Conquering the Convulsions: Your Definitive Guide to Silencing Hiccups
The sudden, involuntary spasm of a hiccup can strike at the most inconvenient times, transforming a pleasant conversation into an embarrassing ordeal, or disrupting a quiet night’s sleep. While often harmless and fleeting, persistent hiccups can be incredibly frustrating, even debilitating, disrupting daily life and causing discomfort. This comprehensive guide will delve into the physiological mechanisms behind hiccups, explore a vast array of effective remedies – from age-old folk cures to modern medical interventions – and empower you with the knowledge to conquer even the most stubborn bouts. We’ll strip away the myths and superficial advice, providing you with actionable strategies and a deep understanding of this peculiar bodily phenomenon.
Understanding the Uninvited Guest: What Exactly Are Hiccups?
Before we can effectively battle hiccups, it’s crucial to understand their origins. A hiccup, medically known as singultus, is an involuntary spasm of the diaphragm, the dome-shaped muscle located at the base of your lungs that plays a crucial role in breathing. This spasm causes a sudden intake of breath, which is then abruptly stopped by the closing of your vocal cords (glottis), producing the characteristic “hic” sound.
The hiccup reflex arc is a complex neurological pathway involving several nerves:
- Phrenic Nerves: These nerves originate in the neck and travel down to innervate the diaphragm. Irritation or stimulation of these nerves is a primary trigger for diaphragmatic spasms.
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Vagus Nerves: These extensive nerves connect the brain to many organs, including the stomach, esophagus, and diaphragm. Problems within the digestive system, for instance, can activate the vagus nerve and lead to hiccups.
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Sympathetic Nerves: These nerves are part of the autonomic nervous system, which controls involuntary bodily functions.
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The Brainstem: This lowest part of the brain acts as the control center for many vital functions, including breathing and the hiccup reflex.
Essentially, anything that irritates or stimulates this complex pathway can initiate a hiccup.
Decoding the Triggers: Why Do We Hiccup?
Hiccups are surprisingly common, and their triggers are diverse, ranging from simple dietary choices to more serious underlying medical conditions. Understanding these common culprits can often help in prevention and effective treatment.
Dietary and Lifestyle Triggers: The Everyday Offenders
Many hiccups are benign and self-limiting, often provoked by our eating and drinking habits or certain lifestyle factors.
- Eating Too Quickly or Swallowing Air: When you eat or drink rapidly, you tend to swallow more air. This excess air can distend the stomach, putting pressure on the diaphragm and triggering spasms.
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Overeating: A very full stomach, regardless of how quickly it was filled, can also press against the diaphragm, initiating hiccups. Think of that uncomfortable feeling after a large holiday meal.
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Carbonated Beverages: The bubbles in sodas, sparkling water, and other carbonated drinks are essentially gas. Consuming these can lead to gas buildup in the stomach, mimicking the effect of swallowed air.
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Alcohol Consumption: Alcohol can irritate the esophagus and stomach, potentially activating the vagus nerve. Furthermore, excessive alcohol consumption can lead to general irritation of the digestive tract and diaphragm.
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Spicy Foods: Capsaicin, the compound responsible for the heat in chili peppers, can irritate the nerves in the esophagus and stomach, which are part of the hiccup reflex arc.
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Sudden Changes in Temperature: Rapid temperature shifts, like drinking a very cold beverage on a hot day or stepping into a cold shower, can sometimes shock the phrenic or vagus nerves, causing hiccups.
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Excitement or Stress: Emotional states like excitement, anxiety, and stress can lead to changes in breathing patterns and nervous system activity, which in turn can trigger hiccups. The fight-or-flight response can sometimes manifest in this peculiar way.
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Gastroesophageal Reflux Disease (GERD) and Heartburn: Acid reflux can irritate the esophagus, a pathway close to the diaphragm. This irritation can easily set off the hiccup reflex.
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Smoking: Inhaling smoke can irritate the diaphragm and respiratory passages, leading to hiccups.
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Chewing Gum: Similar to eating quickly, chewing gum can cause you to swallow excess air, which can then contribute to hiccups.
Medical Conditions: When Hiccups Signal Something More
While most hiccups are harmless, persistent or recurrent hiccups (lasting more than 48 hours) can sometimes be a symptom of an underlying medical condition. In these cases, it’s crucial to consult a healthcare professional.
- Central Nervous System (CNS) Disorders: Conditions affecting the brain or spinal cord can disrupt the hiccup reflex pathway. Examples include strokes, tumors, multiple sclerosis, encephalitis, and meningitis.
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Nerve Irritation: Any condition that irritates the phrenic or vagus nerves can cause hiccups. This could include a tumor in the neck, chest, or abdomen, a goiter, or even a hair or foreign object in the ear canal irritating a branch of the vagus nerve.
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Respiratory Conditions: Pneumonia, pleurisy (inflammation of the lining of the lungs), asthma, and other lung conditions can sometimes irritate the diaphragm and lead to hiccups.
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Cardiovascular Conditions: In rare cases, a heart attack or an aortic aneurysm can irritate the diaphragm or vagus nerve, causing hiccups.
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Gastrointestinal Disorders: Beyond GERD, conditions like gastritis, peptic ulcers, pancreatitis, or inflammatory bowel disease can all irritate the digestive system and lead to hiccups.
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Kidney Failure: Uremia, the buildup of toxins in the blood due to kidney failure, can sometimes trigger hiccups.
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Metabolic Disorders: Electrolyte imbalances, diabetes, and other metabolic disturbances can occasionally be associated with persistent hiccups.
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Certain Medications: Some drugs, including benzodiazepines, barbiturates, corticosteroids, and opioids, can have hiccups as a side effect.
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Surgery: Post-operative hiccups are not uncommon, especially after abdominal or chest surgery, due to irritation of the diaphragm or nerves during the procedure, or even from anesthesia.
The Arsenal of Remedies: Your Actionable Guide to Stopping Hiccups
Now for the crucial part: how to make them stop! The sheer number of home remedies for hiccups is a testament to their annoying persistence. While some are anecdotal, many work by interrupting the hiccup reflex arc through various mechanisms.
Breathing and Respiratory Maneuvers: Manipulating Your Airflow
These techniques aim to increase carbon dioxide levels in your bloodstream or otherwise disrupt your breathing pattern, which can reset the diaphragm.
- Hold Your Breath: This is perhaps the most common and often effective remedy. Inhaling deeply and holding your breath for 10-20 seconds increases the carbon dioxide in your lungs and bloodstream, which can calm the diaphragm. Example: Take a slow, deep breath, fill your lungs completely, and hold it. Count slowly to ten, then exhale gently.
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Breathe into a Paper Bag: This method also increases carbon dioxide levels. Example: Cup a small paper bag over your mouth and nose, ensuring a good seal. Breathe slowly and deeply into the bag for 10-15 breaths. Do not use a plastic bag, as this poses a suffocation risk.
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Gargle with Water: The act of gargling stimulates the vagus nerve, potentially overriding the hiccup reflex. Example: Take a mouthful of water and gargle vigorously for 30-60 seconds. Repeat if necessary.
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Take Slow, Deep Breaths: Sometimes, simply focusing on controlled, diaphragmatic breathing can help to regulate the diaphragm and break the spasm cycle. Example: Lie down or sit comfortably. Place one hand on your chest and the other on your abdomen. Inhale slowly through your nose, feeling your abdomen rise. Exhale slowly through your mouth, feeling your abdomen fall. Focus on making your breaths longer and deeper.
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Knees to Chest: This position can compress the diaphragm, which sometimes helps to reset it. Example: Lie on your back and pull your knees up to your chest, hugging them firmly for a minute or two.
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Lean Forward: Bending at the waist can compress the diaphragm and may provide relief. Example: Stand up straight, then slowly bend forward from your waist, trying to touch your toes (or as far as comfortable). Hold for a few seconds, then return to standing.
Dietary and Swallowing Techniques: Affecting the Vagus Nerve and Diaphragm
These methods often work by stimulating the vagus nerve or by physically distracting the diaphragm.
- Drink a Glass of Water Quickly: The continuous swallowing can stimulate the vagus nerve and provide a distraction to the diaphragm. Example: Gulp down a glass of water (8-10 ounces) without pausing for breath.
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Drink from the “Wrong” Side of the Glass: This awkward drinking position requires you to bend over significantly, compressing the diaphragm and potentially stimulating the vagus nerve. Example: Fill a glass with water. Bend forward from your waist. Place your lower lip on the opposite rim of the glass and sip the water. This will feel unnatural, but it’s the point.
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Suck on a Lemon Wedge (or a Spoonful of Vinegar): The strong, sour taste can shock the system and stimulate the vagus nerve. Example: Take a thin slice of lemon and suck on it for a minute. Alternatively, a teaspoon of apple cider vinegar can be used.
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Eat a Spoonful of Sugar or Honey: The granular texture of sugar or the thick consistency of honey, when swallowed, can provide a strong sensory input that might interrupt the hiccup reflex. Example: Place a teaspoon of granulated sugar directly on your tongue and swallow it without water. Allow it to dissolve slowly, or try to swallow it in one gulp.
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Swallow a Tablespoon of Peanut Butter (or Nutella/Almond Butter): The thick, sticky consistency forces a deliberate swallowing action that can stimulate the vagus nerve. Example: Take a full tablespoon of peanut butter and slowly work it down your throat without drinking anything immediately.
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Gag Yourself (Carefully!): Stimulating the back of your throat (the uvula or soft palate) can trigger the gag reflex, which strongly stimulates the vagus nerve. Example: Gently use a clean finger or the handle of a spoon to touch the back of your throat. Be careful not to induce vomiting.
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Eat Dry Bread or Crackers: The act of chewing and swallowing dry food can be a strong enough distraction to interrupt the hiccup cycle. Example: Chew a piece of plain bread or a cracker slowly and thoroughly before swallowing.
Physical and Pressure Point Techniques: Directly Influencing Nerves and Muscles
These methods involve applying pressure or manipulating specific body parts to influence the nerves involved in the hiccup reflex.
- Pull Your Tongue: Pulling your tongue forward can stimulate the vagus nerve and potentially stop hiccups. Example: With clean fingers or a cloth, gently grasp the tip of your tongue and pull it outwards, holding it for a few seconds.
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Press on Your Diaphragm: Gently applying pressure to the area just below your sternum (breastbone) can sometimes help to relax the diaphragm. Example: Lie on your back or sit comfortably. Place your hand just below your sternum, where your ribs meet, and apply gentle, sustained pressure for 30-60 seconds.
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Press on Your Carotid Arteries: This technique should be performed with caution. The carotid arteries in your neck have baroreceptors that can influence the vagus nerve. Example: Lie down. Gently press on one of your carotid arteries (located on either side of your windpipe, just below your jaw) for 5-10 seconds. Do not press too hard or on both sides simultaneously. Consult a doctor before trying this if you have any heart conditions.
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Press on the Palm of Your Hand: Applying pressure to the center of your palm, a common acupuncture point, is sometimes reported to alleviate hiccups. Example: Use the thumb of your opposite hand to press firmly into the center of your palm for 30-60 seconds.
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Cover Your Ears and Drink Water: This combines two techniques: covering your ears may put pressure on certain nerves, and drinking water stimulates the vagus nerve. Example: Take a large glass of water. Cover your ears firmly with your fingers while someone else holds the glass and helps you drink the water quickly.
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Rub the Roof of Your Mouth: The friction on the roof of your mouth can stimulate nerves that are connected to the hiccup reflex. Example: Use your tongue to firmly rub the roof of your mouth for a minute or two.
Psychological Distractions and Shock: Shifting Focus
Sometimes, simply diverting your attention or delivering a mild shock to your system can break the hiccup cycle.
- Get Scared (A Gentle Scare!): A sudden, harmless fright can sometimes be enough to interrupt the reflex. Example: Ask a friend to give you a sudden, but gentle, surprise.
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Think of Something Else Entirely: Focusing intently on a complex problem or engaging in a demanding mental task can distract your brain from the hiccup reflex. Example: Try to recite the alphabet backward, or multiply large numbers in your head.
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Meditate or Practice Mindfulness: Calming your nervous system through meditation can sometimes help to alleviate hiccups triggered by stress or anxiety. Example: Sit in a quiet place, close your eyes, and focus on your breath. Notice the sensations in your body without judgment. If your mind wanders, gently bring your attention back to your breath.
When to Seek Medical Attention: Recognizing Red Flags
While most hiccups are a temporary nuisance, prolonged or severe cases warrant medical evaluation.
You should consult a doctor if your hiccups:
- Last longer than 48 hours: This is the most critical indicator of persistent hiccups, which may suggest an underlying medical condition.
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Are accompanied by other concerning symptoms: These could include chest pain, difficulty breathing, fever, numbness, weakness, difficulty swallowing, coughing up blood, or changes in speech or vision.
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Interfere significantly with daily life: If hiccups prevent you from eating, sleeping, working, or speaking normally, they require medical attention.
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Are recurrent and frequent: Even if they don’t last longer than 48 hours, frequent bouts of hiccups without an obvious trigger should be investigated.
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Occur after an injury or surgery: Especially if recent surgery involved the chest or abdomen.
A doctor will typically begin with a thorough medical history and physical examination. They may then recommend further tests, such as blood tests, imaging (X-rays, CT scans, MRI), or endoscopy, to identify the root cause.
Medical Treatments for Stubborn Hiccups: Beyond Home Remedies
When home remedies fail and an underlying cause isn’t readily identifiable or treatable, medical interventions can be employed.
Pharmacological Approaches: Medications to the Rescue
Several medications can be prescribed to manage persistent hiccups. These work by targeting various parts of the hiccup reflex arc.
- Chlorpromazine (Thorazine): This antipsychotic medication is often the first-line drug for persistent hiccups. It’s thought to work by calming the central nervous system.
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Metoclopramide (Reglan): This drug is a prokinetic agent that helps to move food through the digestive tract. It can be effective if gastrointestinal issues are contributing to hiccups.
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Baclofen: A muscle relaxant, baclofen can help to calm the diaphragmatic spasms.
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Gabapentin: An anti-seizure medication, gabapentin can sometimes be effective in treating neuropathic pain and also hiccups, possibly by calming nerve activity.
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Anticonvulsants (e.g., Phenytoin, Valproic Acid): These medications may be used if nerve irritation is suspected as the cause.
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Proton Pump Inhibitors (PPIs) or H2 Blockers: If acid reflux (GERD) is identified as the trigger, these medications will reduce stomach acid production.
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Muscle Relaxants (e.g., Cyclobenzaprine): These can sometimes be used if muscle spasms are a significant component.
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Other Medications: In some cases, nifedipine (a calcium channel blocker), lidocaine (a local anesthetic), or even certain antidepressants might be tried.
Non-Pharmacological Medical Interventions: When Drugs Aren’t Enough
For the most intractable cases, other medical procedures might be considered.
- Nasogastric Intubation: A tube is inserted through the nose into the stomach. This can help to decompress the stomach and relieve pressure on the diaphragm.
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Acupuncture: Some individuals find relief from chronic hiccups with acupuncture, which involves inserting thin needles into specific points on the body.
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Nerve Blocks: In severe, localized cases, a nerve block (injection of anesthetic into the phrenic nerve) can temporarily stop the hiccups. This is typically a last resort.
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Diaphragmatic Pacing: In extremely rare and severe cases where hiccups are debilitating and unresponsive to other treatments, an implantable device similar to a pacemaker can be used to stimulate the diaphragm.
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Surgery: If hiccups are caused by a specific anatomical problem (e.g., a tumor pressing on a nerve), surgical intervention to remove or relieve pressure on the nerve may be necessary.
Prevention: Stopping Hiccups Before They Start
An ounce of prevention is worth a pound of cure, especially when it comes to the annoyance of hiccups. Many simple lifestyle adjustments can significantly reduce your susceptibility to hiccup bouts.
- Eat and Drink Slowly: This is perhaps the most fundamental preventative measure. Take your time with meals, chew your food thoroughly, and avoid gulping drinks.
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Avoid Overeating: Portion control is key. Stop eating when you feel satisfied, not overly full.
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Limit Carbonated Beverages and Alcohol: Reduce your intake of sodas, sparkling water, beer, and other alcoholic drinks, especially if you find they trigger your hiccups.
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Manage Stress and Anxiety: Since emotional states can trigger hiccups, practice stress-reducing techniques such as meditation, yoga, deep breathing exercises, or spending time in nature.
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Address Underlying Health Conditions: If you have GERD, irritable bowel syndrome, or other conditions known to cause hiccups, work with your doctor to manage these effectively.
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Avoid Very Hot or Very Cold Foods/Drinks: Extreme temperature changes can sometimes shock the system. Allow foods and beverages to reach a more moderate temperature before consuming.
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Quit Smoking: Smoking irritates the respiratory system and can be a trigger for hiccups.
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Identify Your Personal Triggers: Pay attention to when your hiccups occur. Keep a journal to note what you were eating, drinking, or doing before a hiccup episode. This self-awareness can help you avoid your specific triggers.
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Stay Hydrated: Dehydration can sometimes contribute to various bodily dysfunctions, although its direct link to hiccups is less clear. Nevertheless, maintaining good hydration is always beneficial for overall health.
The Mental Game: Managing the Annoyance
Beyond the physical discomfort, hiccups can be psychologically taxing. The feeling of not being in control of your own body, coupled with potential embarrassment in social situations, can be frustrating.
- Stay Calm: Panicking about hiccups can often make them worse, as stress itself is a trigger. Take a deep breath (if you can!) and remind yourself that they are usually temporary.
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Distract Yourself: As mentioned in the remedies section, engaging your mind in another activity can sometimes be enough to break the cycle.
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Don’t Fixate: The more you think about your hiccups, the more prominent they might seem. Try to shift your focus away from the sensation.
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Communicate: If you’re in a social setting and experiencing hiccups, a simple, “Excuse me, just a little bout of hiccups!” can alleviate awkwardness. Most people understand and have experienced them themselves.
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Have a Go-To Remedy: Knowing you have a few tricks up your sleeve can boost your confidence and reduce anxiety when hiccups strike.
Conclusion: Mastering the Hiccup Reflex
Hiccups, though usually benign, are a peculiar and often frustrating bodily phenomenon. From a simple swallowed breath of air to a complex neurological irritation, their origins are diverse, and their remedies are equally varied. By understanding the underlying mechanisms and identifying your personal triggers, you gain a significant advantage in preventing and conquering these involuntary spasms.
Whether it’s holding your breath, sipping water from the wrong side of the glass, or exploring medical interventions for persistent cases, the key is to approach hiccups with a blend of patience, persistence, and a willingness to experiment. While the “cure” for hiccups might sometimes feel elusive, the strategies outlined in this guide provide a robust framework for regaining control. Remember, knowledge is power, and with this definitive guide, you are now well-equipped to face down even the most stubborn “hic” and restore calm to your diaphragm.