British Guideline on the Management of Asthma.
British Guideline on the Management of Asthma grants permission for British health professionals to recommend Buteyko, stating that the method "may be considered to help patients control the symptoms of asthma". The guideline also grades clinical research on Buteyko with a 'B' classification - indicating that high quality supporting clinical trials are available. No other complementary therapy has been endorsed by this body for the treatment of asthma. The Guidelines are based on the studies summarised below.
British Thoracic Society & Scottish Intercollegiate Guidelines Network (SIGN). British Guideline on the Management of Asthma. Guideline No. 101. Edinburgh:SIGN; 2008. (HTML, Full PDF, Summary PDF)

1. ENGLAND 2009
G. Austin, DipPhys, C. Brown, BSc, T. Watson, PhD and I. Chakravorty, PhD. 
East and North Hertfordshire Primary Care Trust (PCT) England, UK.
Buteyko Breathing Technique Reduces Hyperventilation−Induced Hypocaponea and Dyspnoea after Exercise in Asthma.

Study Design: We conducted a randomised, controlled trial exploring a 5−week course of BBT on post−exercise end−tidal CO2 (EtCO2) and dyspnoea versus conventional therapy. Subjects underwent treadmill exercise testing to a symptom−limited maximum at baseline, 1 & 6 weeks. 

Results: Of 32 subjects enrolled, 20(15 female) completed the study (9 BBT vs 11 controls). Mean(SD) age was 48(15)yrs, BMI 28(5.6)kgm−2, FEV1 89 (24.7)%pred. EtCO2 (mmHg) and Borg Breathlessness score at 5min post−exercise were significantly improved with BBT, *p <0.05 (Repeated meas gen linear model).

Conclusion: Our study demonstrated the hypothesised physiology of BBT, improving hyperventilation induced hypocapnoea and breathlessness, following maximal exercise. By teaching patients to reduce hypernoea of breathing (the rate & depth), BBT may reduce asthma symptoms and improve exercise tolerance and control.

This abstract is funded by: Departmental funds.
ajrccm.atsjournals.org

2. CANADA 2008
Cowie RL, Conley DP, Underwood MF, Reader PG. A randomized controlled trial of the Buteyko technique as an adjunct to conventional management of asthma. Resp Med 2008; 102:726-32.

http://www.ncbi.nlm.nih.gov/pubmed

(The study was funded by an anonymous donor through the Dean’s Office, Faculty of Medicine, University of Calgary, Canada).

At six month follow up the Buteyko group (n=56) had significantly improved asthma control from 40% to 79% and improved quality of life. NB similar result in control (physiotherapy treated) group (n=63).
Corticosteroid daily dose dropped significantly only in the Buteyko group (reduction of 317ug beclomethasone equivalent p=0.0002).

No change in lung function in either group.

Conclusions: Buteyko safe, effective and no adverse effects.

Hard to pick appropriate control for Buteyko, physiotherapy not considered effective for chronic asthma management, chosen as credible intervention of similar intensity and duration. Study disadvantaged when patients found out one arm was Buteyko, lot of interest from world wide web, and volunteers didn’t want to be in control arm (random allocation). It is possible that they educated themselves in asthma in the 10 hours trainer contact time and with others with asthma, and learned about Buteyko. Also possible influence of website info on Buteyko group reducing corticosteroids more readily?

3. NEW ZEALAND 2006
McHugh P, Duncan B, Houghton F. Buteyko breathing technique and asthma in children: a case series. 2) N Z Med J. 2006;119:(1234) "no abstract available"

(The study was funded by grants from the JN Williams Memorial Trust and the Tairawhiti Complementary and Traditional Therapies Research Trust).

At six months Buteyko Group (n=8) achieved reliever medication decrease of 66% and inhaled corticosteroids decreased by 41%

Also improvements in quality of life, symptom scores and fewer courses of oral steroids.

Conclusions: children’s decreased use of reliever medication mirror adults and warrant further studies.

4. AUSTRALIA 2006
Slader CA, Reddel HK, Spencer LM, Belousova EG, Armour CL, Bosnic-Anticevich SZ, Thien FC, Jenkins CR. Double blind randomised controlled trial of two different breathing techniques in the management of asthma. Thorax. 2006 61:651-6. http://www.ncbi.nlm.nih.gov/pubmed

(The study was conducted by the Cooperative Research Centre for Asthma, jointly funded by the Australian Federal Government and Industry, including AstraZeneca, Aventis Pharma and GlaxoSmithKline).

Patients learned either Buteyko (n=23) or upper body exercises (n=25) from instructional videos.
In both groups, at week 28 reliever medication decreased by 86%, and inhaled corticosteroid use decreased by 50%.

Conclusion: breathing techniques useful in management of asthma.

The process of routine and as required exercises may reinforce a message of relaxation and self efficacy and provide a deferral strategy for reliever use.

5. ENGLAND 2003
Cooper S, Oborne J, Newton S, Harrison V, Thompson-Coon J, Lewis S, Tattersfield A. Effect of two breathing exercises (Buteyko and Pranayama) in asthma: a randomized controlled trial. Thorax 2003;58:674-679 http://www.ncbi.nlm.nih.gov/pubmed

(The study was supported by the National Asthma Campaign –now Asthma UK).

Three groups, Buteyko (n=23), Pink City Lung exerciser (n=24) and Pink City Lung exerciser control (n=22).

At 26 weeks, reliever use (p=0.005) and symptoms (p=0.003) reduced in Buteyko group but not the other two groups.

No difference between groups in lung function, exacerbations, or inhaled corticosteroid use.

Conclusion: Buteyko can reduce bronchodilator use and improve symptoms. Buteyko may be worth trying in patients who are sympathetic to the ethos and are willing to commit the time required.

Choice of control is difficult, maintaining blindness is a problem. Limited follow up visits to one for each group to remain comparable, but some subjects would have liked more. Success or failure relies heavily on patient/practitioner relationship.

Paitents need to be motivated, so the success rate of a formal trial may be less than that seen in everyday practice, and since patients did not chose the Buteyko couse, and because they are not paying, they may be less committed to seeing it through.

6. NEW ZEALAND 2003
McHugh P, Aitcheson F, Duncan B, Houghton F. Buteyko Breathing Technique for asthma: an effective intervention. N Z Med J. 2003 Dec 12;116(1187):U710.
http://www.nzma.org.nz/journal/116-1187/710/

(This study was funded by grants from White Cross Group and the Tairawhiti Therapeutics and Arts Trust).

At six months Buteyko Group (n=17) or control (n=17) asthma education and relaxation.
• Reliever medication decreased by 85% in Buteyko group, by 37% in control group.
• Inhaled corticosteroids decreased by 50% in Buteyko group, unchanged in control.

Conclusions: Buteyko is a safe and efficacious asthma management technique with clinical and potential pharmaco-economic benefits.

Investigators blinded to treatment assignment, but participants used term Buteyko. Equal investigator contact of groups ensured in this trial.

7. AUSTRALIA 2000
Opat AJ, Cohen MM, Bailey MJ, Abramson MJ. A clinical trial of the Buteyko Breathing Technique in asthma as taught by a video. J Asthma 2000;37:557–64.
http://www.ncbi.nlm.nih.gov/pubmed

(No funding, voluntary basis).

Buteyko (n=18) or placebo (n=18) video.
After four weeks, significant improvement in quality of life Buteyko group compared with placebo (p=0.043), as well as a significant reduction in inhaled bronchodilator intake (p=0.008).

Conclusions: Buteyko may be effective in improving quality of life and reducing inhaled reliever medication in patients with asthma –warrants further investigation.

8. AUSTRALIA 1998
Bowler SD, Green A, Mitchell CA. Buteyko breathing techniques in asthma: a blinded randomised controlled trial. Med J Aust 1998;169:575–8. http://www.mja.com.au/public/issues/xmas98/bowler/bowler.html

(Study funded by a grant from the Australian Association of Asthma Foundations).

Patients assigned to Buteyko (n=19) or control- general asthma education and relaxation techniques (n=30) groups.
At three months Buteyko Group achieved
• Reliever medication decreased by 90%. Significantly more than control (P=0.002)
• Trend towards reduction of inhaled corticosteroids

Minute volume lower in Buteyko group than control group (p=0.004)

No change in lung function, or end tidal CO2.

Conclusion: Buteyko group reduced hyperventilation and reliever medication use.