Nasal breathing a panacea

There was a 45-year-old chronic moderately persistent asthmatic on preventive inhalers. Despite being on inhalation therapy, she was getting seasonal aggravations. She was otherwise active and well maintained. She was asked to attend our pulmonary rehab program and was subjected to a special breathing technique called Buteyko Breathing Technique (BBT). This method was coined by Ukrainian doctor Konstantin Pavlovich Buteyko.

This method is based on the physiological principle that most of the breathing disorders are based on high respiratory rate what we call hyperventilation. Hyperventilation keeps your blood carbon dioxide low and subsequently leading to disturbances of the acid-base balance in the blood and thereby lowering tissue oxygen levels.

BBT improves their ventilation and wellness. The Buteyko method regains the breathing pattern through chronic repetitive breathing exercises to correct the hyperventilation. It is a series of reduced-breathing exercises that focuses on nasal-breathing, breath-holding and relaxation. The main objective is normalisation of breathing.

This asthmatic was able to reduce the use of rescue inhalers for asthma attacks and also halve their need for inhalation steroids within six month. Basically, it involves breathing out fully and then trying to breathe out a little more – until it feels like your abdomen is being drawn back against your spine. Stay in this exhaled state for as long as you comfortably can, then allow the air back in again reasonably slowly. It must be approached gently — that is, no gulping or gasping. Finally, you breathe normally for a while.

When ready, you start again at the first step – breathing out fully – and go through the process again. People practising Buteyko aim to increase the length of time they can hold the exhaled position.


Nasal breathing is very important because nose is a humidifier and filter. We follow five minutes of steam inhalation with tea leaves. Steam inhalation has three advantages. It humidifies the passage, clears the mucus and cleanses sinuses. After steam inhalation, we teach patients to focus on nasal breathing. Patient has to focus on nasal breathing, very slow and deeply with closed eyes. One nostril at a time with an erect sitting posture.

Nasal breathing as opposed to mouth breathing increases circulation, blood oxygen and slows the breathing rate and improves overall lung volumes

Buteyko exercises involve breath control; consciously reducing either breathing rate or breathing volume. It’s a ‘breathing retraining’ and compare the method to learning to ride a bicycle. Buteyko uses a measurement called the Control Pause (CP), defined as the amount of time that an individual can comfortably hold breath after a normal exhalation. With regular Buteyko reduced-breathing practice, asthmatics are expected to find that their CP gradually increases and their pulse rate decreases.

By controlling this initial over-breathing phase, asthmatics can prevent a “vicious circle of over-breathing” from developing and spiralling into an asthma attack.

If you have, or suspect you have, asthma or related obstructive respiratory symptoms, discuss with your doctor the options of any breathing methods you may want to consider. Do not attempt to practise the Buteyko breathing technique without first consulting your doctor and under no circumstances change the dosage of your asthma medication without consulting your doctor.


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