Breathing Techniques That Work (Review)
“All chronic pain, suffering and diseases
are caused
from a lack of oxygen at the cell level."
Prof. A.C. Guyton, MD, The Textbook of Medical Physiology*
* World’s most widely used
medical textbook of any kind
* World's best-selling physiology book
Here are some proper breathing techniques that are used to gradually change automatic breathing patterns and improve body oxygen content. Note that one can spend months or years practicing some breathing techniques and exercises, but if his or her automatic (unconscious) breathing pattern remains the same, there are no improvements in health, symptoms, and quality of life. Hence, the goal is to achieve breathing retraining or permanent changes in automatic breathing.
There are also some other less known or less common breathing techniques. They include breathing techniques for labor or childbirth (Lamaze breathing techniques), breathing techniques for running, singing, speaking, swimming, meditation, stress, and many others. There is even a breathing technique to help horses. In addition, there are web pages devoted to reviews of respiratory trainers (such as Powerbreathe, Expand-A-Lung, PowerLung and Ultrabreathe). These breathing techniques are used to train inspiratory muscles, but the effects of these devices depend on methods and instructions for their application.
Breathing techniques compared
| Hatha yoga | Pursed lip breathing | Strelnikova breathing gymnastic | Buteyko breathing method | Frolov breathing device | RESPeRATE guided- breathing device | |
| When created | Prior to 16-th century | Before 1910 | Late 1930s-early 1970s | 1960’s | 1990’s | 1990’s |
| Who created | Yogi Swatmarama | Patients | Alexandra Nikolaevna Strelnikova | Konstantin Pavlovich Buteyko | Vladimir Frolov & Eugeniy Kustov |
Benjamin Gavish |
| Major publications | “Hatha Yoga Pradipika” by Yogi Swatmarama | Many articles and trials | “Strelnikova breathing gymnastic” by Michael Schetinin (in RUS) | Many books, articles and trials | “Endogenous breathing: medicine of the third millennium” by Vladimir Frolov (in RUS) | - |
| Patents and applications | None | None | USSR,1972 | Applications and patents | USSR,1991; Russia,1998 USA,1998 | USA, 1998 |
| Number of students | Many tens of millions | >100,000 (worldwide) | >50,000 (mainly in Russia) | >500,000 (half in Russia) | >1,000,000 (over 95% in Russia) | 100,000 (in western countries) |
| Which conditions | Chronic diseases | COPD, asthma, asthma in children, emphysema, stroke, autonomic failure, primary hypertension, major abdominal surgery, cystic fibrosis, myasthenia gravis, myotonic muscular dystrophy, autonomic failure | Some chronic diseases | Chronic diseases | Chronic diseases | Hypertension |
| Clinical trials | Numerous, worldwide | Numerous, worldwide |
No trials, but some MDs' reports | Numerous, worldwide |
Numerous, Russia | 10 western clinical trials |
Note that the "Russian dominance" in this Table reflects the
current situation related to popularity of some proper breathing techniques in Russia.
For example, over 2,000,000 Frolov breathing devices were sold there during the first decade of the 21st century. In Russia, the Frolov breathing
device can be bought in a pharmacy. Furthermore, Russia is probably the only
country in the world where the general population believes and knows that the slower and less you breathe, the better your
health is. This is due to the public activities and clinical work of leading
Soviet physiologist Konstantin Buteyko, MD, PhD and about 600 Russian medical
doctors who teach breathing
techniques.
| Lifestyle factor: | Body oxygen < 30 s | Body oxygen > 50 s |
| Energy level | Medium, low, or very low | High |
| Desire to exercise | Not strong, but possible | Craving and joy of exercise |
| Intensive exercise with nose breathing | Hard or impossible | Easy and effortless |
| Typical mind states | Confusion, anxiety, depression | Focus, concentration, clarity |
| Craving for coffee, sugar and junk foods | Present | Absent |
| Addictions to smoking, alcohol, and drugs | Possible | Absent |
| Desire to eat raw foods | Weak and rare | Very common and natural |
| Correct posture | Rare and requires efforts | Natural and automatic |
| Sleep | Often of poor quality; > 7 hours | Excellent quality; < 5 hours naturally |
How to choose proper breathing techniques?
Proper breathing techniques should satisfy certain criteria in order to be
useful for health of the breathing retraining student. One of the things to
consider is that the general approach of any breathing technique should take our
automatic or unconscious breathing pattern 24/7 into consideration, and not
only suggest doing some breathing exercises.
In other words, what is the point of doing breathing exercises, if one sleeps with his mouth open and on his back every night? He can practice best breathing exercises for several hours every day, but he can still die from advance of cancer, heart disease, diabetes, asthma, bronchitis, or other chronic disease due to the Sleep Heavy Breathing Effect which is the main triggering factor leading to acute episodes (exacerbations) and deaths in the severely sick.
This Table explains why sick people have low body oxygen levels.
Minute ventilation rates (chronic diseases)
| Condition | Minute ventilation |
Number of people |
All
references or click below for abstracts |
| Normal breathing | 6 L/min | - | Medical textbooks |
| Healthy Subjects | 6-7 L/min | >400 | Results of 14 studies |
| Heart disease | 15 (±4) L/min | 22 | Dimopoulou et al, 2001 |
| Heart disease | 16 (±2) L/min | 11 | Johnson et al, 2000 |
| Heart disease | 12 (±3) L/min | 132 | Fanfulla et al, 1998 |
| Heart disease | 15 (±4) L/min | 55 | Clark et al, 1997 |
| Heart disease | 13 (±4) L/min | 15 | Banning et al, 1995 |
| Heart disease | 15 (±4) L/min | 88 | Clark et al, 1995 |
| Heart disease | 14 (±2) L/min | 30 | Buller et al, 1990 |
| Heart disease | 16 (±6) L/min | 20 | Elborn et al, 1990 |
| Pulm hypertension | 12 (±2) L/min | 11 | D'Alonzo et al, 1987 |
| Cancer | 12 (±2) L/min | 40 | Travers et al, 2008 |
| Diabetes | 12-17 L/min | 26 | Bottini et al, 2003 |
| Diabetes | 15 (±2) L/min | 45 | Tantucci et al, 2001 |
| Diabetes | 12 (±2) L/min | 8 | Mancini et al, 1999 |
| Diabetes | 10-20 L/min | 28 | Tantucci et al, 1997 |
| Diabetes | 13 (±2) L/min | 20 | Tantucci et al, 1996 |
| Asthma | 13 (±2) L/min | 16 | Chalupa et al, 2004 |
| Asthma | 15 L/min | 8 | Johnson et al, 1995 |
| Asthma | 14 (±6) L/min | 39 | Bowler et al, 1998 |
| Asthma | 13 (±4) L/min | 17 | Kassabian et al, 1982 |
| Asthma | 12 L/min | 101 | McFadden & Lyons, 1968 |
| COPD | 14 (±2) L/min | 12 | Palange et al, 2001 |
| COPD | 12 (±2) L/min | 10 | Sinderby et al, 2001 |
| COPD | 14 L/min | 3 | Stulbarg et al, 2001 |
| Sleep apnea | 15 (±3) L/min | 20 | Radwan et al, 2001 |
| Liver cirrhosis | 11-18 L/min | 24 | Epstein et al, 1998 |
| Hyperthyroidism | 15 (±1) L/min | 42 | Kahaly, 1998 |
| Cystic fibrosis | 15 L/min | 15 | Fauroux et al, 2006 |
| Cystic fibrosis | 10 L/min | 11 | Browning et al, 1990 |
| Cystic fibrosis* | 10 L/min | 10 | Ward et al, 1999 |
| CF and diabetes* | 10 L/min | 7 | Ward et al, 1999 |
| Cystic fibrosis | 16 L/min | 7 | Dodd et al, 2006 |
| Cystic fibrosis | 18 L/min | 9 | McKone et al, 2005 |
| Cystic fibrosis* | 13 (±2) L/min | 10 | Bell et al, 1996 |
| Cystic fibrosis | 11-14 L/min | 6 | Tepper et al, 1983 |
| Epilepsy | 13 L/min | 12 | Esquivel et al, 1991 |
| CHV | 13 (±2) L/min | 134 | Han et al, 1997 |
| Panic disorder | 12 (±5) L/min | 12 | Pain et al, 1991 |
| Bipolar disorder | 11 (±2) L/min | 16 | MacKinnon et al, 2007 |
| Dystrophia myotonica | 16 (±4) L/min | 12 | Clague et al, 1994 |
Therefore, proper breathing techniques should also have answers to the
following questions:
- What is ideal breathing (or
ideal unconscious breathing pattern) for maximum body oxygen content? Note
that it is not enough to only think about the maximum oxygen content
in the lungs or arterial blood. Oxygen is required in all body cells.
- Which breathing techniques improve or increase oxygen content in cells?
- What are the common breathing patterns and
what are their effects on body oxygen content?
- What is the exact direction of the breathing
techniques?
- What are the effects of lifestyle factors?
Some features of proper breathing techniques
| Traditional Hatha yoga | Pursed lip breathing | Strelnikova paradoxical breathing gymnastic | Buteyko breathing method | Frolov breathing device | RESPeRATE guided- breathing device | |
| Diaphragmatic breathing during breathwork |
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| Lifestyle factors addressed |
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| Learnt without an instructor |
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| Constant breath control |
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| Strict criteria of progress/ success |
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* Out of several hundred Russian Frolov MDs, only a small group of these medical professionals considers the effects of lifestyle on breathing retraining.
The understanding of breathing techniques comes from the knowledge of
breathing parameters in both sick and healthy people as well as the effects
of breathing patterns on cells oxygen levels (see links to medical studies
below).
Breathing techniques can improve one's health only if they make one's breathing pattern after the breathing session lighter and slower in terms of minute ventilation. In this case the student also increases their cells oxygen content, which is measured with the simple Control Pause (CP or body oxygen test - see details below). Hence, the personal goal is to achieve a slow and shallow (but diaphragmatic) breathing pattern manifested in high CP test results. In the long run, better morning CP results reflect efficiency of a proper breathing retraining technique.
Video: How to choose best breathing techniques and morning CP test

In relation to healthy lifestyle factors, the Buteyko breathing technique is the most advanced breathing technique, and only Hatha Yoga comes close. In relation to breathing exercises, the Buteyko method produces good results.
However, most students achieve a faster CP progress when using breathing devices, e.g., the Frolov breathing device or DIY breathing device. While there are now hundreds of MDs in Russia, who promote or endorse the Frolov device, very few of them understand and explain to their patients importance of correct life style factors.
Hence, the optimum breathing retraining program for a typical student with a chronic disease (less than 20 s for the body oxygen test) includes breathwork with a breathing device (that traps a part of exhaled air) and adherence to Buteyko lifestyle factors.
|
Yoga Benefits: How to get best benefits from this amazing ancient practice? Traditional yoga has been teaching us to breathe less, while modern yoga leaders confuse the public about correct breathing, ideal breathing, and effects of CO2. |
Pursed lip breathing web page provides an overview of this breathing technique, health conditions addressed (mostly COPD, but many others too), detailed instructions, and its physiology, and effects. |
|
Breathslim is a breathing device that is featured on the Breathslim website. The Breathslim device is an exact copy of the Frolov breathing device developed by Vladimir Frolov. Can it help with weight loss? |
The Samozdrav breathing device is another patented Russian invention based on Dr. Buteyko's discoveries and CO2 effects. Its creators also worked for Soviet Cosmos (Outer Space Research), and they suggested 4 levels of learning... |
|
Resperate is a FDA-approved portable device for slow paced breathing sessions. It had 10 clinical trials on patients with hypertension and could lead to moderate reduce blood pressure decrease... |
Inspiratory Muscle Training (also known as IMT) can be done using various respiratory trainers of breathing devices, such as Powerbreathe, Expand-A-Lung, PowerLung and Ultrabreathe. They are all presented below. |
|
Powerbreathe is a breathing device used, as the authors and creators claim, to train inspiratory muscles only. It is mostly used for sports performance, but there are medical applications as well. |
Expand-A-Lung breathing resistance exerciser is a more recent breathing trainer used to strengthen respiratory muscles due to resistance that can be regulated. |
|
PowerLung is a device that creates resistance during both inhalations and exhalations. PowerLung has some popularity, especially among athletes.... |
Ultrabreathe: Review of Ultrabreathe Breathing Device suggests that, as with other Western devices, there is one missing factor in training and analysis of effects. |
|
Is etCO2 (end-tidal CO2) or capnography useful for breathing retraining? Can capnometers improve the effectiveness of breathing exercises or could it worsen the outcomes? Capnography and etCO2 web page.... |
*** Under construction *** (Further reviews will include Strelnikova breathing gymnastic and some other breathing techniques.) |
Warning.
There are numerous restrictions and contraindications for some
health problems (anxiety, diabetes, hypertension, GI problems, and so on) in
relation to specific breathing exercises. In addition, pregnant women, people
with organ transplants, and some other groups of people should follow special guidelines
in relation to their general breathing retraining progress. Finally, there are important
preliminary requirements that make breath work safe and more effective (empty stomach,
good thermoregulation, and so forth). All these factors can be found
in the Learning Section of this website.
References: CO2 Effects Web Pages
Vasodilation: CO2 expands arteries and arterioles facilitating perfusion
(or blood
supply) to all vital organs
The Bohr effect
How and why oxygen is released by red blood cells in tissues
Cell Oxygen Levels and oxygen transport are controlled by
alveolar CO2 and breathing
Oxygen Transport depends on
breathing and these two effects (Vasoconstriction-Vasodilation and the Bohr
effect) are parts of two diagrams that summarize influences of hypocapnia (low CO2
content in the blood and cells) on circulation and O2 delivery
Free Radical Generation takes
place due to anaerobic cell respiration caused by cell hypoxia. Hence,
antioxidant defenses of the human body are also regulated by CO2 and breathing
Inflammatory Response is controlled by
breathing since hypoxia leads to or intensifies chronic inflammation through over-expression
of the hypoxia-inducible factor 1, while normal
breathing reduces these processes
Nerve stabilization takes place due to calmative or
sedative effects of carbon dioxide in neurons or nerve cells
Muscle relaxation or relaxation of muscle cells
is normal at high CO2, while hypocapnia causes muscular tension, poor posture
and, sometimes, aggression and violence
Brochodilation - dilation of
airways (bronchi and bronchioles) by carbon dioxide, and their constriction due
to hypocapnia
CO2: Best Natural Cough Suppressant
and "home remedy" since it calms urge-to-cough nerve receptors located in the
tracheobronchial tree and larynx
Blood
pH regulation and regulation of other bodily fluids
CO2: Lung Damage Healer: Elevated carbon
dioxide prevents injury and promotes healing of lung tissues
CO2: Skin and Tissue Healer
Synthesis of Glutamine
in the Brain, CO2 fixation, and other chemical reactions
CO2 myth
"CO2 is a toxic waste gas" myth
Breathing control
How is our breathing regulated? Why hypocapnia makes breathing uneven and erratic?
Reference Web Pages: Breathing norms, Medical Graphs and Tables about Breathing Rates (Minute Ventilation) and
Body Oxygen in Healthy, Normal and Sick People
Breathing
norms Parameters, graph, and description of the normal
breathing pattern
6 breathing myths 6
myths about breathing and body oxygenation (prevalence: over 90%)
Hyperventilation Definitions of
hyperventilation: their advantages and weak points
Hyperventilation Syndrome in the
Sick. Table
1. Western scientific evidence about prevalence of CHV
(chronic hyperventilation) in patients with various chronic conditions
(34 medical studies)
Normal Minute Ventilation in
Healthy Subjects: Easy and Light Breathing (14 Studies)
Hyperventilation Prevalence Present in Over 90% of
Normal People (24 medical publications)
HV and hypoxia
How and why deep breathing reduces oxygenation of cells and tissues of
all vital organs
Body oxygen test
How to measure your own breathing and body oxygenation (a simple DIY test)
Body oxygen in healthy
Table 4. CP (body oxygen level) in healthy people (27 medical
studies)
Body oxygen in sick Table 5.
CP (body oxygen level) in sick people (14 medical studies)
Buteyko
Table of Health Zones with clinical description of most common zones
Morning HV Morning
hyperventilation effect or how and why critically ill people are most
likely to die during early morning hours
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