Investigating the Claims of Konstantin Buteyko,M.D.,Ph.D.: The Relationship of Breath Holding Time to End Tidal CO 2 and Other Proposed Measures of Dysfunctional Breathing

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 CO₂ (Paco₂) 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 (ETCO₂) 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 ETCO₂ 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 ETCO₂ (r = −0.241, p < 0.05), directly opposite to Buteyko's claims. BHT was significantly shorter in people with abnormal spirometry (FEV₁ or FVC < 15% below predicted), with no difference in ETCO₂ 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 ETCO₂, 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.