Part 2 Sectin 2 Cpyright Patrick McKewn, 2015
SIGNS TO LOOK OUT FOR Eyes g glassy Increased saliva in muth Nse may run Hands get warm Face gets pink Sme peple feel sudden calmness, thers may feel slight panic
PROGRESS Lighter breathing Final CP 25-40% higher Pulse lwer by 2-3 secnds
Exercise 3 WALKING WITH THE MOUTH CLOSED Walk, but dn t talk Walk at a pace where yu can sustain nasal breathing If yu need t pen yur muth, slw dwn and relax Walk fr half an hur t ne hur daily
Exercise 4 WALKING WITH SHORT BREATH HOLD While walking, breathe ut thrugh nse Pinch nse with fingers Hld yur breath fr between ten t twenty paces Resume breathing thrugh nse and cntinue walking fr abut ne minute Repeat breath hld every minute r s fr ten repetitins
Exercise 4 WALKING WITH MEDIUM TO STRONG BREATH HOLD While walking, breathe ut thrugh nse Pinch nse with fingers Hld yur breath fr between twenty t eighty paces Resume breathing thrugh nse and cntinue walking fr abut ne minute Repeat breath hld every minute r s fr ten repetitins
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS Measurement f prgress Cunt alud every ten steps Request that child tape muth during all exercises Have child walk frm ne adult t anther while hlding the breath Repeat steps every half minute r s Older kids- will naturally cmpete with each ther
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS Exhale gently thrugh nse. Try t build up a large air shrtage by ding as many steps as pssible - withut verding it f curse! Hld yur breath by pinching yur nse. Walk as many steps as yu can until yu feel a strng need fr air.
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS Resume breathing thrugh yur nse Yu shuld be able t recver frm steps within ne t tw breaths. If yu cannt, yu have held yur breath fr t lng. Yur first breath will usually be bigger than nrmal. Make sure yu calm yur breathing as sn as pssible by suppressing yur secnd and third breaths.
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS During breath hld, child/teenager will g thrugh easy phase, t struggle phase. Diaphragm will spasm as breath hld becmes strng. Lk at child's neck and when yu see child getting stressed, encurage child t let g. Sme kids are very cmpetitive. Encurage nt t get stressed.
Exercise 5: STEPS EXERCISE FOR CHILDREN,TEENAGERS & HEALTHY ADULTS Hlding the breath until a medium-t-strng need fr air mbilizes the diaphragm, prviding it with a wrkut and helping t strengthen it.
Exercise 6 MANY SMALL BREATH HOLDS FOR COUGH, WHEEZE, STRESS OR PANIC D many small breath hlds f 3-5 secnds each Exhale thrugh nse Pinch nse with fingers and thumb Hld breath fr three t five secnds Resume breathing fr ten secnds Repeat until symptms are passed. If having a severe asthma attack, r if symptms dn t stp within ten minutes take rescue medicatin
Exercise 6 MANY SMALL BREATH HOLDS FOR COUGH, WHEEZE, STRESS OR PANIC Success f stpping asthma attack depends n tw factrs: 1) The higher yur nrmal CP, the easier it is t stp symptms 2) The sner yu cmmence the breath hld exercise, the easier it is t stp symptms
Exercise 6 MANY SMALL BREATH HOLDS FOR COUGH, WHEEZE, STRESS OR PANIC Hyperinflatin Breathe in thrugh nse At tp f breath, pause fr a fractin f a secnd, bring a feeling f relaxatin t breathing and allw a gentle relaxed breath ut Cntinue bringing a feeling f relaxatin t breathing muscles
NUANCES
Strng Breath hlds nt suitable if: if: Persns with migraine, panic attacks, heart disease (if recent heart attack- relaxatin withut air shrtage), hypertensin may experience stress frm hlding the breath. (even if measuring the CP) Als, if the heart rate remains higher when measured five minutes after the breath hld. Instead begin with relaxatin, light air shrtage.
Steps and Heart Rate Strng breath hlds are nly suitable if the heart rate nrmalises when measured five t ten minutes after cmpletin f the steps r strng breath hld.
Anxiety May find it difficult t fcus n breathing. Air shrtage may generate panic. If cntrl pause increases t quickly, cleansing reactin may ccur. If necessary practise exercises invlving distractin. (breathing thrugh nse, stp sighing, relaxatin, small breath hlds, walking with muth clsed).
High Bld Pressure In first week- feel better with deeper sleep and mre energy. Bld pressure may increase slightly (10-15mmHg). With cntinued gentle practise, high bld pressure reduces tward nrmal. Dn t d steps r strng breath hlds. Instead relaxatin, reduced breathing, walking with muth clsed, many small breath hlds.
Pregnancy During first trimester- n reduced breathing exercises Prevent hyperventilatin- avid vereating, high temperatures, stress, muth breathing etc CP shuld nt increase by mre than 2 secnds each week 2nd trimester- g gently with air shrtage
Medicatin When the mrning CP increases t abve 20 secnds, persns taking medicatin fr hypertensin, diabetes r thyrid shuld visit their medical dctr t have their medicatin evaluated. Persns taking asthma and rhinitis medicatin als need t have their medicatin evaluated.
SEVERE ASTHMA Limit steps t ten- see hw he r she des, then increase t twelve, see hw he des. Cntinue t increase the steps while bserving recvery. If child r adult has under twenty steps- breathing is very intense. Higher chance f disrupting breathing and causing symptms. Try t achieve as many steps withut causing cugh, wheeze. D hundreds f small breath hlds t make prgress.
IF HAVE SYMPTOMS T difficult t reduce breathing if symptms are present r cntrl pause is very lw. D Exercise 6 (many small breath hlds) until symptms pass, r cntrl pause reaches 12/13 secnds.
IF FEELING VERY SUFFOCATED BLOCKED NOSE / STRONG BREATHING DRIVE Ex 1 r 5: Cncentrate n strnger breath hlds D steps exercise t help reset respiratry centre quickly Breathing will quieten in abut half an hur
MILDLY BLOCKED NOSE AT NIGHT (TAKEN FROM CLOSE YOUR MOUTH ) First clear nse by cmpleting the nse unblcking exercise and rinse yur nse with saline slutin (described in Clse Yur Muth). Wear paper tape ver lips. Nse will cntinue t blck until CP is 20 secnds While wearing the tape, yur nse will never cmpletely blck. Yur nse will partially blck if cntrl pause is lw. Remember, yur nse will nly blck cmpletely if yu switch t muth breathing.
UNCOMFORTABLY BLOCKED NOSE (TAKEN FROM CLOSE YOUR MOUTH ) Practice half an hur f reduced breathing befre bed. (r ten Steps exercise) Rinse yur nse with sea salt and water. Wear the tape ver yur muth. This will help vercme the feeling f suffcatin during sleep. Wear Breathe Right strips n yur nse.
KNOW WHEN TO REFER TO EAR NOSE THROAT SPECIALIST Practise six repetitins f Exercise 5 Steps (create a strng air shrtage) If child r adult can breathe thrugh their nse fr ne minute, they can d s fr life If child r adult is unable t breathe thrugh their nse fr ne minute, then refer t ENT specialist
LIFESTYLE
Lifestyle and breathing Prcessed fds vereating Stress Excessive talking Lack f physical exercise High temperatures f huses/stuffy air Persns wrking in an ffice wh are under stress and talking all day, eating prcessed fds with n time t d physical exercise have mre wrk t d!
Getting a Better Nights Sleep Lw CP and muth breathing cntribute t the fllwing: Snring, Sleep apnea Disrupted sleep Nightmares Asthma symptms (3am-5am) Needing t use the bathrm at abut 6am Children wetting the bed during the night Fatigue first thing in mrning Dry muth upn waking Symptms upn waking- blcked nse, wheezing, cughing r breathlessness
Getting a Better Nights Sleep Avid blue light smart phne and laptp Sleep in a cl and airy bedrm Dn t eat late at night r drink alchl Switch t nasal breathing permanently Practise breathing sftly fr twenty minutes befre sleepparasympathetic NS Determine sleeping psitin
Getting a Better Nights Sleep Tape muth clsed- 3M micrpre tape Prvide each student with a rll f tape Demnstrate hw t apply it Wear tape fr twenty minutes during the day t becme cmfrtable with it If muth naturally mist in the mrning, n need fr tape
Diet Dn t talk abut diet until sessin three r fur Water has n effect n breathing Prcessed fds increase breathing Raw fd, mst fruits and vegetables have less effect n breathing Sme peple are intlerant t different fds- if s better t remve these fds frm the diet
Physical Exercise Only tw ways t increase CO2 in the human rganism. Never muth breathe if the CP is less than 20 secnds. Yu can have yur muth pen during sprts fr shrt perids f time when the CP is greater than 20 secnds. Avid asthma attack by warming up, and warming dwn.
Physical Exercise Create an air shrtage 1. G faster with yur muth clsed 2. Breathe less during physical exercise 3. Practice breath hlds as described in EXERCISE 4 Determine if yu are breathing crrectly during physical exercise; Measure yur CP befre exercise Perfrm physical exercise Yur CP measurement 30 minutes after exercise shuld be greater than yur CP measurement befre exercise
DIFFERENT CATEGORIES OF CLIENTS
Fur categries f clients 1) CP f less than 10 secnds, lder r nt well 2) Panic attack, anxiety, sleep apnea, high bld pressure and mre 3) Children and teenagers 4) Busy adult
PROGRAM FOR CATEGORY ONE FOR LOW CP, OLDER OR NOT WELL Breathe thrugh nse bth day and night. Practice Exercise 2 (Gentle reduced breathing) fr ten minutes by six times daily. (Only if it des nt disrupt breathing. Otherwise practice Exercise 6). r Practice Exercise 6 (Many Small Breath Hlds) fr ten minutes by six times daily. Exercise 3: Gentle walking each day with muth clsed.
PROGRAM FOR CATEGORY ONE FOR LOW CP, OLDER OR NOT WELL If having symptms during sleep, sleep in an upright psitin nly. Set alarm t break sleep every tw t three hurs. If n symptms, g back t sleep. If symptms, practice many small breath hlds t help get yur breathing under cntrl. Dn t g t sleep until breathing under cntrl. Avid excessive talking r ther activities that will increase breathing. Eat fd in small quantities.
PROGRAM FOR CATEGORY ONE FOR LOW CP, OLDER OR NOT WELL Never push yurself during physical exercise beynd the pint where yu lse cntrl f yur breathing. Fr example, getting up ut f bed, rll ver very gently and slwly walk t the bathrm, r ut f the rm. While climbing a stairs, take it ne step at a time and rest as ften as necessary. (especially applicable t severe asthma and COPD).
PROGRAM FOR CATEGORY TWO PANIC ATTACK, ANXIETY, SLEEP APNEA, HIGH BLOOD PRESSURE Breathe thrugh nse bth day and night. Spend six by ten minutes daily ding any f the fllwing: Exercise 2: Reduced Breathing with relaxatin (sleep disrdered breathing- 15 minutes befre sleep) Exercise 3: Walking with Muth Clsed Exercise 6: Many Small Breath Hlds Exercise 7: Relaxatin withut air shrtage
PROGRAM FOR CATEGORY TWO PANIC ATTACK, ANXIETY, SLEEP APNEA, HIGH BLOOD PRESSURE Sleep apnea; may shw unusually high cntrl pause Lst sensitivity f chemreceptrs Cncentrate n relaxatin withut air shrtage Then practise relaxatin with air shrtage Cardi issues may be present
PROGRAM FOR CATEGORY THREE CHILDREN / TEENAGERS Breathe thrugh the nse at all times Exercise 3: physical exercise with muth clsed Exercise 1: if nse gets blcked Exercise 2: be aware f the cncept f reduced breathing and ensure that breathing is quiet 24/7 Exercise 4: breath hlds during exercise Exercise 5: when yu have n symptms, practice 12-18 repetitins f Steps each day. (Ideally 6 befre breakfast, 6 during the day and 6 befre bed.)
PROGRAM FOR CATEGORY THREE CHILDREN / TEENAGERS Exercise 6: when wheezy r cughing When child r teenager can d 80-100 Steps, d enugh repetitins t maintain this figure. Fr example, after a few weeks they might be able t maintain 100 steps by just ding 3 repetitins f Steps each day.
SET EXACT GOALS Knw hw many steps the child is able t d. Set a gal fr the child t increase by ten extra steps each week. If steps are abve sixty- n symptms present but a trigger culd prduce symptms Overall gal is t reach 80-100 steps Rewards may be gd incentive. When child returns t the next sessin, check that they have achieved their gal.
I HAVE BEEN FOOLED SO MANY TIMES! Hld hand ver face and sneak air int muth Make size f steps smaller Sneak air at turns If child has 80 steps in first weekcall a Stewarts enquiry!
HOW TO AVOID BEING FOOLED Child hlds their nse with hand abve face s muth can be seen. (if child's muth taped- less f an issue) Keep an eye n the size f the steps Pay special attentin t 10 year ld bys! Listen t air sneaking in Have child walk frm ne parent t anther s that face is visible at all times
TEACHING CHILDREN FROM FIVE TO TEN YEARS What is gd breathing?
TEACHING CHILDREN FIVE YEARS Can be shy Let kids see ther kids ding the exercise Try nt t vercrwd the child Ask parents t tape their wn muths, children and teenagers frm early n in the curse Have parents wrk with the children Have shrter curse time, but mre sessins -(five sessins f ne hur is ideal) Plenty f practical exercises
WHAT IS GOOD BREATHING?
WHAT IS NOT GOOD BREATHING?
IMPORTANCE OF BREATHING THROUGH NOSE D yu ever see yur cat walking arund with his muth pen? What are yur eyes fr, what is yur muth fr, what are yur ears fr? What is yur nse fr?
MOTIVATING TEENAGERS
MOTIVATING TEENAGERS One swimmer swim a few strkes Anther can swim fr a lt lnger
MOTIVATING TEENAGERS
MOTIVATING TEENAGERS
MOTIVATING TEENAGERS Be careful hw yu cmmunicate facial structures t children and teenagers! Cnvey the message thrugh bks etc.
PROGRAM FOR CATEGORY FOUR FOR BUSY ADULT Exercise 2: Reduce yur breathing fr ten minutes by three times daily Exercise 3: G fr 20-minute walk during yur lunch break. Exercise 4: D five t ten breath hlds thrughut the walk.
PROGRAM FOR CATEGORY FOUR FOR BUSY ADULT Exercise 5: Practice 20 repetitins f Steps daily if yu have n cntraindicatins. Ideally, spend a cumulative 60 minutes per day reducing yur breathing. Frmally- ten minutes every hur.
TEACHING BUTEYKO
TEACHING BUTEYKO Client cmpletes intake frm. Small grups f 3 t 6 children r adults is ideal. Have separate grup fr children and adults. Arrange t see clients fr ne hur t ne and half hurs ver five sessins. Tw sessins n first week, ne sessin a week apart thereafter.
TEACHING BUTEYKO Observe clients thrughut each sessin- get a sense f their breathing. Check if muth pen as they walk int yur clinic etc. Listen fr sighs. Explain thery as this mtivates. Yu can imprve yur bld circulatin by making simple changes t yur breathing!
TEACHING BUTEYKO MOTIVATION Better breathing Better asthma cntrl, less clds, chest infectins, phlegm and pst nasal drip Better speech Significantly less rhinitis
TEACHING BUTEYKO MOTIVATION Imprved sleep Reduced breathlessness during physical exercise Calmer mind Imprved cncentratin, fcus and prductivity Structural changes t the brain
TEACHING BUTEYKO MOTIVATION The adult nervus system has the capacity fr plasticity, and the structure f the brain can change in respnse t training. Changes in gray matter cncentratin in brain regins invlved in learning and memry prcesses, emtin regulatin, self-referential prcessing, and perspective taking. Britta K. Hölzel et al. Mindfulness practice leads t increases in reginal brain gray matter density Psychiatry Res. 2011 Jan 30; 191(1): 36 43.
TEACHING BUTEYKO MOTIVATION Such increases represent enduring changes in brain structure that culd supprt imprved mental functining. Britta K. Hölzel et al. Mindfulness practice leads t increases in reginal brain gray matter density Psychiatry Res. 2011 Jan 30; 191(1): 36 43.
TEACHING BUTEYKO Exercise 2: Reduced breathing is the mst imprtant exercise. Yur client may als be suited t the strnger breath hld exercises 4 and 5. CP ver 15 secnds, n cntraindicatins, relatively gd health. Begin each sessin with mre gentle breath hlds. Ensure that they dn t verd the strng breath hlds.
TYPICAL FORMAT
First sessinsessin- adults Gal is t understand the imprtance f nse breathing and light breathing Traits f dysfunctinal breathing Measure the Cntrl Pause and give feedback Exercise1: Hw t unblck the nse Exercise 6: Many small breath hlds fr stress, asthma
First sessinsessin- adults Exercise 2: Reduced breathing- all three versins - 4 minutes: hands n chest and tummy - 4 minutes: finger blcking ne nstril - 4 minutes: hands cupping face All physical activity with muth clsed Tape muth at night (prvide tape)
First sessinsessin- adults Hmewrk- practice exercises six times by ten minutes daily
Secnd sessinsessin- adults Prgress n day tw is usually mixed. Review prgress f the grup: practice? Muth taped? Breathing lighter? Better awarenes? Recap briefly : imprtance f nse breathing Measure CP after resting fr ten minutes Exercise 1: Hw t unblck the nse Exercise 6: Many small breath hlds - 4 minutes
Secnd sessinsessin- adults Exercise 3: Walking with muth clsed- 5 minutes Exercise 4: Walking with breath hlds- 10 minutes Hmewrk- practice exercises six times by ten minutes daily
Third sessinsessin- adults Check prgress, bserve breathing. Recap briefly: imprtance f nse breathing Measure CP after resting fr ten minutes Exercise 1: Hw t unblck the nse (5 min) Exercise 6: Many small breath hlds (5 min) Exercise 2: Reduced breathing (4 by 4 min) sessins. PULSE, CP, RB, CP, RB, CP RB, CP, RB, CP, PULSE
Third sessinsessin- adults Ex 3: Walking with muth clsed (5 min) Ex 4: Walking with breath hlds (10 min) Talk abut physical exercise Talk abut diet Hmewrk- practice exercises six times by ten minutes daily
Furth and Fifth sessinsessin- adults Check prgress, bserve breathing. Recap briefly : imprtance f nse breathing Measure CP after resting fr ten minutes Ex 1: Hw t unblck the nse Ex 6: Many small breath hlds (4 min)
Furth and Fifth sessinsessin- adults Ex 2: Reduced Breathing Advanced (4 by 4 min) PULSE, CP, RB, CP, RB, CP RB, CP, RB, CP, PULSE Ex 3: Walking with muth clsed (5 min) Ex 4: Walking with breath hlds (10 min) Ex 5: Steps (10 min) Hmewrk- incrprate int yur daily life
Final Wrds It is easy t ffer Buteyk when yu knw the methd very well and practise what yu preach. Hw culd yu ask a client t tape their muth when yu have never dne it yurself? Hw culd yu explain reduced breathing thrugh relaxatin when yu are unable t d it yurself? Yu need t be yur first client.
If Yu Are Passinate Learn as much as pssible Becme an expert Always surce infrmatin Find ways t reach the general public Help cmes t yu frm clients, media and mre
That s all flks! flks! Cpyright Patrick McKewn, 2015