Asthma Causes, Signs, Symptoms: Coughing, Wheezing, Chest Pain

All available medical evidence suggest that you can have bronchial asthma only if your breathing is too heavy. You cannot have asthma, if you breathe in accordance with medical norms. Therefore, to solve problems with asthma one needs to learn how to breathe correctly.

Symptoms and signs of asthma

Classic signs and symptoms of asthma

* Bronchoconstriciton (narrowing of airways: bronchi and bronchioles) - caused by CO2 deficiency
* Inflammation of airways (caused by cell hypoxia produced by hyperventilation, see CO2: Inflammatory Response)
* Increased sensitivity of the immune system to innocent triggers (dust mites, airborne protein from cats and dogs, pollen, and so forth)
* Excessive production of mucus in airways

Early warning signs Increased mouth breathing, both during days and night sleep Increased night-time cough Increased sleeping on one's back Restless sleep or waking up tired Worsening allergy symptoms like runny nose Cough or wheezing with physical activity Tiredness with activities that you normally could complete easily	Symptoms of mild asthma Chronic cough, especially at night Wheezing Shortness of breath Increased mucus production, especially in the morning Chest tightness, pain, or discomfort Increased difficulty completing your normal activities
Further development of asthma You can hear yourself wheezing Experience a cough that just won't go away (day or night) Have more trouble falling asleep and getting a good nights rest Increased heart rate (over 80 beats/min) Have PEFRs (peak expiratory flow rate) well into the yellow zone Get less relief from your 'quick relief' medications	Signs of a possible emergency (life-threatening asthma attack) Severe wheezing while breathing both in and out Breathing very fast Getting short of breath while or having difficulty talking A feeling of impending doom or panic Profuse sweating Inability to perform PEFR Color changes in fingertips

Breathing and causes of asthma

How much do asthmatics breathe?

All available medical research suggests that asthmatics are chronic hyperventilators. Let us review these studies. You can click on the graph to see all references and follow the links to read abstracts of all these 5 studies.

Table. Minute ventilation in patients with asthma

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
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

Chronic hyperventilation causes reduced CO2 levels in alveoli and airways of the lungs.

Can low CO2 levels lead to problems with airways?

"The mechanism of bronchoconstriction due to hypocapnia in man" (“hypocapnia” means abnormally low CO2 concentrations) was the title of the article published in 1968 by Clinical Science Journal. In this article, Dr. Sterling suggested that CO2 deficiency creates an over-excited state of the cholinergic nerve. Since this nerve is responsible for work of the smooth muscles in bronchi, its excitement leads to constriction of bronchi and smaller air passages (bronchioles). This causes wheezing, coughing, and high heart rate in people with asthma. Mucus production makes these symptoms worse.

One modern physiology textbook claims, “Agents that tend to dilate human airways include increased PaCO2 (hypoventilation or inspired CO2),” (p. 545; Straub, 1998). This textbook directly asserts that reduced breathing (or hypoventilation) or increased CO2 in the inspired air will dilate airways. Moreover, CO2 is suggested as the most potent natural chemical substance that promotes this "breathing-easy" effect.

Soviet MD and PhD KP Buteyko suggested that asthma is caused by alveolar hyperventilation in the 1950’s (his first medical article about this effect was published in 1964). He observed and discovered the central role of breathing too much in the progress and degree of asthma (Buteyko, 1964). He and his medical colleagues also found that asthmatics can get quick alternative drug-free relief from asthma attack symptoms, if they practiced shallow or reduced breathing.

Dr. Herxheimer independently suggested that hypocapnia or low CO2 was the cause of bronchial asthma in 1946 (Herxheimer, 1946) and 1952 (Herxheimer, 1952) in his articles "Hyperventilation asthma" and "The late bronchial reaction in induced asthma".

Allergies and asthma

How do asthma and asthma attacks develop?

Low CO2 values in the bronchi cause chronic constriction of airways (that happens in all people). In addition to this direct effect, chronic hyperventilation makes immune reactions abnormal. The immune system becomes too sensitive in relation to intruders from outside (coming with air or food), but weakens the responses to various pathogens, like viruses and bacteria. (That makes sense since hyperventilation is a defensive reaction and a part of the fight-or-flight response. Hyperventilation then should mean a state of increased alertness and emergency for the whole organism, the immune system included.)

The immune system becomes hypersensitive and seemingly innocent events like breathing cold air or inhaling dust particles can trigger an inflammatory response in asthmatics, excessive production of mucus, a sense of anxiety or panic, more hyperventilation, and further constrictions of airways.

As a result, mucus makes air passages narrower (or even blocks some of them) creating a feeling of suffocation and causing asthma attacks. During an attack, an asthmatic may try to clear the mucus by coughing it out, but that further reduces CO2 concentrations in the lungs and makes air passages narrower. The smart solution to these problems is to do the opposite. How? This YouTube video (on the right side) provides a simple breathing exercise "How to stop asthma attacks" that is a similar exercise used to stop coughing.

Prevention and alternative natural therapy for asthma

Clinical trials of the Buteyko method for asthma

What were the main outcomes of randomized controlled trials of the Buteyko breath therapy in western countries? There were 6 trials all together. After 3-6 months of daily breathing exercises, asthmatics required:
- 3-9 times less reliever medication
- about 2 times less steroidal drugs
- significantly improved quality of life
- significantly improved score for asthma symptoms (less cough, wheezing, chest tightness, dyspnea, and other symptoms of asthma).

All these astonishing results in spite of the fact that if we compare pulmonary parameters of the patients in the experimental groups at the end of the trials, they only partially normalized their breathing achieving about 25-30 seconds CP (the body-oxygen test described below).

You can read all abstracts and detailed results of these and other trails: Clinical Trials of the Buteyko Method.

However, there were no changes in lung function results. Why? According to Dr. Buteyko's theory breathing normalization must cure asthma. Did asthmatics change their breathing during these randomized controlled trials? During the most impressive study in Australia (Bowler et al, 1998), in 3 months, consumption of reliever medication was reduced by 96% (or 25 times less) and inhaled steroidal drugs or preventers by about 50%. Respiratory minute volume at rest decreased from initial 14 L/min to 9.6 L/min after 3 months, but the medical norm for breathing is only 6 L/min, while Dr. Buteyko’s standard is 4 L/min at rest for a 70-kg man. Hence, during their best shot, the participated asthmatics got only about a half way towards the standard. Thus, there were a very few asthmatics, if any, who naturally normalized their breath during these trials.

One of the assumptions of the medical doctors, who participated in these asthma trials, was that a Buteyko therapist taught the alternative Buteyko technique, while a controlled group of asthmatics learned the therapy. Indeed, in titles and abstracts of these randomized controlled trials, we can read “trial of the Buteyko method”. How could they study the Buteyko breathing method, if no one learned it?

Of we consider these trials from a practical viewpoint, the patients were mainly limited to practicing breathing exercises (e.g., 1 hour per day). However, breathing retraining requires constant regulation of breathing due to negative effects of lifestyle risk factors. As we already learned it in the past, asthmatics are most likely to die and experience acute episodes and attacks during early morning hours due to the Morning Hyperventilation Effect. What is the point to treat asthma, if most asthmatics sleep on their backs and breathe though the mouth during sleep (hence, dry mouth in the morning)? They will surely produce more irritation of airways, inflammation and mucus during mouth breathing. How could they heal their airways if their irritate them every morning? The typical daily CPs (body-oxygen test results - see below) at the end of these trials, judging by other respiratory parameters, were about 20-30 s. Morning CPs were around 15-22 s. This allows, according to Buteyko Table of Health Zones, reduction in most medication for asthma, but has never been enough to heal airways and normalize lung function results.

Hence, it is not a smart way to teach breathing retraining therapy without:
- nose breathing all the time; mouth taping at night
- avoidance of sleeping on one’s back (it causes higher heart rate and even chest pain)
- wrong coughing techniques and wheezing (ordinary coughing increases production of mucus)
- sufficient physical activity (at least 2 hours every day with nasal breathing only)
- and numerous other lifestyle-related details so that one’s basal breathing pattern is gradually restored back to the medical international standard.

Therefore, when a breathing student normalizes his or her automatic breathing patterns, he or she will have a complete clinical remission (cure) from asthma. More details about Effects of Breathing Retraining on Asthma Symptoms and Medication.

Coughing and acute asthma web pages:
- Stop Acute Asthma Exacerbation in 2-3 min (Breathwork)
- Stop Coughing At Night - A breathing exercise to reduce duration and severity of coughing at night. This exercise helps to fall asleep faster
- Best Cough Treatment Therapy - The ultimate solution to chronic problems with wet or whooping cough, chesty of dry cough, coughing at night, and coughing in children.

How to increase body oxygenation

There are many breathing techniques and methods in order to normalize breathing and increase body-oxygen levels. The Buteyko breathing technique has the most powerful arsenal of lifestyle changing tools, which are described in detail in the Section Learning. The same Section also describes the Buteyko breathing exercises, which are difficult to learn. Furthermore, there are breathing exercises that are more powerful (in comparison with the Buteyko breathing exercises) to increase body oxygenation.

Oxygen remedy is such a program that is based on using the Buteyko lifestyle program and the application of breathing devices (the Amazing DIY breathing device, Frolov device and some others) that trap exhaled air with high CO2 levels for inhalations to boost body-oxygen content. More info about these alternative respiratory techniques can be found here:
* Amazing DIY breathing device
* Frolov breathing device.

Further resources:
- Acute Asthma Exacerbations Clinical Trial - Application of the Frolov breathing device in hospital setting: probably the most successful medical trial in the history of asthma trials
- Clinical effects of the Buteyko breathing technique on asthma and other respiratory disorders - Whatever the breathing technique applied, the final results for over 95% of breathing students depend only on their morning CP achieved.

Reference pages: Breathing norms and medical facts:
- Breathing norms: Parameters, graph, and description of the normal breathing pattern
- 6 breathing myths: Myths and superstitions about breathing and body oxygenation (prevalence: over 90%)
- Hyperventilation: Definitions of hyperventilation: their advantages and weak points
- Hyperventilation syndrome: Western scientific evidence about prevalence of chronic hyperventilation in patients with chronic conditions (37 medical studies)
- Normal minute ventilation: Small and slow breathing at rest is enjoyed by healthy subjects (14 studies)
- Hyperventilation prevalence: Present in over 90% of normal people (24 medical studies)
- HV and hypoxia: How and why deep breathing reduces oxygenation of cells and tissues of all vital organs
- Body-oxygen test (CP test) : How to measure your own breathing and body oxygenation (two in one) using a simple DIY test
- Body oxygen in healthy: Results for the body-oxygen test for healthy people (27 medical studies)
- Body oxygen in sick : Results for the body-oxygen test for sick people (14 medical studies)
- Buteyko Table of Health Zones: Clinical description and ranges for breathing zones: from the critically ill (severely sick) up to super healthy people with maximum possible body oxygenation
- Morning hyperventilation: Why people feel worse and critically ill people are most likely to die during early morning hours

References: pages about CO2 effect:
- 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: How alveolar CO2 influences oxygen transport
- Oxygen transport: O2 transport is controlled by vasoconstriction-vasodilation and the Bohr effects, both of which rely on CO2
- Free radical generation: Reactive oxygen species are produced within cells due to anaerobic cell respiration caused by cell hypoxia
- Inflammatory response: Chronic inflammation in fueled by the hypoxia-inducible factor 1, while normal breathing reduces and eliminates inflammation
- Nerve stabilization: People remain calm due to calmative or sedative effects of carbon dioxide in neurons or nerve cells
- Muscle relaxation: Relaxation of muscle cells is normal at high CO2, while hypocapnia causes muscular tension, poor posture and, sometimes, aggression and violence
- Bronchodilation: Dilation of airways (bronchi and bronchioles) is caused by carbon dioxide, and their constriction by hypocapnia (low CO2)
- Blood pH: Regulation of blood pH due to breathing and regulation of other bodily fluids
- CO2: lung damage: Elevated carbon dioxide prevents lung injury and promotes healing of lung tissues
- CO2: Topical carbon dioxide can heal skin and tissues
- Synthesis of glutamine in the brain, CO2 fixation, and other chemical reactions
- Deep breathing myth: Ignorant and naive people promote the idea that deep breathing and breathing more air at rest is beneficial for health
- Breathing control: How is our breathing regulated? Why hypocapnia makes breathing uneven, irregular and erratic.

References

Buteyko KP, An Instruction for VBN Therapy for Bronchial Asthma, Angina Pectoris, High Blood Pressure and Obliterating Endarteritis: Preprint. - Novosibirsk, 1964.

Herxheimer H, Hyperventilation asthma, Lancet 1946, 6385: p. 83-87.

Herxheimer H, The late bronchial reaction in induced asthma, Int Arch Allergy Appl Immunol 1952; 3: p. 323-328.

Straub NC, Section V, The Respiratory System, in Physiology, eds. RM Berne & MN Levy, 4-th edition, Mosby, St. Louis, 1998.

If you click the above Facebook like button and "like" this page, I will be nearly "forced" to asnwer your question. You can also tweet this page. Mention this in your comment, and you can ask even more. Thanks.

or Go back to Diseases

Disclaimer

Copyright 2013 Artour Rakhimov

Contact details

About Artour Rakhimov (Google profile)