Canadian physician, Sir William Osler, often credited as the Father of Modern Medicine, wrote about asthma in his 1892 book, ‘The principle and practice of medicine’.
He described symptoms of asthma as follows:
- Spasming of the bronchial muscles
- Swelling and inflammation in the airways
- Having distinctive, gelatinous mucus secretions
- Resembling hay fever, and being sensitive to atmosphere, climate and allergens
- Running in families, often beginning in childhood and lasting a lifetime
- Sometimes triggered by fright, strong emotion, over-eating, or particular foods
The Buteyko breathing techniques were first developed by Ukrainian, Dr Konstantin Buteyko. He noted that breathing seemed to have a direct connection to people’s health when he was practicing medicine at a public hospital in Moscow.
He could see that people in poor health often breathed faster and harder and with the upper chest. He asked if it was the sickness causing their poor breathing or whether it was their poor breathing that was feeding into the sickness. He started teaching his patients to breathe through the nose, in-and-out and to breathe lighter. He found that for many of them, their conditions improved.
In terms of asthma, the Buteyko Method has a very quick response. Normally we would expect 50 percent reduction of wheezing, coughing, chest tightness and nasal congestion in two weeks. The science behind Dr Buteyko’s reasoning has been supported by clinical studies in the subsequent years since his method was first published.
Examples of these studies include:
- Effectiveness of Buteyko Breathing Technique on Respiratory Physiological Parameters Among Patients with Bronchial Asthma. By Kimita Huidrom, Geeta Shiroor and Supriya Pottal Ray.
- Buteyko Method for Children with Asthma: A Randomized Controlled Trial.By Karla M.P.P. Mendonca, Diana A. Freitas, Thalita M.F. Macedo, Ada C.J.S. Silva, Cleia T. Amaral, Thayla A. Santino, Patrick McKeown
HOW (AND WHEN) TO PRACTICE BREATHING EXERCISES FOR ASTHMA CONTROL
Buteyko breathing exercises for asthma should be used as part of your daily routine to ensure a strong and controlled breathing base for the day. However, breathing exercises for asthma will often be required when asthma symptoms present themselves or in the presence of asthma triggers which could cause asthma symptoms to be aggravated.
The aim of the Buteyko Method is to normalise the volume of air that the individual is breathing. People with asthma have been shown to breathe too much air. Every minute, every hour, every day, their breathing is faster and harder so that the volume of air that they are breathing into their lungs is greater than normal. This in turn contributes to airway constriction.
If one breathes harder and faster, and especially through an open mouth, the airways cool and dehydrate. Cooling and dehydration of the airways contributes to inflammation. In addition, when one is breathing faster, hard and upper chest, this can cause too much Carbon Dioxide to be removed from the lungs. This in turn can cause the smooth muscle of the airways to constrict.
Nitric Oxide was a gas first discovered on the exhale breath of the human being in 1991. By breathing in-and-out through the nose, the individual harnesses nasal Nitric Oxide which is a bronchodilator. This means it helps open up the airways but it’s also anti-viral. Individuals using nose breathing in our experience since 2002, are less prone to colds and chest infections.
ASTHMA TRIGGERS
Asthma attacks can present themselves in a variety of different ways and there are a variety of different triggers that lead to the onset of an attack.
- allergies
- smoking / cigarette smoke (non-smokers)
- colds and flu
- cold air
- dust mites
- moulds
- noxious fumes
- pollens
- stress
- weather types (e.g. fog and damp)
- exercise in certain circumstances
It’s very important for people with asthma to realise that the first wall of defence for the body from incoming air is the nose. The mouth does absolutely nothing when it comes to breathing. The mouth does not filter the incoming air, does not warm the incoming air, does not moisten the incoming air, does not regulate volume and does not harness nasal Nitric Oxide.
It is common for people with asthma to breathe through an open mouth because their nose is often stuffy. Inflammation in the lungs, which is a characteristic of asthma, will also contribute to inflammation of the nose. Since 2007, researchers have identified a unified airway, so whatever happens in the lungs can travel up to the nose and whatever’s happening in the nose can travel down to the lungs. When the nose is stuffy, sleep is poor.
ASTHMA SYMPTOMS
Nasal breathing using the Buteyko method can lead to a reduction in many of the symptoms associated with asthma.
These include:
- Nasal congestion
- Nasal inflammation
- Coughing
- Breathlessness
- Colds
- Wheezing
Another factor for people with asthma is that they don’t just have asthma. They are more likely to have nasal congestion and because of this are more likely to have poor sleep. There is a direct relationship between poor asthma control and sleep disorder breathing, including sleep apnea. As asthma severity increases, so does obstructive sleep apnea.
BREATHING TECHNIQUES FOR ASTHMA: OVERVIEW
As Buteyko Clinic founder Patrick McKeown says, when you want to control your breathing, the first place to start is with a closed mouth. Nasal breathing, when awake, slows and deepens the breath, which can help to maintain the strength and function of the breathing muscles and reduce breathlessness.
For people with asthma it is necessary to practice nasal breathing in-and-out, breathing light, and practising the Buteyko method to normalise minute ventilation and to normalise the respiratory rate. When breathing low, the greatest concentration of blood flow in the human lungs is in the lower lobes. By breathing through the nose it is recognised since 1988 that the partial pressure of Oxygen increases by 10%.
When people with asthma breathe through their nose during physical exercise, they are less likely to have exercise induced asthma.
In the past two decades, Patrick has taught thousands of people in workshops about relieving asthma symptoms through breathing exercises. In that time, he regularly saw clients enjoy a 50% reduction in asthma symptoms, just two weeks following attendance of a workshop.
When gauging a person’s functional breathing capability, the best place to start is with the Control Pause. Your Control Pause provides effective feedback on functional breathing as well as exercise tolerance, and, as such, can be a good indicator of fitness.
BUTEYKO BREATHING EXERCISES FOR ASTHMA: THE SCIENCE AND PRACTICAL DEMONSTRATION
As mentioned above, Dr Konstantin Buteyko reasoned that a person’s breathing patterns could have a negative effect on their health. Thanks to the previous work of Danish physiologist Christian Bohr, he knew that Carbon Dioxide (CO2) in the blood helped with the transfer of Oxygen (O2) to the cells.
He reasoned that controlling the amount of CO2 in the lungs could help alleviate many conditions associated with the lungs such as asthma and bronchitis. This was the basis for what would become the Buteyko Method.
He found that breathing restrictions in asthmatics often caused them to take big breaths in through their mouths to fill the volume of breath in their lungs in an attempt to deal with the stress brought on by air hunger. Also, he noticed that many sufferers experienced nasal congestion as well as lung inflammation leading to even more open-mouthed breathing. This in turn meant more unconditioned cold air made its way directly to the lungs causing more inflammation.
Buteyko Breathing Exercises for asthma were developed because Dr Buteyko realised that people needed to learn exercises to bring their breathing under control and alleviate asthma symptoms by normalising their breathing volume.
In practical terms, the previously mentioned Control Pause is a very good place to start. The Control Pause score will give a very good indication of a person’s lung function. It also helps Buteyko practitioners know how restricted their client’s breathing may be and from this they can design a program of exercises that will begin to reduce asthma symptoms and prevent the onset of asthma attacks.
HOW TO BREATHE BETTER WITH ASTHMA AND TRACK PROGRESS: CONTROL PAUSE
The Control Pause (also known as the BOLT score) is an integral part of the Buteyko Method. It is a simple, time-measured breath hold, to give you feedback of your breathing patterns.
When the measured Control Pause for an adult is less than 20 seconds during the day, their main symptoms are present. Coughing, wheezing, breathlessness, chest tightness, exercise induced asthma.
Measuring the Control Pause requires a stopwatch or similar timing device.
To measure their Control Pause, a person must:
- Close the mouth
- Take a normal breath in silently through the nose
- Take a normal breath out silently through the nose
- Grip the nostrils to prevent air from entering the lungs
- Count the seconds until there is a distinct hunger for air
For any adult with asthma, it is imperative that their Control Pause increases beyond 20 seconds. You are making progress with the Buteyko Method when your Control Pause is improving and your asthma is under better control. For children, the ‘steps’ measurement is the main measurement and the main exercise. All of the children’s exercises can be found on the Buteyko Clinic app, available in Android or Apple.
Depending on the age of the child, there are specific guidelines in terms of the exercises. Further information on this can be found in the Breathing Cure book.
Two books relevant for children are ‘Always Breathe Correctly’ and ‘Buteyko Meets Dr Mew’. If you do have a child with asthma, it is very important that the child establishes good breathing habits and can help to improve their asthma control for the rest of their lives.
HOW TO INCREASE LUNG CAPACITY FOR ASTHMATICS: NOSE UNBLOCKING EXERCISE
A blocked nose is a common occurrence in asthmatics. Following this simple selection of directions is a very useful exercise to unblock a congested nose.
- Sit upright on a straight-backed chair.
- Take a small, light breath in through your nose if you can and a small breath out through your nose. If you are unable to inhale through your nose, take a tiny breath in through the corner of your mouth.
- After exhaling, pinch your nose and hold your breath. Keep your lips sealed.
- Gently nod your head or rock your body until you feel that you cannot hold your breath for any longer. You should feel a relatively strong need for air.
- At this point, let go of your nose, and breathe in gently through it. Breathe gently in and out with your mouth closed. When you first breathe in, try to avoid taking a deep breath. Instead, keep your breathing calm and focus on relaxation. Use the mantra; ‘Relax and breathe less’, if it helps.
- Repeat the exercise until you can breathe clearly through your nose. If your nose does not become fully unblocked, wait around one minute and practice the same steps again. You may need to do the exercise up to five times.
Please note: holding the breath to generate a strong hunger for air is not suitable during pregnancy or if you have serious medical conditions.
HOW TO BREATHE THROUGH AN ASTHMA ATTACK: MANY SMALL BREATH HOLDS THE PRACTICE OF MANY SMALL BREATH HOLDS HELPS CALM DOWN THE BREATHING.
It is very hard to slow your breathing when it is out of control. The air hunger or sense of suffocation during an asthma or panic attack can be very strong. Instead of trying to slow your breathing, calm it using this exercise.
- Sit up straight and take a normal breath in and out through your nose.
- Pinch your nose and hold the breath for up to five seconds. Count: 5, 4, 3, 2, 1.
- Let go and breathe normally through your nose for 10 seconds.
- Repeat the sequence for as long as symptoms are present.
As you repeat the small breath holds, it is important not to try holding your breath for longer than 2-5 seconds. Longer breath holds may destabilise your breathing. For the purposes of this exercise, your maximum breath hold should be no longer than half your Control Pause score at the time.
INTEGRATING BREATHING EXERCISES INTO EVERYDAY LIFE
Your everyday breathing habits help you to understand how your breathing patterns influence the way you breathe during sleep, rest, exercise, and even sex. Practicing Buteyko breathing exercises will help you learn how to impact the biochemistry, biomechanics and cadence of your breath.
Ultimately, nasal breathing provides the foundation for achieving healthy breathing patterns, gaining control over the autonomic nervous system and building a better relationship with your diaphragm and by association, your overall health.
RISK FACTORS FOR ASTHMA
Poor breathing and chronic asthma can pose a number of risks to long term health. Chronic mouth breathing in children can affect cranio-facial development and is known to be a strong factor in causing sleep apnoea which can affect them for the rest of their lives.
Hyperventilation is a common occurrence related to asthma and breathing difficulties. Hyperventilating during breathing difficulties or asthma attacks can affect the respiratory system through many factors including wheezing, shortness of breath, coughing, chest tightness, snoring and sleep apnoea. Left untreated, these conditions can lead to life altering conditions and even premature death in extreme cases.
ASTHMA AND DIET
Healthy eating habits have been proven to contribute to a healthy lifestyle and this of course includes breathing and breath related disorders like asthma. Asthma is known to have a major effect on the body so correct nutrient intake is vital.
Asthma sufferers are recommended to use vitamin and mineral supplements as hyperventilation causes the body to excrete minerals. These include magnesium, calcium and potassium and are required to maintain the body’s PH as the loss of these minerals exacerbates hyperventilation.
Modern ultra-processed foods and alcohol can also have negative effects on asthma symptoms due to the variety of additives, pesticides and chemicals used in modern food production. Eating a balanced diet for asthma high in vegetables and low in unhealthy ingredients is the basis for health breathing.
IS RUNNING GOOD FOR ASTHMA?
Running is a very good exercise to help with asthma symptoms, however running (and all exercises for that matter) can cause breathing difficulties, especially at more intense levels. An informed knowledge of how the body breathes and reacts to these circumstances and how to reduce and calm asthma symptoms with functional breathing can bring life changing benefits.
A recent review of medical studies from the University of Salzburg found that implementing breathing strategies during running can bring long term improvements to exercise performance and psychological health and is especially effective in those individuals who are respiratory-limited with such individuals likely enjoying “transformative benefits”.
EVIDENCE FOR BREATHING EXERCISES IN ASTHMA
The first clinical trial of the Buteyko Method in the western world was in 1994 at the Mater Hospital in Brisbane, Australia. It was published in the Australian Medical Journal in 1998.
In comparison to the control group which were taught the in-house hospital program, the people who were practising the Buteyko Method, after a 12-week follow-up, had 49 percent less need for inhaled corticosteroids, 90 percent less need for rescue medications such as Ventolin and 70 percent fewer symptoms such as coughing, wheezing, breathlessness, etc. The control group had zero percent change in their inhaled corticosteroids.
The Mater Hospital Trial showed that those practicing Buteyko breathing were able to maintain the same lung function following the trial but with 49 percent less need for medication and a significant improvement to their quality of life.
Nineteen clinical trials have shown the effectiveness of initiating Buteyko breathing techniques as a way to alleviate asthma symptoms and significantly improve control, often reducing and even removing the need for medical intervention, such as nebulisers and inhalers over time (changes to medication must only be made in conjunction with your doctor).
GET YOUR COMPLETE BUTEYKO ASTHMA GUIDE
Our online asthma course is designed to help you improve your breathing and manage your asthma symptoms. With detailed exercises, videos, and tips from Patrick McKeown, the course provides guidance to control your asthma.
