Buteyko Method | Hacker News Reader

Buteyko Method

en.wikipedia.org

71 pointsrzk49 comments

wow never thought this would make the front page of HN. My great grandfather learned this method from Konstantin himself to help manage his debilitating asthma (back in the Soviet Union) and he kept it up daily into his 80s once we moved to the US. He did it daily for so long that he was able to hold his breath for almost 10 minutes if I remember correctly. He taught it to my grandma who then taught it to me when I was a kid but neither she nor I do it anymore unfortunately. Imagine an 11 year old sitting in a bedroom with his grandma doing breathing exercises. I honestly can't believe she got me to sit still longer than 5minutes to do it.

What a lovely story and a great connection to a post. Thanks for sharing.

> hold his breath for almost 10 minutes

Konstantin must have learned that from Guybrush Threepwood!

Full disclosure: my mother runs a practice in NYC and implements Buteyko a lot with patients. It’s called HappyMyo and I helped her set up the website.

—

I think Buteyko suffers from a marketing problem wherein it sounds really “eastern medicine”. I think it actually can be super beneficial to people, assuming they have the patience and discipline to commit to it for many months. It’s not easy and I think the success rate is so high because the people that seek it out are pretty determined.

I strongly encourage people research myofunctional therapy also if you snore/have sleep issues or find yourself out of breath often. It’s like physical therapy for your airway where you do lots of exercises regularly over months. I’m not even trying to advertise here, just trying to spread the word in case it helps someone.

links: Assorted research papers - https://happymyo.com/2024/02/11/research-papers-on-omt/

A sample of what the exercises look like, I am not affiliated with this site and these are the ones without props - https://www.singhealth.com.sg/tests-procedures/myofunctional...

Much more user friendly than https://en.wikipedia.org/wiki/Khecar%C4%AB_mudr%C4%81

I highly recommend the book Breath by James Nestor. The only health/pop sci book I'd recommend. Doing breathwork has increased my HRV by ~10ms and lowered my respiratory rate when I sleep. I no longer snore as a result.

What breath work do you do every week please?

Reason why I'm asking: the book contains many techniques, and I'm curious about what's working best for people.

Not the person you asked the question of, but you may find this helpful - https://news.ycombinator.com/item?id=46333769

Thank you.

I've read that book and also Patrick McKeown's 'Oxygen Advantage', which also talks about CO2 tolerance and the benefits of Buteyko.

https://www.amazon.com/Oxygen-Advantage-Scientifically-Breat...

https://www.youtube.com/watch?v=-m8jIhQyiDY

Good stuff honestly, helped me a lot

I cannot tell, from the article, how to perform the Buteyko method.

From the "Medical Evidence" section, it seems I'm not missing much.

There are a few free apps that will teach it, I have used the “Advanced Buteyko” ios app.

If you demand extensive peer reviewed medical evidence of some specific quantified outcome before doing any activity in life you will miss quite a lot of valuable things that can’t be easily quantified or measured, or funded academically. There is however actually a lot of medical research on breathwork like this, they just will use the technical terms for what you are actually doing instead of a name like Buteyko.

> you will miss quite a lot of valuable things

Arguably, the lack of medical evidence tells us that this is in fact not a valuable thing.

Absence of evidence is not evidence of absence. So yes, extremely arguable indeed

There may be evidence, but there may not be a peer reviewed study of the evidence.

Medical evidence costs money. What would look convincing costs sums few can pay. If you use only that medicine you basically use only Big Pharma. And they are set to produce only specific type of medicine: something you have to buy, preferably for life. A breathing technique is not like that so it will never amass that much "proof".

1. There are plenty of non-profitable non-financial things that do have scientific evidence backing them. Massage for example which can be performed by essentially anyone.

2. There needs to be some way to separate the wheat from the chaff, as it were. Otherwise we all drown beneath the waves of lying charlatans. So how do we differentiate what works? "Evidence" seems like a reasonable criterion.

> "Evidence" seems like a reasonable criterion

Evidence is an excellent criteria, but only if you look more broadly so you're not ignoring most of the actual evidence available to you. All you really need to try something personally is decide that the likely benefit, given the limited information you have, outweighs the likely risk.

If you're sufficiently convinced it's not dangerous or difficult, the reasonable standard of evidence for some possible benefit needed to consider trying it might become correspondingly low.

Scientific studies are strong evidence of something really narrowly specific that they tested like "does X cause Y," but most decisions in life need to be made from things like direct observation, and anecdotes, because the scientific studies rarely exist to provide the full picture, even a good study on "does X cause Y" might tell you absolutely nothing about if "X causes Z" even if Z is more important than Y.

If there is something like a breathwork technique developed by a long dead soviet physician that regular people all around the world have been using for 60+ years and consistently reporting that it offered them some tangible benefits and didn't harm them, this is evidence that it might be worth a try. With the Buteyko method, most of its strongest advocates I have personally heard of are long dead from normal old age, and never had any plausible financial or personal motive to promote it.

For things like breathwork, I usually do carefully and broadly look at things like personal reports from regular people, on e.g. forums that are unlikely to have any motive to lie. If there's a strong consistent pattern of some harm or benefit, that can be quite useful evidence, even without any formal studies.

> the lack of medical evidence tells us that this is in fact not a valuable thing

Except almost none of the most valuable things I've encountered in life had any convincing medical evidence I could find beforehand.

I am an academic scientist that designs and reviews studies all day long, so I am very steeped in the practicalities and limitations of biomedical research, and as such have completely lost any illusion that biomedical research is in a state where it can guide most of my personal decisions in a useful way- maybe it will be someday. There are many things I know about as a scientist, but can't get funding to study or publish on because the funding agencies don't care about them, and/or there are practical constraints that make it impractical to study.

If all of your personal decisions are guided by peer reviewed literature in it's current state, you'll probably be sicker, and have an empty dull life compared to someone that just uses common sense, tries things, and pays attention. I say this from having seen it happen many times in the biohacking community, the people most steeped in attempting to translate research into life decisions often died young, or even got to be one of the only modern people to experience diseases of malnutrition.

For one, you have to pretty much assume there is some specific benefit you can physically quantify, and that it will apply to almost everyone in your study population, both very unlikely to be true in cases like studying breathwork.

For example, I'm a person that tends to be pretty uptight and overstressed, what you might assume in scientific terms is "sympathetic activation"- and there is a lot of breathwork research showing that almost anything that has an extended exhale can shift you into parasympathetic activation, where you calm down and relax. There is lots of research on this, and it arguably covers Buteyko, but they won't use that term in the article title, because it's more general than just Buteyko alone.

Now, I don't need some peer reviewed study to just try Buteyko for a few minutes, and immediately feel calm and relaxed, and see that I can suddenly notice the colors around me, and feel joy, when I couldn't before. If a massive peer reviewed study proved to me that this does not happen to most, or even any other people except me, why would I care about that at all? Does it mean I shouldn't do it? What if I have a problem not enough of those people have to make it show up in the statistical analysis, or my body responds in a way most of theirs do not?

There are huge limits to how meaningfully you can generalize from scientific studies about populations of other people, to yourself. Moreover, you have to choose up front what outcomes or effects you will look at in a study, and if our biological understanding can't even guess at the outcome that would have been useful to look at, the study is doomed to miss everything.

Sit down, and try it- or don't, but don't assume you can learn ahead of time if it will be worthwhile or not for you personally by looking on Google Scholar.

Advanced buteyko doesn't let me go very far unless I sign up for an $160 course

I only did the basic free thing, and found it an interesting experience that calmed me down a lot. Personally I've moved on to other breathwork systems that I think accomplish the same things, but I like better- I practive several of Wim Hof's breathwork methods, as well as the breathwork training that freedivers use.

All of them involve intentionally and temporarily invoking hypercapnia (high CO2) and hypoxemia through slower breathing and/or breath holds.

A lot of the Buteyko studies suffer from small sample sizes unfortunately. I have heard good things about Buteyko from athletes but I’m not well-read on this. I think myofunctional therapy has more Western research done on it and is strongly related

> The Buteyko method is not widely supported in the medical community, in part due to the lack of research supporting the theory that hyperventilation and hypocapnia causes disease,[7] with one review noting the absence of convincing evidence to indicate that trying to change asthmatics' carbon dioxide level is either "desirable or achievable."

The comment about it being neither desirable nor achievable is so funny to me! It really walks the line between complete dismissal and polite confusion.

There's a guy I follow for years that posts a lot out this, highly recommended:

https://breatheless.substack.com/

https://breatheless.gumroad.com/

https://x.com/breathelesss

very good stuff, thanks

I have tried a lot of breathwork techniques lately and Buteyko is very good. One thing I always tell people that sit and slouch a lot is that your diaphragm is probably very tight (the same way your quads/hamstrings/etc can get tight). breathing exercises are very good for loosening it up, which, at least for me, have had a very positive impact on my health and wellbeing.

It’s also possible that something is good for you for some pretty unexpected reasons.

I practiced the Buteyko method for many years when I was in states of high anxiety and frequent panic attacks, and it was incredibly helpful. I had a syndrome called new daily persistent headache, which means a sudden-onset headache that becomes constant from that instant forward, as in 24/7, for years. It's hard for people who haven't experienced that to understand I mean that literally. Buteyko breathing was the only thing that ever cut down on that headache, and a couple times I was able to suspend it for an hour or two, which when you have a literally constant headache for years, is a big deal.

My big takeaway from it was that breathing and neurological state are deeply connected and actually relaxed, natural, healthy breathing (and the corresponding state of the brain and nervous system) is something that most people have probably never even experienced unfortunately. We all think our state is normal, but I assure you, it is very far from the state where your control pause is 40s-60s or more, it's a radically different experience.

Also the nuance of what the control pause and how to measure it correctly is lost on I would say, even most people who attempt to learn Buteyko. The control pause is how long you can, under normal breathing, suspend breath with zero discomfort, and then prefectly resume normal breathing without any change from before. If you took a bigger breath to start, or when you start breathing again it's even slightly heavier, it's not a control pause measurement, it becomes an ego metric juiced to make you feel better about a number while avoiding the disappointing facts.

Buteyko claimed that healthy breathing had a 40+ second control pause. Which if you think about the real meaning and how to measure it, is a super long time. And I got there sometimes, it's a major learning experience about what deep alignment and relaxation of the brain/nerves can really feel like.

Do you mean while sitting in a meditative state, or during light activity (i.e., interacting with the world without much physicality)?

I used to do Buteyko breathing exercises. The main idea is that over breathing results in a loss of co2 and less co2 in the body results in less oxygen being released from the blood due to the Bohr Effect https://en.wikipedia.org/wiki/Bohr_effect.

One of the earliest findings of the investigations into oxygen that O2 is toxic in excess.

Space-cabin Atmospheres: Oxygen toxicity (1964) (google.com) - https://news.ycombinator.com/item?id=25883728

The Haldane Effect and the Bohr Effect are the central findings that explain the transportation and exchange of carbon dioxide and oxygen: https://en.wikipedia.org/wiki/Haldane_effect / https://en.wikipedia.org/wiki/Bohr_effect

People who hyperventilate exhale too much carbon dioxide, which disrupts the acid/alkaline balance of the blood and makes it harder for the body to use the oxygen available to it.

The Apollo capsules were originally spec'd to use a mixed gas atmosphere. When the capsule got too heavy they switched to using a pure-O2 atmosphere. After the Apollo 1 fire they switched to using an atmospheric mix (80/20 N2/O2) at launch, which gradually changed to pure oxygen as the flights progressed.

Treatment with pure oxygen is not helpful for sick people:

Mortality/morbidity: acutely ill adults liberal vs. conservative Oxygen Tx (2018) (thelancet.com) - https://news.ycombinator.com/item?id=22993262

I typed up some notes about oxygen toxicity: https://www.taxiwars.org/2021/06/folly-medical-hyperventilat...

Medicine decided that the antidote to oxygen toxicity didn't need to be used anymore in the mid-1950's.

These are unproven techniques based on retelling/modifications of ancient techniques from Pranayama - https://en.wikipedia.org/wiki/Pranayama

Yes, i have read James Nestor's book "Breath" and did not find it illuminating.

A better way is to read some good books explaining the techniques of Pranayama. There are plenty (the two books "Prana and Pranayama", "Prana Vidya" published by Yoga Publications Trust, Munger, Bihar, India are good) so buy a few which appeal to you.

Here are some suggestions (based on my practice);

1) Do not practise the breathing exercises when you are feeling hungry, too full, tired, hyper, sleepy etc. Your practice should be done only when you are feeling comfortable and calm.

2) Do the exercises in a well ventilated place.

3) Do not do any breath holding exercises in the beginning for at least a few months. You should only practise inhalation/exhalation with various lengths and force as prescribed in the techniques.

4) Generally, the ratio of lengths of Inhalataion:Exhalation should be 1:2

5) Generally, Inhalation/Exhalation should be "subtle" and in a "thin stream" unless the technique calls for force, but should not hurt the nostrils.

6) Both before and after the practice massage your whole body lightly with your hands; particularly the forehead, eyebrow ridge, temples, and the scalp.

7) The following techniques are enough to give you immediate benefits; a) Kapalabhati b) Bhastrika c) Nadi shodana (alternate nostril breathing) d) Deep Inhalation through the Nose followed by slow Exhalation through the Nose e) Deep Inhalation through the Nose followed by slow Exhalation through the Mouth. Note: The first two will clear your sinuses/nostrils and energize you making the subsequent ones easy, the third one will stabilize and integrate you, and the last two return you to relaxed and calm mode.

Finally, you can use a Blood Pressure Monitor/Pulse Oximeter/Spirometer etc. to monitor/measure your physiological parameters both before and after practice.

I’ve found all of these techniques including Win Hoff to be rehashes of pranayama.

They are wrong and dangerous takes on Pranayama. I saw a video of Wim Hof demonstrating his technique and the violence of the technique elicited a immediate no-no from me who studies this (and related) subjects.

People should get some popular books on Pranayama and then also get the original books so that they can see what the original text actually says. Follow all the cautions mentioned before starting the practice, do everything gently and proceed slowly. If you do it properly, you will see immediate results in terms of self-feeling within a week. You will also see external signs like clear skin, whites of the eyes becoming clearer, gait/body becoming lighter etc. They are all mentioned in the texts which indicate to the student that he is doing the practice correctly.

For example, here is a Tibetan Yogi demonstrating a specific type of exercise+pranayama. It is dynamic but not violent - https://www.youtube.com/watch?v=BESrdlf-cPg

Buteyko is helping me manage thoracic outlet syndrome (I think; haven't had a diagnosis). My main symptom was a jarring feeling in my head when walking. Went from months where walking even a short distance gave me very mild concussion symptoms, to walking and running 12 miles in a day without issue, and the only difference seemed to be the way I was breathing.

Edit - a couple of other things possibly helped around the same time, so I'm not sure if I ever isolated the effect of breathing. But it definitely felt like it was a significant part of it.

I thought I had that too, similar problems but it was just anxiety mixed with the effects of trying to quit smoking.

I recommend getting an ultrasound of the relevant veins/arteries, it's a relatively cheap and safe way to confirm what kind of problems you have.

> Edit - a couple of other things possibly helped around the same time, so I'm not sure if I ever isolated the effect of breathing. But it definitely felt like it was a significant part of it.

Hey, even if it only helped 5% of your recovery, that’s still good. It’s not like there’s any medicine or treatment that fixes 100% of a problem. It’s like saying “pickleball is a treatment for obesity, but doesn’t cure it”

Anecdata- I did this as a 13 year old in the 90s. My old man came upon it after I was repeatedly ending up in hospital in Australia with asthma as a kid. I think there was a presentation in a local scout hall!

I didn’t understand the history at the time - but it stopped me going to hospital, I ended up being able to do a controlled hold (no discomfort) of around 1:30 min and a max hold of just shy of 5 mins.

So for me it had a big impact.

I stopped in my 20s and now I am no where near able to get those numbers.

It seems Buteyko method aims to increase carbon dioxide tolerance. This blog post has an interesting discussion about that:

Carbon Dioxide as a Stimulant for Respiratory Function —https://blog.supplysideliberal.com/post/2020/7/28/carbon-dio...

I have a close friend who got her pretty hardcore asthma and nasal issues under control over last year. Her quality of life improved dramatically after doing this thing – I tried some basic first exercises and I felt there is some practical resemblance to breathing meditation. Anyway, I am planning to get more into it and would definitely recommend it if you upper respiratory issues have strong negative effects on your life.

I was taught this method as a child to help with constantly blocked nasal passages. I think it helped! I'm still doing it, although not religiously.

I think the major part of what makes it useful is just adding resistance for breathing. It helps to train the breathing muscles, just like any other resistance training.

Isn't its opposite condition, namely hypoventilation, particularly while sleeping, a more serious and common condition? Hypoventilation would lead to high blood bicarbonate which causes immediate problems.

>Strictly nasal breathing during physical exercise is another key element of the Buteyko method.

This seems like extreme nonsense. How light would you have to exercise to only breathe through your nose? I had an ex gf that tried to do this when we would go running and it was a disaster.

Nasal breathing has a lot of benefits and it's arguable that maintaining your level of exertion such that you're always breathing nasally is a good technique for building cardiovascular & aerobic capacity.

I’m actually good friends with Jacob Kiplimo. He swears that the reason he was able to have such success in the half last year was by exclusively breathing through his nose during training.

My one HUGE gripe about Buteyko in particular is the nasal breathing bit. Breathing through your nose is good imo, but I don’t think it needs to be such an important goal all the time

A few counter anecdotes: I read a story about a baseball coach making the players hold water in their mouths while training to make sure they couldn't mouth breathe. I'm pretty sure if you watch an MMA fight the fighters will mostly have their mouths closed. And the airway-focused orthodontist Bill Hang ran a marathon with tape over his mouth (only removing it for hydration) to make a point about the importance of nasal breathing. Also, I can do sustained moderate to high intensity exercise with only nose breathing.

Buteyko practioners build up the ability to work very hard while only nasal breathing over the long term. The point is to learn to modulate breathing in a way that keeps a certain kind of blood chemistry (CO2 levels) and cellular oxygenation.

If you commit to nasal breathing for exercise as a constraint, it does force you to modulate your exertion while also increasing your CO2 and developing, according to the Buteyko folks, a new baseline for respiratory health and capability.

If you're running for your life from a tsunami, by all means mouth breathe. If your purpose is maximum exertion, of course mouth breathe. But that's not the only possible purpose of exercise. It can also be about respiratory training. Nasal breathing becomes a natural guideline/modulator for long term improvement in that regard.

This method helped me stop snoring. Life-changing.

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