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clinicalupdate 74
AUGUST 2004
By Mary Birch
Obstructive sleep apnoea and
breathing retraining

About the author
Mary Birch, RN, BA, MBioE, Grad Dip Soc, is a registered Buteyko practitioner.
Introduction
Obstructive sleep apnoea (OSA) is a sleep disorder where repeated upper airway obstruction during
sleep leads to a decrease in blood oxygen saturation and disrupted sleep.
Current treatment options include oral appliances, surgery, and/or the use of a continuous positive
airway pressure (CPAP) machine.
However, breathing retraining with the Buteyko Institute Method (BIM) is a safe, effective and
convenient approach to OSA that could help eliminate the need for surgery or CPAP.
This paper examines the role of breathing retraining in OSA and presents a case study to illustrate its
effectiveness.
Hyperventilation, OSA and
thousands of years, it is only in the last breathing retraining
Apnoea is defined as the total cessation of airflow at the nose and mouth, lasting more. Hypopnoea is generally taken to associated with lack of quality sleep.
Buteyko dedicated his life to researching tired, irritable, sleepy during the day, Buteyko developed spreadinternationally in 1991, and is now used Dysfunctional breathing and OSA
with ageing, obesity or airway anatomy.
OSA profile
airway and a drop in oxygen saturation.
2 clinicalupdate
pH shift:
CO2 deficit
HYPERVENTILATION
(respiratory
(hypocapnia)
alkalosis)
BUTEYKO THEORY AND
Bohr Effect
Bohr Effect
OBSTRUCTIVE SLEEP APNOEA
Compensation:
pH normalised
2 increase
(hypoxia)
Hyperventilation
breaths, snoring, frequent waking at night sweating, irritability, lack of concentration, body are critical in many conditions.
The optimal level of CO2 in the air sacs is consisting of fluticasone and salmeterol).
gradual alkaline reaction in the lungs.
gradual alkaline reaction in the lungs is machine, but found it was not effective in while performing daily living activities and possibility of surgery to alleviate his OSA.
means of a haemoglobin (Hb) molecule.
day. These exercises, totalling around 15 O2 is bound tighter than normal to the Hb he only used the CPAP intermittently.
Assessment
obviously tired and distressed, unable to available to the tissues. Therefore, when John’s progress
concentrate or listen effectively, and at overweight. John’s initial pulse was high (at 96) and his respiration rate was 20 per better and the night sweats had stopped.
breathing, ie. mouth-breathing constantly, night only and stated that he was feeling A case study
When John, (not his real name) a 44 improved as were his asthma symptoms.
and the Seretide had been withdrawn.
BIM breathing retraining
He was now taking Flixotide (fluticasone) clinicalupdate 3
Conclusion
results obtained in the first clinical trial of Institute Method offers a safe, effective, the need for surgery, oral appliances, or The benefits of breathing retraining have and the severity of their condition.
clinical practice in teaching BIM courses 20 episodes of apnoea or hypopnoea alternatives, there are no side effects with throughout the night without the CPAP.
Treatment options
His breathing had improved significantly, generally involve surgery or nightly however, there are currently no trials breathing exercises three times per day.
elated, to say: ‘I’ve had repeat sleep studies done and I don’t have apnoeas at available do not support the use of drugs References
all. Based on the results, I don’t need Every breath you take, New Holland Publishers (Australia) Pty. Ltd., Sydney, 1997.
3 Bridgman, S.A., et al. Surgery for obstructive sleep apnoea, Cochrane Review, Issue 2, 2004. Available at http://www.cochrane.org/cochrane/revabstr /AB001004.htm. Accessed 18 June 2004.
4 National Health and Medical Research Council, Effectiveness of nasal continuous positive airwaypressure (nCPAP) in obstructive sleep apnoea in adults, 2000. Available at http://www.nhmrc.gov.au/ include dry nose, mouth or throat, rhinitis, 7 Bowler, S.D., et al. Buteyko breathing techniques in Flixotide (very low dose) daily for ‘security asthma: A blinded randomised controlled trial,Medical Journal of Australia, December 1998, 169, Incidence, morbidity and mortality
8 McHugh, P., et al. Buteyko Breathing Technique for asthma: An effective intervention, The New Zealand In Australia, a 1995 clinical study found Medical Journal, December 2003, 116:1187.
find them noisy and intrusive, and people 12 Smith, I., et al. Drug treatments for obstructive sleep apnoea, Cochrane Review, Issue 2, 2004. Available at http://www.cochrane.org/cochrane/revabstr/AB003002.htm. Accessed 21 June 2004.
surgery for OSA found that no completedtrials were identified to compare surgical interventions for OSA with other surgical daytime sleepiness associated with or non-surgical interventions or no number of studies have suggested thatOSA is associated with premature mortality, largely as a result of vascular Correction
controlled trials to be carried out in the Associate Professor Paul Desmond, MBBS FRAC and OSA Diagnosis
co-author of Hepatitis C: A medical and social diagnosis research should be undertaken to identify (Clinical Update 73, ANJ July 2004, pp.23-25) is director of gastroenterology, St Vincent’s Hospital, Melbourne, monitoring an individual’s sleep patterns Victoria. The ANJ apologises for its error.

Source: http://www.buteykoairways.com.au/documents/ANJ%20Article%20Aug%202004.pdf

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