The overall aims of breathing exercises are to increase the level of carbon dioxide in the alveoli, and to train the body to become accustomed to it. As indicated in previous chapters, our lungs require a concentration of between five per cent and six-and-a-half per cent carbon dioxide, equating to a control pause (CP), taken while at rest, of between forty and sixty seconds. Most of those with an asthma problem will have a CP of between 10 and 20 seconds, and this points to a carbon dioxide level of between four and four-and-a-half per cent. As you can see, this is much lower than what the body requires.
To trap a higher level of carbon dioxide and to readjust the respiratory centre to this increased amount, exercises specifically aimed at reducing breathing are performed at specific times each day. These exercises should be continued until a reduced volume of breathing becomes a way of life, and until the control pause reaches at least forty seconds. When you are able to maintain a control pause of forty seconds, you will have mastered the art of correct breathing, it will be an unconscious activity, and will be incorporated into your daily life.
To increase the control pause to your interim target of twenty seconds, breathing exercises are essential. As you train yourself to breathe correctly, physical activity should be used in conjunction with breathing exercises to help increase the control pause from twenty to your ultimate aim of forty seconds.
The objectives of these exercises are:
• To lower the incidence of asthma attacks.
• To halt an attack at the first sign of symptoms. For example, a simple blocked nose is one of the first signs of an attack.
Over a twelve-month period, breathing is brought to the more normal level of three to five litres as shown in the following diagram. This breathing is best described as regular, calm and smooth.
Diagram- The change to correct breathing.
The most important requirement before starting these exercises is to be aware of your breathing. If you are not aware of your breathing, you will not be able to reduce the volume of air drawn in and consequently you will not experience any improvement at all. I have included in this book a number of different breathing exercises. Choosing the most appropriate depends on a number of factors, such as whether you are an adult or a child, whether you have mild or severe asthma, whether you are having an attack or not, and whether or not you are physically exercising at the time.
As you read on, you will see that five breathing exercises are outlined in this chapter as follows:
Exercise One: Reduced breathing by relaxation and monitoring air-flow with finger.
Exercise Two: Reduced breathing for children.
Exercise Three: Reduced breathing to overcome an asthma attack.
Exercise Four: Reduced breathing during nose-blowing.
Reduced breathing by relaxation and monitoring air-flow with finger
The following is a very simplified version of one of the main exercises involved in breath correction. Certain steps have been omitted as it is essential they are practiced under the direct supervision of a practitioner to take into account individual nuances of the patient.
This exercise lasts about half-an-hour and it is recommended that you practice two to three times each day. If you can, you should practice before breakfast, during the day if possible, and again in the evening. Exercises should be carried out in a quiet place with no distractions. The temperature should be cool and the room airy because a hot and stuffy environment can promote big breathing, the exact opposite of what you are trying to achieve.
Food affects your breathing, so it is not recommended that you practice immediately after eating a meal. Exercises are best practised before meals or at least two hours after them. At half hourly intervals there should be pulse and control pause measurement, as well as a number of sets of breathing exercises.
If you want to get the best out of these exercises, it is recommended that you adhere to the following general guidelines. Go to a quiet place where you are unlikely to be disturbed and where you will have no distractions. Place a ‘Do Not Disturb’ sign on the door, if you need to, and take the telephone off the hook or switch off your mobile. You will need to concentrate to complete this exercise correctly, particularly in the early days.
Adopt a correct but comfortable posture. Correct posture involves sitting up straight with both feet underneath your chair. If you have difficulty with this, then imagine a thread suspended from the ceiling, attached to the top of your head, holding you in an upright position.
Correct posture is very important in helping to reduce your breathing. When you sit slouched, your breathing will increase and will be more from the upper chest than the tummy, where it should be coming from. When you adopt the correct posture, your tummy will move more than your upper chest and your breathing will require less effort. Your tummy will move out with each inhalation (breathing in) and will move in with each exhalation (breathing out) because of the action of the diaphragm, which is the main breathing muscle. Make sure that your tummy moves in the right sequence. If not, you are performing what is known as reverse breathing.
Now that you are in the right place and the right posture for you, focus on your breathing. Feel the movement of air in and out of your body, particularly through your nostrils. Concentrate on the slight movement your body makes with each inhalation and exhalation. It is vital to be aware of your breathing so that you can correct it. If you are unaware of your breathing, you will not be able to improve it.
As you breathe, let your shoulders fall to their natural position. Raised or tense shoulders increase the volume of the chest cavity and so increase the volume of air inhaled. Tension increases breathing, but relaxation decreases it. Relax the muscles involved in respiration, such as the muscles above your tummy and in your chest.
The next step is to monitor the amount of air flowing through your nostrils by placing your finger under your nose in a horizontal position. Your finger should lie just above your top lip, and close enough to your nostrils so that you can feel the airflow, but not so close that the air-flow is blocked.
Now, breathe air slightly into the tip of your nostrils. Little breaths or short breaths mean the amount of air reaching your lungs reduces. By reducing the depth of your breathing or the length of each breath, in other words, the number of breaths you take every minute may increase, but don’ t worry because this is normal. Remember that the aim is to reduce the volume.
When you breathe out, the more warm air you feel, the bigger your breathing. Concentrate on reducing the amount of warm air you feel on your finger.
Diagram Creating a little air shortage.
Don’t worry if this exercise does not work for you the first time you try it. It will take time for your body to become accustomed to the lower volume of breathing. Over time it will become easier. A gradual and relaxed approach is best, because if you try to decrease the amount of air too quickly or too much, it may cause involuntary gasps of air or cause you to take bigger breaths. It is important that you get to the stage where you can sustain reduced breathing over the course of three to five minutes.
Take a few minutes’ break before you start the next five minutes of reduced breathing. Two sets of twenty minutes per day is the minimum time that should be spent on this exercise, combined with relaxation and observation of your breathing for the remainder of the day and night (more about this later). In order to make progress it is necessary to spend this amount of time practising. After a number of months, and depending on your progress, breathing exercises can be performed while doing any activity such as reading a book or watching television.
People with severe asthma should practice breathing exercises three times per day, preferably before breakfast, before lunch and in the evening. For those with mild and moderate asthma, breathing exercises should be practised twice daily, before breakfast and before going to bed. For correct exercise practice, each block should take about half-an-hour to do correctly.
A block of exercises consists of:
1. Take your pulse, and note it.
2. Control pause.
3. Reduced breathing for five minutes.
4. Control pause.
5. Reduced breathing for five minutes.
6. Control pause.
7. Reduced breathing for five minutes.
8. Control pause.
9. Reduced breathing for five minutes.
10. Control pause.
11. Check your pulse again and compare with your pulse rate when you started the exercise.
In order to reset the respiratory centre you must spend at least fifteen minutes doing breathing exercises. The control pauses in between each set of breathing exercises may decrease due to accumulation of carbon dioxide. It is vital that the pulse at the end of exercise (11) has decreased and the control pause (10) has increased due to a readjustment of the respiratory centre to a higher level of carbon dioxide. If your results are different, it means that you are overbreathing during the exercises, but this can be corrected by applying greater relaxation and reducing the intensity of the air shortage created.
I am very familiar with what happens when the exercises are not done correctly. When I first started using the Buteyko method myself, I tried to reduce the depth of my breathing by tensing my stomach to influence the amount of air I inhaled. However, this led to an increase in my breathing because of the additional tension I created. When I learned how to do the exercise correctly, I then had to begin reversing my previous breathing pattern.
Your lower respiratory muscles can become tense in response to a decreased volume of breathing, so the best advice is to try to relax throughout the exercises. Some will find this more difficult than others some people are, by nature, more relaxed than others but relaxation is a priority.
Summary of Exercise One
• Set aside time when you will have no distractions.
• Sit down and adopt the correct posture.
• Relax your respiratory muscles.
• Place your finger under your nose without blocking the air-flow.
• Concentrate on reducing the amount of air that is blown onto your finger by monitoring the temperature of the air you are breathing out through your nose.
• Reduce volume by taking very small breaths.
• Your control pause should increase when the exercises have been completed.
• Your pulse should decrease when the exercises have been completed.