Investigating the claims of Konstantin Buteyko, MD, PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing.

Investigating the claims of Konstantin Buteyko, MD, PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing.

Courtney, R., Cohen, M. Investigating the claims of Konstantin Buteyko, MD., PhD: The relationship of breath holding time to end tidal CO2 and other proposed measures of dysfunctional breathing. Journal of Alternative and Complementary Medicine, 2008, 14(2):115 -123

Abstract

 

OBJECTIVES:
Konstantin Buteyko, M.D., Ph.D., claimed that breath holding time (BHT) can be used to detect chronic hyperventilation and that BHT predicts alveolar CO(2) (Pa(CO(2))) according to his patented mathematical formula. The Buteyko Breathing Technique (BBT) is believed to correct chronic hyperventilation as evidenced by increased BHT. In this study, we test Buteyko’s claims and explore the relationship between BHT and end-tidal carbon dioxide (ETCO(2)) as well as measures of dysfunctional breathing (DB) including the Nijmegen questionnaire, the Self Evaluation of Breathing Questionnaire, and thoracic dominant breathing pattern.
SUBJECTS:
Eighty-three (83) adults healthy or suspected of having dysfunctional breathing, 29 with abnormal spirometry readings, 54 with normal spirometry.
OUTCOME MEASURES:
BHT, performed according to BBT protocols, was measured along with ETCO(2) and other measures of DB including the Nijmegen questionnaire, and manual assessment of respiratory motion, a palpatory technique for measuring thoraco-abdominal balance during breathing. Correlations between measures of DB were made in the whole sample and also in subgroups with normal or abnormal spirometry. DB measures were compared in normal and abnormal spirometry groups.
RESULTS:
The results revealed a negative correlation between BHT and ETCO(2) (r= -0.241, p<0.05), directly opposite to Buteyko’s claims. BHT was significantly shorter in people with abnormal spirometry (FEV(1) or FVC<15% below predicted), with no difference in ETCO(2) levels between the abnormal and normal spirometry groups. In the abnormal spirometry group, lower BHT was found to correlate with a thoracic dominant breathing pattern. (r= -0.408, p<0.028).
CONCLUSIONS:
Although BHT does not predict resting ETCO(2), it does correlate with breathing pattern in subjects with abnormal spirometry. It is proposed that altered breathing pattern could contribute to breathing symptoms such as dyspnea and that breathing therapies such as BBT might influence symptoms by improving the efficiency of the biomechanics of breathing.

Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of “coherence” during biofeedback.

Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of “coherence” during biofeedback.

Courtney, R., Cohen, M., van Dixhoorn J., Relationship between dysfunctional breathing patterns and ability to achieve target heart rate variability with features of “coherence” during biofeedback. Altern Ther Health Med. 2011 May-Jun;17(3):38-44.

Abstract

 

BACKGROUND:
Heart rate variability (HRV) biofeedback is a self-regulation strategy used to improve conditions including asthma, stress, hypertension, and chronic obstructive pulmonary disease. Respiratory muscle function affects hemodynamic influences on respiratory sinus arrhythmia (RSA), and HRV and HRV-biofeedback protocols often include slow abdominal breathing to achieve physiologically optimal patterns of HRV with power spectral distribution concentrated around the 0.1-Hz frequency and large amplitude. It is likely that optimal balanced breathing patterns and ability to entrain heart rhythms to breathing reflect physiological efficiency and resilience and that individuals with dysfunctional breathing patterns may have difficulty voluntarily modulating HRV and RSA. The relationship between breathing movement patterns and HRV, however, has not been investigated. This study examines how individuals’ habitual breathing patterns correspond with their ability to optimize HRV and RSA.
METHOD:
Breathing pattern was assessed using the Manual Assessment of Respiratory Motion (MARM) and the Hi Lo manual palpation techniques in 83 people with possible dysfunctional breathing before they attempted HRV biofeedback. Mean respiratory rate was also assessed. Subsequently, participants applied a brief 5-minute biofeedback protocol, involving breathing and positive emotional focus, to achieve HRV patterns proposed to reflect physiological “coherence” and entrainment of heart rhythm oscillations to other oscillating body systems.
RESULTS:
Thoracic-dominant breathing was associated with decreased coherence of HRV (r = -.463, P = .0001). Individuals with paradoxical breathing had the lowest HRV coherence (t(8) = 10.7, P = .001), and the negative relationship between coherence of HRV and extent of thoracic breathing was strongest in this group (r = -.768, P = .03).
CONCLUSION:
Dysfunctional breathing patterns are associated with decreased ability to achieve HRV patterns that reflect cardiorespiratory efficiency and autonomic nervous system balance. This suggests that dysfunctional breathing patterns are not only biomechanically inefficient but also reflect decreased physiological resilience. Breathing assessment using simple manual techniques such as the MARM and Hi Lo may be useful in HRV biofeedback to identify if poor responders require more emphasis on correction of dysfunctional breathing.

 An explorative study of metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and people with metabolic syndrome

 An explorative study of metabolic responses to mental stress and yoga practices in yoga practitioners, non-yoga practitioners and people with metabolic syndrome

Tyagi, A., Cohen, M., Reece, J., Telles, S., (2014) An Explorative Study of Metabolic Responses to Mental Stress and Yoga Practices in Yoga Practitioners, Non-Yoga Practitioners and People with Metabolic Syndrome. BMC Complementary and Alternative Medicine 14(445)

Abstract

 

Background: Stress places a metabolic burden on homeostasis and is linked to heightened sympathetic activity,
increased energy expenditure and pathology. The yogic state is a hypometabolic state that corresponds with
mind-body coherence and reduced stress. This study aimed to investigate metabolic responses to stress and different
yoga practices in regular yoga practitioners (YP), non-yoga practitioners (NY) and metabolic syndrome patients (MS).
Methods: YP (n = 16), NY (n = 15) and MS (n = 15) subjects underwent an experimental protocol that comprised of
different 5-minute interventions including mental arithmetic stress test (MAST), alternate nostril breathing (ANB),
Kapabhati breathing (KB) and meditation (Med) interspersed with 5 minutes of quiet resting (neutral condition (NC)).
During the intervention periods continuous body weight adjusted oxygen consumption (VO2ml/min/kg) was measured
using open circuit indirect calorimetry with a canopy hood.
Results: This is the first study to report oxygen consumption (OC) in yoga practitioners during and after MAST and the
first to report both within and between different populations. The results were analysed with SPSS 16 using 3X9
mixed factorial ANOVAs. The single between-subject factor was group (YP, NY and MS), the single within-subject factor
was made up of the nine intervention phases (NC1, MAST, NC2, ANB, NC3, KB, NC4, Med, NC5). The results demonstrated
that the regular YP group had significantly less OC and greater variability in their OC across all phases compared to the
MS group (p = .003) and NY group (p = .01). All groups significantly raised their OC during the mental arithmetic stress,
however the MS group had a significantly blunted post-stress recovery whereas the YP group rapidly recovered back to
baseline levels with post stress recovery being greater than either the NY group or MS group.
Conclusions: Yoga practitioners have greater metabolic variability compared to non-yoga practitioners and metabolic
syndrome patients with reduced oxygen requirements during resting conditions and more rapid post-stress recovery.
OC in metabolic syndrome patients displays significantly blunted post-stress recovery demonstrating reduced metabolic
resilience. Our results support the findings of previous randomised trials that suggest regular yoga practice may mitigate
against the effects of metabolic syndrome.
Clinical trial number: ACTRN12614001075673; Date of Registration: 07/10/2014.