Clinical Trials Investigating the Buteyko Method

This review examines the four phenotypes of OSAHS and looks at how these can be targeted using breathing re-education from three dimensions of functional breathing – biomechanical, biochemical and resonant frequency. The review concluded that breathing re-education and myofunctional therapy could be helpful for individuals across all four phenotypes of OSAHS.

McKeown, P, Reina, C, Plaza, G, 2021. J Clin Med, Volume 10, Issue 3, p. 471.

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The overall goal of this study was to see a reduction in bronchodilator use among children with asthma. It concluded that the Buteyko Breathing Technique could be used in addition to asthma treatment for children, to further improve their outcomes but it does not result in reductions in medication, at least over the short term.

Vagedes, J, Helmert, E, Kuderer, S, Vagedes, K, Wildhaber, J, Andrasik, F, 2021. Complement Ther Med.

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The purpose of this paper was to evaluate the evidence for the efficacy of breathing exercises in the management of adults with asthma. The research included randomised controlled trials where adults with asthma received breathing exercises compared to a control group who were receiving asthma education. It concluded that breathing exercises could have positive effects on quality of life, lung function and hyperventilation symptoms. Santino, T, et al, 2020. Cochrane Database Syst Rev, Volume 3, Issue 3.

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The aim of this clinical trial was to determine the impact breathing retraining has on asthma symptoms and dysfunctional breathing in children. The trial involved 169 children with asthma and they completed six physiotherapy sessions over 15 weeks. The trial concluded that alongside standard medical therapy, individually tailored physiotherapy interventions helped with asthma control and dysfunctional breathing in children on each level of asthma treatment. Hepworth, C, Sinha, I, Saint, G, Hawcutt, D. (2019) Pediatr Pulmonol. Volume 54, Issue 6, pp. 706-712.

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The goal of this study was to assess the effectiveness of the Buteyko Breathing Method in patients with obstructive Eustachian Tube Dysfunction (ETD). A total of 51 participants between 21 and 62 years old were randomised to Buteyko Breathing along with medical management. The findings were that the Buteyko Breathing Method could be an effective adjunctive intervention in treating obstructive ETD, particularly for individuals who are refractory to medical treatment and cannot afford surgery. Zeng, H, et al, 2019. Epub. Volume 40, Issue 5.

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The purpose of this study was to determine the effectiveness of the Buteyko Breathing Technique in lessening dyspnea in patients with one form of Paradoxical Vocal Fold Motion (PVFM), exertion-induced PVFM (EI-PVFM), concomitant with hyperventilation. The findings were post-treatment decreases in dyspnea severity, RTMV and HR, in addition to increases in ETCO2. There were also decreases in RTMV and dyspnea which remained after correction for alpha inflation. Therefore, the Buteyko Breathing Method could be useful for individuals with hyperventilation and EI-PVFM. Katz, D et al, 2019. Epub. Volume 35, Issue 1, pp. 40-51.

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To describe the role of breathing exercises in managing childhood asthma, the authors conducted an updated literature search and discovered relevant literature. They discovered breathing exercises are typically multi-component packaged interventions and modify the pattern of breathing to lessen hyperventilation resulting in normalisation of CO2 levels and reduction of bronchospasm, leading to breathlessness. They discovered 10 clinical trials on the topic and found incorporating breathing exercises could improve asthma and quality of life but it must be further researched. Sankar, J, Das, R, 2017. Indian J Pediatr. Volume 85, Issue 10.

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Data from the above Buteyko clinical trial shows the Buteyko Method is effective in improving some lung function and symptoms parameters. Both the Buteyko Method and asthma education improved quality of life in the children assessed. 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. American Journal of Respiratory and Critical Care Medicine 2017:195: A2203

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The Buteyko Method was found to improve the sleep disorders scores and lung function in the children assessed. In addition, the technique reduced the number of school absences in children with asthma and mouth breathing. Karla M.P.P Mendonca, Thalita M.F. Macedo, Diana A. Freitas, Ada C.J.S. Silva, Cleia T. Amaral, Thayla A. Santino, Patrick McKeown. American Journal of Respiratory and Critical Care Medicine 2017:195: A2204

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The Buteyko Breathing Method was found to be significantly effective in improving the respiratory physiological parameters among patients with bronchial asthma. Huidrom K. et al, 2016. International Journal of Recent Scientific Research, Vol 7, Issue 5, pp. 11328-11331.

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This study demonstrated that the Buteyko Breathing Method and the thoracic lymphatic pump technique (TLPT) can effectively improve the total serum IgE, the ventilatory function in terms of FVC, FEV 1, PEF, FEF 25-75% and FEV 1/FVC, and C-ACT scores in children with bronchial asthma. However, Buteyko Breathing was recorded as far more superior when compared with the TLPT.

Ragab K Elnaggar, Mohammed A Shendy, 2016. Bulletin of Faculty of Physical Therapy. Volume 21, Issue 1, Page 1-10.

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The participants were treated with pursed lip breathing and the Buteyko Breathing Method alongside relaxation techniques and a chest mobility exercise using bilateral upper limb patterns of PNF for 1 week. This combination was found to be effective in lessening the symptoms of EIA. The research also found clinical significance in both the groups but participants using the Buteyko Breathing Technique showed more improvement than those participants using the pursed lip breathing technique. Chavda MV and Shah HM, 2016. International Journal of Current Research. Volume 8, Issue 07, pp. 35058-35064.

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The results of this study support the effectiveness of the Buteyko Breathing Method over the standard treatment in the newly diagnosed asthmatic patients. There was a statistically significant improvement of daily asthma control and PEFR in the group who carried out the technique for 2 months over the control group. With an intervention that is safe, equally efficacious and cheap, it is possible to use the technique as a primary treatment method in the management of asthmatic patients as the primary healthcare level itself. Prasanna K, Sowmiya K, Dhileeban C, 2015. Int J Med Public Health. Issue 5, pp. 77-81.

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The aim of this study was to assess the educational quality of YouTube videos for asthma. The authors performed a YouTube search by using ‘asthma’ as a keyword. 200 videos were included in the study and they assessed them for source, content and characteristics. Videos with misleading information scored negatively. The study concluded that YouTube videos about asthma were generally of poor quality in regards to accurate health care information. Estrada, A, et al. (2015) Allergy Asthma Proc. Volume 36, Issue 6, pp. 121-126.

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The aim of this study was to assess the educational quality of YouTube videos for asthma. The authors performed a YouTube search by using ‘asthma’ as a keyword. 200 videos were included in the study and they assessed them for source, content and characteristics. Videos with misleading information scored negatively. The study concluded that YouTube videos about asthma were generally of poor quality in regards to accurate health care information. Estrada, A, et al. (2015) Allergy Asthma Proc. Volume 36, Issue 6, pp. 121-126.

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This review sought to determine to what extent breathing retraining can help children with dysfunctional breathing. In addition, whether it has beneficial effects as measured by quality-of-life indices. The authors also wanted to discover if there were any side effects of breathing retraining in young people who have dysfunctional breathing. The authors concluded more trials are needed to understand how the Buteyko Breathing Method can help dysfunctional breathing and hyperventilation syndrome in children. Barker, N, Jones, M, O’Connell, N, Everard, M. (2013) Cochrane Database Syst Rev. Volume 18, Issue 12.

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The objectives of this review were to determine whether breathing exercises in people with dysfunctional breathing/hyperventilation syndrome have beneficial effects as measured by quality of life and to discover if there are any adverse effects of breathing methods for these patients. The results of this review were unable to inform clinical practice as a result of only one small, poorly reported RCT. They did not find any credible evidence regarding the effectiveness of breathing exercises in easing the symptoms for these issues. The authors state that since breathing exercises are used regularly to treat these health concerns, there is a dire need for further research. Jones, M, Harvey, A, Marston, L, O’Connell, N, 2013. Cochrane Database Syst Rev.

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In collaboration with the University of Limerick, Patrick McKeown was the instructor in a clinical study investigating the Buteyko Method as a treatment for rhinitis in asthma. The results showed a 70% reduction of nasal symptoms in participants, including snoring, loss of smell, nasal congestion and difficulty breathing through the nose. Adelola OQ, et all, 2013. Clinical Otolaryngology. Volume 38, Issue 2, pp. 190-199

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In this study, the Buteyko Breathing Method showed a decrease in daily asthma symptoms and showed the good effect of the Buteyko Breathing Technique on patients with bronchial asthma. It significantly decreases the recurrence and the severity of the main bronchial asthma symptoms (nocturnal waking, morning symptoms, activity limitation, shortness of breath, wheezing, PEFR% predicted, and inhaled Corticosteroids). The study concluded the Buteyko Breathing Method will improve patients’ function level and the capacity for independent living by decreasing the severity of asthma symptoms and recurrence of asthma attacks. Hassan Z, Riad N, Ahmed F., 2013. Department of Physical Therapy, Cairo University, Egypt. Chest Department, Faculty of Medicine, Ain Shams University, Egypt, Faculty of Physical Therapy, Cairo University, Egypt.

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This study showed greater trends of improvement in quality of life and asthma control in the group performing the Buteyko Breathing Method than the group performing the pranayama breathing exercise. Venkatesan Prem, Ramesh Chandra Sahoo, Prahbha Adhikari, 2012. Clinic Rehanbil, Volume 27, Issue 2, pp. 133-141.

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The goal of this randomized controlled trial was to test whether the placebo or nonspecific enhancement of well-being brought about by a health-promoting behaviour was a result of the response expectancy theory or the motivational concordance theory. A total of 57 participants completed a breathing exercise – the Buteyko Method over a 4-day period. The results remained consistent with the hypothesis that placebo effects in therapeutic contexts are mediated through the affective consequences of performing a motivated ritual. Sierra, C, Hyland, M. (2011) Health Psychol. Volume 30, Issue 6, pp. 793-796.

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This review looks at the literature on complementary and alternative medicine techniques that use breathing re-training as a technique for asthma management. It also compares evidence from controlled trials. They recorded that in some of the trials, due to the breathing re-training, there was a significant reduction in bronchodilator medication use. In addition, that the Buteyko Breathing Method improved asthma-related quality of life. Burgess, J, Ekanayake, B, Lowe, A, Dunt, D, Thien, F, Dharmage, S. (2011) Expert Rev Respir Med, Volume 5, Issue 6, pp. 789-807.

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This study demonstrated the hypothesised physiology of the Buteyko Breathing Technique, improving hyperventilation included hypocapnoea and breathlessness, following maximal exercise. It concluded that by teaching patients to reduce hypernoea of breathing (the rate and depth), the Buteyko Breathing Technique may reduce asthma symptoms and improve exercise tolerance and control. Austin G, Brown C, Watson T, Chakravorty I, 2009. Pulmonary Rehabilitation. Physiotherapy School, U Hertfordshire, Hatfield, Herts, United Kingdom.

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This study sought to assess whether taping the mouth at night has a positive impact on asthma control since it would be a simple method to implement. It was a randomised, single-blind, crossover study of individuals with symptomatic asthma. The study concluded that taping the mouth at night did not have an effect on asthma control in the individuals who had symptomatic asthma. Cooper, S, Oborne, J, Harrison, T, Tattersfield, A. (2009) Respir Med. Volume 103, Issue 6, pp. 813-819.

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At a six month follow up, the Buteyko group had:

• Improved asthma control from 40% to 75%.
• 39% of patients decreased inhaled corticosteroids.
• 21% eliminated decreased inhaled corticosteroids.

The Buteyko Breathing Method illustrated excellent results, including no disruption to their life at all by their disease, normal activities, not waking at night and not requiring any reliever medications. Zero side effects were reported too, making it incredibly safe while also being an important adjunct to treatment. Cowie RL, et al, 2008. University of Calgary, Canada. Respiratory Journal. Volume 102, Issue 5, pp. 726 – 732.

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This comparative study tests Buteyko’s claims and explores the relationship between end-tidal carbon dioxide (ETCO) and BHT in addition to dysfunctional breathing, including the Nijmegen questionnaire, the Self Evaluation of Breathing Questionnaire, and thoracic dominant breathing pattern. The findings showed while BHT does not predict resting ETCO, it does correlate with breathing patterns in participants with abnormal spirometry. It is proposed that altered breathing pattern could assist in breathing symptoms like dyspnea. In addition, breathing therapies like the Buteyko Breathing Method could influence symptoms by enhancing the efficiency of the biomechanics of breathing. Courtney, R, Cohen, M, 2007. J Altern Complement Med. Volume 14, Issue 2, pp. 115-123.

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At week 28, the Buteyko Method Group achieved the following:

• Reliever medication decreased by 86%.
• Inhaled Corticosteroids decreased by 50%.

Slader et al, 2006. Volume 61, Issue 8, pp. 651-656.

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At 3 months, the Buteyko Method Group achieved the following:

• Reliever medication decreased by 66%.
• Inhaled Corticosteroids decreased by 41%.

McHugh et al, 2006. The New Zealand Medical Journal. Volume 119, Number 1234.

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Jill McGowan was convinced the Buteyko Breathing Method could reduce the medication needs of individuals with asthma. So, she gave up her nursing job and sold her belongings to finance her research. Training was found to require five 90-minute sessions. The 30-minute exercise program must be repeated six times per day at first. This paper concludes that this method could have a significant impact on asthma management and potentially result in huge savings on cost. Millar, B. (2006) Nurs Strand. Volume 20, Issue 31.

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This was a qualitative study that comprised 50 semi-structured interviews with a purposeful sample of 22 adults and 28 children with asthma, recruited from a range of NHS and non-NHS settings in Bristol. The study found complementary therapy use reflects parents’ and patients’ underlying desire for greater self-care and need of opportunities to address some of their concerns related to NHS asthma care. Shaw, A, Thompson, E, Sharp, D. (2006) BMC Health Serv Res.

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The trial found the Buteyko Breathing Method can improve asthma and reduce bronchodilator use; however, it does not appear to change bronchial responsiveness or lung function in asthma patients. Cooper S. et al, 2003. Thorax. Volume 58, Number 08, pp. 649-659.

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After 6 months, the Buteyko Method Group achieved the following:

• Reliever medication decreased by 85%.
• Inhaled Corticosteroids decreased by 50%.

The study concludes that the Buteyko Breathing Technique is a safe and efficacious asthma management technique. It has clinical and potential pharmaco-economic benefits that merit further study.

McHugh et al, 2003. The New Zealand Medical Journal. Volume 116, Number 1187.

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The goal of this Buteyko clinical trial was to assess the impact of the Buteyko Breathing Method on medical use in asthma. The conclusion was that the Buteyko Breathing Method is an efficacious and safe asthma management technique and has great potential that should encourage further study. McHugh, P, Aitcheson, F, Duncan, B, Houghton, F, 2003. N Z Med J. Volume 116, Number 1187.

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The aim of this survey was to estimate how prevalent dysfunctional breathing is in adults with asthma and how it is treated. The survey included a postal questionnaire survey and 7033 patients between 17-65 with diagnosed asthma who were receiving treatment. The survey found around one third of women and one fifth of men with asthma may have dysfunctional breathing. It also suggested further studies are needed to confirm the validity of this screening tool and results and that these prevalences may suggest scope for therapeutic intervention and could explain the success of the Buteyko Breathing Method in treating asthma to date. Thomas, M, McKinley, R, Freeman, E, Foy, C. (2001) BMJ. Volume 322, Number 7294.

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The goal of this Buteyko clinical trial was to examine the effect of breathing 3% carbon dioxide on exercise-induced asthma, as a raised airway CO2 level is claimed to mediate the effects of the Buteyko Breathing Method. The study concluded breathing 3% CO2 during exercise does not prevent exercise-induced asthma. The shape of the FEV1 response curve after 3% CO2 suggests that a greater degree of exercise-induced asthma was opposed by a direct relaxant effect of CO2 on the airway. It also suggests that increased airway CO2 by itself is likely not a mechanism for the reported benefits of BBT, however, further study of the effects of hypoventilation in asthma should be investigated. Delaimy, W, Hay, S, Gain, K, Jones, D, Crane, J (2001). Med J Aust. Volume 174, Issue 2.

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This clinical trial was taught by a video and the results showed a significant improvement in the quality of life among those assigned to the Buteyko Breathing Method compared with placebo as well as a significant reduction in the use of bronchodilators.

Opat Aj, Cohen MM, Bailey Mj, Abramson Mj, 2000.

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At 3 months, the Buteyko Method Group achieved the following:

• Reliever medication decreased by 90%.
• Inhaled Corticosteroids decreased by 49%.

The study discovered when the breathing volume of ashmatics decreased from 14 litres to 9.6 litres per minute, their symptoms reduced by 70%. Similarly, the need for rescue medication decreased by 90%, and the need for preventer steroid medication decreased by 49%.

Simon D Bowler, Amanda Green and Charles A Mitchell, 1998.

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