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The practical results of all randomised controlled trials of the Buteyko method were quite notable: 3-10 times less reliever medication, twice less steroids, better quality of life and less asthma symptoms, but unchanged lung function results or bronchial responsiveness after some months of breath-work. However, all these trials had a major methodological fault, which I am going to discuss here.
Dr. K. Buteyko proposed the following ideas:
- Sick people, asthmatics including, breathe more air at rest than the miniature physiological norm (chronic hyperventilation). Hyperventilation diminishes body oxygen content and augments our desire to breathe even more.
- If the sick normalize their breathing pattern, then they will not experience their symptoms and will not require medication.
- The Buteyko Table of Health Zones connects respiratory parameters of sick people, regardless of the name of the disease, with their current health state. His table suggests parameters that reflect normal breathing (8 breaths/min for breathing frequency at rest, 6.5% for alveolar CO2 content, 60 s for stress-free breath holding time after usual exhalation, etc.). These parameters match to absence of asthma and many other diseases and normal health since normal breathing parameters improve tissue oxygenation.
- Someone has acquired the Buteyko breathing technique, if their breathing parameters are normal.
Dr. Buteyko did not claim that a particular Buteyko teacher may achieve a certain result in relation to asthma. Let us apply these Buteyko's assertions to these randomised controlled trials and medical research studies.
First of all, hundreds of research articles have shown that over-breathing DECREASES body oxygen content. Do asthmatics over-breathe? A usual respiratory minute volume for a typical asthmatic is about 12-15 L/minute at rest (5 publications are available on my website), while the medical norm is only 6 L/min. Hence, asthmatics breathe at rest about 2-2.5 times more air than the physiological standard.
Did asthmatics change their breath parameters during these randomised controlled trials of the Buteyko breathing technique? During the most successful study (Bowler et al, 1998), in 3 months, consumption of bronchodilators was reduced by 96% (25 times less!) and preventers or inhaled steroids by 49%. Respiratory minute volume decreased from initial 14 L/min to 9.6 L/min, but the medical norm is only 6 L/min, while Dr. Buteyko's tough standard is 4 L/min at rest for a 70-kg man. Therefore, during their best shot, the participated asthmatics got only about a half way towards the norm. Thus, there were a very few asthmatics, if any, who normalized their breathing during these trials.
The assumption of the medical doctors, who conducted these randomised controlled trials, was that a Buteyko practitioner taught the Buteyko breathing method and a controlled group learned the therapy. This is easy to see from the titles, which usually announce about a "trial of the Buteyko method". How could they study the method, if no one learned it?
From a practical viewpoint, since I taught the Buteyko method to hundreds of people, the key flaw during these randomised controlled trials were following. The participants were mainly restricted to learning breathing exercises (e.g., 40-70 min per day). They could not use the versatile arsenal of lifestyle correcting tools of the method. Breathing retraining process requires 24/7 control of breathing including:
- nasal breathing all the time (hence, it is necessary then to tape one's mouth with a surgical tape, if the mouth is usually dry in the morning; and a sick person will never resolve their problems with asthma, if mouth breathing happens during each night sleep
- avoidance of sleeping on one's back (we breathe about two times more air, when we sleep on our backs at night)
- physical exercise (at least 2 hours daily with nasal breathing only, in and out, otherwise exercise is almost a waste of time for most, especially sick patients)
- and many other lifestyle-related details so that one's unconscious breathing pattern is restored back to our physiological standard.
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