Buteyko

Buteyko was first developed in Russia in the 1950's by Professor Buteyko and has been adopted by many practitioners around the world.

The main concept behind Buteyko is that people with asthma tend to hyperventilate i.e. they breath more deeply and more rapidly than they need to. The principal aim of the Buteyko technique is to learn through a series of breathing exercises how to breathe less deeply and less rapidly i.e. a tendency to hypoventilation . Breathing through the nose is encouraged and clients are advised to tape their mouth shut at night to avoid mouth breathing. Life long practice of this technique is required.

From a scientific point of view the theory that increasing the carbon dioxide level in the blood could improve asthma is somewhat tenuous and not substantiated by good physiological research. Asthma is an inflammatory condition of the airways, which causes shortness of breath, wheeze and cough rather than a disorder of breathing technique or problems in the breathing control centre

Notwithstanding this, there is now published research available that has evaluated the Buteyko technique and the results of the three most recent studies do show some benefits.

In the first of these studies, published by Bowler et al in 1998, the Buteyko method was compared with traditional asthma education and general breathing exercises (without hypoventilation). In both groups the participants were encouraged to use their reliever (beta-agonist) only when asthma symptoms were present. Inhaled preventer (corticosteroid ) medicines were gradually reduced if the patient remained stable.

Thirty-nine subjects were randomised to this study (20 in the control group and 19 in the Buteyko group). Those randomised to the Buteyko group had a significant reduction in beta-agonist use and a trend towards a reduction in inhaled corticosteroid use.

The second study, published by Cooper et al, enrolled ninety patients and compared three different breathing techniques in the management of asthma. Those completing the Buteyko treatment had an improvement in symptom score and a significant reduction in beta-agonist use after six months. There was no change in the measured lung function (spirometry), exacerbations or dose of inhaled corticosteroids required.

In 2003 McHugh et al undertook a study, which broadly replicated the findings of Bowler et al. Nineteen participants were randomised to a group that received training in Buteyko and nineteen received traditional asthma education and relaxation techniques. Both groups showed a reduction in beta-agonist use by six months with those in the Buteyko group also reducing their inhaled corticosteroid dose.

Taken together these studies suggest that the Buteyko method has a significant impact on the perception of asthma, the use of beta-agonists and a reduction in inhaled corticosteroid dose in some people. It is important to realise that other interventions can lead to similar outcomes and in these published studies there was no sustained improvement in lung function or other markers of asthma disease severity.

There is no evidence that participating in the Buteyko treatment causes any harm. It is important that all those with asthma who try this technique continue to use their preventer medication and follow their doctor's recommendations. Individuals planning to enrol in a Buteyko course would be strongly advised to discuss this with their general practitioner first.

In summary

1.There do not appear to be any obvious safety problems with the technique. The advice given by Buteyko to use relievers when required and continue with preventers is in accordance with current medical advice.

2.Individuals planning to try the technique should inform and discuss their intentions with their doctor, especially if they are contemplating any changes to their treatment.

Professor Ian Town
Medical Director, Asthma and Respiratory Foundation of New Zealand (Inc.)

References

Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial . Medical Journal of Australia 1998; 169: 575-578.

Cooper S, Oborne J, Newton S, Harrison V, Thompson Coon J, Lewis S, Tattersfield A. Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial. Thorax 2003; 58:674-679

McHugh P, Aitcheson F, Duncan B, Houghton F. Buteyko breathing technique for asthma: an effective intervention. The New Zealand Medical Journal 2003; 116-1187: www.nzma.org.nz/journal/116-1187/710/

© Asthma and Respiratory Foundation of New Zealand (Inc.) 10/2000  Photocopy permission granted