The Buteyko Breathing Method

The Buteyko Breathing Method or Buteyko Breathing Technique (BBT) is a set of breathing techniques and tools designed for people with asthma and other breathing disorders, such as chronic obstructive pulmonary disorder (COPD), hyperventilation (e.g. during a panic attack), bronchitis, and emphysema.

The technique teaches people to ‘breathe less’, as well as emphasising the importance of looking after their general health. The BBT was developed by a Russian Professor called Konstantin Buteyko in the 1940s, and is now used in some areas of the NHS to teach people to take control of their asthma symptoms, or other breathing problems.

The most important part of the BBT is the breathing exercises themselves, which are taught via a series of lectures or sometimes by DVD. The exercises focus on teaching normal breathing.

The techniques are taught alongside guidance designed to help people who experience the symptoms of asthma take control of their breathing again without using asthma inhalers, drugs or any other treatments.

The BBT is often taught as a five-week programme for people who are still getting symptoms even though they’re using asthma medication.

You learn the BBT over a period of weeks, and each week builds on the last to teach you different ways to improve your breathing and manage your symptoms. It covers a number of areas:

• How to breathe through your nose
• Relaxed breathing
• The Control Pause
• Restricted mouth breathing
• The Stop Cough (advanced)

How to breathe through your nose – the first thing you’ll learn, or relearn, is how to breathe through your nose. This can be harder than it sounds if you’re used to mouth breathing. There’s also a set of nodding, tipping, and ‘hold and blow’ exercises that are designed to clear your nostrils before you start the proper breathing exercises.

Relaxed breathing – to start with, you’ll practice ‘relaxed breathing’ while sitting quietly, relaxing your body and becoming aware of your breathing. This should take three to five minutes and is repeated a few times daily.

The control pause – you’ll also learn a technique called the ‘Control Pause’ which involves timing yourself while holding your breath. The aim is to create a mild ‘air hunger’, and to test your progress on how long you can hold your breath for throughout the course.

Restricted mouth breathing – along with these exercises, you might also be asked to cover your mouth for an hour a day so that you’re forced to breathe through your nose, and go for 15 minute ‘nose-breathing walks’ daily where you’re not allowed to speak, and have to remember to breathe through your nose.

The Stop Cough – other more advanced exercises include the ‘Stop Cough’ exercise, the Extended Pause and Reduced and Very Reduced Breathing. Most people are taught the methods one-to-one although it is now possible to learn them via DVD or online.

You can learn Buteyko methods from a number of places:

• A trained therapist
• Books that will help you teach yourself the techniques
• Instructional videos online
• Websites with support and guidance

4 clinical trials have suggested benefits in terms of reduced symptoms and use of reliever inhalers but the studies didn’t show any improvement in tests to check how the lungs work. This means that there’s limited use of the technique via the NHS.

The BBT is useful for a wide range of breathing problems including:

• Asthma attacks
• General asthma
• COPD
• Emphysema
• Sleep apnea
• Hay fever

Asthma attacks – the BBT is mainly used by people who have symptoms of asthma. Many people automatically tend to over-breathe when they start to experience asthma symptoms. They may start to hyperventilate while breathing through their mouth, which leads to more breathlessness. This type of breathing also dries out the mucous membranes of the lungs, which irritates them even more, leading to coughing and inflammation. This can also help with hyperventilation during a panic attack.

Asthma in general – the BBT teaches people ways that they can reverse the cycle of asthma symptoms leading to over-breathing and more asthma symptoms, and encourages people to think about their breathing technique.

Some diseases related to smoking – BBT is also useful in chronic obstructive pulmonary disease (COPD), or emphysema. Some physiotherapists are using the technique to teach patients with COPD to breathe through their nose, which makes it almost impossible to hyperventilate.

Other breathing problems – the BBT also claims to be effective for other breathing-related conditions including sleep apnoea, hay fever, and also for migraine, although the evidence for this is mostly anecdotal.

Non-breathing related – the BBT can even be used to treat chronic fatigue syndrome and reduce anxiety.

Medical trials have shown that the technique, when correctly used, can be effective at improving symptoms of asthma. One six month long trial in New Zealand found that people who tried the Buteyko technique reduced their use of reliever medication by 85 per cent, and inhaled steroids by 50 per cent.

Is the BBT a cure for asthma? – although it’s not a cure for the allergic reactions that cause asthma symptoms, people who teach the method call it a conditional cure for asthma. This is because most people who practice the method regularly and correctly say that they have been able to change the way they breathe and avoid their asthma symptoms.

The British Thoracic Society suggests that for people with asthma, methods like Buteyko breathing can:

• improve quality of life
• reduce asthma symptoms
• reduce the need for inhalers

But, the society also says the method does not have a long term impact on lung function, so it can’t cure asthma.

Professor Konstantin Buteyko developed the technique in Russia during the 1940s. It took until the 1990s for BBT to reach Australia and New Zealand, where the first randomised controlled trial took place. The technique is now included in the British Thoracic Society guidelines for asthma, and physiotherapists (and other medical professionals) have been using the technique for some time.

Although it does seem to have a beneficial effect in people who experience the symptoms of asthma, BBT isn’t widely available on the NHS, although more NHS physiotherapists and respiratory nurses are teaching the techniques after taking a course run by the Buteyko Breathing Association.