What is Buteyko?

The Buteyko breathing technique (also called ‘Buteyko method’) focuses on nasal breathing, breath holding and relaxation. Studies show it may have positive effects for some people with asthma, though anyone undertaking a Buteyko course should continue with their prescribed asthma medicines and talk to their doctor, particularly before changing their regular treatment.

Who developed Buteyko?

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

What is the theory of Buteyko?

The main concept behind Buteyko is that people with asthma tend to breathe more deeply and more rapidly (hyperventilate) than they need to. Buteyko teaches clients, through a series of breathing exercises, how to breathe less deeply and less rapidly. Breathing through the nose is encouraged. Lifelong practice of this technique is recommended (by Buteyko).

Can Buteyko help asthma?

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.

However, many people with asthma may develop an abnormal breathing pattern, which may increase their symptoms of breathlessness. The Buteyko technique may help to reduce these symptoms. Several research studies have evaluated the Buteyko technique and the results do show some benefits.

Studies looking at Buteyko

Bowler 1998:
In a study published by Bowler et al, the Buteyko method was compared with traditional asthma education and general breathing exercises. 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 treated with Buteyko needed their reliever inhalers less often, and there was a trend towards lower inhaled corticosteroid use.

Cooper 2003:
A study published by Cooper et al (2003), enrolled 90 patients and compared three different breathing techniques in the management of asthma. Those completing the Buteyko treatment had an improvement in symptoms and a reduction in reliever use after six months, but there was no change in the lung function (spirometry), asthma exacerbations or dose of inhaled corticosteroids required.

McHugh 2003:
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 19 received traditional asthma education and relaxation techniques. Both groups showed a reduction in reliever use by six months, with those in the Buteyko group also reducing their inhaled corticosteroid dose.

Positive and negative results

The studies mentioned suggest that the Buteyko method has a significant impact on people’s feelings about their asthma, the use of relievers and a reduction in inhaled corticosteroid dose in some people.

However, there was no sustained improvement in lung function or other markers of asthma disease severity, but neither was there any impairment to lung function demonstrated.

One of the Buteyko techniques – taping the mouth closed at night – has been shown to have no benefit on asthma control (Cooper et al, 2009). It is also worth noting that Buteyko’s claim that the ability to hold your breath is related to the level of carbon dioxide in the blood has been shown to be false (Courtney et al, 2008).

Other techniques may have similar effects

Slader 2006:
It is important to realise that other interventions can lead to similar outcomes, as demonstrated by Slader et al in 2006. Some 57 participants were randomised to one of two breathing techniques. Group A’s exercises were Buteyko-like and Group B’s exercises were non-specific upper body exercises. Reliever use was decreased by 86 per cent in both groups. Quality of life, lung function and airway responsiveness were unchanged after 14 weeks.

Cowie 2008:
A recent study by Cowie et al (2008) found that asthma control improved just as much with breathing and relaxation advice as with Buteyko treatments, although the Buteyko group ended up on a lower dose of inhaled steroids.

British guideline finds some benefit

The 'British Guideline on the Management of Asthma 2008', states that the Buteyko method “may be considered to help patients control the symptoms of asthma”. The guideline also grades clinical research on Buteyko with a ‘B’ classification – indicating that supporting clinical trials are available. No other complementary therapy has been endorsed by this body for the treatment of asthma.

Buteyko does not replace prescribed treatment

There do not appear to be any obvious safety problems with the Buteyko technique as long as it does not replace normal asthma treatment. The advice given by Buteyko to use relievers when required and continue with preventer medication is in accordance with current medical advice.

Individuals planning to enrol in a Buteyko course would be strongly advised to discuss this with their doctor, especially if they are contemplating any changes to their treatment.

References for studies

• 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/
• Slader C, Redde H, Spencer L, Belousova E, Armour C, Bosnic-Anticevich S, Thien F, Jenkins C. Double blind randomized controlled trial of two different breathing techniques in the management of asthma. Thorax 2006;61:651
• British Thoracic Society & Scottish Intercollegiate Guidelines Network (SIGN). British Guideline on the Management of Asthma. Guideline No. 101. Edinburgh: SIGN; 2008. (large pdf file: www.sign.ac.uk/pdf/sign101.pdf )
• Cowie R, Conley D, Underwood M, Reader P, A randomised controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Respiratory Medicine 2008; 102:726-32
• Cooper S, Oborne J, Harrison T, Tattersfield A. Effect of mouth taping at night on asthma – a randomised single-blind crossover study. Respiratory Medicine 2009; 103:813-819
• Courtney R, Cohen M. Investigating the claims of Konstantin Buteyko: the relationship of breath holding time to end-tidal CO2 and other proposed measures of dysfunctional breathing. Journal of Alternative and Complementary Medicine 2008; 14: 115-123.

Further information

More information about Buteyko can be found on the Buteyko website.

Related topics

Also see: Asthma medicines and Safety of inhaled corticosteroids and Keeping your asthma under control

Original material provided by The Asthma Foundation of New Zealand, 2010. Edited by everybody, December 2010.