The book's Chapter 13 cites the Cochrane review on this and makes the point that the Buteyko method's real finding is quality of life, not airway change. The largest single trial since then says the same thing with more precision.
In 34 British general practices, 655 adults with asthma and impaired quality of life were randomized to a self-guided breathing-retraining program on DVD and booklet, three face-to-face physiotherapy sessions, or usual care, for a year. Both breathing groups scored higher on the asthma quality-of-life questionnaire than usual care at twelve months, by about a quarter of a point on a seven-point scale, and the DVD did as well as the physiotherapist. There was no difference in lung function or airway inflammation between groups. Serious adverse events were, if anything, fewer in the breathing groups.
If you have asthma, breathing retraining is a reasonable add-on that may make you feel better day to day, delivered cheaply, and it is not a reason to change your medication. The book's safety note on asthma is in Before you begin.
The studies
Bruton A, Lee A, Yardley L, et al. Physiotherapy breathing retraining for asthma: a randomised controlled trial. The Lancet Respiratory Medicine 6(1), 2018, 19–28. Read the abstract
- Sample
- 655
- Design
- Three-arm randomized trial over twelve months in UK primary care.
- Found
- Quality of life improved versus usual care with both the self-guided program (difference 0.28) and face-to-face sessions (0.24); no change in FEV1 or exhaled nitric oxide.
- Limits
- Open-label; participants selected for impaired quality of life; effect modest in size.
Where this lands in the book
Techniques
Rooms
Two rules, no exceptions
Never practice any technique on this site while you are driving, operating machinery, or doing anything that needs your full attention. The slow ones can make you drowsy, faster than you’d expect. And never practice a breath-hold, bellows breath, or any vigorous breathing in or near water. Read Before you begin for the doctor’s list and the rest.
Verdict scale: Science means trials or meta-analyses with consistent findings; Promising means real trials that are small, few, or unreplicated; Mixed means the studies point both ways; Mechanism means it shows how something works in the body, not that it helps in life. Checked against the published abstracts in October 2026. Not medical advice.