a year of work.
I’m any case, the app looks polished.
If you get some traction you might consider porting the app to run on smart watches. Current Garmin wearable devices are apparently able to detect individual breaths using the wrist optical heart rate sensor based on slight difference in heartbeat timing. They have a breathwork app built in but functionality is very limited.
And on this embeded video I couldn't even change the volume!
It's frustrating me to the point that I just opted not to watch the video on this website :(
Maybe it's CDN location serving up the videos? I'm near Toronto. Also I checked your webpage and perhaps, by being in the business of video streaming, you're more attuned to these things than the average person? (P.S. your website is so elegant!)
I was actually going to say, Wistia has a nice player but it’s expensive - and then I just checked their pricing and they actually have lowered prices quite a bit! There’s even a generous free tier now.
I’ve also been curious about how hard it’d be to self-host an embedded video. Naively it seems like the hardest part would be encoding it into a bunch of sizes and chunks… and then keeping an eye on bandwidth. I found a good blog on it a while ago and can’t find it now.
Is there a paper showing the accuracy of measuring breath volume and frequency using a phone microphone as compared to other known methods (i.e, medical sensors, but also more consumer-focused devices such as chest straps)? The frequency seems like an easy problem to solve, volume much less so.
Sure hope you meant per minute!
Brief structured respiration practices enhance mood and reduce physiological arousal
https://www.cell.com/cell-reports-medicine/fulltext/S2666-37...
A small portion of the app reminds me of this demo: https://paveldogreat.github.io/WebGL-Fluid-Simulation/ (click/tap/drag)
Lung diseases aside, I think many people would be interested in an app that lets them know when their breathing becomes shallow or non-tidal, and helps them refocus and get back to baseline.
A question for you: I have a relative who has been recovering from a pneumonectomy – is this a use case that you currently support or plan to support in the future (i.e. are the breathing exercises on the app similar to the ones prescribed for these patients)?
EDIT: found it: https://somnox.com/
They are quite expensive.
(Not affiliated)
https://bradbarb.in/emdr/demo/
Fwiw
GP’s site is just a non-commercialized prototype so seems more like showing vis level of interest vs self promotion.
Thanks!
I had to pause a bit for this while reading the page. This was a brand new phrase for me, never expected to see it in a mobile app.
What a boring future, "pay $9.99 to unlock this secret tip to survive in case you have trouble breathing!"
health is not a thing that should available with a pay-wall, we must advocate for a better world
- I like the concept as I was using mindfulness app mostly for the breathing exercises but ended up downloading the video and playing it to myself. I like that the whole app is just around this.
- I personally would enjoy a mood tracker and a daily notification or quiet time moment reminder to increase adherence.
- on top of this some motivational aspects and smileys can help :)
Good job by the way.
PS: I manage a patient facing MS app will many trackers:).
One of my COVID readings was Breath: The New Science of a Lost Art, by James Nestor. Its author says, "humans have lost the ability to breathe correctly". Like your app, it proposes a lot of breathing exercises. It explains their benefits in terms of increasing CO2 tolerance, and believes that we've all got too much O2 in our systems.
That smells like horse puckey to me, but I've been unable to find an informed review either way. I'm sure that slow, deep breathing as a focus for meditation is a very good thing, and I'm sure that your particular app is well founded. But I'm curious to know if you've read that particular book, and what your opinions are.
Thanks!
For practicing breath holding, "co2 tables" is the exercise to go for, btw. I find it very relaxing in a sort of meditative "ignore the burning pain" sense, but not sure I'd recommend it vs the app in the OP hehe.
Breath exercises that increase CO2 tolerance like Buteyko breathing allow one to interrupt this process. It's not clear to me exactly what the increased CO2 is doing, if anything, but it's clear that this works to escape this chronic stress state, which is really unhealthy.
I think the Radiolab breath episode discusses this well: https://radiolab.org/episodes/breath
[1] https://pubmed.ncbi.nlm.nih.gov/11015814/
I noticed I would get fairly fatigued, and have to take a nap around 11am every morning, and eventually found that it was basically every 4-5 hours, even mid-day too. I would take a 10-20m power nap and usually wake up feeling really good, I would even hit REM in that time.
Then a few months ago, I noticed when I was having this feeling I was usually ruminating about something, and it was something like grappling or repressed anger, AND what this did was cause very shallow breathing and "breath holding" patterns. And I've been doing a lot of work around Gabor Mate, MD's work lately and processing trauma responses so I was able to identify this and feel the feelings in a more present way, and in doing so, start very intentional deep, slow breath and exhales.
Compared to my shallow breathing and holding, my breaths became like 3-4x longer. And... to my surprise, the fatigue would pass in about 5minutes or so and I would not need a nap, and get my brain back to an "alert" state, as opposed to that "foggy" state.
I have been doing this for months now, and it keeps working. And now, this was really blurry because sometimes I would be genuinely tired from sleep debt from pulling a late night, and it was a similar feeling. So when I get a solid nights sleep for multiple nights in a row, then the breathing works to keep me alert, and helps me get more in touch with my emotions and subconscious thoughts rise up and become concious. I can detect the shallow breathing/breath holding fairly well now, but not always, and it is still a work in progress to make these breaths the default. The breathing does help me move through life much better now, and I walk slower, and not so rushed, and am more at peace with doing things in the present.
This actually wouldn't really be possible though if it weren't for a discovery that I breathed through my mouth my whole life (40 years) recently too. I learned about the "nasal cycle" and in combination with a deviated septum I have, my nose would plug up every now and then with no rhyme or reason, I thought it was diet for a long time but eventually learned about the "nasal cycle" where the turbinates in our noses swap the swelling to change the airflow every 4-6 hours or so. And when it swapped to my non-blocked septum side, my airflow would stop and I would be forced to breathe through my mouth. What this meant is that I could never develop a habit of nasal breathing my entire life. I started using Afrin about 5 months ago, and then stopped because it says not to use it continuously and you get a rebound when you stop using it. But then I found a Ear Nose Throat doctor/surgeon and presented my hypothesis to him and he confirmed that the nasal cycle + deviated septum hypothesis was correct! And he suggested I use Afrin plus a nasal steroid (Sensimist) together and that will reduce the rebound effect and that enabled me to use Afrin long term to stop the natural swelling of the turbinates in my nose. And, so I've been using Afrin for 3 months now and can breath so good through my nose now, and it is so sweet, and so precious, I can't imagine going back to mouth breathing ever again. I do have increased sensitivity to cold with the Afrin and my nose drips like a faucet. Or maybe that was because I never breathed through my nose in the cold to begin with? Regardless, I need to bring tissues with me in cold weather wherever I go.
And that leads to the fact that now when I noticed the breathing pausing, I can take big deep breaths through my nose and it feels so good, and calming, I can break out of the trauma/anxiety cycle and self-regulate with breathing.
I think the breathing cycle issue is mostly a trauma response from a young age and then it turns into a learned habit. This is the result of a caretaker not being there for me/us to help us self-regulate at a young age. The Wisdom of Trauma film and In the Realm of th...
-I have the exact same issue, I feel overwhelming fatigue that lifts with a 10 minute nap, and need to do it many times per day. I work from home, and can't really work in person because without a nap I just crash, despite getting a good nights sleep -My girlfriend pointed out that I normally breath unusually fast and shallow, about twice as fast as her -I've had some very traumatic experiences in the last few years that I still haven't dealt with fully. Around the time of these experiences I couldn't sleep well because I had to constantly get up to urinate, and also at the same time felt an "air hunger" where I felt no amount of breathing was enough
Could you recommend something specific to start working on with these things? I actually just started reading the Mate book "The Myth of Normal" but haven't gotten very far in it yet.
It seems like there are quite a few people here discovering these things, I wish we could form a discussion group or something.
I hope you've been checked for diabetes?
Second thing, do you have chronic pain? That will keep the body in a stress response. Chronic pain is actually easier to get rid of than I thought, and I tried a lot of things for 20 years. The new research at University of Colorado Boulder, using functional MRI scans in 2020 proves that much chronic pain can be eliminated in a short period with a very specific technique called Pain Reprocessing Therapy (PRT), which is a compassion-based therapy. This is a really, really hard thing to believe, and one doesn't have to believe it fully, they just have to believe it enough to be curious and learn more. And if one is curious, I recommend listening to a 15 episode mini-series podcast called Tell Me About Your Pain by Alon Gordon (Pain Pyschologist) and Alon Ziv (Neuroscientist), then after that listen to the audio book (not ebook) by the same people called "The Way Out" (2022). Then there are 6 specific meditations by Alan Gordon on an app called Curable that I used to eliminate my chronic neck and back pain, I can dig up the link to them if you like. This same technique is what I use to react to my shallow breathing and fatigue with deeper breathing. This got me sleeping through the night.
Third, the trauma therapy (it isn't if we have trauma, it is how much), I recommend starting with the film The Wisdom of Trauma. And if that is interesting then reading In the Realm of Hungry Ghosts. Myth of Normal seems like a great book too, I haven't read it yet though but it is on my list. I did start reading Gabor's AD(H)D book Scattered Minds a while back, way before this breathing breakthrough surfaced and need to finish it, but to sum up one thing I learned I have ADD-Like symptoms and this whole shallow breathing thing I have noticed is a large part of it. Once I start conscious breathing, by ADD-like stuff reduces. I've been more motivated to actually exercise and not fall asleep doing it, and I have been working on cold-exposure therapy (What Doesn't Kill Us by Mark Carney, investigative journalist who tried to debunk Wim Hoff, ended up drinking the Koolaid, and explains why). The cold-exposure increases the chemical called norepinephrine, which is one of the chemicals that Adderall increases (along with Dopamine). There is a quote from the film "My Octopus Teacher" (fantastic film) where he says "the cold really upgrades the brain" and references him diving into the ocean without a wetsuit almost every day for a year making friends with an octopus. I really like that quote. The cold does help me think when I do it, and I am still easing into it, and getting my brain back.
All in all, I feel at a really new phase of my life, and that includes this thing called "Hope". I no longer think my fatigue is caused by my diet, and in fact I know it isn't.
I'm happy to chat about this with you or anyone else. I'm also open to saying "hi" on a real-time communication (RTC) chat here https://cal.com/ElijahLynn.
Be careful of the "rebound" effect with nasal sprays. Years ago I was "hooked" on Afrin. Not in a getting high sense but in the sense that I started to constantly need it in order to breath out of my nose, even after my cold went away. It was a terrible feeling and took weeks to wean off.
With a bad cold and miserable congestion, nasal spray like Afrin is like a miracle. I still use it in those instances but only for 2-3 days max and very sparingly.
If you really can't breath out of your nose well see a doctor.
https://www.mayoclinic.org/diseases-conditions/allergies/exp...
https://www.goodrx.com/conditions/nasal-congestion/rebound-c...
I don’t snore, I am not overweight.
And I had some ADHD like symptoms.
My doctor didn’t think that it would be useful to test but I insisted, lack of sleep was making me desperate. I took at least three naps a day just to be able to function.
The results were surprising even to me, AHI of 23.
CPAP treatment has been life changing.
I read the book a week ago, said, why not. Instant improvement. Before, I'd have to wake up to go to the bathroom every night for the past 10 years, and when I woke up I'd have this eye pain every day leading to these giant eye bags. On top of those, if I didn't get that last sleep cycle in, I'd have to take a nap to get rid of this weird headache which made the time in the morning before nap seem pointless. In the book he mentioned how face skin can improve, and less bathroom in the middle of the night because apparently the body releases something to tell the body to hold water because we're sleeping. Mouth breating at night didn't cause this to happen.
I did the mouth tape and instantly, first night and every night in the past week, eye pain is gone, I don't have get up to use the bathroom, and the amount of consistent energy is absurd compared to before.
Seriously, I want to shout it out to everyone to tape their mouths at night.
If you might have that anxiety, I'd say try putting tape on your mouth during the day at times to get used to it, and you might find you'll forget about it and that can ease the worry. It might be difficult, but we all can breathe only through our noses, even if that requires some practice and reassurance.
I especially enjoy how the nasal cycle with nose breathing just seems to physically “halve” colds. Even with a cold with nose breathing one nostril just opens up at night in order to let me breathe.
Watch this guys two videos on a DIY CPAP. https://www.youtube.com/watch?v=g8JzXEoT9LI
I never felt a sense of uncomfortableness, it felt almost comfortable for me as if the tape was making me feel more secure, maybe? Similarly I didn't have the worry about not being able to breathe and not know about it. In both those cases, don't feel weird about wearing some around when waking and you can get used to it.
The other mindset to have is remember that our bodies are really incredible at things after millions of years of evolution. Nose breathing especially is something we're able to do. That acknowledgement and trust can go a long way mentally.
A quick suggestion, I’d love to see you add the “cyclic sighing” pattern from [1] as it’s recently gotten some amount of attention for it’s effectiveness, and is potentially less common than the others.
[1]: https://www.cell.com/cell-reports-medicine/fulltext/S2666-37...