Asthma Answers

Intro

It's the middle of the night. Suddenly you're wide awake, suffocating, gasping for air but unable to catch your breath. The whole world seems to be closing in around your throat and chest. The urgency to breathe that woke you in the first place is rapidly giving way to panic. You're having an asthma attack.

For millions of Americans, this is an all-too-frequent occurrence, a nightmare that can't be fully appreciated by those without the disorder. That was certainly true for me. Until late 1987 I had never given asthma much thought. Then I had a bout with viral pneumonia. Even after I recovered, a nagging cough lingered. The cough became chronic and, after several months, so did bouts of breathlessness. After one particularly anxious episode, I went to the doctor. She diagnosed my problem as asthma.

What Is Asthma?

Asthma comes from the Greek word for "panting". My doctor described it as a reversible, chronic lung disease characterized by coughing, wheezing and inflamed airways. Though asthmatics always have some degree of inflammation, an asthma attack or "flare" occurs when some trigger provokes increased swelling, mucus, coughing, and a tightening of the smooth muscle around the airways. As airways close, breathing becomes shallow, fast, and difficult. Symptoms can be mild, severe, or even fatal.

This is the clinical explanation, but it hardly conveys the terror of an experience that leaves even the strongest person feeling out of control and helpless.

Upon my doctor's diagnosis, I became one of the 17 million asthma sufferers in America. Figures from the U.S. Department of Health and Human Services are sobering: Six percent of children under five have asthma (a 160 percent increase since 1980), and older children miss 10 million school days each year. Asthma accounted for nearly two million emergency room visits last year; over 6 billion dollars was spent on asthma care. According to the World Health Organization, the situation isn't much better throughout the industrialized world. In Australia, for instance, 1 in 8 children have asthma. Annually, there are over 180,000 deaths worldwide from the condition, and asthma seems to have become a more serious disease in recent years. Researchers are scrambling to figure out why.

Pollution is often cited as a cause, and with good reason: airborne and environmental pollutants can trigger asthma attacks but it doesn't fully explain the epidemic since pollution rates are declining even as asthma continues its upward climb.

Other scientists theorize that perhaps we are too clean! Researchers at Columbia University are trying to determine if the important sensitizing of the immune system that should take place early in life has been reduced by modern hygiene, leading to later hyperactive immune reactions that contribute to the occurrence of asthma.

Especially intriguing is the recent theory that the very drugs that revolutionized asthma care are partly responsible for the increase in overall incidence, and especially for the growing mortality rate. This hypothesis is particularly compelling since the current epidemic indeed began at about the same time modern asthma drugs went on the market.

Medical Treatments for Asthma

Successful treatments for asthma have always been elusive. Remedies changed little through the ages and included herbal tinctures, relocation to arid climates and, believe it or not, smoking tobacco and cannabis. With the development of bronchodilators or "rescue" inhalers during the 1960s, everything changed. These drugs (the most popular is Albuterol) bring rapid relief of the most common symptoms of asthma. Airways quickly reopen, wheezing stops, and mucus clears. This lets the asthmatic relax and breathe more easily. These sprays seemed to be the big breakthrough that would banish asthma forever, but there was a down side. Many asthmatics overuse their inhalers. Though doctors warn against this, it's easy to see how such a pattern develops. People are less likely to avoid the situations that trigger asthma attacks if they know a puff or two from an inhaler will magically banish their symptoms. Inhaler overuse also masks a silent increase in chronic airway inflammation, giving asthmatics a blunted perception of how severe their asthma is, so that they put off getting further treatment until they have a real crisis. Furthermore,overuse can lead to "locked lung" syndrome, a paradoxical reaction that makes bronchospasms difficult to reverse and the British Medical Journal Chest reports that frequent use of a bronchodilator is "a dire warning of the immediate need for another kind of treatment: oral steroids or hospital rescue" and in other words, while inhalers relieve symptoms in the short term, in the long run they contribute to an overall increase in the frequency and severity of attacks.

Doctors now recognize the limits of rescue inhalers and often recommend the use of newer drugs, primarily corticosteroids, which treat asthmatics' chronic inflammation. With the development of these anti-inflammatories, medical treatment of asthma has entered a new era. Prednisone, the most popular of these drugs, is now the last line of defense against asthma and has saved many lives, including my own. Regular use can reduce the need for bronchodilators and prevent asthma attacks. However, Prednisone is a potent drug with severe adverse effects that can include dependence, hormonal changes, weight gain, glaucoma, and severe bone loss. With long term use a person can be affected by problems more crippling than asthma itself.

A Turning Point

Like 90% of diagnosed asthmatics, I relied upon popular medications, using a combination of inhalers and Prednisone to prevent and relieve symptoms. I had also tried a number of alternative therapies like herbs, acupuncture, and dietary supplements, which were of some help. I was vigilant about avoiding the common triggers of asthma attacks. But none of these strategies provided long term relief from my symptoms, nor did they free me from drugs and hospital visits, which had come to average about five a year.

Most perplexing, the pranayama techniques that I had practiced for years and that I thought would help me actually triggered symptoms (especially those exercises which emphasized the inhalation or its retention). Later I would understand why, but at the time I felt helpless. I was afraid to take less medicine, but my situation was deteriorating.

Then in late 1995 it happened. Two days after coming down with the flu, I went into respiratory failure and spent the next three days unconscious in intensive care on a respirator. Later I was told I nearly died.

During my long recuperation I had ample time to contemplate my predicament. I had to come to terms with the fact that the medicines I had been taking were no longer helping me. I knew my asthma was severe enough to be fatal, and might be unless I took proactive steps to improve my circumstances. I had to find something new.

A Holistic Approach

A question had nagged at me ever since I was first diagnosed. What change had occurred in me that now caused me to react so severely to triggers that, in the past, were harmless? I think this is a relevant question whether one has had asthma a few months or for years. What is going on inside this particular body, right now, that causes me to have asthma?

It is so easy to define asthma by its symptoms. The majority of treatments, in both allopathic and complementary medicine, are designed to alleviate those symptoms. However, symptoms are not the cause of asthma, and I knew from years of practicing and teaching yoga that treating symptoms without considering the whole person seldom solves the underlying problem.

So I set out to learn why certain triggers cause the body to react with an asthma attack. As I read everything I could about asthma, I was intrigued to find that several prominent experts on breathing, including Dr. Gay Hendricks, author of the excellent book Conscious Breathing, and Dr. Konstantin Buteyko, a pioneer in the use of breath retraining for asthmatics, consider the malady to be more a disturbed breathing pattern than a disease. I began to wonder if my breathing patterns had been so thrown out of sync by the stress of coping with pneumonia that the changes had become chronic. Of course, I was acutely aware that my breathing was disturbed when I was having an asthma attack; now I began to consider the possibility that my breathing might be significantly disturbed even when I had no symptoms. Was it possible that my disordered breathing was actually a cause of my asthma and was perpetuating it? Could it also be that disordered breathing was sabotaging my attempts to help myself through pranayama? Not only did these ideas help me to make sense of my condition, they also gave me hope. If the way I breathed was causing my asthma, then retraining my breath might alleviate my problems. Excited by this prospect, I dived into learning more about how the body breathes.

How We Breathe

Respiration, like other essential bodily functions, is involuntary. Our bodies are programmed from birth to perform these functions automatically, without having to think about them. Respiration is unique, however, since it can be voluntarily modified by the average person. This capability is the basis for breathing techniques that have been part of yoga tradition for thousands of years. For asthmatics, these techniques can be the foundation for a program of breath retraining that can help them manage their disorder.

Breathing is ideally a process of maximum efficiency with minimum effort. Its efficiency depends on the correct functioning of the diaphragm, a strong sheet of muscle that separates the heart and lungs from the abdomen. In simple terms, each breath starts in response to a message from the respiratory center in the brain which causes the diaphragm to activate. It flattens into a disc, making the lower ribs swing out, and thus increasing the volume of the chest cavity. The lungs follow this expansion, creating a partial vacuum that pulls air into the lower lungs, much like a bellows.

When we exhale, the diaphragm simply relaxes. The lungs have a natural recoil that allows them to shrink back to their regular size and expel air. The abdominal and rib muscles can enhance this process, but it is the release of the diaphragm and the recoil of the lungs that are the crucial elements in the exhalation. After a pause, the breath cycle begins again, a pumping rhythm we can all easily feel. When our breathing apparatus is working efficiently, we breathe 6-14 times per minute at rest. In a healthy person, this rate increases appropriately when the physical needs of the body require it.

The Autonomic Nervous System

Like other involuntary bodily functions, breathing is usually controlled by the autonomic nervous system, which enables the human organism to run like a well-oiled, self-correcting machine. There are two branches to this system, the parasympathetic and sympathetic. The parasympathetic branch, known as the "relaxation response", controls resting functions of the body. It slows the heart and breathing rate, as well as activating digestion and elimination. The sympathetic branch has the opposite effect. It rouses the body and regulates active functions related to emergencies and exercise. When emergencies arise, the sympathetic branch floods the body with adrenaline – the well-known "fight or flight" response. Heart rate goes up, and breathing rate increases to supply the body with an infusion of oxygen. If the danger is real, the increased energy is used. If not, the body stays in a state of overstimulation which can become chronic, causing a number of symptoms including anxiety and hyperventilation (over breathing). Since few of us are immune to the constant stresses and strains of modern life, the alarm bells of the sympathetic nervous system are constantly being rung. It is a real juggling act to maintain a healthy autonomic balance, a challenge at which asthmatics generally fail.

Although most asthmatics are unaware of it, we tend to chronically breathe at a rate two to three times higher than normal which disrupts the vital balance of respiration. Paradoxically, instead of providing more oxygen, over breathing actually robs our cells of this essential fuel. We do take in more oxygen when we over breathe; but, more importantly, we also breathe out too much CO2. Most of us learned in school that when we breathe we (deleted words) expel carbon dioxide as a waste gas but not that how much we expel is very important. If the CO2 level gets too low, the hemoglobin that carries oxygen through the blood becomes too "sticky" and doesn't release sufficient oxygen to the cells. Eventually, starved for oxygen, the body's natural defenses kick to try and halt the dangerous depletion of CO2. These measures produce the classic symptoms of an asthma attack: smooth muscles tighten around the airways, and the body produces excess mucus and histamine (which causes swelling) to constrict them even further—and we're left gasping for breath.

A Yoga Approach

Once I understood that breaking the cycle of over-breathing is essential to overcoming asthma naturally, I could draw on all my years of experience with pranayama. I experimented with breathing techniques to see what would restore my natural breath rhythm. Over time I settled on a handful of exercises that are simple and effective in slowing the breath rate, and reducing the incidence and severity of my asthma. This program is meant to restore a natural breathing pattern and to provide a foundation from which the body can adapt well whether we are practicing other breath work, exercising, weathering a crisis, or simply going about our daily lives.

There are certain precautions to consider as you embark on this program. Please do not stop taking your medications. The program may ultimately reduce your dependence on medication or do away with it altogether, but this should not be done hastily or without the approval of a doctor. If you have diabetes, kidney disease, or chronic low blood pressure, have had recent abdominal surgery, or are pregnant, you should consult with your physician before doing these exercises. I also strongly suggest that asthmatics generally avoid additional breathing exercises which call for rapid breathing, retention of the inhalation, or tightening the throat. Asthmatics must realize that many breathing exercises which are quite beneficial for a normal breather may have a paradoxical impact on an asthmatic.

Let me stress that patience and perseverance are required in this program. The disrupted breathing patterns common among asthmatics are deeply ingrained and can take a while to change. The truth is, it can seem easier to take a pill or use an inhaler than to spend 15 minutes a day on exercises that confront these stubborn patterns and bring up the fears and emotions that often surround the disease. I know the frustrations firsthand. But I also know, from my experience, that if you make these behavioral changes a daily regimen, you'll gain valuable tools for managing your asthma.

The Guidelines

Here are a number of practical guidelines that will help your efforts be more successful.

1. Refer to the directions frequently.
2. At first, practice the exercises in order. You may eventually find you prefer a different sequence, and that's fine. (You may also have other exercises that have helped you in the past. Feel free to include them.) But whatever you do, I recommend you start each session with the Deep Relaxation exercise.
3. Don't be too ambitious. Asthmatics are often chronically overstimulated and tend to overdo. Keep things simple. Resist the urge to do more even if you feel you are ready. Wait a few months before increasing your efforts.
4. The exercises work best on an empty stomach, but you should have water to sip during the exercises. It will help keep your airways moist.
5. For optimal results wear warm, loose fitting clothing and practice in a comfortable place where you have room to lie down on the floor. (It is fine to pad the floor with a blanket or two.) In this position, less effort is required for your diaphragm to move well. However, if you are experiencing asthma symptoms, lying down may be uncomfortable. In that case, try sitting on the edge of a chair and leaning forward onto a table. Rest your head on folded arms and turn your head to one side. But you don't need such ideal conditions to practice; I encourage you to do exercises whenever and wherever they come to mind. I often practice while driving.
6. If you feel anxious, nauseous or short of breath while doing the following exercises, STOP. Get up and walk around. You are probably hyperventilating and need to burn off some energy. Don't try to continue your exercises immediately, but come back to them the next day.
7. Remind yourself often - especially if you get frustrated&endash;that the way you breathe now is making you ill; that it's learned behavior; and that it can be changed.
8. Practice the exercises once or twice daily. When you are exhibiting symptoms, Exercises 3 and 4 can be done more frequently.

Exercises

#1 DEEP RELAXATION

This exercise establishes a calm state before doing the other exercises. Begin by lying down with a firm pillow or a folded blanket under your head. Bend your knees and rest your feet flat on the floor. If that is not comfortable, place a bolster or rolled blanket under the knees. Feel free to shift your position and stretch if you become uncomfortable. Some people like to play calming music as well.

Place your hands on the belly, close your eyes, and turn your attention inward. How do you feel? Are you uneasy, uncomfortable, buzzing, or distracted? Is it difficult to lie still? Is your mind racing? These are common experiences for an asthmatic. The goal is to let go of all that, which is not always easy. It may take several minutes (or several sessions) to relax deeply. Give yourself time.

With each exhalation, let your belly sink away from your hands and into the back body. After a gentle pause, can you feel the belly rise effortlessly when you inhale? This relaxed action cannot be rushed, so don't suck in the abdomen or force the movement in any way; an easy rhythm will settle in as your state of relaxation deepens.

As the body grows quiet, you will feel and hear the breath more clearly. The sound and movement have a rhythm that soothes and focuses the body even more. As a feeling of peace comes to the belly, allow your whole body to share in the experience. Pay attention to the sensations; this is an opportunity to compare how the body behaves when tense and when relaxed. The goal is to consciously relax until the body is in a state of non-action, i.e., alert passivity. When you feel truly relaxed and calm, exhale and bring your knees toward your chest.

#2 THE WAVE

I call this exercise The Wave because of the wonderful movement that ripples up and down the spine when the body settles into the natural breath. This movement helps unlock the diaphragm and massages the abdomen, chest, and spine, releasing tension that can interfere with healthy breathing. It produces a breathing pattern similar to that of a baby, and it is very soothing.
After Deep Relaxation, relax your arms out to your sides. Close your eyes and turn your attention to the belly and the way it melts into the pelvis each time you exhale.

Begin The Wave by gently relaxing the lower back into the floor as you exhale, and then lifting it a couple of inches as you inhale. The hips stay on the floor as the lower back rises and falls. This need not be a big movement, and the pace of breathing should be slow and easy. Allow yourself to settle into and slightly amplify this rhythmic wave, and notice if you can feel movement all the way up and down the spine. Do you notice the massage of the abdomen when you inhale and the chest when you exhale? Repeat this exercise 10 or 15 times before continuing to the next technique.

Poor breathing habits may confuse you and cause you to reverse the coordination of movement and breath, so pay close attention. If you find yourself feeling tense, take a few normal relaxing breaths between cycles. When finished, bring the knees into the chest on an exhalation.

#3 SHUT YOUR MOUTH

This is the first of the active exercises in this program and one I suggest you practice it and the one to follow until they become reasonably comfortable before you go further. Always keep them in mind as you progress with the program.
Asthmatics are often chronic mouth breathers but it is important to breathe through your nose during all the exercises. In fact, it is important to breathe through your nose most of the time. Air breathed in through the nose is filtered, warmed, and moistened, making it just right for sensitive airways. Nose breathing also promotes correct diaphragmatic action since it makes hyperventilation more difficult. You may protest that you have to breathe through your mouth because your nose is always blocked. But did you know that a chronically blocked nose can be a result of poor breathing, instead of the other way around?

Here are a few tips to help unblock that schnozz and keep you breathing through it.

After an exhalation, try holding your nose and shaking your head up and down for a few seconds, stopping when you need to inhale. This can be very effective, especially if you repeat it a few times. If you do Headstand in your asana practice, you may find that it helps, too. Using a mild saline solution to wash out your sinuses is also a great habit to develop. (Neti pots are designed for this purpose.)

When you're trying to breathe through your nose, don't pull the air into the nostrils; instead, open the throat. I do this by imagining my mouth is located at the hollow of my throat. My last suggestion is an unorthodox but highly effective way to break the mouth breathing habit. Tape your mouth closed with surgical tape! It's a bit weird, but it really works&endash;especially at night, when you can't use other strategies. Be patient with your chronically stuffy nose; you will gradually feel improvement.

#4 SOFTENING THE INHALATION

It is common for an asthmatic to over breath, i.e., the breath in is usually easier and longer than the breath out. As I've already explained, over-inhaling may actually lead to under oxygenation of the body. With this exercise you will try to soften the effort of your inhalation until it is shorter than the exhalation by as much as half. Chances are it will take some work to accomplish this because, as an asthmatic, you may have a skewed perception that if you don't inhale more strongly you aren't getting enough air. Expect to feel an urgency to breathe in and even a little uncomfortable but remember that over breathing is a habit that has gotten you into trouble.

Begin by counting the length of the exhalation, the pause afterward, and the following breath in for several minutes to establish a relaxed breathing rate. Then, use the baseline length of your exhalation as the gauge for any modifications you make in your breath rhythm. In other words, don't struggle to lengthen your exhalation; instead, shorten your inhalation. With practice, this will become easier. In the meantime, please take several "normal" breaths between cycles if your fell anxious or strained.

#5 COMPLETE DIAPHRAGMATIC EXHALATIONS

An inability to exhale fully is a defining symptom of asthma. I do this exercise to help slow my breathing down and restore the diaphragmatic movement that allows a good exhalation, which in turn sets up a smooth inhalation. I practice this exercise frequently whenever I feel short of breath. It is also a good exercise to do when you need to calm down in general.
Lie on your back with your eyes closed and arms relaxed out to the sides. Remember the breathing guidelines. Then, beginning with an exhalation, purse your lips and blow the breath out in a steady stream. You will feel a strong action in the belly as the abdominal muscles assist the exhalation. Your exhalation should be longer than usual, but it is important not to push this too far. If you do, it will be very difficult to pause after exhaling and your subsequent inhalation will be strained.

Pause for a few seconds after your exhalation, relaxing the abdomen. Then, keeping your throat open, allow the inhalation to flow in through the nose. Because of the stronger exhalation, you should be able to feel the inhalation being drawn effortlessly into the lower chest.

Count the length of the exhalation, the pause, and the inhalation. At first, try to make the exhalation at least as long as the inhalation; do this by shortening your inhalation as in the previous exercise. Unlike the previous exercise, where breathing is at a resting rate, the overall rate of breathing here will be stronger and longer. Eventually, aim to make your exhalation more than twice as long as the inhalation and to make the pause after the exhalation comfortable rather than hurried. delete - (It may take you a while to accomplish these goals.)

Since asthmatics find exhalation difficult, it may help to imagine and eventually feel the sensation of the exhalation "flowing" upward, like a breeze, inside the ribs as it leaves the body.

Repeat 5 to 10 cycles of this exercise. As with all the exercises, I recommend you take several normal breaths between cycles. When finished, hug your knees toward your chest.

#6 EXTENDED PAUSE

In combination with the previous exercise, this one provides excellent first aid for asthma symptoms. It doesn't give the same quick fix as an inhaler, but it can turn an asthma attack around if you start it early enough. I do this exercise frequently throughout the day when my breathing is compromised, and I find it easier if I have first practiced Complete Diaphragmatic Exhalations (Exercise 3).

This exercise is designed to help regulate the CO2 levels in the body. By pausing before you inhale, you give the body a chance to slow down and build up the level of carbon dioxide. (As I discussed before, asthmatics have chronically low levels of CO2.) An over-breather may find this to be the hardest exercise of all. At the outset it may be difficult to pause for even a few seconds, but if you keep trying you will notice improvement, perhaps even during a single practice session. Eventually, the pause can extend up to 45 seconds or even longer.

Position yourself as before: on your back, knees bent, with feet flat on the floor. With this exercise I recommend that you consciously shorten your inhalations and exhalation though the extended pause will, in effect, keep the overall breath rate slow. I suggest you inhale for one or two seconds, exhale for two to four seconds, and then pause. During the pause you may feel an urge to exhale a bit more, which is O.K.; in fact, the overall feeling of the pause should be like the natural relaxation that occurs as you exhale. You can extend the pause by consciously relaxing wherever you feel specific tensions.

As with all these exercises, patience yields better results than force. Repeat the exercise 5 to 10 times, and feel free to take normal breaths between cycles.

Going Further

When you are proficient at the exercises in a reclining position, begin to do them sitting up. Sit at the edge of a chair or on a floor cushion. Keep your back straight and your head upright. It can be surprisingly more difficult to do these exercises sitting up, so if you feel any stress lie down again. I always go through the exercises lying down first and often don't sit up at all. Remember that these exercises are remedial and therapeutic. They're not a contest!
Signs of success with this program include a decrease in symptoms, reduction in the use of rescue inhalers, and a general ease in breathing. When you reach this point it is important to begin to rebuild the strength that many asthmatics lose while ill. Since exercise can induce asthma in over breathers, many asthmatics avoid exercise and become weak.

But once you feel confident in your ability to breathe well, you should begin to exercise more. Start with brisk walks or some similar mild effort. From there take up a more aerobic activity you enjoy preferably one with repetitive motion such as jogging or hiking which allows you to more easily follow your breath. Over time, you'll feel strength returning to your body.

Here's an additional challenge: Keep your mouth closed while you exercise! At first you'll find this difficult. You may only be able to take two or three nose breaths before having to revert to mouth breathing. Don't push, but keep trying. Remember the tips about opening the throat and keeping your exhalation at least as long as your inhalation. Eventually, you'll be able to exercise as hard as you want while maintaining nose breathing.

Freedom Regained

There are, of course, many other breathing techniques that can be beneficial in the management of asthma, but I can personally vouch for the transformative power of the exercises in this program. I am still an asthmatic, but for weeks and even months I have no symptoms and rarely give my disorder a thought. I haven't been hospitalized or on Prednisone for a very long time.

The results of my efforts have been nothing short of exhilarating. Though I continued to practice yoga throughout my worst asthma years, my practice has become stronger as a result of the breathing exercises, and they helped me develop a greater sensitivity to the role of breath in asana practice. Also, I've been able to return to cycling, a favorite pastime I'd given up for more than a decade. Less than one year after adopting this program, I was able to cycle over Colorado's Loveland Pass (11,990 ft.) and to ride from Boston to New York City in a weekend without taking a single breath through an open mouth!

As an asthmatic, I accept that there are certain strategies I must implement to maintain a symptom-free lifestyle. I practice my breathing exercises daily and, if I find myself in a situation that in the past triggered an asthma attack, I use the exercises more frequently as preventive medicine. For me this regime is far preferable to a daily regimen of pills and sprays, and to the gradual deterioration of health that seemed to be my fate only five years ago.

Although each asthmatic has his or her unique set of circumstances, I hope my story and my eventual success at managing my own asthma will inspire others to have hope, take active steps to change their respiration, and prevail in finding their own way to breathe free.

How Healthy is Your Breathing?

Asthmatics have poor breathing habits that are easy to spot. Here are a number of self-tests to help determine if you can benefit from the breath retraining exercises.

Upper Chest Breathing

Lie on your back, placing one hand on your upper chest and the other on your abdomen. If the hand on your chest moves as you breathe but the one on the abdomen doesn't, you're definitely an upper chest-breather. Anything more than slight movement in the chest is a sign of a problem.

Shallow Breathing

Lie on your back and place your hands around your lower ribs. You should feel an effortless expansion of the lower ribs on the breath in and a slow recoil on the breath out. If your ribs remain motionless your breathing is too shallow, even if your belly moves.

Over breathing

Lie down and take a few minutes to let your body establish its relaxed breathing rate. Then count the length of your next exhalation and compare it to the length of the following inhalation. The exhalation should be slightly longer. If not, you are an over breather. As a second test, try to shorten your inhalation. If that causes distress you are probably an over breather. Note: Because it is easy to manipulate the outcome of these two tests, you may want someone else to count for you at a time when you are not paying attention to your breath.

Breath Holding

Holding one's breath after inhaling may be the most common poor breathing habit. To determine if you do this, pay attention to the transition from inhalation to exhalation. A breath holder usually feels a "catch" and may actually struggle to initiate the exhalation. This tendency is particularly noticeable during exercise. You can reduce the holding by consciously relaxing your abdomen just as an inhalation ends.

Reverse Breathing

Reverse breathing happens when the diaphragm is pulled into the chest upon inhalation and drops into the abdomen on exhalation. Lie on your back and place your hands on your abdomen. The abdomen should slowly flatten as you exhale and rise gently as you inhale. If the opposite occurs you are a reverse breather. (This test is not completely reliable since reverse breathing may only occur during exertion.)

Mouth Breathing

It's fairly easy to notice if you're a mouth breather; if you're not sure, ask your friends or try to catch yourself at unguarded moments.

Asthma Attack Triggers 

Inhaled irritants such as smoke, airborne chemicals, and dust
Allergens like animals, dust mites, mold, and pollen
Viral respiratory infections
Exercise
Reflux Disease
Weather changes (especially exposure to cold)
Foods and food additives, especially sulfites
Drugs, including aspirin or other non-steroidal anti-inflammatories such as ibuprofen, beta-blockers and excessive use of asthma inhalers
Emotional stress

An Apple a Day: Supplements and Dietary Suggestions 

Tips

1. Eat as little processed food as possible.
2. Eat an apple a day. They are rich in flavinoids and function as an antioxidant and anti-inflammatory.
3. Avoid dairy products if your asthma produces excess mucus.
4. Drink plenty of water to loosen mucus and keep airways moist.

Daily Nutritional Supplements

Daily nutritional supplements can be helpful for asthma as well as adrenal gland exhaustion that often goes with it.

Magnesium Glycinate, Oratate or Aspartate (up to 800 milligrams)
In chelated form for easier absorption

Intravenous magnesium is used in hospitals to halt asthma attacks because it relaxes the smooth muscles of the air passages. Start with small doses several times daily with food and increase dosage gradually to avoid diarrhea. Even if you usually do not take supplements, this one is strongly recommended.

L-Arginine (500-1000 milligrams)
Gas nitric oxide, that dilates the small airways in the lungs, is formed from this amino acid by lung lining cells.

L-Tyrosine (100-200 milligrams)
This amino acid is depleted with corticosteroid use and contributes to adrenal exhaustion.

Vitamins and Minerals

You may be able to get these dosages in a good multivitamin tablet.

Vitamin A (10,000 i.u)
Plays a role in preventing colds and flu

Vitamin E (400 i.u.)
Antioxidant and can increase the capacity of blood to carry oxygen

Vitamin B-6 (100 milligrams)
Promotes immune function and formation of hemoglobin

Zinc (15-30 milligrams)
Immune enhancer, supports adrenal gland

Omega-3 Fatty Acids (3 tbls. flaxseed oil)
Reduces acute inflammatory response and repairs lung damage

Selenium (250 micrograms)
Antioxidant, protects against hyersensitivity

Herbal Remedies

Quercetin (1,000-2,000 milligrams)
Reduces inflammation

Licorice Root Extract (1 teaspoon)
Supports the adrenal gland