How to Support Breathing in MND/ALS: A Case Study Using the Buteyko Method for Bulbar Onset
What I’m learning about supporting someone with progressive bulbar palsy (PBP) using breath retraining techniques rooted in the Buteyko method.
Disclaimer:
The information provided in this post is for educational and informational purposes only and is not intended as a substitute for professional medical advice, diagnosis, or treatment. The Buteyko breathing method and the breathing exercise demonstrated here are general practices that may not be suitable for everyone.
By choosing to follow the techniques shared, you do so at your own risk. Neither the creator of this content nor anyone associated with this blog shall be held liable or responsible for any injury, health issues, or adverse effects resulting from the use or misuse of the information provided.
If you have any pre-existing health conditions, are pregnant, or are currently taking medication, please consult with a qualified healthcare provider or medical practitioner before beginning any new breathing or wellness practice.
Always listen to your body and stop any exercise that causes discomfort, dizziness, or distress.
I have been asked to work with a man with Motor Neurone Disease, by his wife. His physiotherapist actually recommended the Buteyko method to help manage the man’s symptoms. This is very good news insofar as the benefits of Buteyko are being recognised as important in helping people with all manner of diseases and symptoms, by other health care practitioners.
The man’s wife explained to me that her husband has the Progressive Bulbar Palsy (PBP) form of Motor Neurone Disease, which affects his ability to speak and swallow. This also means that “Breath Stacking” is not an option.
Because this is such a specific and rarely discussed application of the Buteyko breathing method, I felt it would be valuable to share how I plan to approach his case. My hope is that by documenting what I’m learning, others in similar situations, whether practitioners, patients, or carers, might also find support or reassurance in this work.
Here’s just a little bit of information about Motor Neurone Disease, for those of you that might be interested:
Motor Neurone Disease (MND):
The main types of motor neurone disease:
Amyotrophic lateral sclerosis (ALS) - the most common type of MND. Symptoms tend to start in the hands and feet. Sometimes ALS is referred to as Lou Gehrig’s Disease as he was a baseball player from the US, who had been diagnosed with this disease.
Progressive bulbar palsy (PBP) - About 2 in 10 people with MND have PBP. The first muscles that are affected are those used for talking, chewing and swallowing (the bulbar muscles).
Primary lateral sclerosis (PLS) - this is a rare type of MND and it mainly affects the leg muscles.
The cause of MND is not known. There is no known cure for ALS-MND, however, medical treatments such as Riluzole have been shown to have some protective effect on the nerves. Mask ventilator systems are also used during sleep. “People using this have been shown not only to have longer survival but also improvement in the quality of their lives.” - from Patient.info
Now, knowing that Buteyko is definitely not a cure all, I was initially reticent about working with this potential client. I really did not want to over-promise, especially as this was not a disease I knew all that much about. So, I contacted my tutor, Patrick McKeown, founder of the Buteyko Clinic International, about this case, and Patrick really gave me the inspiration, and the confidence to know how to proceed with this man. We agreed that even though the Buteyko breathing method is not a magic bullet for MND, it will certainly help to dampen the stress response, it will help to improve sleep, and it will help to improve quality of life.
This is the beauty of Buteyko, and it is also true for all diseases and symptoms; Buteyko will definitely help and support through most illnesses and diseases. Patrick highlighted a couple of things to me in our discussion; he emphasised that the effectiveness of the Buteyko method will depend upon the student’s ability to put this into practice, and may offer gentle nervous system support, reduce over-breathing, and help regulate tension patterns, especially when integrated alongside any traditional therapy.
The gentleness of the Buteyko method means it’s perfectly safe to begin with the softest, most subtle approach. This means I will be suggesting that my potential client starts by practicing breathing in and out through the nose; that he slows down the speed of the exhalation and that he works on softening the exhalation.
By practicing Buteyko breathing exercises, we aim to gently increase blood flow to the brain. This happens because, as we reduce our breathing (also known as reducing our minute volume) we begin to retain a little more carbon dioxide. That rise in carbon dioxide leads to natural vasodilation, which helps to improve circulation and better delivery of blood to the brain.
Consider the Bohr effect, which increases oxygen delivery to the tissues, exactly where we want the oxygen to be. Meanwhile, the increased carbon dioxide, which has lowered the blood pH slightly, in turn means that neuronal brain cell excitability is reduced. Again, this is the kind of outcome that we are aiming for.
Bohr Effect: When you breathe more slowly and calmly, your body produces just the right amount of carbon dioxide (CO₂). This CO₂ helps oxygen "unload" from haemoglobin and move into your cells where it’s needed for energy.
Why It Matters: If you over-breathe (like during anxiety, panic, or ill-health), you lose too much CO₂, and oxygen stays stuck to the haemoglobin, so your tissues don’t get enough oxygen, even if you’re breathing a lot.
Breathing Less, Getting More: When you practice gentle, controlled breathing (like Buteyko), you keep enough CO₂, which makes it easier for oxygen to flow into your cells, improving energy, calmness, and overall health.
In the case of MND/ALS/PBP, practicing Buteyko little and often, would be key. It’s also incredibly important for those living with MND or ALS to spend time mindfully reassuring their brain that they are safe. How do we tell our brain that we are safe? Well, we do this by taking a soft breath in through the nose, and a really slow, relaxed, breath out.
I am going to lead you in a very gentle practice right now to show you how to do this. This is a very gentle and very safe practice that you can try whether or not you’re living with MND. However, I don’t recommend this practice for anyone in the first trimester of pregnancy. The purpose of this exercise really does signal to our brain that we are safe, and it gives us some control over how we are feeling, especially if we might feel powerless and out of control. It gives us something to work on when we might otherwise be caught up in our heads. This practice gives us some degree of control over that, it will get us out of our head, and reduce overthinking about the situation that we find ourselves in. This is also really worth doing if you are supporting and caring for someone with MND. Another great thing about Buteyko is that even if you have difficulty holding your attention on the breath, it doesn’t really matter, as the practice will still work anyway.
Now let’s move on to the practice. Firstly, two of the most important things to bear in mind when we do this exercise:
1) breathe in and out through your nose;
2) make sure that your breathing is silent.
The point of functional breathing is to focus on light, nasal breathing, and to breathe in a way that optimises oxygen delivery to our tissues.
So, I want you to start off by taking a normal breath, in through your nose and out through your nose, and pinch your nose and hold, and hold for 1,2,3, let go, and breathe in through your nose and breathe normally for 10-15 seconds. (Repeat this 6X).
So, how did that feel?
These are baby steps, but this is how gently we need to go. And, if you are comfortable with holding for 3 secs, you could try increasing the small breath holds to 4 secs, and gradually working your way up to 5 seconds, and beyond, in each following breath hold. This is what I do when working with my private clients; I will use exercises such as this, and others, alongside some gentle, somatic practices to support regulation, safety, and reconnection within the body.
For people with MND, a little and often approach tends to be most supportive (when the exercise feels manageable). Even the smallest steps can make a difference. Aim to practice this exercise that we have just done six times, up to 10 times a day. If 10 times a day is too much, just do it as many times as you can throughout the day, ensuring that you get adequate rest and breaks in between.
I really hope that you have found this post helpful, and wish you the very best of luck if you choose to use this practice.
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About me:
My approach integrates the science of functional breathing with a deep understanding of the nervous system and its role in long-term health and emotional resilience. I specialise in working in a trauma-informed way, combining the Buteyko Method with gentle somatic practices to support regulation, safety, and reconnection within the body.
My work is rooted in the belief that how we breathe is how we live: our breath is intimately connected to our nervous system and shapes our experience of stress, rest, and recovery. I support clients in retraining their breathing patterns not only to naturally improve physical health, but also to restore calm, clarity, and control in daily life.
With a background in holistic health and a focus on nervous system education, I offer a compassionate and practical path for those living with anxiety, burnout, sleep disruption, and chronic stress. My sessions are designed to be accessible and deeply respectful of each person’s pace and lived experience, creating space for healing and transformation through the breath.