AsthmaCARE Blog

When Irish flights are cancelled, asthmatics close your mouth!
While volcanic ash plumes over Ireland may have been an isolated event in the past, this is no longer the situation. For how long the Icelandic volcanoes roar into the atmosphere and cast a fine dust cloud of silica covering northern Europe is impossible to know. While the direct effect on flights is obvious, there might be wider implications for children and adults with breathing difficulties such as asthma.
The word asthma originates from the Greek word meaning panting. While the condition has been around for a long time, it has increased exponentially in the past twenty years. The condition affects more boys than girls during childhood and more females than males during adulthood. Stress is often a factor preceding late onset asthma.
A popular explanation explaining the increased incidence is the hygiene hypothesis of lower exposure to infection during childhood, which results from improved living standards. However, challenging this hypothesis, there is growing evidence that in many affluent countries the prevalence is higher among those in low socio-economic status. These socio-economic differentials in asthma support a role of environmental factors in the development of asthma.
So what are the environmental factors and how do they cause asthma? As we become wealthier, our lifestyles change and this has a significant affect on the way that we breathe. With modern living we eat more processed foods, overeat, do less physical exercise, experience more stress and have higher temperatures in the home. Jobs in the modern economy tend to be service-based. As a result they entail very little physical activity and many hours of talking. In addition we are subjected to the unhealthy belief that prevails in gyms, sports class, stress counselling and even western Yoga about the benefits of big breathing. The modern western lifestyle has quite a profound influence on our breathing- IT INCREASES IT.
This explanation concurs with the work of Russian Doctor Konstantin Buteyko who discovered that asthmatic children and adults habitually breathe a volume of air greater than what is required. For example, the mouth might be open, there may be periodic sighs and there will be visible movements of the chest and tummy. This is supported by a number of clinical trials indicating that the breathing volume of asthmatics is two to three times the normal amount of five litres per minute as determined by the World Health Organisation.
Dr Buteyko discovered that the heavy breathing of the asthmatic is causing their airways to tighten resulting in chest tightness, coughing wheezing and breathlessness. Buteyko espoused that asthmatics must always breathe through their nose and keep their breathing calm and quiet. His method is now recognised by the British Thoracic Society, has been subject to six clinical trials and is taught as part of nurses Masters Degree programme at Coventry University.
It would be fine if volcanic ash clouds remained high in the atmosphere out of reach of our breathing, but with reports of particles found on cars in several places in Ireland and the UK, there is no point in throwing caution to the wind. Given the physiological benefits of the nose as an effect filter of airborne particles, it remains our first point of defence.
An estimated 60% of asthmatics have rhinitis or “asthma of the nose”, making breathing through it somewhat difficult. Part of the Buteyko Method contains a simple breath hold exercise to free the nose;
• Take a small breath in
• Have a small breath out
• Pinch nose with fingers to prevent air flow
• Nod head up and down for as long as possible
• When you feel a strong need to breathe, let go of the nose and breathe through it
• Calm breathing immediately
Wait about one minute for your breathing to recover and repeat about four times. In five minutes your nose will be free!
Patrick McKeown was a chronic asthmatic for most of his life. As a child he recounts “waking up fighting for breath and wheezing on his way to school as he carried his school bag”. McKeown has a Masters degree from Trinity College Dublin, but ten years ago after he made a full recovery from his condition, he left it behind to become a Buteyko practitioner. He is one of a few people to study under the tutelage of the late Dr Buteyko and now his work takes him throughout Ireland, Europe and the USA. In addition he has penned four books including his most recent book linking overbreathing to anxiety called “Anxiety Free”.
Finally, when you hear of flights to and from Irish airports being cancelled- take the obvious action of keeping your mouth closed, breathing through your nose and keeping your breathing calm. While this should be an everyday occurrence, it becomes even more important when fine ash particles are present.

BREATHE FREELY IF YOU HAVE ASTHMA

by Jerome Burne, The Sunday Telegraph, 31 December 1995.

Asthma, as we all know, is a disease that prevents people getting enough air into their lungs, because the passageways close up. The trouble is we have got it completely wrong. Actually, asthma is the body’s way of saying: “You are breathing too deeply”. Learn to breathe more shallowly and the asthma will disappear.

This apparently ridiculous idea is at the heart of a revolutionary new cure for this often chronic and crippling disease which affects one in 20 adults in this country and kills more than 2,000 a year. Traditional treatment aims to force the constricted air passages open with steroids and “bronchodilator” drugs.

However, Australian Christopher Drake, who runs group sessions in the Buteyko Breathing Reconditioning Technique at the Hale clinic in London, believes this is profoundly mistaken. “Within a week we can get 97 per cent of patients off most of their drugs and able to control attacks. “All we use are specific breathing techniques”.

Among his successful cases is Jonathan Aitken MP, who had asthma for 5 years before doing the course. “It’s the only thing that has worked for me,” he says. “I think it is remarkable.” Another supporter is Dr. John Stanley, a medical microbiologist at the Central Public Health Laboratory who, although he wants to wait three months before making a final assessment, says that he has not felt so well in years. “I’d had asthma for nine years, and it was gradually getting worse.”

The technique was developed in Russia by Professor Konstantin Buteyko. Drake first encountered it in Australia about five years ago, and now an estimated 8,000 Australians have been treated with it. One clinical trial written up in the Medical Journal of Australia, describes the results as showing “unprecedented broad-spectrum improvement”.

What makes Buteyko approach so controversial is that it turns our idea of what happens during breathing on its head. In the authorised version, what we all need is oxygen. The job of the lungs is to transfer oxygen into the blood making it bright red and healthy and to breathe out carbon dioxide -the waste product.

In the Buteyko version, it is carbon dioxide that gets the lead role. Drake points out, and physiologists would not disagree, that CO2 is vital for control of the major body systems, such as the immune system, the digestion and the heart. Certainly the transference of oxygen to the blood from the lungs depends on the right amount of CO2 being available.

“Now it is textbook stuff, but not widely known that for the exchange to work most efficiently you need in your lungs about 6 per cent CO2 and 2 per cent oxygen,” says Drake. “This means that the focus of everyone’s breathing is not, as we all think, getting enough oxygen – there’s lots of it around, 20 per cent in every breath – the problem is getting enough CO2, as each breath contains only .035 per cent. The key role of the lungs is to act as a CO2 reservoir”. The storage tanks are the alveoli – millions of tiny sacs in the lungs where CO2 is transferred into the blood.

“When someone constantly takes in too much air,” says Drake, “these reservoirs get diluted with other gases. The asthmatic spasm is a dramatic message from the body that screams ‘Slow down, CO2 reserves running low.’ Literally, the last thing you need at this point is a drug to force your airways open.”

It might have remained yet another eccentric personal theory, were it not for the results. “You have to be pretty well motivated,” says Dr. Stanley. “The exercises aren’t easy. They are the opposite of what you have been doing all those years. But within just a few days you get back a control of something as basic as your breathing. And that’s amazing.”

ASTHMATICS TAUGHT TO BREATHE AS COSMONAUTS

NZ Doctor, 23/06/95

A breathing technique similar to that which allows Russian cosmonauts to survive for long periods in outer space is being trialled in Australia to assess its application for treating asthma.

In a controlled trial of asthma patients conducted in Brisbane, Buteyko breathing hyperventilation exercises were shown to improve symptoms, and reduce beta agonist use by 90 per cent.

However, there were no changes in physiological parameters such as peak flow rate in people using the technique.

Preliminary results of the randomised, controlled trial were reported at a meeting of the Thoracic Society of Australia and New Zealand In Hobart last month by a respiratory physician at Mater Hospital in Brisbane, Simon Bowler. The results defy obvious explanation. The research team was surprised at the results as no significant changes had been expected.

Proponents of the Buteyko technique claim that hyperventilation and the subsequent increase in carbon dioxide levels can relieve the symptoms of bronchospasm, and have a favourable effect on the long term course of asthma.

Under the study funded by the Australian Association of Asthma Foundations, 40 patients with well-documented asthma and significant daily use of bronchodilators were recruited and randomised to a Buteyko or a control group. Those in the Buteyko group received classes from a Buteyko practitioner for 90 minutes a day for seven days. Patients were encouraged to minimise beta agonist use.

The control patients received a similar regimen of physiotherapy classes and standard asthma education, breathing exercises (but not hypoventilation), and relaxation techniques.

Patients In both groups were instructed to use bronchodilators only as required, and not on a routine basis.

After six weeks there was a 90 per cent reduction In beta agonist use in the Buteyko group, compared with a 5 per cent reduction in patients in the control group.

Patients in the Buteyko group reported significant improvements in both their symptoms, and their quality of life.

A further six week trial investigating the effect of reducing inhaled corticosteroid use has been completed, but data analysis is not yet complete.

New Zealanders use the method

About 700 New Zealanders are using the Buteyko technique for asthma control, according to Russell Stark, one of the only two Buteyko practitioners teaching the method here.

The Buteyko technique was developed In the Soviet Union in the 1950s. Mainly used to treat asthma and emphysema, it has been an integral part of the Russian health system since 1981 but was unknown in the West until the early 1990s.

By learning to saturate their bodies with carbon dioxide, patients can lessen muscle tension and slow breathing to a normal rate.

The Buteyko method is used to teach patients to control an asthma attack, and to prevent attacks from occurring. Patients are never told to stop taking their prescribed medications.

“We ask people to stay on their preventative medications but to try the technique before using their relief medication when they have an attack, ” he said.

“If they find it doesn’t work, then they take their medication. ”

If a patient finds the technique successful they can then talk to their GP about coming off preventative drugs.

Patients using the technique for asthma have reported “tremendous improvements” in their quality of life, said Mr Stark. They sleep better, feel less tired and more relaxed, allergies disappear, and they are less prone to Infection.

“It Is difficult for conventional medicine to accept that such good results can be had from something that is just a breathing technique.”

In Russia, the Buteyko technique is also used to treat a wide range of conditions other than asthma. These include angina, high and low blood pressure, haemorrhoids, varicose veins and even cancer.

QUOTES & REFERENCES

“I have just watched a roomful of people who have suffered terribly from perhaps the most rampant disease of this generation, long thought to be incurable, begin to recover from it. Dramatically. Almost incredibly. Within five days.”
Sally Magnusson, The Herald, Glasgow

“It has changed my life. Before, I could barely walk up stairs now I can manage a 10 mile hike. I was using my puffer four times a day as well as steroids and now I’m off all drugs”
Dr. John Stanley, The Independent Newspaper (UK)

“It has given me a new lease on life”
Jonathan Aitken Member of Parliament UK

“Impressive results ”
Charles Mitchell, Professor of Medicine University of Queensland, (Australia)

“I am surprised and impressed”
Dr. Paul J. Ameisan, MB.,BS.,MD. Ac., N.D. (Sydney)

“I recommend this skill without reservation, this is a resource anyone would benefit from learning. All this in addition to the broad spectrum of well documented therapeutic applications.”
Dr. Anthony Soyer MB., BS. (London)

“Very impressive”
Dr. Gerald Spence, MB,BS (Glasgow)

” It’s great to get through a game without all those other medications. Having to use them all the time is a worry,”
Asthmatic Canterbury Rugby player and former All-Black Con Barrell

“I haven’t looked back and I describe Buteyko’s work as the discovery of the century”
Caren Clonda- Former Australian Squash Champion

EVERY BREATH YOU TAKE

Sunday Tribune, 14 July 2002

Most of us know somebody with asthma writes Kate O Flaherty,

It affects some 300,000 adults and children in Ireland, and we have the forth highest prevalence in the world.

The causes of asthma are unclear, with various theories suggesting environmental pollution, allergens and the hygiene hypothesis, which claims that the rise of asthma is linked to our more sterile environments, where children are exposed to less infectious disease and so their immune system do not mature properly. However, the medical consensus is that asthma is a disorder of the inflammatory or immune system.

There is however, an alternative explanation for the symptoms of asthma, based on the observations of Russian physician Professor Konstantin Buteyko, which claims that asthma is caused by over breathing.

Breathing is something we all take for granted, so it may come as a surprise to learn that many of us are probably not doing it properly. We all know the basics- we breathe in oxygen which is transferred from the lungs to the blood stream and around the body, and we breathe out carbon dioxide. However, the lungs need to retain a certain concentration of carbon dioxide in order for the oxygen transfer system to operate efficiently.

The normal volume of air we should breathe is about six litres a minute, but if people breathe greater volumes than this, they exhale too much carbon dioxide from their lungs. The body then switches on its defence mechanism to avoid losing carbon dioxide (as this is turn affects our oxygen supply), which is to constrict the airways, which gives rise to symptoms such as wheezing, breathlessness, coughing and chest tightness.

Buteyko tested thousands of asthmatics and found that all of them were breathing twice or three times the normal amount of air. He developed a breathing therapy, based on training people to use a lesser volume of air. By correcting their chronic over breathing, the carbon dioxide levels in the lungs remain normal, and the airways remain open. The results for asthmatics is that they no longer require medication to control their symptoms.

The Buteyko therapy was brought to the Western world in the 1990’s first to Australia and then to Europe, and has generated much debate and controversy, as it was initially greeted with scepticism by the medical establishment, which advised patients of the dangers of substituting breathing techniques for medication. However, the basic principles behind the method are accepted, and while much of the evidence is anecdotal, the task for Buteyko practitioners now is to prove its benefits in clinical trials.

It’s a task that one Scottish woman has taken on with a passion. Jill McGowan had asthma and worked as a practice nurse in Glasgow. Initially sceptical, as she was very involved in helping people manage their asthma through medication , she attended a Buteyko seminar in Glasgow. “Within 24 hours, my breathing had improved – it was unbelievable” she says. “I was using a nebuliser and ventolin inhaler, and I haven’t been using either since first the weekend. After about twelve weeks of being symptom-free, and when I had mastered the breathing exercises, I started to slowly reduce my steroids, which I eventually came off as well. I haven’t taken steroids or antibiotics since.

“Since it had such a dramatic effect on my own health, I became quite committed to using and teaching the Buteyko method, but it took a full year for me to believe, because it was challenging my own beliefs. I thought about patients who had died from asthma, wondering if we were doing the right things for them, and that was very difficult to come to terms with. So I resolved to try and get the therapy into wider practice”.

Jill’s commitment was so great that when she found it difficult to get funding for a clinical trial. She sold her own house to fund the research project. The trial, involving 600 patients, is the largest to date in the world. The preliminary results after the first year are impressive. Patients using the Buteyko method show a 98% reduction in asthma symptoms, a 92% reduction in the use of preventer or steroid inhalers and a 100% reduction in the use of inhalers. They also report huge increases in vitality, emotional health and quality of life. These results are preliminary and the completed study must undergo scientific scrutiny if it is to be accepted and change the long held beliefs of respiratory experts.

Jill’s goal is to have the Buteyko method made available on the NHS, and she hopes that her research will provide the scientific evidence for such a decision. Her study was discussed in the British Parliament in June, and senior politicians have responded favourably to her efforts to make the therapy more widely available.

Here in Ireland, Patrick McKeown was also a severe asthmatic who became medication free after trying the Buteyko method. He trained as a practitioner in Moscow and set up a practice called Asthma care in March of this year. He holds workshops around the country where he trains people in the breathing techniques and offers lifestyle advise to minimise symptoms. “The Buteyko method is not a cure,” he says. “Its a way of better understanding and controlling your asthma. Patients who come to us sign a contract stating that they will remain on prescribed medication and will only change it after consultation with their family doctor, when their symptoms improve substantially. Anyone over five can learn the therapy, but it does require discipline to practice it in the initial stages”. Patrick too would like to see further research into the therapy to enable the benefits he has experienced to be more widely available.

RUSSIAN TECHNIQUE HELPS ASTHMATICS

by Kathryn McNeil, Christchurch Press; June 1995

A breathing technique similar to that which allows Russian cosmonauts to survive a long time in outer space is being used to help asthma sufferers in Australia and New Zealand.

An Australian study has shown that the breathing exercises are successful, allowing asthma patients to reduce medication by 90 per cent and significantly improve their symptoms.

The Buteyko technique was developed in the Soviet Union in the 1950′s. The technique, used to treat asthma, emphysema, and some other illnesses, has been an integral part of the Russian health system since 1981 but unheard of in the West until the end of the decade.

Introduced to Australia in 1990, doctors are said to be surprised that breathing exercises can achieve results that medication often cannot.

Russell Stark, one of only two trained Buteyko practitioners teaching the technique in New Zealand, said more than 700 New Zealanders were now using the breathing technique for asthma control. The technique has been available here only in the last six months.

Mr Stark and his son both suffered from asthma. Before learning the Buteyko technique at the age of 14, his son’s asthma condition was chronic. On high levels of medication (Ventolin inhaler and steroids), he was unable to cycle even 200m and completed his homework while connected to a nebuliser.

Now 17, he is able to run, competes in athletics, and is “full of confidence”.

The technique teaches hypoventilation exercises. The natural reaction to an asthma attack is to try to breath more, but with the Buteyko technique patients learn to breath less. Through breathing less, patients “saturate” their bodies with carbon dioxide. This lessens muscle constriction, and slows down breathing to a more normal rate.

Patients using the method learn how to overcome an attack, and by regularly using the exercises can learn to prevent attacks from occurring.

Mr Stark said patients using the technique were never told to stop taking prescribed medications. “We ask people to stay on their preventative medications but to try (the Buteyko technique) before using their relief medication when they have an attack,” he said. “If they find it doesn’t work, then they take their medication.”

Usually the technique worked, and once patients found it worked for them, it was suggested they talk to their doctor about coming off preventative medicines.

About one in four people in New Zealand had respiratory problems, he said. More than 100,000 people were on medication for asthma or breathing related problems.

People using the Butevko technique for asthma had reported “tremendous improvements” in their quality of life, he said. They slept better, felt less tired, and more relaxed did not have to worry about medication, allergies disappeared and they were less prone to infection.

“Within a week their pulse-rate dropped about 20 points. It is difficult for conventional medicine to accept that such good results can be had from something that is just a breathing technique.”

Health professionals had been slow to pick up on the success of the technique but asthma patients who had used it were living proof that it worked, he said.

ASTHMA UNDER ATTACK

Breathing space: A controversial approach to treating asthma has brought rapid relief and lifestyle benefits to one chronic sufferer and his family.

by Russell Lander, The Bulletin (Australia); 8 October 1996, p26-27.

For 14 years I have been on asthma medication but on February 9 this year I threw out my spray and have remained drug-free and well for some six months. For those who suffer from chronic asthma, this assertion is likely to engender astonishment or extreme skepticism, as this now very common medical condition is generally regarded as intractable, requiring lifelong preventative drug treatment. Doctors won’t promise that you’ll never get off asthma drugs because they don’t know the precise cause of what is now an epidemic.

I hope my story will encourage chronic asthmatics to consider an alternative approach to what is now regarded as standard treatment reliever and preventer medication delivered by puffers, turbuhalers and nebulisers, and cortisone and theophylline tablets. Needless to say, each of these treatments comes with its own suite of side effects and asthma sufferers who follow this course are riding a tiger.

Technique: My wife heard from her physiotherapist about the Buteyko breathing technique and we decided that, with our daughter Jennie, we would do the course. A Buteyko instructor, one of a number of practitioners in Australia teaching the technique, took us through a series of breathing exercises, explaining the theory as he went along. It is surprising how many people have heard about what has become known as “That Russian breathing technique”, but few, it seems, actually do a course.

Our two-week course, conducted at home, comprised five sessions of about one-and-a-half hours each. During this period we had to practise a routine and time our results. The instructor encouraged us to reduce our use of reliever medications within a comfort zone but not to reduce the preventers. I chose to stop all medication at a stroke on day one of the course, even though the instructor had advised against it.

Like many great ideas, the Buteyko approach seems deceptively simple, but is actually quite complex to apply. In essence, the method advocates taking in small breaths through the nose, breathing out gently and holding the breath for extended periods. At first it is foreign to the asthma sufferer but with a little practice it soon becomes second nature.

So how does it work? Konstantin Pavlovich Buteyko is a 73-year-old Russian doctor whose research over many years revealed that deep breathing far from being a virtue can be harmful, and that shallow breathing is the natural way to inhale. Deep breathing, he claims, depletes the bloodstream of carbon dioxide, causing blood vessel spasms and oxygen starvation. This in turn may bring about asthma, headaches, rapid heart beat and a number of other medical conditions.

Gulp: Asthmatics tend to gulp in too much air and their efforts to exhale as much as possible to make way for the next hard-won breath deprives the bloodstream of carbon dioxide, a smooth muscle dilator. The effect is that the more asthmatics strain to take in extra air, the less oxygen is actually being released to the body’s cells. Buteyko’s technique of breathing through the nose is alien to most asthmatics because more air can be inhaled via the mouth than the nose, and in any case the nose may well be blocked.

But there are four good reasons why breathing through the nose is beneficial to asthmatics. It regulates the temperature of the air, filters it, humidifies the lungs and limits the volume of air that can be inhaled. The Buteyko method teaches how to unblock the nose and how to maintain nasal breathing all day and all night.

Since giving up all asthma drugs, I have noticed a number of positive changes. I am generally calmer, my hands are steadier, I have stopped suddenly feeling breathless, I can sleep peacefully right through the night instead of waking feeling choked, I have stopped bruising badly at the slightest knock or scratch (attributed to cortisone use), pain experienced in my upper back over many years associated with hyperventilation has disappeared and I seem to have more cash.

That is not to say that I haven’t had asthmatic symptoms occasionally, but I have been able to overcome these by following the book, as it were lowering the breathing rate, softening exhalation and holding the breath for extended intervals every five minutes or so. The Buteyko method has worked for my daughter, Jennie, too. Now 28, she has been a chronic asthmatic from the age of two. On numerous occasions she has been rushed to casualty in a state of dire breathlessness, sometimes put on a cortisone drip for days. Since doing the course she has come down from a towering 25 or more puffs of Ventolin each day to none at all. She has also been able to reduce her preventer medication from six to two puffs of Pulmicort a day. The Buteyko method of controlled breathing has worked wonders in my family and I urge asthma sufferers to be open-minded about it. Although it is not currently covered by health funds, sufferers should weigh the cost against that of regular asthma medications, doctors’ fees and possible hospitalisation. And, anyway, what price quality of life?

Drug Seller Defection

by Ray Moynihan

From the Australian Financial Review, Thursday, 23 August 2001

While the alarming incidence of asthma has health authorities worried, drug companies are making a fortune out of medications. Ray Moynihan meets a former pharmaceutical company manager who’s now an enthusiastic advocate of alternative treatments.

Two weeks ago, Michael Cichorski was working for a drug company with annual sales of more than $50 billion. As marketing manager for asthma medications at Glaxo, he promoted drugs such as the top-selling Ventolin to doctors and the public

With 2 million Australians diagnosed as asthmatic, and many on life-long medication, asthma drugs are a massive $300 million annual market, dominated by Glaxo SmithKline. For three years, Cichorski was arguably Australia’s biggest promoter of these medications. And he was committed both professionally and personally. Not only was he marketing the drugs, he was also taking them, having had asthma since he was seven.

But the salesman lost the faith. Last week, he defected from the drug industry for a new career in asthma, this time teaching simple breathing techniques. His conversion followed his fears of dependence on the very products he was selling.

“I was taking more and more medications – both the puffers for relief and the steroids used for prevention, but if I stopped them, the asthma came back,” he told the Australian Financial Review. “I was concerned I was building a life-long dependency on very potent medications.”

Working inside a global pharmaceutical company, Cichorski had easy access to the large body of scientific literature. “I had no concern about the effectiveness of the drugs but, reading the literature, I became more and more worried about side effects, particularly with long-term usage,” he said.

Two years ago, while still marketing Glaxo’s asthma brands, he accepted a challenge from a practitioner of the little- known Buteyko breathing technique. Despite being initially skeptical, after just five sessions learning to control his breathing, he was able to dramatically reduce his reliever medications. Within six months, he had stopped using steroids as well. And now? “I am asthma free and drug free,” he says.

Anecdotes like this might sound convincing but are worth little scientifically. As it happens, though, there is a small but growing body of scientific evidence that a range of breathing methods, such as Buteyko and yoga classes, can help. But even though early results have been promising, there have been no large trials to date, and simple non-drug options remain on the margins of Australian medicine.

Asked whether the closeness between doctors and drug companies has retarded the progress of breathing methods in Australia, senior asthma specialist Dr. Michael Abramson told the AFR: “That’s a difficult question. Certainly, the drug industry provides more infrastructure for trialling drugs.”

Abramson recently published results from a small trial of the breathing methods conducted at Mortash University in Melbourne. “We found it very hard to attract any funding for our study of Buteyko,” he says, adding that the Monash trial was done without any external funding, relying almost entirely on the hard work of an individual student, Ashley Opat.

That trial found asthmatics who learned breathing exercises from a video were able to reduce their use of reliever medications by 60 per cent and significantly improve their quality of life – as compared with a control group who watched a nature video.

Several years earlier, a small study run at the Mater Hospital in Brisbane found people doing Buteyko classes were able to reduce their use of reliever puffers by more than 90 per cent. Drug use in the control group remained virtually unchanged. Neither trial reported any adverse effects.

If breathing classes like this were more widely adopted, and results anything like those achieved in Melbourne and Brisbane were replicated, the $80 million sales of- Ventolin-style puffers would clearly be in trouble.

Interestingly, despite reductions in medication use and improvements in quality of life, patients showed no improvement on the standard lung function tests in either trial. Associate professor at Monash University, Michael Abramson, says the fact that people didn’t show any change on the standard tests is probably less important than the fact that they improved their quality of life. “We think there is evidence they got better,” he says.

Abramson’ s openness indicates a shift in attitudes within medical science, which treated breathing techniques with extreme skepticism just a decade ago.

Proponents argue that the medical establishment has been far too slow to study the breathing method. The chief executive of the Buteyko Institute, Paul O’Connell, says: “In Australia, much of the funding for asthma research comes from the manufacturers of asthma medications.

“Those companies have no interest in a technique which doesn’t involve medications – and, in fact, progressively takes people off them. The influence they have over decision makers in government and health organisations has prohibited non-drug therapy receiving serious attention.”

According to O’Connell, this is one reason he and others recently set up the Buteyko Institute, which is now seeking funding for more trials.

The chairman of the National Asthma Council, Dr Ron Tomlins, rejects criticism that decision makers are too close to industry.

While conceding his organisation relies on drug companies for a substantial portion of its funding, he says there are strict guidelines guaranteeing independence. He adds that the Federal Government made a significant contribution to the NAC’s work in the Budget this year.

Because most of the trials done so far have been small, there is still uncertainty about whether breathing classes can help, how much they can help and who they can help. A recent systematic review of all the scientific evidence, published by the highly respected international Cochrane Collaboration, concluded: “No reliable conclusions can be drawn concerning the use of breathing exercises for asthma in clinical practice.” However, the authors of the Cochrane review strongly supported more research.

As it happens, a very large trial involving 600 people is under way in Scotland. While early non-peer-reviewed results from Scotland again show dramatic reductions in drug use, final results are a number of years away.

Most asthma specialists do not yet endorse the method, but it’s estimated that more than 10,000 Australians have already tried the breathing techniques – commonly taught in five short sessions for a fee of about $600.

Throughout the classes people learn to hold their breath, breathe through their nose, and breath less – in line with the Buteyko belief that asthma symptoms are largely due to over-breathing.

Every night last, week at an RSL club in the Melbourne suburb of Glen Waverley, a small group gathered for breathing classes. Among the group is seven-year-old Christine, whose parents told the AFR they were trying the exercises because of concerns that Christine was already being prescribed large doses of medications.

Under the watchful eyes of Paul O’Connell, tiny Christine was walked through her exercises by new recruit Michael Cichorski, the former drug company manager who has just graduated as a practitioner in the Buteyko Institute method.

So keen is the former Glaxo manager that he has just refurbished his suburban home, transforming it into a working clinic. Despite his obvious vested interest, Cichorski is not shy about his passion for the new enterprise. – “It can reverse a life-long dependency on medication,” he says.

Asked to explain his defection from. drug promoter to born-again breathing practitioner, he simply says, “‘My interest-has shifted” – largely because of his own health concerns about drug dependency.

Like his colleagues, he cautions that breathing classes are not a “cure” for asthma and people should not throw away their medications, insisting instead that reductions should be achieved in consultation with a doctor.

While loath to make any critical comments about his former industry, Cichorski calmly observes that educational bodies such as the National Asthma Council should be free of all company funding, in order to boost objectivity and credibility. For its part, Glaxo declined to comment on either the former manager or breathing classes.

While Western medicine may have been slow to rigorously investigate breathing techniques such as yoga classes and Buteyko, the tide may be turning. In May this year, researchers writing in the prestigious British Medical Journal suggested many problems put down to asthma may in fact be caused by abnormal breathing patterns.

Doctors from the University of Leicester argued in the BMJ that a large minority of asthma patients might be experiencing -avoidable harm, “because of inappropriate diagnosis and ineffective treatment”.

They concluded that many people treated for asthma “may be helped by simple non- pharmacological interventions”.

While other researchers have challenged that view, there are growing concerns that too many people are taking asthma meditations they may not really need.

Global sales of asthma puffers are clearly making a healthy contribution to Glaxo’s $17 billion pre-tax profits and are of obvious benefit to the company shareholders.

What is not so clear is whether the benefits are also flowing to all of those taking the drugs.