The control pause is a measure of the level of carbon dioxide in the alveoli based on a comfortable breath hold. The control pause and pulse are used together to monitor asthma. Over time, paying attention to the breathing pattern, your carbon dioxide threshold will adjust to a higher and healthier level. As a result the body becomes less sensitive to carbon dioxide accumulation, which will result in a gradual improvement in the length of time a person can hold their breath. By reducing the volume of breathing, carbon dioxide levels increase and therefore the control pause will increase.
Through overbreathing, the carbon dioxide level will decrease and therefore the control pause will decrease. The control pause will also decrease if medication is reduced too drastically. The control pause is consistent and is a very good indi- cator of progress and of the current condition of the asthma, because of this it is essential to learn how to measure it correctly. Bear in mind that the control pause is only a measure; it is not an exercise to increase the level of your carbon dioxide. The control pause enables the measurement of carbon dioxide in the alveoli without the need for any equipment other than a stopwatch or a watch/clock with a second hand.
Measuring your control pause
✦ Sit in an upright chair and adopt a good posture. Relax your shoulders and rest your lower back against the back of the chair.
✦ Do not change your breathing before taking your CP. Take a small breath in (two seconds) and a small breath out (three seconds). Hold your nose on the ‘out’ breath, with empty lungs but not too empty. Holding your nose is necessary to prevent air entering into the airways.
✦ Count how many seconds until you feel the first push of your breathing muscles. You should feel a jerk or move- ment from the area around your tummy (diaphragm) or larynx (neck). Let go of your nose and breathe through it.
✦ Your ﬁrst intake of breath after the CP should be no greater than your breath prior to taking measurement; you should not hold your breath for too long as this may cause you to take a big breath after measuring the CP.
Points to bear in mind
There are a number of important points to bear in kind when measuring your CP:
- Breathe normally before taking your CP. Try not to take a big breath before you start as this will give an inconsistent reading. If you have just completed breathing exercises, wait two or three minutes. Measuring your CP directly after exercises will give an inaccurate reading due to an existing air short- age from the exercise.
- Do not breathe all the air out of your lungs because this will be very uncomfortable and will result in a reduced CP. Also do not try to hold your breath for too long as this will give an incorrect reading. The CP is a measurement of your progress only: it is not an exercise to see how long you can hold your breath before you burst!
- Hold your breath only until you feel the ﬁrst urge to breathe in. You may not like the result but it is the correct one and that’s what you need to know. You can then take steps to correct it and gauge your progress with conﬁdence.
It does take some practice before you become consistent in measuring your control pause. The measure is subjective because it is difﬁcult to know what the ﬁrst urge is. At ﬁrst, it is very easy to push a little too hard and this is the case when the breath after taking the CP is greater than before. With practice, the control pause will become more consistent. A reading of the level of carbon dioxide in the alveoli will be achieved with a correct control pause.