What sports are best for asthma?

March 7th, 2010

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The question really should be What sports are best for MY asthma?, or  What sports are best for the current state of my respiratory health?

 Depending on your breath control physical activity can be highly  beneficial, have no beneficial effect or it can be harmful. So if you ask Is swimming, running etc  good for me , the answer is it could be good for you if you know when and how to perform physical activity to get maximum health benefits  and not to exacerbate your health condition.

Aerobic type exercise is a good way to quickly build up Carbon Dioxide thus it is very beneficial from the Buteyko point of view. However, if you are a moderate to severe asthmatic with below 20 sec CP, it might be difficult for you to keep up nasal breathing during such exercises (a strict rule of Buteyko).  And breathing through your mouth will likely bring on your asthma symptoms and won’t be helpful for your overall health improvement goals.

If you are using a bronchodilator every time before aerobic exercise or regularly have symptoms, you are not ready to participate in such intense exercise.  Moderate to severe asthmatics  don’t generally have enough  Carbon Dioxide to get past the beginning of aerobic exercises stage where the breathing deepens significantly but their CO2 level is so low that any further  “leak” will bring on the body’s defense mechanism – airway spasm.  Hence exercise induced asthma that usually strikes shortly after the beginning of the routine.

The solution is to improve your breathing with the Buteyko Method to the point where you are able to sustain such physical activity without asthma symptoms and need for bronchodilators.  While your CP is moving up your physical activities should be adjusted according to your respiratory health.  A Buteyko Practitioner will help you with detailed recommendations for your particular level.

Generally speaking if your (or your child’s) CP is less than 35 sec avoid following activities

  • Robust or prolonged intensive effort sports like soccer, high-skill gymnastics, track and field, and basketball
  • Cold environment sports such as ice skating, ice hockey, snow skiing
  • Professional sports involvement with exhausting routines, extended training hours etc  
  • Sports that  involves allergens you are sensitive to (for some it could be  swimming in the pools, horseback riding, golf)

Consider gentler activities such as

  • baseball/softball
  • golf
  • martial arts
  • fencing
  • volleyball
  • horseback riding

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DuPuytrens Contracture Case Report

March 1st, 2010
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 The following article about DuPuytrens Contracture case is kindly provided by Pippa Kiraly, an inspirational Buteyko Educator since 2004 in Seattle, WA. Pippa was a nurse and a lifelong serious asthma sufferer who after 35 years on steroids and many other drugs was able to recover by applying the Butyeko Method. With her improved breathing she went trekking in the Himalayas in 2003, climbing to 10,500 feet in the Annapurna range.
 
  DuPuytrens Contracture is a hand condition in which there is painless thickening and fibrosis of the palmar fascia with localized formation of scar tissue beneath the skin accumulating in the fascia that normally covers the tendons that pull the fingers to grip.
As Dupuytren contracture progresses, more of the fascia becomes thickened and shortened. Dimpling and puckering of the skin over the area eventually occurs and it can become impossible to straighten fingers, usually the fourth and fifth.How could Buteyko alleviate this?It has, in one client I saw last September.S.E. 61, a Rolfer, came to me for allergies and asthma and I taught her a course Sept 21-28, 2009. She also checked offmuscle and joint pain, anxiety and bladder irritability.

October 14, 2009 

S.E. told me of the hereditary DuPuytren’s Contracture affecting her left hand, saying that, along with the other symptoms for which I had taught her, the inflammation and soreness in her hand after a day of Rolfing (a form of deep tissue massage) was diminishing. 

Looking at the hand, I saw a dead white patch about the size of a silver dollar in the center of the palm, with a thickened tendon, also dead white, prominent in it. This patch, she said, was smaller than it had been, and her hand less sore.

Her CP had risen slightly, from the mid teens at the end of the course, to mostly averaging around 20 at this point.

November 17, 2009 

I saw S.E.s hand again. To my astonishment, the palm color had changed from white to pink, and the tendon was less prominent. Her CP was still inching up, low 20s at this point, but her other symptoms were continuing to unprove.

December 18, 2009

S. E. has eye surgery coming up, and is fighting a cold.

Her general symptoms continue to improve, and her hand also. She said in an e-mail: “The palm has more color and is softer and looks less ‘glued down.’ I was able to do a full week ofRolfing with no resulting soreness in that palmar fascia, which is great. I would not say the sense of contracture is completely gone, but it is so much better and continues to improve.” S.E. still struggles with CPs, now as high as 30 or as low as 13, but she is getting a better sense of relaxation in her rib cage, diaphragm, face and cranium, and then her CP rises more.

February 2, 2010.

S.E. reports a big shift in CP to high 20s-

lower 30s, and she finds doing RB easier. Her hand continues to improve. She no longer feels pulling in the palm when stretching it. She does not say the condition has totally disappeared but it is close.

S.E. has been a model client, diligent and observant. I will see her again when she comes in for a refresher class February 20.

This appears to be the first instance of Buteyko helping this condition.

If you wish to contact Pippa, send Email to info@lifelongeasybreathing.com.

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Why are elite athletes prone to asthma?

February 20th, 2010
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The Winter Olympics continue in Vancouver, Canada, and I just came across the New York Times article “Why Do So Many Winter Olympians Have Asthma?” by GRETCHEN REYNOLDS.

Exercise-induced asthma has been diagnosed in as many as half of all elite cross-country skiers and almost as many world-class ice skaters and hockey players. It’s far more common in winter athletes than in those who compete in the summer, although nearly 17 percent of Olympic-level distance runners have been given the same diagnosis.

Wondering why this might be, the author looks to doctors and researchers for the answers. First they suggest that:

Exercise-induced asthma is not quite the same condition as asthma. According to  Dr. Christopher Randolph, a clinical professor at Yale University (Center for Allergy, Asthma and Immunology), the “preferred term” in the scientific community for exercise-induced asthma is exercise-induced bronchoconstriction, or E.I.B. “It’s a reversible, obstructive airway disease” that typically begins about five minutes after you stop exercising — particularly if your exercise was intense, “at between 85 and 95 percent of maximum heart rate,” Dr. Randolph says.

The first suggestion is that cooling and drying of the airways contribute to the development of exercise-related asthma symptoms. And there is a genetic factor, but
… pinpointing genetic susceptibilities to E.I.B. doesn’t answer the question of why it strikes so disproportionately among the world’s best athletes, especially those in winter sports.

And finally,
This theory posits that E.I.B. is, in some fashion, a sports injury. “What we think is happening,” Dr. Randolph says, is that elite endurance athletes, especially those training more than 20 hours a week, actually “injure their airways” by breathing so much and so hard. “They take in up to 200 liters of air per minute,” he says, in comparison to perhaps five or six liters per minute at rest, all of which must be humidified.

At the end of the article, I was pleased to read that in addition to their advice about visiting a doctor and drug treatments, there were a couple of simple and sound recommendations such as Breathe through your nose and Warm up for at least 5 to 15 minutes.

While doctors and researchers look for answers, professional and amateur athletes can find them through the principals and practice of the Buteyko Breathing Method. Exercise-induced asthma (or EIA) causes breathing difficulty usually 5-20 minutes after starting intense physical activity, or shortly after stopping the activity. Yes, there is always a genetic factor, and yes, EIA occurs more easily in cold, dry environments, therefore, drying and cooling of the airways plays a role.

But the core reason is that during certain points of sports activities, the athlete’s lungs are ventilated more than their metabolism requires. The frequent large breaths in and out results in loss of CO2, which is not compensated properly by CO2 production due to the increased physical activity. As a result, the defense mechanism (airway constriction) activates. If you recall from the article, doctor Randolph said They take in up to 200 liters of air per minute (as opposed to 4-6 liters per minute at rest). And here lies the answer as to why EIA strikes shortly after starting intense physical activity or shortly after stopping the activity. That’s when the balance between CO2 production and ventilation is most out of proportion.

There is an easy solution to this problem. One of AsthmaCare students, a basketball player, writes:
I have a significant improvement with Exercise-Induced Asthma. I played a basketball game early on after starting the Buteyko Course and found that using the need to mouth breathe as a guideline to activity level, I had a great game. I recovered much quicker and could play at a satisfactory level. I am very pleased and motivated to continue bringing up my CP.

Another student who took a course just for wellbeing and physical endurance said:
When I exercise at the gym now, I am watching people mouth breathing, huffing and puffing through the same intensity routine I do with nasal breathing. I exercise to greater lengths with less effort, and I feel energized, not exhausted, after that.

By following the Buteyko Course recommendations you will be able to advance your fitness level and avoid breathlessness, wheezing and coughing during sports participation as well as fatigue after sports activities.

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Wellness Paradigm

February 14th, 2010
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Starting this month we are featuring inspirational guest writers – Buteyko educators, enthusiasts, students and natural health advocates.
dorisse   The following article is kindly provided by Dorisse Neale, a Registered Nurse, Herbalist, Mother, Writer, Performing Artist, Respiratory, Movement, Wellness and Buteyko Breathing Educator who has been teaching people of all ages about natural health for over 33 years. She has a private practice based in Asheville, NC, and travels and teaches throughout the country. 
The erroneous preconception that medicine and doctors somehow have absolute understanding and responsibility for people’s health has been the issue of my life and so many of us who might be called “wounded healers” – those who grew up with potentially life threatening illness, turned it around, and now teach what they learned. 20-30 years ago people began talking about the need for a paradigm shift. I began asking myself what exactly does that mean, and how do we apply it to health? The foundation of my work is in the embracing of the “Wellness paradigm” and unless people really understand it, therapeutics often are short lived.

In nursing school 33 years ago, we were taught that there was a wellness/illness continuum, with wellness at one end and illness at the other. In that model, there is forever a degree of illness present. As a paradigm shifter, I put wellness at the center of that continuum, which is our inherent right as human beings. That being our center, recovery from any condition depends on bringing the body back to center by nourishing, toning, remediating and supporting the body in doing what it intuitively can do by strengthening the respiratory, immune, cardiovascular, digestive, integumentary and other systems. So in any given situation, we can have individuals with different symptomatology, and the work of getting out of the ruts (symptoms) and returning to health is the same (yes, with some tweaking needed for the individual with asthma vs diabetes vs hypertension). This is the responsibility of the individual, and health care practitioners are here as guides and helpers, not to do it for them.

In the illness paradigm, “curing” is a matter of fighting and doing battle with “what’s wrong”. The problem becomes the focus. Endless diagnostic testing, supported by a system that is financially dependent on people being sick, often exaggerates the problem and creates new ones. Mentally, people are brought on board immediately by the diagnoses, and fear becomes their guide as they become more and more entwined with the doctors who have convinced them that they have a problem.

I remember an incident when I in my early 40’s, a few years before I discovered Buteyko breathing, although I had been involved in holistic health and wellness for almost 20 years. I was lying in my hospital bed after another severe asthma crisis which had landed me in the emergency room 36 hours previously, during which time I had been given nebulizer treatments every 4 hours. Finally the broncho-constriction had relaxed; I was exhausted yet could breathe easily. The doctor, on his hurried morning rounds, came in with my chest xrays, held them up in front of the window for me to see, pointed and waved his finger at me, and angrily said, “Look at this. You have the lungs of an 80 year old, and you need to be on steroids for the rest of your life, otherwise, go find another doctor.” Wow! That hit me like a brick, and my immediate reaction inside was anger, as I thought, “well !@#%&* you, I WILL find another doctor! “That was the moment which began my eventual move to California in search of a greater destiny which I knew I had, having no idea at the time that it would be as a respiratory educator. The point of this story is that I held that image of “my lungs are those of an 80 year old” for years, until I finally got it that what I needed to do was hold the image of perfect, healthy, vibrant lungs as a crucial part of returning to my optimal health and well being. THIS is a major player in a shift to the Wellness paradigm, the images and beliefs that we hold about ourselves. And since then, I have met many 80 years who I know have healthier lungs than I probably did at 40 anyway!

In the Wellness paradigm we make it clear that we take responsibility – no longer will the doctor take care of our body in the same way that the mechanic takes care of our car. Gently yet firmly reminding people that each time they say “my asthma” or “my heart disease”, they do not have to own that condition; they can rethink the issue and see it as a symptom that is reversible. I have seen so many miracles in my years in health care (tumors disappearing, quadriplegics walking) that I believe anything is possible if we make the commitment to change. And yes, this is a tall order for some, although it is what we are given and the choice becomes ours regarding how to deal with it and achieve the outcome that we desire.

If you wish to contact Dorisse, send Email to dorisse@breathdance.org.

 

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Brittany Murphy’s death

February 4th, 2010
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I wasn’t planning on a Blog article today, but couldn’t help it after seeing the news about Brittany Murphy’s cause of death. There is a young beautiful actress who had her whole life ahead of her and who suddenly died of pneumonia at the age of 32. A coroner’s official stated that prescription drugs also played a role.

The statistics says that the majority of flu deaths are actually due to quickly developed complications, like pneumonia. If your overall health is compromised because of a weakened immune system, you are more at risk.

What’s the best defense? I wrote in my earlier article “Viral respiratory infections. Are you protected?” that flu shots and anti viral medications are not always effective, and antibiotics are a double-edged sword. Every workshop I spend time with my students explaining how to deal with respiratory infections to minimize their impact on your health. The ultimate goal is, of course, to establish a healthy breathing pattern for life, the state where body naturally resists viral, bacterial and fungal infections.

In my practice I have seen people with different conditions. While going through the Butyeko therapy is somewhat individual experience, one thing is always true –

People with high Control Pause

• have significantly reduced number of viral respiratory infections (with CP close to 40 sec and over – virtually none)
• if they get a viral respiratory infection it is typically short lived and very mild
• they do not get complications like bronchitis, pneumonia, reactive airway disease etc

Flu and colds don’t have to ravage your body. Pneumonia and bronchitis are preventable, as well as Flu related deaths.

Significantly strengthened immune system is one of the most amazing benefits of the Butyeko Method.

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22 reasons to use your nose for breathing

February 1st, 2010
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picture1   The first (and a very strict) rule of the Buteyko therapy is to switch to nasal breathing.  It is amazing how a lot of health problems could be avoided just following this rule, yet rarely doctors or dentists would emphasize that.    
Think it is no big deal? You’d be amazed at how many important functions the nature’s perfect instrument for breathing, your NOSE, performs
 

1. Warms the air to about 95 degrees Fahrenheit, the optimal temperature for lungs.

2. Humidifies the air. Humidity supports tiny microscopic hairs (cilia) which assist in moving sticky mucus, debris and allergens out. Without enough humidity, cilia don’t work. Debris is trapped causing a cough.

3. Filters the air during inhalation through nose hairs and triggers the release of anti-bacterial molecules helping to clean the air.

4. Stimulates the release of odiferous molecules, so that we can smell the quality of air.

5. The nose has very sensitive nerve endings at hair roots, which warn about unhealthy particles in the air. Turbinate (or concha nasalis – a long, narrow and curled bone shelf which protrudes into the breathing passage of the nose) cause air to centrifuge any particles inhaled which then stick to the mucous membrane, preventing it from being sucked into the lungs.

6. Regulates incoming volume of air by providing extra resistance and anatomical dead space which is important in the regulation of breathing. Mouth breathing promotes hyperventilation.

7. Moves the air along the nasal septum, slowing movement of air and facilitating a more complete integration of ventilation process with other biological processes.

8. Exhalation through the nose reduces the rapid loss of Carbon Dioxide, which is needed to release oxygen from the blood to the brain, organs, muscles and cells (Bohr Effect). CO2 also dilates airways and blood vessels.

9. Promotes Oral health. Mouth breathing causes a drying out of the gums, increases the acidity in the mouth promoting both cavities and gum disease.

10. Stimulates normal Facial development. Nasal breathing allows the tongue and lips to properly form the natural arch around the mouth, thereby preventing tooth malformation. Improves the aesthetics of the entire face as the jaw forms in a healthy way.

11. Helps children to form sinuses by activating their growth with the movement of air. Mouth-breathers often have very narrow faces. The sinuses start growing at age 4.

12. Lubricates sinus membranes, lessening the chance of sinus infection. Reduces swelling and congestion of nose tissues and other airways. Keeps the nasal passages open.

13. Reduces snoring.

14. Reduces anxiety.

15. Due to reduced air volume fewer allergens are breathed in.

16. Increases sense of smell, linking it to the limbic system, the seat of emotions making us more aware of our emotions; also an important environmental factor for survival.

17. Activates movement at several head and neck joints.

18. Allows excess tears to have a clear passageway for drainage.

19. Allows air to pass structures that mark the head center , keeping you balanced. Paranasal sinuses produce nitric oxide, which is a potent vasodilator and a powerful sterilizing agent (klls bacteria).

20. Activates the production of immunoglobulins to strengthen the immune system

21. Helps increase the fluctuations of the cerebral spinal fluid by activation and movement of the sphenobasilar joint thereby nourishing the central nervous system.

22. Facilitates a deep meditation.

Hope you are convinced and started watching your breathing already!
More on nasal versus mouth breathing, including dental health and facial development, is coming up in our February Newsletter and future articles. Don’t miss it!

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What is the Buteyko Breathing Method?

January 13th, 2010
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The Butyeko Method is surely drawing a lot of attention lately. I am finding numerous posts on different asthma support groups’ web sites, the majority of them triggered by NY Times articles, with questions about the Buteyko Method. Unfortunately, because of such a low Buteyko Method awareness in the United States, many people who answer those questions usually don’t have a first -hand experience practicing or teaching the Buteyko Method. 

So, if you’ve never heard of the Butyeko Breathing Method and are curious about it, the following is a short summary to get you started.

1. The Buteyko Method was developed by a Russian doctor, Professor Konstantin Buteyko, in the 1950s. Despite initial skepticism from medical communities, the Buteyko Breathing Method continued to gain popularity and to spread not only in the Soviet Union, but around the world. In the 1990s, Buteyko’s students and followers eventually introduced the Method in Australia, New Zealand, the United Kingdom and many other European countries.

2. The Buteyko Method is used for achieving natural, drug-free control over many chronic conditions or diseases of civilization. The Butyeko Breathing Method is a complete therapy with a physiologically-based theory, developed over time-application techniques, measurements of progress etc., and has nothing to do with other breathing techniques such as traditional respiratory therapies, Yoga breathing, deep breathing exercises, etc.

3. In the West, the Buteyko Method has been mostly researched and practiced for asthma and other respiratory conditions.

4. The theory is based on the assumption that most patients with a variety of modern, chronic health problems constantly hyperventilate. They continuously breathe volumes of air, that are significantly above their metabolic requirements. The severity of the disease is proportional to the degree of hyperventilation. Restoring normal breathing leads to elimination of symptoms and reversal of the disease.

5. Seven clinical trials were conducted to-date in Western countries for asthma. The trials show consistent breathing improvement in asthmatic patients and significant reduction in medication use.

6. Worldwide, Buteyko Therapy recognition facts include a number of medical and government institutions admitting the benefits of the Buteyko Method in treating asthmatic patients.

7. The reluctance of many medical practitioners to recommend the Method is based mostly on the following:
- difficulty validating the theory, as not enough research is done on the subject of Chronic Hyperventilation’s affect on human health
-the absence of large-scale, long-term, clinical trials and corresponding medical publications
-in the short-term trials that were conducted, a significant reduction in symptoms and medication was achieved, although the lung function didn’t change 
-fear that patients might abandon their asthma treatment plan and exacerbate symptoms

8. The goal of a practical application of the Method is to reverse Chronic Hyperventilation and restore a healthy breathing pattern. Buteyko therapy is essentially an educational breathing retraining program, that, among other things, teaches the importance of nasal breathing at all times, includes daily breathing practice and physical exercise with correct breathing, and encourages changes toward a healthier lifestyle. 

9. Despite the lack of scientific proof (little or no publications in Western medical literature, no large-scale, long-term clinical trials, etc.), years of experience of Russian and Western Buteyko practitioners show that with the correct application, Buteyko therapy can considerably reduce symptoms and dependency on medication, and, in many cases, completely reverse the condition. With increased awareness, hopefully more Buteyko research will be initiated.

10. The Buteyko Method is generally safe for any age and disease severity if practiced under the supervision of a qualified Practitioner. The Buteyko Method does not include the use of any drugs, supplements or devices. The only optional cost is a Practitioner fee, which averages around the cost of a one-to-two month supply of commonly prescribed, preventive combination inhalers (for example–Advair).

11. Best practices of the Buteyko Practitioners in the West usually include a series of workshops or individual lessons where students learn to apply the Buteyko Breathing Technique. Lessons also include a theory introduction, as well as lifestyle guidelines. The practitioner’s role is to make sure a patient fully understands the theory behind the method, that the patient can correctly measure progress, and is able to practice breathing exercises in the most efficient way according to age, history of their disease, other health conditions, etc.

12. Buteyko is not a “quick fix”, and success with the therapy largely depends on a student’s understanding of the goals of the therapy, perseverance with breathing practice and making necessary lifestyle adjustments.

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Unmet Needs In Asthma Care In The U.S

January 8th, 2010
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In the past year, an estimated more than one million patients were hospitalized and nearly three million visited emergency rooms in the United States as a result of asthma, according to a new comprehensive national survey. Additionally, approximately one in three asthma patients 12 and older surveyed were hospitalized, visited emergency rooms or had other unscheduled healthcare visits due to their asthma in the past year.

Additional findings include:

- One in five asthma patients live in fear of hospitalizations or emergency room visits due to asthma and 29 percent of patients say that fear of asthma exacerbations keeps them from doing the things they want.

- Twelve percent of asthma patients who had an episode in the past year when asthma symptoms were more frequent or severe than normal report that these episodes last between seven and 13 days, while 18 percent reported that these episodes last three to four days. The mean duration of these episodes is 6.5 days.

- Asthma patients report a 33 percent decline in average productivity at times of the year when asthma was at its worst compared to a typical day.

- Adult asthma patients reported taking an average of 12.4 sick days compared with 3.6 sick days for adults without asthma in the past year, and 37.9 days in which they limited their activities compared with 15.8 days for adults without asthma in the past year.2

- Twenty-eight percent of adult asthma patients say they feel “a lot” or “some” limitations in social activities due to their asthma compared to 14 percent of adults without asthma who say they feel “a lot” or “some” limitations in social activities due to their health.

Nearly half of the general adult population surveyed (45 percent) report that they or another family member have had asthma.  (Asthma Insight and Management (AIM) Survey: Executive Summary. 2009)

If you are one of the 22 million asthmatics in the United States, the Buteyko Method is the answer to your condition. The Buteyko Therapy is a gradual breathing retraining program that is effective for any age or asthma severity. Years of experience of Buteyko Practitioners worldwide show that with a correct application Buteyko therapy can considerably reduce symptoms and dependency on medication, and in many cases completely reverse the condition.  Call us today to schedule your free consultation  612 337-9075

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Flu Shot Not Effective in Preventing Flu-Related Hospitalizations in Asthmatic Children.

January 2nd, 2010
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The inactivated flu vaccine does not appear to be effective in preventing influenza-related hospitalizations in children, especially the ones with asthma. In fact, children who get the flu vaccine are more at risk for hospitalization than their peers who do not get the vaccine, according to new research that will be presented on Tuesday, May 19, at the 105th International Conference of the American Thoracic Society in San Diego. Flu vaccine (trivalent inactivated flu vaccine—TIV) has unknown effects on asthmatics.

In order to determine whether the vaccine was effective in reducing the number of hospitalizations that all children, and especially the ones with asthma, faced over eight consecutive flu seasons, the researchers conducted a cohort study of 263 children who were evaluated at the Mayo Clinic in Minnesota from six months to 18 years of age, each of whom had had laboratory-confirmed influenza between 1996 to 2006. The investigators determined who had and had not received the flu vaccine, their asthma status and who did and did not require hospitalization. Records were reviewed for each subject with influenza-related illness for flu vaccination preceding the illness and hospitalization during that illness. They found that children who had received the flu vaccine had three times the risk of hospitalization, as compared to children who had not received the vaccine. In asthmatic children, there was a significantly higher risk of hospitalization in subjects who received the TIV, as compared to those who did not (p= 0.006). But no other measured factors—such as insurance plans or severity of asthma—appeared to affect risk of hospitalization.

CONCLUSION:
1) TIV did not provide any protection against hospitalization in pediatric subjects’ esp. children with asthma. On the contrary, we found a 3- fold increased risk of hospitalization in subjects who did get the TIV vaccine.This may be a reflection not only of the vaccine effectiveness but also the population of children who are more likely to get the vaccine.
2) More studies are needed to assess not only the immunogenicity but also efficacy of different influenza vaccines in asthmatic subjects. (Flu Vaccination in Asthmatics: Does It Work?)

What is the best defense strategy against seasonal viral infections? Take a second look at our earlier article Viral respiratory infections. Are you protected?

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Buteyko and Sleep Apnea

December 31st, 2009
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Snoring, Sleep Apnea and other breathing related sleep disorders affect millions of Americans.

Symptoms of sleep disordered breathing include
snoring ,nocturnal choking episodes, apnea, night sweats, daytime sleepiness, chronic tiredness, headaches, sexual dysfunction, anxiety and/or depression, irritable and aggressive behavior,   memory problems, difficulty concentrating, reflux.

The term apnea is used to describe a pause in breathing of 10 or more seconds. The stoppage of breathing can last anywhere from 10 to 30 seconds per incident – up to 400 seconds over the course of a single night with multiple occurrences. The criteria for being diagnosed with sleep apnea is an average of 10 apneic episodes over the course of an hour of sleep.
 
Apnea occurs due to abnormal ventilatory drive or upper airway resistance or obstruction. Snoring is associated with hyperventilation, nasal obstruction, upper airway narrowing and vibration.

There are three types of sleep apnea – obstructive, central and mixed. Of the three, obstructive sleep apnea (OSA) is by far the most widespread. OSA can be mild, moderate or severe. And because it is a progressive condition, the severity can worsen over time.

Approximately 6 million Americans suffer from moderate to severe sleep apnea – sometimes requiring a late-night emergency room visit. 24% of men suffer from sleep apnea of some form while only 9% of women do. Women are far more likely to suffer from sleep apnea after going through menopause. After menopause, the percentage is roughly the same as it is for men.

Estimates are that 50% of those who suffer from sleep apnea also have a snoring problem. According to the National Commission on Sleep Disorders Research, roughly 38,000 cardiovascular deaths annually are in some way related to sleep apnea. The links include high blood pressure, hypertension and stroke.

Why apnea occurs

In conventional medicine sleep apnea is still misunderstood for a large part.

According to Professor Buteyko’s theory , hyperventilation is considered to be the fundamental cause of OSA. He argues that apneas or pauses in breathing are the body’s defense mechanism against the excessive loss of carbon dioxide due to hyperventilation and consequent hypoxia (lack of oxygen).

Buteyko, Naughton and Javaheri* have shown that sleep apnea happens subsequent to over-breathing. Heavy breathing and snoring is associated with a drop in airway carbon dioxide levels. If the CO2 concentration goes below a critical level, the “apneic threshold”, apnea occurs. Breathing stops temporarily due to this dangerous imbalance in blood gases. In some cases this is accompanied by collapsing of the airway. These processes allow the CO2 levels to return to normal. Then breathing recommences usually with a snort, sigh or sharp intake of breath.  Both the lack of oxygen during the apnea and the inhibition of oxygenation during the hyperventilation, (Bohr effect) can lead to hypoxia. Prolonged periods of hyperventilation may result in severe tiredness and exhaustion and can lead to temporary paralysis of muscles in different parts of the body, including throat musculature. Poorly oxygenated tissues lack tone.

* References:

1. Naughton M et al
 University School of Medicine. Postgraduate Medicine Volume 53.
3. Javaheri S, Corbett WS. Assoc. Effect of continuous positive airway pressure on central sleep apnea and nocturnal PCO2 in heart failure.
American Journal of Respiratory Care Medicine 1994; 1509-1604
2. Lewis, B I. 1959. Stanford iation of low PaCO2 with central sleep apnea and ventricular arrhythmia in ambulatory patients with stable heart failure. Ann Intern Med 1998 Feb1;128(3):204-207

Treatment Options

1. CPAP machine – the application of continuous positive airway pressure during sleep. CPAP is effective in preventing the episodes of apnea. However some people may find it uncomfortable, and wearing a mask while sleeping is inconvenient. Some find the noise of the machine disturbing and complications of CPAP may include nasal congestion, runny nose, dry mouth, air swallowing and flatulence. The machine is to be used in bed every night, as it has no “curative” action on the snoring and apnea.

2. Sometimes surgery will be suggested. This involves pharyngeal soft tissue reduction and /or stiffening of the soft palate. Tracheotomy, which requires the surgical insertion of a tube into the trachea, may be suggested for people with very severe symptoms.

3. Dental appliances may be suggested

4. Breathing retraining – this option aims to correct the faulty breathing pattern that is typical for people with snoring and apnea.

The research by Naughton (see ref. in Why apnea occurs section above) shows that the mechanism by which CPAP improves apnea is by raising the pressure in the airways, which reduces the breathing volume (reduces hyperventilation) and increases the CO2  level above the threshold for apnea and keeps it there whilst the machine is applied.

The Buteyko breathing technique aims to teach you to do this for yourself by correcting the hyperventilation breathing pattern that is associated with snoring and apnea. You retrain your breathing when you are awake, reducing your breathing volume, increasing the airway CO2 towards normal, which can prevent apnea and results in quieter breathing. Oxygenation is improved. Practice of the breathing exercises can effect a resetting of the automatic respiratory drive to the correct rate. This carries over into the sleep stage.
By using the Buteyko exercises, people commonly report reduced nasal blockage, snoring and sleep apnea within a few days. Weight normalization is commonly experienced.  Improved oxygenation reduces fatigue and daytime drowsiness. The cardiovascular system benefits. Improvements in exercise capacity and resting and performance heart rate are reported. Heart rate recovery post exercise is enhanced. 

(*Large part of this article is quoted from Sleep Disordered Breathing by Tess Graham BSc Grad Dip Phty. Dip.BM)

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