How Healthy is Your Breathing?
How we breathe is commonly considered to be innate; that we breathe according to nature. This is only partly true as breathing changes in response to many environmental conditions including stress, lack of exercise, processed foods, overeating, false beliefs about what constitutes good breathing, chemicals, pollution, overheating in houses and other factors. The reality is that we do not live according to nature. In simple terms good breathing can be measured by whether we adhere to three basic principles.
The first is that breathing during rest should be unnoticeable and silent, the second that all breathing should be through the nose and third that we use the diaphragm. Healthy infants and wild animals will adhere to these principals. The same however does not apply to many children over three years of age or adults. Chronic hyperventilation is the term used to describe breathing a volume of air greater than bodily requirements. It is a habit whereby the respiratory centre within the brain becomes programmed to maintain a larger breathing volume than normal. An adult can habitually breathe two to three times more air per minute than required without it being overtly noticeable.
It is chronic rather than acute with the main characteristics being seemingly innocuous periodic mouth breathing, regular sighs or sniffing, audible breathing, yawning with big breaths and upper chest breathing. Normally when people think about breathing, oxygen is considered as a good gas and carbon dioxide as waste. However, this is not the complete picture. For normal bodily functioning, it is essential that the body has a certain level of both gases.
Carbon dioxide or CO2 is a gas created from our metabolic process as an end product. If we breathe too heavily, CO2 is exhaled or washed from our lungs. A loss of CO2 from the lungs results in a reduction of CO2 in the blood, tissues and cells.
What are the functions of carbon dioxide?
a) The release of oxygen from red blood cells depends on the partial pressure or quantity of carbon dioxide in your lungs/arterial blood. When one is overbreathing, carbon dioxide is removed from the body, causing the oxygen to “stick” to Haemoglobin is the protein that is found in red blood cells. It contains iron and is responsible for carrying oxygen from the lungs to the… within the red blood cells. This prevents its release into tissues and organs. This bond, discovered in 1904, is known as the Bohr Effect. Ironically, the heavier you breathe the less oxygen is released to tissues and organs.
b) Carbon dioxide relaxes the smooth muscles that surround the airways, arteries and capillaries. With a normal breathing volume of five litres of air per minute, the partial pressure of carbon dioxide amounts to 40mmHg. Each 1mmHg drop of arterial CO2 reduces blood flow to the brain by 2% . In other words; oxygenation of your brain significantly decreases when you breathe heavily. It is no coincidence that persons who noticeably breathe during sleep and rest often have poor concentration, fatigue, vertigo and a racing mind.
c) Professor Buteyko points to the loss of Carbon Dioxide (CO2) as the cause of airway obstruction in asthma. Similarly, in a paper entitled The Mechanism of Bronchoconstriction Due To Hypocapnia in Man , Sterling writes, “hypocapnia (loss of Carbon Dioxide) due to voluntary hyperventilation in man causes increased resistance to airflow”. Furthermore, when subjects inhaled an air mixture containing 5% carbon dioxide “bronchoconstriction was prevented, indicating that it had been due to hypocapnia, not to mechanical factors associated with hyperventilation”
Now we examine the role of chronic overbreathing in common conditions such as rhinitis/hay fever, asthma, snoring, anxiety and crooked teeth.
Allergic rhinitis or hay fever describes inflammation of the upper airways manifesting as symptoms such as a blocked, runny nose, sneezing or loss of smell. The standard Sino Nasal Outcome Test (SNOT) for evaluating rhinitis/sinusitis patients lists additional symptoms such as cough, dizziness, facial pain pressure, waking up at night, lack of a good night’s sleep, waking up tired, fatigue, reduced productivity, reduced concentration, irritable, sad and embarrassed. There is no doubt that rhinitis is not only uncomfortable, but also lowers quality of life.
Buteyko explained that rhinitis is due to chronic overbreathing which causes pooling of venous blood in the nose. In addition to swollen blood vessels, there is an increased secretion of mucus which narrows nasal passages and creates a feeling of suffocation during nasal breathing. A partially blocked nose results in mouth breathing thus increasing breathing volume and completing the circle. Dr Buteyko developed an exercise to unblock the nose which works by simply holding the breath to accumulate carbon dioxide. (click here for free video)
The Buteyko Method has received more attention in the western world as a treatment for asthma than for any other condition. In 1998 it was the subject of a compelling QED documentary  by the BBC, a House of Commons debate  during 2002 and recognition by the British Thoracic Society during 2008 . The first clinical trials were conducted at the Mater Hospital in Brisbane , Australia. After three months follow up, the Buteyko group had 90% less need for reliever medication, 50% reduced need for steroid medication and a significant improvement to quality of life. Further trials held at Gisborne Hospital, New Zealand  showed an 86% reduced need for reliever medication and a 50% reduced need for steroid medication.
The most recent Buteyko trial was conducted at Calgary hospital, Canada . Results at six months follow up found asthma control improving from 40% to 79% with a reduced need for steroid medication. (click here for free video)
It is a normal occurrence that chronic overbreathers will snore. After all, what is snoring other than loud breathing during sleep? Listen to the breathing of a snorer and you will find it to be noisy, heavy and loud as they draw a large volume of air in through their nose, mouth or both. Snoring through the nose occurs as a result of turbulence in the nasaopharnx. Snoring through the mouth results from vibration of soft tissue at the back of the throat. The next progression of snoring is a condition called sleep apnoea. This occurs when the snorer holds their breath frequently during the night. While sufferers may not be aware of this, it is likely that their partners will be concerned as they listen to the gasping and heaving of the snorer attempting to take air into their lungs.
Sleep apnoea is often undiagnosed and is significant factor in causing fatigue, blood pressure, anxiety and more. Click here to read more.
Anxiety and racing mind
Chronic overbreathing is a habit present with any person who experiences stress, anxiety, panic attacks and depression. It causes both a constriction of blood vessels and reduced delivery of oxygen to tissues and organs, most notably the brain. If only you had a chance to look inside people’s minds, you would see the same turmoil that goes on in your own head. Hidden behind the nice white smile is fear of the future and regrets from the past. A racing and repetitive mind is just below the surface. It might not have reached the depths that someone in depression has reached, but at the same time, you will see common traits. In fact, all of us are just a few stressful events away from mental problems.
Cumulative stressful events take their toll on everybody unless, of course, we have some understanding of thought processes and can better oxygenate our brain. The Buteyko Method is a simple approach that significantly improves oxygenation of the brain, resulting in far less brain cell excitability. Click here to read more.
Crooked teeth and cranio facial changes
Dr John Mew is a London based orthodontist. For the past fifty years, he has observed the craniofacial changes of children from mouth breathing. In the foreword to a new book entitled Buteyko meets Dr Mew he comments that “few parents realise the true extent that their child’s health can be damaged by such simple factors. As a surgeon it used to upset me to realise that just for the lack of this knowledge many attractive kids would grow up with plain faces and chronic health problems”.
In a similar vein, Dr Josh Jefferson in a peer reviewed paper published in the Journal General Dentist states that “children whose mouth breathing is untreated may develop long, narrow faces, narrow mouths, high palatal vaults, dental malocclusion, gummy smiles, and many other unattractive facial features, such as skeletal Class II or Class III facial profiles. These children do not sleep well at night due to obstructed airways; this lack of sleep can adversely affect their growth and academic performance. Many of these children are misdiagnosed with attention deficit disorder (ADD) and hyperactivity” .
What is involved with Buteyko Method?
The Buteyko Method reverses the habit of chronic overbreathing through the application of correct posture, breathing exercises and lifestyle guidelines. The first step is learning how to unblock the nose using a breath hold exercise and switching to nasal breathing on a permanent basis. The patient is then taught to become more aware of their breathing and to relax the muscles involved in respiration in order to create a tolerable need for air. Through mental commands, the aim is to reduce breathing volume by about 30%. Over time, with continued observation, this practise resets the respiratory centre to tolerate a higher pressure of carbon dioxide thereby bringing breathing volume to normal levels. Patients are also taught correct breathing during physical exercise and sleeping, how to stop a hyperventilation attack, foods that affect breathing and other factors such as stress and overheating. The Control Phase Central to the Buteyko Method is a measurement of progress known as the control pause. Measure your own control pause and find out the significance of it: For this you will need a watch or clock with a second hand.
1. Take a small silent breath in and a small silent breath out.
2. Hold your nose with your fingers to prevent air entering into your lungs.
3. Count how many seconds until you feel the first signs of an air hunger. You may also feel your diaphragm involuntarily “jerking” or pushing downwards at about the same time.
4. Release your nose and breathe in through it. Your inhalation after the breath hold should be no larger than your breath prior to taking the measurement. It should be calm and quiet. If your breath in is disrupted, then you have held for too long and so have an inaccurate CP. Important things to be aware of before you start:
1. The breath is taken after gently exhaling.
2. The breath is held until the first urges only. It is not a measurement of the maximum length of time that you can hold your breath.
3. The CP is a measurement of your breath hold time only. It is not an exercise to correct your breathing. Remember that the CP is holding your breath only until the first urges. If you had to take a big breath at the end of the breath hold, then you held it for too long. The most accurate CP is taken first thing in the morning. The lower your breath hold, the greater your breathing volume and the greater your hyperventilation related symptoms. For example, a very severe asthmatic will have a Control Pause of less than 10 seconds. Their breathing will be very noticeable both at rest and while participating in physical exercise. An asthmatic with a morning CP of 40 seconds will have no symptoms. Their breathing will be unnoticeable during rest.
Physical exercise will produce a lot less ventilation and they should not experience exercise-induced asthma at all.
Patrick McKeown is the author of several books about the Buteyko Method including Anxiety Free Naturally, Asthma-Free Naturally, Buteyko meets Dr Mew, Close Your Mouth and ABC to be Asthma Free. Accredited by the late Dr Konstantin Buteyko in 2002, he instructs the Buteyko method internationally. Websites: www.ButeykoDvd.com, www.ButeykoClinic.com, www.AsthmaCare.ie.
1. GJ Magarian, DA Middaugh, and DH Linz, ‘Hyperventilation syndrome: a diagnosis begging for recognition’, West J Med, (1983), vol 138 (5), pp 733-736.
2. LC Lum, ‘Hyperventilation: The tip of the iceberg’, J Psychosom Res, (1975), vol 19 (5-6), pp 375-83.
3. Cited in Multidisiplinary approaches to breathing disorders by Leon Chaitow, Dinah Bradley and Christopher Gilbert.
4. GM Sterling, ‘The mechanism of bronchoconstriction due to hypocapnia in man’, Clinical Science (1968), vol 34 (2), pp 277-85.
5. BBC QED “The breathless way to ‘cure’ asthma” aired on August 18, 1998.
6. UK House of Commons debate on Buteyko 25 Jun 2002 : Column 851.
7. British Thoracic Society Asthma management guidelines 2008.
8. SD Bowler, A Green and A Mitchell, ‘Buteyko breathing techniques in asthma: a blinded randomised controlled trial’, MJA, (1998), vol 169, pp 575-578.
9. P McHugh, F Aitcheson, B Duncan and F Houghton, ‘Buteyko Breathing Technique for asthma: an effective intervention’, Journal of the New Zealand Medical Association, (2003), vol 116 (1187).
10. RL Cowie, DP Conley, MF Underwood, PG Reader, ‘A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma’ Respir Med, (2008), vol 102 (5), pp 726-32.
11. Y Jefferson, ‘Mouth breathing: adverse effects on facial growth, health, academics, and behavior’ Gen Dent, (2010), vol 58 (1), pp 18-25; quiz 26-7, 79-80.