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Helier & Sutton CFS Service

Breathing Techniques for CFS Symptom Control

Why are breathing exercises recommended in Chronic Fatigue Syndrome?
! ! It is thought that some people with Chronic Fatigue Syndrome may be burdened by hypocapnia reduced levels of blood carbon dioxide. This happens unnoticed as even minor degrees of over breathing can, over a period of time, lead to a significant reduction in the level of carbon dioxide in your blood. This causes an alteration in the level of ionized calcium in the blood as well as other important substances. Low levels of carbon dioxide can lead to a constriction of several important blood vessels. This is especially important in the case of the central nervous system where it is possible that constriction of blood vessels may contribute to a sensation of being remote from the environment as well as tiredness, pins and needles in the hands and feet and an increase in pain levels. Controlling the rate of breathing and correcting the low carbon dioxide level could therefore be an important part of the therapy used in the management of Chronic Fatigue Syndrome. The control of breathing has been found helpful by several of our patients with severe Chronic Fatigue Syndrome where, in addition to relieving the tiredness, it has helped to reduce muscle aching and spasms and contributed to an improvement in concentration and stamina.

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What do the exercises involve?

1) The following steps are based on the Buteyko or shallow breathing method that is sometimes recommended for people with asthma. Step 1 Take 2 normal breaths, then breathe out and see how long you can hold your breath for. Step 2 Breathe through your nose for 5 minutes taking shallow breaths and keeping your mouth shut. Then do Step 1 again and see if your count has improved. Step 3 Repeat Step 1 and Step 2 four times in a row, it should take no more than 25 minutes. Practise at least once a day. 2) Progressive Breath-Holding Step (i) Hold breath for 5 seconds. Repeat 5 6 times per hour for at least 2 separate hours in a day. Repeat for 3 consecutive days. On the 4th day increase the duration of breath-holding by 2 seconds to 7 seconds and repeat as indicated in Step (i). After a further 3 days increase breath-holding by further 2 seconds to 9 seconds and continue as in Step (i). Gradually increase breath-holding by further 2 second intervals every 3 days until you can comfortably hold your breath for 20 to 30 seconds. Repeat the breath-holding several times a day for the next 3 months and continue thereafter if helpful.

Step (ii) Step (iii) Step (iv)

www.epsom-sthelier.nhs.uk/cfs