Dr. Nigel Sprent: Asthma

Email: enquiries@nigelsprent.co.uk

Nigel Sprent practises as a hypno-psychotherapist in Oxford dealing with a range of anxiety and stress related problems.

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Asthma is characterised by wheezing, tightness in the chest, and difficulty in breathing. These symptoms are caused primarily by spasmodic contractions of the muscle fibres around the small air tubes (bronchioles) in the lungs. These contractions restrict the flow of air, particularly when air is breathed out of the lungs. The flow of air may also be restricted by swelling due to chronic inflammation, and a build-up of mucus, on the inner walls of the bronchioles. These symptoms can often be rapidly relieved, in the short term, by bronchodilator drugs such as salbutamol (e.g. Ventolin) usually inhaled in the form of a spray, which relaxes the bronchial muscles. Relief may be obtained through the regular inhalation of corticosteroids (e.g. Becotide) which opens the bronchioles by reducing inflammation and mucous production.

Despite the widespread use of such medications, asthma is one of the few diseases in the Western world that is growing in frequency. Although it has been known for over 4,000 years, it has only recently started to reach epidemic proportions. For example in the 1960s there were an estimated 100,000 asthma sufferers in the UK, whereas now the figure is about three million. The increase is particularly marked amongst children: in 1970 less than 4% suffered, by the mid-1990s this figure had risen to 12%. The reasons for this are unclear. Greater exposure to house-dust mites, atmospheric pollution and other allergens have been suggested, but cannot fully explain the rise in cases.

Two other factors which have been identified as perhaps more fundamental are anxiety and inappropriate patterns of breathing. These tend to be related in a vicious circle because difficulty in breathing is likely to likely arouse anxiety. This anxiety, in turn, causes a change in the natural pattern of breathing which has the unfortunate effect of further restricting the bronchioles, leading to greater difficulty in breathing, greater anxiety, more disruption to breathing and so on.

Evidence for the importance of breathing patterns in asthma comes from controlled clinical trials in Moscow (1981) with asthmatic children, and Brisbane (1995) with severe adult asthmatics who were averaging over 12 puffs of relief medication daily. In both trials patients were taught a simple breathing pattern developed by Buteyko, which led to a considerable improvement in symptoms. For example, in the Brisbane trial, after three months, patients showed average reductions of 90% in their use of bronchodilators, and of 49% in the use of steroids. Subsequent findings have shown that, in less severe cases, many patients are able to come off medication completely.

The value of hypnotherapy in the treatment of asthma lies in the fact that it can facilitate both the reduction of anxiety levels, and the development of healthy breathing patterns, through the use of suggestion, progressive relaxation techniques and visualisation. A course of treatment takes, on average, between five and eight sessions.