2000 WINNER

Breathe slowly and keep asthma at bay

By Lewis Brindley

AFTER having asthma all my life, I finally discovered something that helped me. Buteyko is a Russian method that uses breath-holding and reduced breathing techniques. I have no doubt that it works and have seen improvement not only in myself but also in other asthmatics.

Doctors are sceptical because there is no firm scientific evidence or studies of the Buteyko technique. But as Professor Edzard Ernst of Exeter University says: "Breathing techniques have a place in treating asthma symptoms. Buteyko may be helpful, though probably not through the mechanism by which it is supposed to work.

"I am not concerned that the physiology of Buteyko is implausible. The history of medicine is full of implausible things. The important thing is to find out whether something works. The mechanism can fall into place later."

Professor Buteyko's "implausible theory" is that asthmatics breathe too much, and he calls this chronic hyperventilation. Acute hyperventilation is a widely accepted condition that occurs in panic or anxiety attacks and can be treated by breathing into a paper bag. This is because rapid breathing quickly depletes carbon dioxide levels in the blood and breathing into a paper bag for a minute restores the levels to normal.

Conventional medicine does not accept that chronic hyperventilation exists, other than at altitude where the low levels of oxygen cause people to breathe faster. Professor Buteyko believes that if people breathe more air than they need over a long period of time, they gradually deplete their carbon dioxide levels.

Carbon dioxide is more than just a waste gas ­ it is essential for the body to maintain the correct acid-alkali balance. He believes that asthma is a body-defence mechanism designed to stop further loss of carbon dioxide. His breathing techniques are designed to restore these levels to normal.

But what is the evidence? Only one clinical trial has looked at the Buteyko method. Results showed that asthmatics in the trial did breathe more than non-asthmatics. Carbon dioxide levels were also lower than normal in the tested asthmatics. However, other results contradict these findings and show no difference.

In the Buteyko method, the severity of asthma is measured by a timed breath-hold. Gradually my timed breath-hold has increased and my symptoms have decreased. The main technique I practise is breathing less, so I feel a slight lack of air. In my experience, when practised for a length of time, this can reverse the typical asthmatic early symptoms of a tight-chest and wheezing.

WHAT is happening in the lungs? During breath-holding and breathing less, the levels of gases made by the body will increase and oxygen levels will decrease. Recent discoveries show that carbon dioxide is not the only gas in exhaled breath, there is nitric oxide and organic gases such as pentane, ethane and propane. Nitric oxide seems to be very important in regulating the respiratory system. It may be that many elements are important in determining how long you can comfortably hold a breath Ñnot only carbon dioxide.

Asthmatics have higher levels of nitric oxide in their exhaled breath than normal people and this is believed to correlate with the number of inflammatory cells in the lungs. Treatment with inhaled steroids is associated with a significant reduction in exhaled nitric oxide levels and the improvement in asthma symptoms. Could Buteyko exercise have the similar effect?

The Buteyko method stresses breathing through the nose at all times. Typically asthmatics breathe through their mouth. The nose is an excellent filter so nose breathing is better for asthmatics as it will cut down the amount of allergens and other material going into the lungs. The nose also produces the highest quantities of nitric oxide in the whole body, where it is thought to kill bacteria and viruses.

Many factors such as genetics, allergies and atmospheric pollution contribute to asthma. It could be that the Buteyko technique, by altering body chemistry, nudges the body into a positive spiral, instead of a vicious circle of hyperventilation.

Whatever the explanation, the effects are tremendous, and I believe further investigations are needed.