Breathing Matters > Asthma

Asthma and dysfunctional breathing are closely intertwined. Some patients with lung disease often have symptoms of breathlessness, which are not in keeping with any measure of lung function. The behavioural treatment approach to the reduction of asthma focuses on self-awareness and other relaxation techniques. It teaches breathing manoeuvres intended to improve breathing efficiency, and restore diaphragmatic muscle control. Breathing well also influences respiratory sinus arrhythmia. The improvement of respiratory sinus arrhythmia with biofeedback improves asthma treatment. From a psychological perspective, breathing retraining allows patients to take some control of their asthma.

A patient's perception of breathlessness correlates best with an abnormal pattern of breathing. A good breathing pattern reduces the sensation of breathlessness, while all the other physiological measurements remain stable. Dysfunctional breathers are the people who are more likely to be high medication users, particularly the reliever medications. Medication use correlates with symptoms, not the degree of bronchoconstriction.

The Cochrane group, a group that critically evaluates the effectiveness of medical interventions, concluded that while more robust, well-controlled trials were needed to test such claims for asthma control "the evidence looking at quality of life measures was encouraging." A number of studies have now been published, that not only document the benefits of breathing reeducation for asthma, but also for chronic obstructive airways disease. Breathing reeducation is cheap, causes no harm and quality of life measures are improved. It is a valuable adjunct to other medical measures helping patients manage their asthma.