Information for Healthcare Professionals

WHAT IS BUTEYKO?
The Buteyko Method was developed in the 1960’s by a Ukrainian physician and academic called Professor Konstantin Buteyko. However, it was only in the late 1980’s that the technique began to spread to Western countries as a result of the opening up of the former Soviet Union. The core of the method consists of a system of breathing exercises designed to help patients control their breathing and reduce their tendency to hyperventilate.

HOW DOES IT WORK?
The initial stages of an asthma attack are commonly associated with a reduction in arterial CO2, indicative of a degree of hyperventilation¹. This is a significant finding in view of the fact that hyperventilation by itself is known to have a negative effect on lung function in the majority of asthmatics².

Given these two facts one can see how a vicious circle can develop early on in an asthma attack where the initial urge to hyperventilate provokes more broncho-spasm and symptoms, which in turn leads to further hyperventilation.

The primary aim of the Buteyko method is to teach asthmatics how to avoid the tendency to hyperventilate, both in general and especially at the start of an attack. By doing so they develop the ability to reduce both the frequency and severity of their asthma symptoms.

WHERE IS THE EVIDENCE THAT IT WORKS?
There are now five published studies^3-7 showing that this approach to managing asthma symptoms leads to a reduction in the need for bronchodilator medication in the order of 60-95%, with no reduction in quality of life. There are currently no known studies that contradict this finding.

IS IT SAFE?
None of the clinical trials have shown any increase in adverse events such as increased symptoms, hospital attendances or the need for rescue courses of steroids as a result of learning the Buteyko method.

HOW DOES BUTEYKO FIT IN WITH CONVENTIONAL ASTHMA CARE?
The Buteyko method is regarded as entirely complementary to conventional care. In particular practitioners of Buteyko recognise the key importance of the appropriate use of steroids in the control of asthma. There is thus no conflict between the use of Buteyko and the medical management of asthma according to the current BTS/SIGN guidelines⁸.

In practical terms all decisions regarding alterations in prescribed medications are left to the patient’s medical practitioner. Patients are therefore actively encouraged to return to their prescriber to discuss any changes to their medication that may be indicated as a result of their reduction in symptoms.

HOW CAN I HELP MY PATIENT SUCCEED WITH BUTEYKO?
One of the first major goals of the Buteyko method is to teach patients how to control their asthma symptoms using their breathing. This is clearly difficult if patients are experiencing few symptoms because they are taking a long-acting beta-agonist (LABA) preparation. Therefore it can be useful for patients with relatively few symptoms to be given permission to reduce or even discontinue their LABA, on the understanding that they can always compensate for this by taking more short-acting reliever if necessary.

With patients on combined steroid/LABA preparations it is clearly important that the steroid component is continued, at least until their next review. To be able to do this, patients will usually ask if they can be prescribed a separate steroid inhaler at the equivalent dose to their previous preparation.

Once patients have successfully controlled their asthma to the point where their condition is stable and they are requiring very little in the way of reliever medication, then clearly a slow, step-wise reduction in their preventer medication may be considered as recommended in the current guidelines.

ACADEMIC REFERENCES:
1. McFadden ERJ, Lyons HA ‘Arterial blood gas tension in asthma’ N Engl J Med 1968 278:1027-32
2. Hurwitz K et al ‘Interpretation of Eucapnic Voluntary Hyperventilation in the Diagnosis of Asthma’ Chest 1995; 108:1240-45
3. Bowler SD et al ‘Buteyko breathing techniques in asthma: a blinded randomised controlled trial’ Med J Aust 1998 169:575-578
4. Opat AJ et al ‘A clinical trial of the Buteyko Breathing Technique in Asthma as taught by a video’ J Asthma 2000 37:557-564
5. Cooper S et al ‘Effect of two breathing exercises (Buteyko and pranayama) in asthma: a randomised controlled trial’ Thorax 2003 58:674-679
6. McHugh P et al ‘Buteyko Breathing Technique for asthma: an effective intervention’ N Z Med J 2003 116 : U710
7. Slader CA. et al ‘Double blind randomised controlled trial of two different breathing techniques in the management of asthma’. Thorax 2006 61(8):651-6
8. Scottish Intercollegiate Guidelines Network + British Thoracic Society ‘British Guideline on the Management of Asthma’ 2003. (available at www.sign.ac.uk)

For information about Buteyko teacher training click here