Dinah Bradley - Asthma Free: Managing Your Asthma with the BradCliff Breathing Method

A s easy as breathing in and out is a phrase often used to describe the ease of things that come naturally. The first obvious sign of a new life is the cry that comes after taking those first big breaths and opening the airless lungs. The switch from obtaining oxygen and disposing of carbon-dioxide via the placenta to air breathing is dramatic and sudden, and the switch only takes minutes to complete. From then on, breathing is on autopilot.

For the best part of our lives, we are not aware of our breathing. But breathing can be modified according to need: both the pattern and depth of breathing can be modified semi-consciously or consciously. For example, a singer trains her diaphragm for vibrato and other vocal dynamics, or a birthday child draws in a huge breath to blow out all the candles in one go.

Apart from the intentional use of breath, we are generally not aware of our breathing. George Bernard Shaw was correct to say that awareness of breathing already indicates problems. The patterns of breathing respond automatically to need, such as exercise. At the same time, all the respiratory muscles can be consciously modified. We can deliberately take in a big breath of fresh sea air at the beach, or hold our breath when walking through thick smoke.

The respiratory muscles consist of two main groups: those related to the movement of the ribcage and those related to the diaphragm. When we need to take a deep breath in, it is often the ribcage muscles (intercostal muscles) that are activated. When we want to hold a breath, both groups of muscles temporarily stop their actions at whatever phase of respiration. The diaphragm is a very powerful respiratory muscle and often needs to be trained to achieve the degree of respiratory control demanded by those who need big lungs.

The relevance and importance of abnormal breathing patterns in the diagnosis and treatment of disease is well known through all civilisations.

Western medicine has had a clear run of medical discoveries, in both scientific unveilings of disease mechanisms as well as the silver bullet of pharmaceuticals to cure them. Only recently have we begun to rediscover the wisdom of our forefathers with regard to the use of breathing in the promotion of good health, and as an adjunct to recovery from poor health.

The emphasis on breathing for health is particularly strong in the East. Chinese emphasise chi, which can be roughly translated as air, and features prominently in the practice of chi-oong (qi-gong). The practice of chi-oong concentrates on the mind and its ability to fully utilise the breathing muscles (especially the diaphragm) to achieve internal tranquillity and metabolic balance.

The practice of tai-chi (incidentally, this chi is not the same as in chi-oong , and actually means extreme or ultimate) involves not just the flow of movements; the pattern of breathing is important for those who want to reach tai-chis higher levels. Similarly, yoga, the ancient Hindu discipline, is not just about tying oneself in knots a big part of its practice has to do with breathing control to effect union of the soul with a universal spirit. In particular, pranayama (one of the eight steps of yoga training) deals explicitly with the control of breathing. Pranayama deals with a gradual reduction in breathing frequency (attainment of a 1:2 ratio in inspiration: expiration) and mental concentration on breathing effecting an exclusion of worldly interference as a means to inner tranquillity.

Scientific studies examining the effectiveness of yoga on breathing pattern disorders, asthma and chronic obstructive airway diseases have reported a variable degree of success. Its effectiveness in some patients is unquestionable, but among those who do not achieve control of their disease, the criticism is of the difficulty of mindbody training when a patient is fully distracted by the symptoms of the disease. Yoga aficionados already well versed in its practice claim much better effects when employing yoga in the event of respiratory distress. Other yoga practices, such as Hatha yoga, have been shown to improve the vital capacity of normal healthy subjects as well as patients with lung diseases.

As a young university student during a summer voluntary project in Lantau plateau, Hong Kong, I observed a young lady being brought into a monastery who was in obvious respiratory distress. She was breathing heavily, her hands were shaking and her neck was somewhat contorted. I remember her being put into a side room with a number of monks who began chanting quickly in accordance with the patients breathing.

As a bystander, I witnessed the progressive slowing of the chanting, and the woman was finally ushered into participating. The progressive slowing of her breathing finally calmed her so much that she actually recovered and was later left to sleep. This was my first encounter with passive modification of breathing patterns to achieve an end. I was in my early days as a medical student and foolish enough not to enquire further. Obviously it was a known method, used without herbs or needles.

Many modernised breathing-modification techniques exist in different parts of the world. The better-known ones are the Alexander Technique and the much-advertised Buteyko Method. These techniques suffer from a lack of robust research to back up claims of benefits. The Cochrane Database Research Group has so far concluded that more robust, well-controlled trials are required to test such claims of effects on asthma control.

The sensation of dyspnoea (difficulty of breathing) varies in patients. Some patients perceive dyspnoea earlier and in greater discomfort than others. Such high perceivers tend to consume relatively high doses of reliever medication. Specific inspiratory muscle training and breathing exercises reduce both the perception of dyspnoea and bronchodilator consumption. This may explain the few success stories of breathing techniques. Franchise breathing technique holders unfortunately modify well-meaning methods through commercial hype that may eventually hurt the patient while transferring monies from the patients pocket to their franchise accounts.