Holds and breath training

Buteyko method: breathing less, on purpose

By GyroscopeUpdated November 15, 202611 sources

Family

Holds and breath training

Breaths

A little less than you want

Carbon dioxide

Rises

How well tested

Moderate

Risk

Low

The Buteyko method is a set of exercises built on breathing less, through your nose, with smaller breaths and short, comfortable holds. A Soviet doctor, Konstantin Buteyko, developed it in the 1950s. In people with asthma, small trials found it cut how much reliever inhaler they used, but their lung function tests didn’t change. We’d use it as an add-on with your doctor’s knowledge, and never as a reason to stop an asthma medicine.

Buteyko believed that sick people breathe too much without knowing it, a habit he called hidden hyperventilation, and his followers see it as a major cause of asthma. The idea sticks because part of it holds up, since people with asthma who learn his exercises often feel better and use less reliever, though nobody has shown that his explanation is the reason.

What it is and where it comes from

Konstantin Buteyko was born in 1923 in Ukraine and trained at the First Medical Institute in Moscow. According to Buteyko Clinic International, which teaches the method today, he noticed as a student that the sicker the patient, the faster and harder they breathed. In the 1950s in Moscow he studied the breathing of sick and healthy people, and he decided that long-term overbreathing knocked the body out of balance. The clinic says the method grew out of his own struggle with high blood pressure.

The Soviet Union’s Committee on Inventions and Discoveries recognized his method in 1983, and Buteyko died in 2003. By then it had spread to Australia, where doctors at the Mater Hospital in Brisbane ran a well-known trial of it in 1995.

How to do it

Buteyko Clinic International teaches these core exercises. Do them sitting upright, on dry land.

1. Measure your control pause. Take a small, silent breath in and out through your nose. Pinch your nose and time how long until you feel the first real need to breathe. Let go and breathe normally through your nose. The first urge is the stopping point, so don’t push past it.
2. Breathe light. Put one hand on your chest and one on your belly and watch your nose breathing. Breathe a little less air than you want, until you feel a slight, tolerable air hunger.
3. Back off when it’s too much. If it gets stressful, rest for about 30 seconds, then come back to it.
4. Nose all day. Breathe through your nose as much as you can, including when you walk and exercise.
5. Build it up. The clinic suggests 20 to 60 minutes a day in total, depending on the exercise and the person.

If your symptoms get worse, the clinic says to stop.

A simple way to picture it

Think of a tap that’s been left running a bit too hard. Buteyko breathing eases it back a little at a time, until the flow is just enough.

What happens in your body

In Buteyko’s theory, breathing too much lowers carbon dioxide, low carbon dioxide narrows the airways, and breathing less raises it back and opens them. A 2005 review from the University of Southampton called the theory attractive, with some support from lab experiments, but said nobody knows whether changing your breathing raises carbon dioxide by much. In the Australian trial, people in the Buteyko group breathed less air each minute, and their carbon dioxide still didn’t change. The review points out that the classes also include advice on medicines, food, exercise and relaxation, so it’s hard to pin the effect on one thing. Carbon dioxide explains what it does in your blood, and breath holds covers what sets off the urge to breathe.

What the evidence shows

In Brisbane in 1995, researchers split 39 people with asthma who used a lot of medicine into two groups. One learned Buteyko breathing in classes over seven days, and the other got asthma education, relaxation and belly breathing. After three months, the Buteyko group had cut their daily reliever use by a median of 904 micrograms, against 57 in the other group. Their inhaled steroid dose fell by about half, against no change, though that difference wasn’t quite significant. Their lung function didn’t change at all.

A 2008 trial in Calgary, Canada, found Buteyko about as good as breathing and relaxation taught by a physiotherapist. Six months on, controlled asthma had risen from 40 to 79 percent with Buteyko and from 44 to 72 percent with physiotherapy, and the Buteyko group had cut their inhaled steroids more.

A 2020 Cochrane review pooled 22 trials of breathing exercises in 2,880 adults with mild to moderate asthma, two of them Buteyko and 14 yoga. Breathing exercises improved quality of life at three months, with moderate certainty, but the effect on symptoms was unclear and lung function results were mixed.

The British guideline from the BTS and SIGN, in 2019, which the 2024 joint British asthma pathway still quotes on this point, said programs built on breathing exercises, including physiotherapy methods and the Buteyko method, can modestly improve asthma symptoms and quality of life and cut reliever use, with little effect on lung function or airway inflammation. It recommends offering breathing exercise programs to adults “as an adjuvant to pharmacological treatment.” It found too little evidence in children 12 and under to make a recommendation.

The control pause, BOLT and mouth taping

The control pause is the same comfortable hold that’s now called the BOLT test. It’s useful for tracking your own breathing over time, but it can’t tell you how fit you are. In 49 highly trained speedskaters, it had nothing to do with their sprint or endurance results. What’s a good BOLT score has the bands, and the breath hold test times it for you.

Nose breathing day and night is central to the method. If you’re thinking of taking that as far as taping your mouth shut at night, a 2025 review found little evidence it helps and four studies that warned of a suffocation risk if your nose blocks up. Taping your mouth at night has the details.

Who should skip it

Never stop or cut an asthma medicine on your own. The US National Center for Complementary and Integrative Health says not to substitute other approaches for treatments your health care provider prescribed, and any taper happens only under your doctor’s supervision. In an attack, follow the asthma action plan your doctor gave you.

Buteyko Clinic International says not to start if you have sickle cell anemia, an aneurysm, very high uncontrolled blood pressure, heart problems in the past three months, uncontrolled hyperthyroidism, a known brain tumor or kidney disease. People with severe asthma, emphysema, epilepsy, schizophrenia or chest pain should only do it with an instructor, it says, and people with diabetes with their diabetes doctor too. With any of those, never hold past the first urge. We’d also keep every hold short if you’re pregnant, and never practice breath holds in water or while driving.