Qs and As from the ebook Normal Breathing: the Key to Vital Health
Q: What were the historical origins of concerns about the dangers of CO2?
A: In the 1780s, French scientist Antoine-Laurent Lavoisier determined the
composition of air. He also discovered the mechanism of gas exchange during
respiration and burning. Oxygen is consumed for the production of energy and
carbon dioxide is expelled as an end product. In his classical experiments, mice
died in a closed glass jar in an atmosphere containing large quantities of
carbon dioxide and almost no oxygen. A candle also quickly expired in such air.
That was probably the time when a superficial understanding of respiration
produced the idea that carbon dioxide was a “toxic, waste and poisonous” gas
while oxygen brought life and vigor. “Take a deep breath”, “Breathe more air, it
is good for your health”, “Breathe deeper, get more air into your lungs, we need
oxygen”, etc. became popular phrases for which there is no scientific basis.
Even now, some scientific publications contain such misleading sentences, as
“Respiration is the process of oxygen delivery.”
Professor Yandell Henderson gave the following explanation of this ignorance,
“Likeness of Life to Fire. - Lavoisier's supreme contribution to science, and
particularly to physiology was the demonstration that, in their broad outlines,
combustion in a fire and respiratory metabolism in an animal are identical. Both
consist in the union of oxygen from the air with carbonaceous material: and both
result in the liberation of heat and the production of carbon dioxide…
The human mind is inherently inclined to take moralistic view of nature.
Prior to the modern scientific era, which only goes back a generation or two, if
indeed it can be said as yet even to have begun in popular thought, nearly every
problem was viewed as an alternative between good and evil, righteousness and
sin, God and the Devil. This superstitious slant still distorts the conceptions
of health and disease; indeed, it is mainly derived from the experience of
physical suffering. Lavoisier contributed unintentionally to this conception
when he defined the life supporting character of oxygen and the suffocating
power of carbon dioxide. Accordingly, for more than a century after his death,
and even now in the field of respiration and related functions, oxygen typifies
the Good and carbon dioxide is still regarded as a spirit of Evil. There could
scarcely be a greater misconception of the true biological relations of these
gases…” (Henderson, 1940).
Q: How did the parameter “40 mm Hg CO2” appear in textbooks?
A: This number is important because it is present in all main physiological
textbooks used nowadays by western students. This is the current medical norm
for CO2 content in alveoli and the arterial blood. The number was established
about a century ago by the famous British physiologists Charles G. Douglas and
John S. Haldane from Oxford University. Their results were published in the
article The regulation of normal breathing by the Journal of Physiology (Douglas
& Haldane, 1909). The investigators analysed arterial blood gases of staff
members at Oxford University, including scientists and support personnel, and
found the average for the group. It is possible to argue that even during those
times many University workers had a sedentary life style with little physical
activity. Hence, their CO2 concentrations could be lower than those for most
healthy people a hundred years ago. Indeed, another old study by the also famous
Karl Albert Hasselbalch had about 46 mm Hg aCO2 as the average value for
volunteers at rest (Hasselbalch, 1912). Doctor Buteyko suggested about the same
value to be the norm for people in good health.
Q: How many people have normal breathing?
A: If we accept medical standards (6 l/min for ventilation, as in most
medical and physiological textbooks, and 40 s for the BHT), only a small
percentage (less than 10%) of the population satisfies this criterion.
Experience shows that on average, only a few, if any, per 1,000 people have
breathing with Doctor Buteyko norm (60 s BHT or more).
Q: How much oxygen is retained in the human organism? In other words, are we
efficient in oxygen extraction from air?
A: Typical patients with asthma and heart disease breathe about 15 l/min at
rest and have about 15 s BHT. They utilize or absorb only about 10% of inhaled
oxygen, the remaining 90% is exhaled back in air. People, who are considered
normal by medical standards (6 l/min and 40 s BHT) retain only about a quarter
(25%) of the oxygen that they inhale. Their lungs are more efficient at
extracting oxygen. Those healthy people, who breathe in accordance with
Buteyko norm (4 l/min; 60 s BHT), can extract up to 30-35% of the oxygen they
inhale. People with over 3 min BHT (hatha yoga masters. Dr. Buteyko and many of
his colleagues, etc.) would have about 2 l/min for minute ventilation and retain
up to 60% of inhaled oxygen.
Q: Which body parts or tissues are particularly sensitive to tissue hypoxia?
In other words, how long can various organs and tissues survive without oxygen?
A: The time of survival will relate to initial oxygenation (reflected in the
breath holding time) and existing pollution of tissues. This table from the
British Medical Journal (Leach & Treacher, 1998) reflects tolerance to hypoxia
of various tissues for an ordinary person.
|Kidney and liver
|Vascular smooth muscle
|Hair and nails
Q: Some people claim that overbreathing can help the organism to "expel
toxins". Is this opinion correct?
A: Although some medical and physiological textbooks on respiration state
that unwanted substances can be removed from the organism through the air
passages, their quantities are small. In addition, overbreathing or
hyperventilation is unlikely to be useful due to greatly decreased blood
supply to other organs of elimination, which will then function less
efficiently. Moreover, poor blood supply to the tissues is going to diminish
the rate at which these substances are collected by body fluids and
Meanwhile, normal breathing (about 6 l/min), in addition to the described
normalisation of body physiology, means that smaller amounts of polluted
air, smoke, dust, etc. are taken in to the organism through the lungs.
Q: Does deep breathing help to deliver more fresh air to poorly
ventilated parts of the lungs filled with old stale air?
A: Often people also ask, “Is it true that, if I breathe little, I do not
exercise my lungs and can develop some lungs problems?” Vice versa. All
people with asthma, emphysema, bronchitis, and many other problems are heavy
breathers. They need CO2 to heal their lungs. In addition, people with heavy
or deep breathing are often chest-breathers since the smooth muscle of the
diaphragm is in the state of spasm. Hence, their lower layers of the lungs
get much less, if any, fresh air. Normal breathing is diaphragmatic allowing
homogeneous inflation of the whole lungs with fresh air, similar to what
happens in the cylinder of a car due to the movement of the piston.
Q: Can a few deep breaths or sighing relieve tension in the chest?
A: During the first of several deep breaths, not only are all alveoli in
the lungs greatly expanded providing more oxygen for all tissues, but also
any tightness in the chest muscles can be temporarily relieved, due to their
stretching and subsequent relaxation. Periodic sighing (a typical symptom of
diabetics, CFS sufferers, cardiac patients, asthmatics, etc.) is an example
of chest tension relief, but such deep breaths also remove more CO2, first,
from the lungs, and finally, from all cells.
As a result, any beneficial effects of deep breathing are very
short-lived. Moreover, lowered CO2 levels lead to worsening of the problems
which deep breathing was intended to solve causing: 1) further
bronchoconstriction, up to partial or total closure of some lung areas and
less effective gas exchange; 2) more muscular tightness due to increased
hypoxia, excessive excitability and tension in the chest and other muscles,
constriction of arteries and capillaries, and certain other physiological
disorders discussed above.
Thus, the temporary relief provided by periodic deep breaths or sighing
can become a part of the vicious circle. It is no surprise that various
medical professionals, authors of the already cited publications, viewed
sighing as a clear symptom of the chronic hyperventilation syndrome.
Q: How does breathing affect the quality of sleep?
A: A normal person needs about 5-6 hours of sleep. He falls asleep within
a few minutes, sleeps the whole night in the same position without
awakening, does not remember his dreams and wakes up fully refreshed. That
corresponds to normal breathing and normal breath holding time (about 40 s).
A typical asthmatic with 15 l/min ventilation and about 15 s BHT tends to
have 8-10 hours of sleep. He is likely to need some 5-20 minutes to fall
asleep. During the night he can awaken, get anxious, change positions, have
dreams, etc. In spite of the long period of sleep, he may still feel tired
in the morning. How and why are these abnormalities possible?
As mentioned above, hyperventilation "leads to spontaneous and
asynchronous firing of cortical neurons" (Huttunen et. al., 1999). This
phrase, from the professional magazine Experimental Brain Research, has very
serious personal and even social ramifications (as we are going to see in
For example, when this asthmatic goes to sleep he has thoughts, which are
self-generated by his brain in spite of his conscious attempts to calm down,
relax, put everything aside, etc. These “spontaneous and asynchronous”
thoughts often cause problems with falling asleep.
Let us consider the duration of sleep. Two main known physiological
purposes of sleep are to give rest to the brain (especially to cortical
areas) and the muscles. The normal person, due to normal aCO2
concentrations, has had a relaxed, easy attitude, with normal perception
during the whole day. He has experienced less stress (since stress in modern
people is mainly due to distorted attitudes to outer events and stimuli, not
due to life-threatening situations). His muscles have been relaxed (again
due to carbon dioxide). Hence, he needs only 5-6 hours of sleep.
The asthmatic, due to chronic hyperventilation, has had tense muscles and
over-excited brain during the whole day. Normally, he needs more time for
sleep in order to relax and rest his muscles and brain.
Moreover, severely sick and hospitalised people with 5-8 s BHT may need
up to 12-14 hours of sleep, usually of miserable quality: with frequent
awakenings, changed body positions, dreams, nightmares, etc. The causes are
the same: tense muscles and “spontaneous and asynchronous firing of cortical
[and other] neurons”.
Certain practical evidence and hatha yoga studies also have found that,
when breath holding time is about 1 minute, people need on average only
about 4 hours of sleep, while for 2-3 minutes BHT, 2 hours of sleep is
sufficient. In my view, that corresponds to the way Nature designed the
The relationships between sleep and breathing will be considered in more
Q: Are concentration and other mental skills (like logic, analytical
abilities, memory, etc.) similarly affected and why?
A: We know from above, that brain blood flow is proportional to aCO2. In
addition, brain oxygenation is impaired in such conditions due to the Bohr
effect. Both factors produce predictable effects on all our senses and
communication within the nervous system. At some moments of time, these
“spontaneous and asynchronous firings of cortical” and other neurons may
coincide with the normal image of the world. However, considering long
periods of time, it is unreasonable to expect that a chronically
hyperventilating brain can function normally.
Q: I have heard that in some places pure O2 can be bought for breathing.
Is it good for health?
A: While breathing pure O2, “Free radicals (and other toxic metabolites
of oxygen) are generated in most cells as a consequence of normal metabolic
processes, but cells are protected from injury by antioxidant mechanisms.
Several forms of lung injury appear to result from generation of toxic
metabolites of oxygen in quantities which exceed the antioxidant capacity of
lung cells…”, as stated at the very beginning of the abstract by Brigham
Moreover, detailed investigation of lung tissues revealed that, “Exposure
of animals to oxidant gases produces a mild emphysema, and O2-derived free
radicals are capable of degrading connective tissues in vitro. It is
postulated that degradation of connective tissue by O2-derived free radicals
leads to emphysema in these models” (abstract, Kerr et al, 1987).
A review, “Data on oxidants and antioxidants”, conducted by Junod (1986),
also found that “Since O2 intermediates can affect the general cellular
metabolism and inhibit cell replication or reduce protein synthesis, all the
biological effects of O2 and its metabolites should therefore be considered
in the pathogenesis of emphysematous lesions in the lung” (Junod, 1986).
Another related question is why anti-oxidants are important supplements.
They are used in order to diminish the possible damage done by oxidants
generated by, among other sources, excessive freely-dissolved O2
Finally, a textbook on medical physiology (Ganong, 1995) contains a
section entitled "Oxygen toxicity". It starts with: "It is interesting that
while O2 is necessary for life in aerobic organisms, it is also toxic.
Indeed, 100% O2 has been demonstrated to exert toxic effects not only in
animals, but also in bacteria, fungi, cultured animal cells, and plants. The
toxicity seems to be due to the production of the superoxide anion (O2-),
which is a free radical, and H2O2. When 80-100% O2 is administered to humans
for periods of 8 hours or more, the respiratory passages become irritated,
causing substantial distress, nasal congestion, sore throat, and coughing.
Exposure for 24-48 hours causes lung damage as well. In animals, more
prolonged administration without irritation is possible if treatment is
briefly interrupted from time to time, but it is not certain that periodic
interruptions are of benefit to humans" (Ganong, 1995).
In subsequent paragraphs, Professor Ganong describes development of lung
cysts and serious visual defects due to retinal damage in infants treated
with O2 for respiratory distress syndrome. Increased O2 pressure (in some
places pure O2 is administered at increased pressure) accelerates the
harmful effects of O2.
Meanwhile, breathing O2 for a few minutes would probably not be very
harmful. Generally, breathing pure oxygen can be useful as a short-term
emergency measure in cases of life-threatening hypoxia.
Q: What is the long-term influence of different air compositions on human
health? Has anybody investigated the optimum composition of air?
A: The first experiments in this area were done about a century ago by
Yale researchers. Professor John Haldane was, probably, the most prominent
scientist of those times. He wrote a classic textbook “Respiration” (Yale
University Press, New Haven, UK, 1922) which is mostly devoted to the
interaction between breathing and arterial blood CO2 concentrations. During
the later years of his career he served in the British Navy, working on air
supply for submarines (where people can spend several months). The results
of his research are still classified by British government agencies.
Available information about air composition on spaceships indicates that
during the first three US space missions astronauts used pure O2. Pure
oxygen would be expected to cause impairment of mental performance and
physical health, due to decreased blood flow to the brain, as discussed in
section 1.2 and other negative effects mentioned above. On later missions US
astronauts were provided with much less O2 in the air of their spaceships.
In 1960s Doctor Buteyko was the manager of the laboratory of functional
diagnostic and studied various breathing –related effects on cardiovascular
and other systems of the human organism. His research was supported and
funded by the Soviet Ministry of Aviation and Space Exploration for first
Soviet space missions. According to Doctor Buteyko, the optimum air for
long-term health benefits should be about 10-12% O2 (as found on high
mountains) and 2% CO2 (Buteyko, 1977). Probably, this extra 2% CO2 increases
aCO2, improving body oxygen level and producing other positive changes,
while 10-12% O2 (twice less than normal air) is small enough to minimize
oxidative lung damage.
Surprisingly little information is published about research on optimum
air for submarines. Also, very little is published about the growth
processes of plants and animals in CO2 rich air, while known results are
Q: Could you [doctor KP Buteyko] please explain us shortly your
principle of breathing?
A: Here it is: we know that deep breathing decreases the concentration of
carbon dioxide in the blood, lungs and cells. A Russian scientist from Perm,
Verigo discovered this law at the end of 19-th century, which is, as it
seems, strange: a fall of carbon dioxide increases the chemical link between
oxygen and haemoglobin. As a result, it is more difficult for oxygen to get
from the blood to the brain, heart, kidneys, and other organs. In other
words, the deeper the breathing, the less the oxygenation of the cells in
the brain, heart, and kidneys. This law is in the foundation of our
discovery. CO2 deficiency causes constant spasms in all organs. Hence, it is
necessary to learn right breathing” (Buteyko, 1997).
Q: Why did the western clinical trials not revealed improvements in lung
function test in those students who learned the Buteyko method?
A: The lung tests reflect presence of inflammation meaning that, while
the Buteyko group could reduce medication, their airways, on average,
remained inflamed after they practiced the method for 3-6 months (typical
durations of last follow ups). Healing would result in better numbers. It is
a big physiological change to eliminate inflammation and it needs large
morning CPs (about 30-35 s) with no exposure to triggers for some weeks so
that the tissues can get healed. Another expected achievement is elimination
of allergies leading to full clinical remission of asthma. This is how the
method was and is taught in Russia (so that the patient has no inflammation
and no allergies).
Many western students, as we know, progress only until about 25-30 s (no
medication, better sleep, ability to exercise, etc.). Why do they not
progress further? Practice indicates that usually breathing teachers help
their students to achieve the same level as they have.
It is not a surprise then that Buteyko demanded 60 s for his doctors in
Russia so that the students learn the method till the level of the teacher.
High CP teachers, from the very beginning, target their students to
Professor’s golden health standard: 60 s CP. Russian doctors explain to
their students that being stuck, during the healing process, at 40 s is a
normal phenomenon due to fundamental changes in the organism. Such
information about the known future obstacle (40 s threshold) is important
for long-term motivation.
Q: Is CO2 the only cause of success for the Buteyko method?
A: CO2 is the most known and investigated factor that relates to
breathing and the Buteyko method. There are many other factors that are
known to students and practitioners.
The Buteyko method also includes, for example, psychological factors.
The students learn how to stop their symptoms and prevent attacks, how to
pay attention to stress and other factors that cause hyperventilation.
Hence, they acquire a sense of control over their health. Helplessness and
depression are no longer the parameters that define the course of their
Nasal breathing helps the body to use its own nitric oxide that is
produced in nasal passages. The roles and some important effects of this
hormone have been discovered very recently and there are still many
questions in relation to this substance.
Emphasis on diaphragmatic breathing and relaxation of chest breathing
muscles should favour elimination of possible abnormalities in regulation of
breathing by the autonomous nervous system. Activity of the chest breathing
muscles at rest often points to sympathetic dominance since chest muscles
get active during both exercise and hyperventilation. While the Buteyko
method is not focused on slow diaphragmatic breathing pattern, this pattern
gradually appears by itself, for example, during sleep. This effect promotes
lymphatic drainage of the nodes located under the diaphragm.
Passive relaxed exhalation during the breathing sessions should also have
good effects on the balance between parasympathetic and sympathetic nervous
systems. These systems are often out of balance for many diseases, like
asthma, heart disease, chronic fatigue, cancer and other health problems.
Deliberate attention to posture and relaxation of body muscles should
also influence the autonomous nervous system. When we relax we again pacify
the overexcited sympathetic nervous system which is often too active due to
the fight-or-flight mode. Healing and tissue repair are more active when the
parasympathetic system is dominant.
Reduced breathing decreases oxygen levels in the lungs and blood creating
temporary hypoxia. Such hypoxia is beneficial for various reasons. First,
modern air has too much oxygen. Free oxygen in our bodies generates free
radicals causing cellular damage and aging. This damage is stronger during
hyperventilation. Second, hypoxic training at high altitude has many known
It is difficult to tell at the moment what the contributions of these
factors are. Clearly, they are individual. Can the various effects of the
Buteyko method be separated? Probably yes, for example, using CO2 injections
or CO2 chambers or submarines with special air. Can CO2 chambers have
similar effects? There are many other interesting scientific questions for
Q: There are many medical studies indicating that acute hyperventilation
produces asthma attacks in asthmatics. However, several studies found that
acute hyperventilation with CO2 enriched air also results in asthma attacks.
Therefore, as some doctors claimed, low aCO2 could not be considered as a
single cause of asthma. Is this opinion correct?
A: Before being tested with CO2 enriched air in laboratories, typical
asthmatics had many hundreds of times the following course of events. On the
background of chronic hyperventilation (all known studies reported presence
of hyperventilation for initial stages of asthma), asthmatics experienced
the influence of some other triggering factors (like exercise, overeating,
oversleeping, allergies, etc.), which resulted in additional
hyperventilation and further bronchoconstriction or in further inflammation
of airways with the same results: feelings of air shortage (due to airway
obstruction), chest tightness, laboured breathing, etc. all signs of an
asthma attack. (Sometimes, this airway obstruction could be due to, for
example, excessive mucus production or inflammation. That could result in
anxiety and panic causing acute hyperventilation.)
In all cases these asthmatics breathed normal air with about 0.04% CO2
concentration. Thus, before the attacks the following physiological changes
were repeated many hundred times: abnormally hard work of the respiratory
muscles, increased air flow through the respiratory tract, increased
amplitude of pressure variations in internal organs, etc. All these changes,
before the attacks, were sensed many hundred times by the millions of
nervous cells of the nervous system. Finally, further lowered aCO2 and some
other factors produced additional bronchoconstriction and the attacks.
Now exactly the same asthmatics arrive in the laboratories, where they
perform the same acute hyperventilation, which is accompanied by all these
described additional features (again sensed by the millions of nervous
cells) with one difference, the inspired air is CO2-rich. Such air has never
been experienced by these asthmatics before, but the whole nervous system
learned that such situation causes bronchoconstriction. What would be the
The result due to the changed stimulus would be defined by how much of
the previous stimulus is left. Low carbon dioxide already created many
chronic abnormal changes. Finally, some other triggers which cause the
attacks can also be at work when the person deliberately hyperventilates,
even with temporary increase in carbon dioxide stores. It was not sudden
drop or increase in carbon dioxide stores that causes or prevents asthma
attacks, but those chronic changes which affect every cell of the
respiratory tract in asthmatics. Therefore, since less than 1% stimulus is
absent (low CO2), while the remaining 99% is left, the reaction would be
exactly the same, as for the whole stimulus.
But assuming that the human nervous system is incapable of learning from
the previous experiences repeated hundreds of times, and that all these
events sensed and recorded by the nervous system did not produce habituation
and conditioning, one can assert that low carbon dioxide is not the cause of
Therefore, even in conditions of artificially increased aCO2, the
influence of so many areas of the nervous system should be more powerful,
than that of the breathing centre. Meanwhile, if such tests with CO2-rich
air were repeated many times, the effect of gradual relearning can be
observed and acute hyperventilation with CO2-rich air would not cause
bronchoconstriction and the attacks.
Moreover, physiological studies found the confirmations of this
psychological effect based on physiology of the nervous cells. It is known
that, for example, some breathing manoeuvres (chapter 2), e.g., Valsalva and
Müller manoeuvres, or breathing air with the same composition at the end of
the breath hold, as in the lungs, extends BHT. Why? All previous life,
movements of respiratory muscles resulted in new oxygenated air coming into
the lungs. Normally, the nervous system learned millions of times, that such
respiratory movements are signs of new (fresh) air flow. When, all of the
sudden, the conditions are different, only the breathing centre creates the
stimulus to breathe, while the rest of the nervous system is “happy” and
does not contribute to the urge to breathe.
It is now a clear fact, which has been confirmed by all published
studies, that development and first stages of asthma are always accompanied
by hyperventilation. The situation with medical respiratory professionals
and asthma was accurately reflected by Peter Kolb,
“… asthma is a disorder which is investigated by thousands of respiratory
specialists with millions of dollars worth of equipment to measure
breathing. Yet after more than half a century of work by all these people
measuring patients’ breathing, they haven’t picked up that asthmatics are
just breathing too much” (Kolb, private communication, 2001).
Q: Doctor Buteyko claimed that, for example, gastritis is caused by
hyperventilation. However, it is known that, poor dietary habits (like
eating when not hungry, not chewing food properly, eating spicy and hot
meals) can create gastritis without any influence of breathing. How can such
facts be explained?
A: Practical studies done by Doctor Buteyko revealed that it was
necessary for the patients with GI (gastrointestinal) problems to have low
levels of aCO2 pressure (e.g., less than about 40 mm Hg) in order for
gastritis and other GI disorders development to take place. That is probably
due to appearance of certain pathological substances generated by affected
mucosa of the stomach lining. In practical terms, low CPs (less than 40 s)
are required for the progress and existence of the disease. At the same
time, the ideal CP of 60 s makes such pathological processes impossible due
to normal repair, adequate oxygenation and blood supply of the stomach. The
ideal CP and GI disorders are incompatible.
Thus, if we accept 40 mm Hg aCO2 level (about 35 s MP) as normal (as it
is done by official medicine), then GI problems and hyperventilation are
independent events. A person can have GI problems, gastritis included, with
or without hyperventilation.
If our norm is 6.5% aCO2 (60 s CP), then gastritis and other GI problems
cannot take place, unless this aCO2 level is lowered. Damage to tissues
intensifies respiration making the CP less than 40 s.
Q: Which health conditions, while related to breathing and curable by
breathing retraining, are not considered as breath-related by ordinary
A: “Breath”, in Russian, has the same translation as “spirit”. Similarly,
other people consider breathing as something immaterial. Hence, when
thinking about breathing, many people believe that breath can only relate to
respiratory problems, fatigue, and, maybe, asthma. What would be opposite,
in our minds, to the volatile and escapable breath? Of course, our strong
bones. Hence, it is difficult for many people to make a mental connection
between fragile breath and bones. However, musculoskeletal problems respond
to the Buteyko breathing method as nicely as heart disease or diabetes. The
short summary of the effects of breathing retraining on various disorders is
provided in Appendix 7. Russians even published a study about a greatly
accelerated rate of bone healing in chickens who were living in air enriched
Q: How can the breathing teacher deal with a student who has some rare
disorder or a variety of symptoms related to different diseases? How could
one know if the Buteyko method can solve some specific health problems?
A: The names of health conditions, even in official medical literature,
often do not have strict definitions. For example, asthma can have wide
range of cases with varying degree of symptoms. Many cases of asthma can be
close or even diagnosed as COPD, emphysema, bronchitis, etc., by different
countries and doctors. Russia, for example, have bronchial asthma, asthmatic
bronchitis, etc. Some leading medical authorities claim that the term
“asthma” should not be used by medical professionals. The same vagueness
relates to many other health conditions, ranging from heart disease to
various neurological and GI problems.
This absence of clear criteria in official medicine is based on absence
of the understanding of the mechanisms of disease appearance, development,
and treatment. However, breathing teachers are armed with understanding of:
- the cause and mechanism of development of various symptoms;
- the method of their treatment.
Doctor Buteyko in his lectures was often going, one by one, through the
effects of hypocapnia on different systems, organs and tissues of the body
(what happens with cardiovascular system, musculo-skeletal, nervous, GI,
etc.). These facts indicate more emphasis on symptoms and specific
abnormalities rather than official labels.
It would be logical therefore, to view the “sudden” appearance of various
human abnormalities and symptoms with the assumption of increased
ventilation. Practically, when a student asks a breathing teacher about
possible efficiency of the method for a certain rare health condition (“Can
you help me with my …?”), the teacher may ask the student about particular
symptoms and tests’ manifestation of the disease, time sequence of their
appearance, their severity, and evaluate current breathing (e.g., visually,
by voice, posture, and/or CP test). This information could provide the
teacher with information related to the likely effects of the method when
the certain CP level is achieved (when fatigue is reduced, rigorous exercise
is possible, nose is clear, medication can be safely reduced, cold shower
can be taken, etc.)
It would therefore make more sense to speak, in many cases, about the
same parameters that practically matters: current symptoms, tests’
abnormalities (as manifestations of hyperventilation in respiratory,
cardiovascular, nervous, immune, and other systems), and current CP.
Finally, let us look at the dynamic of labelling in Russia. The website
in Novosibirsk and early Russian doctors used official medical names
(Appendix 3). Later, instead of diseases, many websites have been using the
names of symptoms (like coughing, blocked nose, running nose, too much
mucus, allergies, cold hands, feeling tired, pains in various body parts,
sensation of panic, digestive complaints, insomnia, etc.).
The real life teaches us that there is one disease of deep breathing and
many symptoms (asthma, heart disease, diabetes, chronic fatigue, etc.)
depending on personal factors.
“Q: What is most important in your method?
A: To decrease deep breathing (the volume of inspiration) until the norm.
Not to hold breathing, but gradually normalize it. This is difficult,
although primitive people and animals breathe like that…” (Buteyko, 1997).
Q: Which criteria can be used in order to choose a Buteyko practitioner?
A: According to Doctor Buteyko, the CP of the practitioner is probably
the best indicator of his/her qualification, knowledge, and ability to teach
the method. Dr. Souliagin agreed with this criterion. He also observed that
usually practitioners advocate and use those auxiliary methods of breathing
normalization, which helped them to achieve their individual CPs.
It was a norm for Buteyko medical colleagues to have over 1 min CP. That
indicated deep understanding of the method and qualified teaching abilities.
Many of them had about 2 min CP or more, indicating their good professional
When the CP is below 35-40 s (or the MP is less than 60-70 s), a
practitioner may get too excited about abilities of the method or may have
other changes in attitudes. At the same time, normal breathing requires
long-term commitment from the practitioners, so that they can teach this
commitment to their students.
Therefore, ask the practitioner about his/her morning CP.
Q: Do modern western yoga schools teach people traditional ideas and
conduct traditional hatha yoga exercises?
A: Most western yoga schools are different from traditional yoga
approaches. First, the staff of modern yoga schools has poor understanding
of the physiology of breathing. They often believe in the usefulness of deep
breathing and hyperventilation. Second, those schools that use breathing
exercises usually emphasize deep breathing sessions (without a requirement
for improving breath holding time) or high frequency shallow breathing
(which is not difficult to do). Those who follow traditional ideas emphasize
that the Guru is very important in order to "restrain the breath".
Q: What about modern yoga books? Are they valuable in terms of breathing
A: Modern books either exclude traditional hatha yoga ideas or change
them. Such books usually contain many asanas (postures), where people are,
unfortunately, often with their mouths open. However, asanas, when done
under proper professional supervision, favour relaxation of muscles and easy
breathing. Thus, these exercises and books can be used for gymnastics, body
plasticity, relaxation, and slight health improvement.
Q: Hatha yoga suggests having breath holding after inhalation. Can that
A: Buteyko believes that sick people (low CP) must not do MP or other
long pauses after inhalation. That leads to quick exhalation and problems
with breathing control afterwards. Exhalation, as he and old yoga schools
teach, in normal life should be smooth and long. Also, there are some
medical papers about [add: the] influence of slow exhalation exercises on
increased parasympathetic tone. By the way, the pulse is also greatly
reduced during exhalation, in comparison with inhalation, in normal health
(by 10 or more beats per minute).
For healthy people, (as Doctor Buteyko once said) there is no big
difference when to hold the breath.
Q: Many modern yoga books are cautious about breath holding in general.
For example, various editions of Iyengar's books on pranayama (e.g., "Light
on pranayama") have over dozens of warnings about dangers of breath holds
for people with various health problems. Why?
A: Indeed, most modern authors and modern schools (e.g., Iyengar's)
suggest that breath holding should not be used by sick people. That probably
reflects their experience of dealing with western yoga students, many of
whom have different ailments, which can be worsened by the practice of
hyperventilation. Those who could manage to raise their CO2 during practices
may have cleansing reactions, which can create other problems together with
fear and anxiety, often causing the patient to quit the exercises.
Q: There are many statements in traditional hatha yoga teaching about
some mysterious "prana" (hence, the word "pranayama"), as a force that
should be conserved or accumulated. Is there any physiological sense in such
A: Doctor Buteyko, during his public speeches, once mentioned that prana
was simply CO2. Indeed, if one reads old hatha yoga books, while
substituting CO2 instead of "prana", deep physiological sense, in
traditional yoga teaching, can be found.
Q: There were cases in the past, when some yogis did not survive "burial"
feats. What are the possible physiological causes of such deaths?
A: Burial feats were often conducted over the course of days. The amount
of air available for breathing during such experiments (a person can be
buried alive in a coffin) would be enough for some dozens of minutes or
hours only. It would be sensible, then, in order to answer this question, to
consider what happens during the hibernation of animals. That is the next
Q: Which other traditional yoga schools realized the importance of
A: Most, if not all of them. For example, the following extract is taken
from “Autobiography of a Yogi” written by Yogananda Paramahansa who
practiced Kriya yoga.
“Many illustrations can be given of the mathematical relationship between
man's respiratory rate and the variations in his states of consciousness. A
person whose attention is wholly engrossed, as in following some closely
knit intellectual argument, or in attempting some delicate physical feat,
automatically breathes very slowly. Fixity of attention depends on slow
breathing; quick or uneven breaths are an inevitable accompaniment of
harmful emotional states: fear, lust, anger. The restless monkey breathes at
the rate of 32 times a minute, in contrast to man's average rate of 18
times. The elephant, tortoise, snake, and other creatures noted for their
longevity have a respiratory rate that is less than man's. The giant
tortoise, for instance, which may attain the age of three hundred years,
breathes only 4 times a minute.” (p.280, Paramahansa, 1950).
“The mystery of life and death, whose solution is the only purpose of
man's sojourn on earth, is intimately interwoven with breath. Breathlessness
is deathlessness. Realizing this truth, the ancient rishis of India on the
sole clue of the breath developed a precise and rational science of
breathlessness.” (p. 564, Paramahansa, 1950).
Q: What are the breath holding abilities in animals?
A: The northern elephant seal can dive for periods of up to one hour and
less than 5 minutes surface intervals are required between dives. Even while
sleeping on the beaches, elephant seals often have many minutes of breath
holding (Castellini et al, 1994).
Hibernating mammals also possess remarkable breath-holding abilities. For
example, a garden dormouse can hold its breath for periods of up to 130
minutes and the European hedgehog for up to 2.5 hours. In many other
species, prolonged periods of apnoea (5 to 45 minutes) occur regularly and
alternate with brief periods of intense respiration (2 to 5 minutes) (Milsom,
A review of breath holding abilities during diving, sleep, and
hibernation of various animals was done by Zoology Professor, Dr. Bill
Milsom (Milsom, 2000).
There are 2 physiological gas-related mechanisms that cause humans and
other animals to resume respiration at the end of breath holding: CO2 drive
(increased concentrations of CO2 in the lungs and the arterial blood) and,
to a lesser extent, O2 drive (lack of O2 in tissues). However, during 90% of
our evolution (from one half to five billion years ago), the atmosphere had
negligible amounts of O2 (less than 1%) and very large concentrations of CO2
(many %). Therefore, it is likely that all those prehistoric creatures had
superior breath holding abilities (according to our standards and while
breathing their hypoxic air) compared with our performance under present-day
As it was many times noted by Doctor Buteyko, constant increase in O2 and
fall in CO2 in air produced a profound impact on the evolution of animals.
Indeed, hyperventilation can provide and did provide more oxygen for tissues
in conditions of prehistoric air since CO2 concentrations were much larger.
However, ancient creatures did not hyperventilate all the time due to
excessive energetic demands of heavy breathing. Therefore, hyperventilation
was the tool useful in conditions of stress. Even now periods of
hyperventilation in animals, in cases of danger, usually lasts seconds or
tens of seconds. That would reduce CO2 stores in the lungs and some blood,
while tissue CO2 and brain CO2 concentrations would be unaffected.
Modern air, on the other hand, has so little CO2 that chronic (or
prolonged) hyperventilation causes the opposite effect (hypoxia).
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