Buteyko Breathing Technique

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What is Buteyko Breathing Method?

Developed in 1952 by Ukrainian Dr Konstantin Pavlovich Buteyko, the Buteyko Method is a breathing technique designed to improve functional breathing patterns, health and wellbeing by altering the way you breathe.

By practicing breathing exercises from the Buteyko Method you can experience more open airways and improved blood circulation in a matter of minutes. This alone is enough to demonstrate the relationship between your everyday breathing and state of health. The following paragraphs explore the exercises from the Buteyko Method, their benefits and the reasoning behind them.

History: Dr. Konstantin Pavlovich Buteyko

Konstantin Pavlovich Buteyko was born in Ukraine in 1927. During his studies at the First Medical Institute in Moscow, he noticed that the sicker the patient, the harder and the faster they breathed. He discovered that when his patients breathed faster and harder, they became nauseous and dizzy, often developing symptoms like coughing and wheezing.

A sufferer of high blood pressure, he practiced reduced breathing and was able to normalize his blood pressure. After making these discoveries, he began designing a program to help others. The Buteyko Breathing Method was the result.

The origins of Dr. Buteyko’s work can be found in the book Shut Your Mouth and Save Your Life by an American author named George Catlin, written in 1870. In it, Catlin discussed the dangers of mouth breathing and the benefits of switching to nose breathing.

Buteyko Breathing Benefits

The Buteyko Breathing Method provides life changing relief to thousands with conditions that negatively affected their everyday lives.

Asthma

Buteyko Clinic International founder Patrick McKeown controlled his own asthma using Buteyko breathing exercises. Asthma sufferers benefit from the Buteyko Breathing Method by learning to breathe light, deep, low and slow to prevent the onset of an attack, to improve their everyday breathing, to reduce medication (with doctor supervision), or to use their breathing to stop an asthma attack already underway.

High Blood Pressure

Hypertension is a chronic condition in which the blood pressure is high. Dr. Buteyko made a connection between poor breathing and his worsening high blood pressure in 1952. He discovered that by reducing and slowing down his breathing he could normalize his blood pressure.

A number of studies have since proven breathing exercises beneficial in lowering high blood pressure. The Buteyko Breathing Method is also helpful in normalizing blood pressure for people with hypotension/low blood pressure.

Practicing breathing exercise to stimulate the vagus nerve and strengthen the baroreflex, dampen the stress the response, activate the relaxation response and improve sleep quality to help normalize blood pressure.

More on Breathing Exercises to Lower Blood Pressure

Reducing Insomnia

Insomnia is a sleep disorder characterized by difficulty sleeping. The Buteyko Breathing Method helps to activate the body’s rest and digest response to enable the person to fall asleep easily.

Breathing through the nose during sleep ensures a deeper quality of sleep so that the person is less likely to wake up in the middle of the night. Conversely, breathing through an open mouth during sleep causes sleep to be lighter. This often results in the person waking up frequently during the night.

A common occurrence when one sleeps with the mouth open is having to get up and visit the bathroom. This means sleep is disrupted. It is imperative that children and adults sleep with the mouth closed. A good sign is waking up with a moist mouth.

Over stimulation of the mind – like insomnia, overthinking and worrying, prevents us from falling into a deeper sleep. Therefore, knowing breathing exercises to switch off the mind, down regulate, reduce thinking, allow the person to fall asleep quicker and achieve a deeper sleep. Waking up more refreshed in the morning.

Buteyko Breathing Method exercises teach you to breath slow, light, and deeply through your nose, improving your everyday breathing patterns, and your sleep quality.

More on Breathing Exercises for Sleep and Insomnia

Sleep Apnea

Obstructive sleep apnea is a severe form of sleep-disordered breathing in which the sleeper involuntarily stops breathing during sleep due to the collapse of their upper airways. Patrick McKeown along with ENT doctors, Dr. Carlos O’Connor-Reina and Dr. Guillermo Plaza wrote a peer reviewed article connecting how you breathe during the day affects your breathing during sleep.

If you breathe a little bit faster and harder, upper chest and /or mouth breathing during the day, this will increase the chance of obstructive sleep apnea. Improving your breathing during sleep begins with improving your breathing during the day. This involves breathing light, slow and low, in and out through your nose.

When breathing is lighter during sleep, driven by the diaphragm, the throat is stiffer and less likely to collapse. Breathing in and out through your nose during sleep helps open the upper airway and allows the correct tongue resting posture. On the other hand, breathing through an open mouth during sleep narrows the upper airway, thereby increasing the severity of obstructive sleep apnea.

While breathing through the nose during sleep significantly reduces obstructive sleep apnea, one must also practice breathing light, slow and low.

Mouth taping for sleep helps to ensure nasal breathing thereby reducing obstructive sleep apnea.

More on Breathing Exercises for Sleep Apnea

Anxiety

Anxiety is a common mental health problem that can cause physical and psychological discomfort, feelings of fear, avoidance, restlessness, irritability, fatigue, disturbed sleep, memory problems, muscle tension, poor focus and panic attacks.

Hyperventilation, irregular breathing and frequent sighing can lead to over breathing and other symptoms of panic attack. By addressing breathing pattern disorders, it is possible to relieve symptoms of anxiety and improve your overall quality of life. 75% of persons with anxiety and panic disorder have dysfunctional breathing patterns. Traits of dysfunctional breathing include slightly faster breathing rate, upper chest breathing, irregular breathing, mouth breathing and harder breathing.

It’s not just that anxiety and stress change our breathing patterns but how we breathe feeds into anxiety stress and panic disorder. It is very important for persons with anxiety, panic disorder and depression to address dysfunctional breathing patterns.

Cognitive Behavioral Therapy (CBT) while very helpful for persons with high stress, panic disorder and depression does not address respiratory physiology. In addition to CBT, it is imperative to understand the connection between your everyday breathing and your symptoms.

More on Breathing Exercises for Panic Attacks and Anxiety

Crooked Teeth

A 2019 study in the European Journal of Pediatric Dentistry advised that mouth breathing can be instrumental in the development of crooked teeth. The study concluded that dentists should aim to promote correct growth of the face by reducing risk factors such as mouth breathing.

25-50% of studied children consistently mouth breathe. When a child breathes through an open mouth, they are unable to have their tongue resting in the roof of the mouth. It is vital for the tongue to rest in the roof of the mouth as often as possible throughout day.

It is the pressures exerted by the tongue as it rests in the roof of the mouth that helps to guide the growth of the jaws both in forward direction and in width. Forward growth of the jaws helps to ensure adequate development of the child’s airway.

The tongue is U-shaped. As the tongue rests in the roof of the mouth it helps ensure that the top jaw is wide and U-shaped to house all teeth. If the top jaw is too small, not only are teeth overcrowded, but there is not enough room for the tongue in the mouth. The tongue therefore is more likely to encroach the airway, reducing airway size and causing sleep problems for the child.

These issues also carry into adulthood. When the child’s airways do not develop correctly, they have increased risk of lifelong sleep problems. Patrick McKeown wrote on this topic in his book The Breathing Cure. Despite the available evidence, healthcare professionals often overlook oral breathing in childhood.

Crooked teeth in children is an indication that the jaw did not fully develop. Factors that contribute to poor development of the jaws include:

Mouth breathing
Tongue tied
Eating soft foods
Lack of breast feeding
Thumb sucking

If the child’s jaws and airways do not develop normally, the child may experience poorer sleep quality and children who are sleepy have 10 times the risk of learning difficulty. For children to reach their full potential, nose breathing, both during the day and during sleep is imperative. The importance of this has been documented by the late Dr. Christian Guilleminault, considered one of the founding fathers of sleep medicine.

Hyperventilation and the Role of Carbon Dioxide

Hyperventilation is a major trigger for over breathing and conditions such as asthma. Over-breathing results in the constriction of blood vessels and leads to many common health issues such as high blood pressure, fatigue, difficulty sleeping, poor concentration, weight gain, and more.

Oxygen is carried through the blood by a molecule called hemoglobin and then converted to energy in the cells. In order to release oxygen from the blood, hemoglobin requires an increase in body temperature, and the presence of carbon dioxide.

The way we breathe determines the amount of carbon dioxide present in our blood, and therefore how well our bodies are oxygenated. By breathing calmly and quietly, you will retain healthy levels of carbon dioxide and your blood vessels and airways will remain open and clear.

There are only two ways to increase the amount of carbon dioxide in the body:

By practicing breathing exercises to gently reduce the amount of air we breathe.
By increasing metabolic activity through physical exercise.

While exercise is beneficial, breathing too much during physical activity can be counterproductive. A more controlled method of increasing the body’s carbon dioxide tolerance is to simply practice breathing lightly.

The Control Pause: Measure your Relative Breathing Volume

The Control Pause (CP) is an assessment of your breathing pattern. It is a measurement based on how long you can hold your breath after exhaling.

The CP measurement is influenced by your sensitivity to the build-up of carbon dioxide in the blood. As you practice the Buteyko Breathing Method, your sensitivity to carbon dioxide reduces. This in turn enables you to hold your breath for longer.

If your CP is less than 25 seconds, it indicates that your breathing has room for improvement. If your CP is above 25 seconds, there is an 89% chance that your breathing is functional. As CP increases, breathing improves.

How Do You Measure Your Control Pause?

Take a small, silent breath in and out through your nose.
After the exhaling, pinch your nose with your fingers to stop air from entering.
Use a timer to count the seconds until you feel the first real need to inhale.
Release your nose and breathe normally through it.

Buteyko Breathing Exercises: How-To

The nose unblocking exercise is a simple exercise designed to unblock the nose and make functional nasal breathing easier. It involves taking a normal breath in and out through your nose, pinching the nose to stop air entering, nod the head until there is a moderate air hunger, then stop pinching the nose and breathe in through it.

Exercise 1: Nose Unblocking Exercise

Exercise 2a: Normalizing Breathing Volume - Hands on Chest and Tummy

The intention of the exercise is to reduce the volume of air you are taking into your lungs, in order to create a tolerable air hunger, in other words to breathe less air. By breathing less air, carbon dioxide slightly accumulates in the blood. This creates the feeling of air hunger.

For this version of the exercise, you place your hands on your chest and tummy and observe your nasal breathing as your chest and stomach move in and out. The fine hairs of the nose should not move.

As CO2 accumulates in the blood, red blood cells release oxygen more readily to tissues and organs. Blood vessels dilate, stimulate the vagus nerve and help to reduce our sensitivity to the gas carbon dioxide.

Practicing breathing light, helps to ensure slower, lighter and lower breathing patterns. Benefits include:

Dampening of the stress response
Activation of the relaxation response
More open airways including the nose and lungs
Improved quality of sleep

If you feel a sensation of air hunger during normal everyday breathing, are sighing frequently, experiencing disproportionate breathlessness during physical exercise or have a faster breathing pattern, strong chemosensitivity to CO2 is feeding into these symptoms.

Chronic stress, trauma and anxiety, increase the chemosensitivity to CO2. Everyday breathing then becomes faster and harder and this can affect us to differing degrees. For example, one study investigating breathing patterns in persons with exhaustion syndrome, found that 100% of had chronic hyperventilation syndrome.

By addressing hyperventilation syndrome, there was a “significant reduction in exhaustion scores and scores of depression and anxiety.”

Study: Hyperventilation and Exhaustion Syndrome. Ristiniemi 2013 (PubMed)

Exercise 2b: Normalizing Breathing Volume - Finger Under Nostril

Like above, the intention of this exercise is to reduce the volume of air you are taking into your lungs, in order to create a tolerable air “hunger” so that you can continue to breathe while at the same increasing your tolerance to CO2. It is helpful to place the finger under your nose in order to detect the air flow from your nose.

Slow your breathing so you feel less airflow on your finger. A sign you are doing this correctly is when you feel air hunger. The air hunger should be tolerable. If you feel stressed or if you have involuntary contractions of the diaphragm, take a rest for 30 seconds and return to the exercise.

Exercise 2c: Normalizing Breathing Volume - Hands Cupping Face

In this third version of the Normalizing Breathing Volume exercise, you cup your hands over your face with no gaps between the fingers. As with exercises 2a and 2b, closely observe and slow your breathing until you feel just enough air to fill your nostrils, a feeling that you would like to take a deeper breath.

If you become stressed from practicing any of the ‘Normalizing Breathing’ exercises, take a 20-30 second break before starting again.

Exercise 3: Walking with Mouth Closed

An excellent breathing exercise is to walk with your mouth closed. As you exercise, oxygen uptake in the blood is higher, oxygen delivery to the working muscles is increased, the airways are protected and there is better recruitment of the diaphragm.

Breathing through the nose adds an extra load onto breathing and this may help to improve respiratory muscle strength. In a recent paper, it was shown that Inspiratory Muscle Training (IMT) helps lower high blood pressure.

Exercise 4a: Walking with Breath Holds to Create a Light Air Hunger

This exercise often continues where exercise 3 left off. It is not suitable for those with unstable breathing or asthma as it may disrupt breathing and encourage asthma symptoms.

With normal breathing in and out through the nose, pinch the nose and hold. Walk for 10 paces, then inhale through nose. Resume normal breathing while still walking for 30-60 paces. Let go, breathe normally for 30 seconds and repeat.

Exercise 4b: Walking with Breath Holds to Create Medium to Strong Air Hunger

This is a continuation from exercise 4a. Continue exhaling through the nose, pinching the nose and holding your breath. First at 10 paces and repeat, then at 15 and repeat. Continue raising by 5 paces after each two rounds until a medium to strong air hunger is achieved.

Exercise 5: Steps (light air hunger) for Severe Asthma, Anxiety, Panic Attacks

The steps exercise is one of the best for creating air hunger, improving CO2 sensitivity and improving breathing efficiency. Take a normal breath in through the nose, out through the nose, pinch your nose and hold your breath for 5 to 10 paces. Rest for 30 seconds and repeat. This should create a moderate air hunger and is a great help for sufferers of severe asthma, COPD, panic disorder, anxiety and breathlessness.

Exercise 5: Steps (medium to strong air hunger) for Children and Teenagers

This is a more advanced version of the first Steps exercise. Do as above then hold your breath while walking or running. As air huger increases, run or walk faster. Relax into the diaphragm muscle contractions. When the air hunger is strong to moderate, let go of the nose and breathe in through the nose. The goal is to reach 50-70 paces for kids below 10 years and 80 paces for those above. Take care, the exercise should be challenging but not distressing.

Exercise 6: Many Small Breath Holds (Mini Pauses)

Many Small Breath Holds is an emergency breathing exercise that helps stop symptoms of coughing and calms the mind. It involves a 3-5 second breath hold. Breathe normally for 10-15 seconds or two to three breaths and repeat.

Exercise 7: Relaxation to Create Air Hunger

This exercise does not involve breath holds and so is suitable for everybody, including those with more chronic conditions like severe asthma or cardiac issues. The exercise creates an air hunger by concentrating on breathing slowly. While stationary, block one nostril with your finger and breathe slowly in and out through the free nostril. Slow down the speed of air entering and really concentrate on the breath. How long can you hold your attention on your breathing before your mind wanders? A 20-minute guided breathing exercise with relaxation by Patrick McKeown is available free of charge from the Buteyko Clinic App available from the Apple store and the Google play store. An experienced Buteyko instructor will advise you on the best exercises for the maximum effect. Many Buteyko breathing exercises can also be viewed on the ButeykoClinic YouTube channel. Detailed exercises can be found in Patrick’s bestselling book, ‘The Breathing Cure’.

Buteyko Breathing for Children

Buteyko breathing exercises for kids will help if your child suffers from asthma, rhinitis, anxiety, or sleep difficulties and other conditions. Mouth breathing can have a significant impact on early childhood development, behavior, and wellbeing. So nasal breathing should start as soon as possible.

– MyoTape and the Importance of Nose Breathing

Buteyko breathing exercises and encouraging nose breathing are made easier with MyoTape, a purpose-built tape designed by Patrick McKeown. It does not cover the mouth but gently surrounds it to encourage nasal breathing during rest, sleep, and exercise.

– Magic Nose Unblocking Exercise

This is a quick and simple exercise to decongest the nose.

– Dolphin Breathing for Sports Performance

This steps exercise opens up the lungs and nose and also works as a way to track your child’s progress. You can also track your child’s progress in our Always Breathe Correctly book.

– Tortoise Breathing 1

Tortoise breathing 1 is a functional Buteyko breathing exercise encouraging use of the diaphragm. This is one of our deep breathing exercises for kids. It is particularly suitable for children with anxiety or asthma.

– Tortoise Breathing 2

This technique is another of our deep breathing exercises for kids.

– Race Horse Breathing

This Buteyko breathing exercise helps your child learn to run with their mouth closed and should be completed using nasal breathing. Children should be nose breathing when exercising, at rest and at play.

– Breath Recovery Exercise

This breathing exercise introduces gentle breath holds to the child to help alleviate any worries over thinking, wheezing, coughing, etc. This Buteyko breathing technique helps to calm the mind. It is one of the best anxiety breathing exercises for kids.

Scientific Research

Buteyko Clinic International has always ensured that its breathwork is backed by science, including collaborations with medical professionals in a variety of fields for more than 20 years to prove the effectiveness of the Buteyko Breathing Method.

There are 20 clinical trials on the Buteyko Method for asthma, as well as clinical trials on Buteyko’s effectiveness for Exertion-Induced Paradoxical Vocal Fold Motion and Obstructive Eustachian Tube Dysfunction. A peer reviewed article on Buteyko Breathing and Obstructive Sleep Apnea was also co-authored by Patrick McKeown.

Medical Journals
Clinical Trials

FREQUENTLY ASKED QUESTIONS

Does Buteyko improve sleep quality?

Buteyko breathing exercises benefit suffers of many sleep disorders and associated conditions such as insomnia, snoring, sleep apnea and chronic fatigue as well as poor concentration and focus.

How does the Buteyko Breathing Method improve your health?

Practicing Buteyko breathing techniques regularly ensures a switch from mouth to nasal breathing. By learning to stop over breathing and improving our CO2 sensitivity, we can help with conditions including asthma, anxiety and panic disorders and sleep issues such as insomnia, sleep apnea, and snoring. Additionally, the Buteyko Breathing Method is effective for high blood pressure, COPD, rhinitis, Covid, and general mental well-being.

Does Buteyko breathing lower blood pressure?

The Buteyko Breathing Method can lower high blood pressure. Founder of the method, Dr. Konstantin Buteyko discovered that by practicing reduced breathing daily, he was able to lower his high blood pressure levels and improve his health.

Is Buteyko breathing legit and evidence based?

There are 20 clinical trials investigating the Buteyko Breathing Method for asthma, one clinical trial for Exertion-Induced Paradoxical Vocal Fold Motion and one for Obstructive Eustachian Tube Dysfunction.

Patrick McKeown has as co-written a peer reviewed article on Buteyko Breathing and Obstructive Sleep Apnea.

A search of PubMed reveals there are over 40 articles and studies on the Buteyko Breathing Method. Links to most of these medical journals and clinical trials are available on the Buteyko Clinic website.

Is Buteyko breathing dangerous?

Buteyko breathing is a safe and non-invasive way to offer relief for a wide variety of conditions including asthma, rhinitis, anxiety, chronic fatigue, insomnia, sleep apnea, COPD, Covid and many more.

While Buteyko Breathing is a perfectly safe therapy, it can involve an element of risk for people with particular illnesses or susceptibilities.

Please note the following in particular:

✦ If you experience an exacerbation of your symptoms, then you are not doing the exercises correctly and you should stop until you establish that you can do them correctly.

Do not commence breath retraining if you have any of the following conditions: sickle cell anemia; arterial aneurysm; very high uncontrolled blood pressure; any heart problems in the past three months; uncontrolled hyperthyroidism; a known brain tumor or kidney disease.

✦ If you suffer from any of the following, then you should only undertake breath retraining under the direct supervision of an experienced qualiﬁed Buteyko Clinic instructor: diabetes; (a reversal of hyperventilation will reduce blood sugar levels which may in turn lead to a coma, exercises must be performed only with an experienced Buteyko instructor in conjunction with an endocrinologist) severe asthma; emphysema; epilepsy; schizophrenia; unsatisfactory blood pressure levels or chest pains or pain in the heart region.

✦ If you have any of the above conditions, or if you experience any distress, or are in any way unsure, please refrain from doing exercises involving holding the breath beyond the ﬁrst feeling of a need for air. Exercises involving holding the breath include nose unblocking, maximum pause, breath-hold during physical exercise and Steps. If you are in any doubt as to whether breath retraining may be suitable for you, please contact Asthma Care.

Roughly two thirds of those who apply breath retraining will experience a cleansing reaction within the ﬁrst two weeks and each time the control pause increases by ten seconds. Reduced breathing leads to an increased blood ﬂow and better oxygenation of all internal organs, especially eliminatory organs. Cleansing reactions are indicative of the powerful physiological change that the body undergoes.

For people with asthma, the most common reaction is excess mucus from the nose and airways. For a few days and weeks, the nose may be runny, especially during physical activity with nasal breathing. It is also possible to experience an increased amount of mucus moving up from the lower airways. Mucus that was previously trapped is released by a dilation of the airways and is brushed upwards to the throat. If it is green or yellow, spit it out. Most importantly, do not force the mucus to the throat. If necessary a gentle throat clearing will sufﬁce. Let the mucus come up naturally because forcing mucus up without addressing hyperventilation will only lead to the creation of more mucus.

In addition, you may experience other symptoms such as a slight headache, diarrhea, nausea, excessive tiredness with increased yawning, mild depression, general ﬂu like symptoms, insomnia, a bad taste from the mouth, foamy saliva, colored urine, a greatly reduced appetite or a general feeling of being unwell. People who have been on a large course of steroids may be able to smell the tablets/medicine through their skin.

Do not be alarmed if you do experience some symptoms. This is simply your body readjusting to a healthier way of life. Symptoms are, in general, not disruptive and will pass in two or three days. Like any detoxifying process of the body, there is a short adjustment phase. Many people look forward to the reaction because it is direct feedback as their body cleanses itself after all those years of bad breathing.

Do the following to help reduce the intensity and duration of cleansing reactions:

Drink warm water regularly throughout the day.
Continue with reduced breathing by relaxation.
Take pain relievers, such as a headache tablet, if necessary.

Most importantly, do not stop doing the exercises when you experience a cleansing reaction. The symptoms are a direct result of over-breathing and the control pause (explained later) will increase when the cleansing reaction has passed.

On a positive note, everyone will experience signs of health improvement including: fewer asthma symptoms; less coughing, wheezing and congestion especially in the mornings; increased calmness and concentration; better sleep and more energy, and reduced appetite and cravings for coffee, chocolate and other foodstuffs.

When first learning the Buteyko Breathing Method, it is best practice to take guidance from one of the many online or in-person courses offered on the Buteyko Clinic. Many Buteyko Clinic trained practitioners are available worldwide to guide you.

Is it better to breathe through mouth or nose?

It is far better to breathe through the nose. Breathing through the nose increases oxygen uptake in the blood, protects the airways and helps us relax. By nasal breathing we take advantage of natural defenses like nasal mucosa and the small cilia hairs of the nose that prevent pathogens from reaching our lungs and making us potentially ill. Also, the presence of nasal nitric oxide, a natural anti-viral, increases in the nose when we breathe nasally.

Mouth breathing typically activates the stress response, reduces oxygen uptake and can irritate the airways as cold dry air is taken directly into the lungs. It is especially pertinent for persons prone to breathing disorders including asthma to breathe only through the nose during rest, physical exercise and sleep.

How do I stop mouth breathing at night?

You can stop mouth breathing at night by learning to nose breathe using Buteyko breathing exercises. With functional nose breathing we can stop mouth snoring, reduce nasal snoring and reduce the risk of sleep apnea. Breathing through the nose during the day helps ensure a deeper sleep and means you wake up more refreshed. Using a sleep aid like MyoTape helps to keep the mouth closed during the night.

How often should you practice Buteyko Breathing?

Duration and regularity of practice varies from exercise to exercise and person to person so it’s best to follow the advice of your Buteyko practitioner. However, it’s usually a good rule of thumb to practice your recommended Buteyko breathing techniques for 20-60 minutes daily.

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A science-based approach to integrating breathing into mental health care.