To understand why breathing techniques are not a front-line treatment for asthma you need to think like a doctor.
Medicine is a profession where getting things wrong is costly. In medicine the question of “is it worth it?” is the study of health economics. Unfortunately, in the real world, what happens on paper does not always transfer the way we would like.
Here is a quote from an article titled “Breathing exercises for asthma” in Breathe, Dec 2014.
“Although most patients in clinical trials can achieve high levels of control with optimised pharmacotherapy, in ‘‘real-life’’ practice, poor control is common, with over-reliance on rescue bronchodilator medication and ongoing symptoms and quality-of-life impairment.”
Doctors are trained to be rational, patients not so much.
It’s time to act like a scientist to help you decide if breathing techniques are going to be worth your time.
To allow scientists to compare a baseline measure with various treatments they use a control group and different treatment options. The question posed is this. “Are the treatments better or worse than doing nothing at all?”
Since doing nothing at all is not on the table here. And n =1. This is what scientists call a single case study design. You against you.
Step 1: List your assumptions and constraints.
Questions like this will help.
For assumptions: What do you think you know about breathwork?
For constraints: How do you spend your time? Do you have any pre-existing medical conditions that prevent you from working with your breath?
Step 2: List the ways that you think you can try to improve the change you seek.
If you have no knowledge of breathwork techniques. Good! Now you know you have a knowledge gap. Things can only improve from here on in. Let’s get back to how we apply the knowledge we do have.
Step 3: Develop the hypothesis that you are about to test.
Buteyko breathing has a hypothesis that asthmatics over breathe. Logically, Buteyko practitioners teach breath control and are interested in a measure called the control pause. Increase your control pause to greater than 20 seconds and your asthma symptoms will be reduced, goes the hypothesis.
Remember when developing your hypothesis to start somewhere. Better to begin with something that makes sense than do nothing and point at the flaws. As this amorphism by the statistician George Box reminds us. “All models are wrong, some are useful.”
At this point, it is also worth remembering that a good scientist is curious and not invested in the outcome.
Step 4: Create a definition of the measure of success and the change you seek.
Think small wins. What is the smallest step you can make now?
In the following sentence, we see both the Buteyko method’s measure of success defined and the change that is sought. “Every 5-second increase in Control Pause is an indicator for reduced symptoms of asthma, wheezing, breathlessness, chest tightness, and exercise-induced asthma.”
The potential upside of breathwork is breath control. The downside is no obvious change. And the worst possible result you can carry forward is a learned breathing technique.
The punchline as I’m sure you are now aware is this. Act like a scientist to work with the information you do have and you will always see results even if they are not the ones you expected.