The Buteyko Method, or Buteyko Breathing Technique (BTT) is a set of breathing exercises developed by the Ukranian doctor Konstantin Pavlovich Buteyko. It advocates controlling the process of breathing in order to better regulate and even increase the quantity of carbon dioxide in the bloodstream. It is used to alleviate respiratory conditions such as asthma and emphysema, although it's also claimed a multitude of medical conditions can be eased - everything from obesity to migraines. Advocates of the technique claim that asthmatics can abandon inhalers and live a medication-free life. Sceptics claim that the causal relation is flawed and there is little evidence there is any effect other than placebo.
Central to the method is the theory that respiratory illnesses are caused (or at least made worse) by poor breathing patterns - what Buteyko calls "hyperventilation". In particular, Buteyko claimed that the bloodstream of asthmatics contained too much oxygen and not enough carbon dioxide. He claimed the body cannot metabolise oxygen unless there is a healthy supply of CO2 and that the balance in increasing numbers of ordinary people is improper.
The technique revolves around breathing exercises designed to increase the 'control pause' - the amount of time the individual can survive comfortably between exhaling and having to breath in again. The control pause is effectively a method of measuring the quantity of carbon dioxide gas in the bloodstream - a short pause means that the individual has less CO2 and is over-oxygenated.
Typically asthmatics are measured to have control pauses of less than 15 seconds. On practice by the patient, using the control pause exercise, this is usually increased to 40 seconds (which is considered 'normal'). With extreme practice, a control pause of anywhere upwards of a minute is possible. It is at this stage that the patient usually notes asthma attacks are greatly reduced.
Buteyko also advocated shallow breathing and breathing through the nose rather than the mouth, in order that smaller and therefore less oxygenated breaths might be taken.
Note that the technique/method isn't designed to be a treatment for an asthma attack. It's effectively a change in lifestyle which is designed to minimise or stop attacks occurring in the first place.
The technique is very popular in Australia and is starting to get a foothold in Britain. It's normally learned via weekend or five-day courses from teachers trained in the technique. It's widely agreed that it must be learned from a teacher and that students may cause harm by attempting to self-teach.
Critics of the methods consider it another example of quack medicine - a technique that has no real reason to work. This situation isn't helped by the great many medical conditions, many unrelated to respiratory complaints, which the technique claims to alleviate.
In particular the reason for Buteyko's success against asthma is claimed that it increased CO2, yet asthma sufferers are noted for increased levels of CO2 during attacks. This is as a side effect of the inability to exhale fully. Criticis say this suggests improvement by making the CO2 problem worse seems unlikely to work.
When faced with difficulties such as these, Buteyko supporters are quick to provide a number of personal testimonials. There's also the fact that, by practice, the control pause can be lengthened significantly so something on a physiological level is clearly being changed or retrained.
However, others suggest that asthma is greatly effected by general mental state, and relaxation of any form is known to be fairly effective. No scientific evidence has been presented to suggest this is anything but another placebo.
In 1998 a randomized double blind study on the technique was run using the methacholine challenge test, which triggers short-term asthma attacks.
People in the test were taught either the Buteyko method or a placebo breathing method, and changes in behavior noted. The results of the test showed no benefit of Buteyko compared with the placebo technique on physiological measures of asthma, such as forced expiratory volume in one second, peak flow, and number of attacks. However, improvements were noticed in the Buteyko group.
Interestingly the tests also showed no change in actual CO2 or hypocapnia, suggesting that if the method has an effect, it is likely not due to the reasons given.
That said the study also detected statistically significant changes in drug use, with the Buteyko group showing a decrease in inhaler use. To quote the summary of the trial: "Those practising [the Buteyko technique] reduced hyperventilation and their use of beta2-agonists. A trend toward reduced inhaled steroid use and better quality of life was observed in these patients without objective changes in measures of airway calibre."
The results are somewhat clouded as it was later learned that the Buteyko group was being constantly telephoned by the Buteyko teacher during the trial, something that was not happening with the control group. Since it is well known that asthamatics are generally overmedicated in terms of beta-antagonist use, it has been suggested that this portion of the test should be re-run for clarity.
Another complaint is that no placebo "pill" was offered as an additional control.Theory
Critical analysis
