Breathing Training for Asthma

For this randomized controlled treatment study, the investigators plan to compare the effects
of hypoventilation-based breathing training with a control intervention that will focus on
breathing regularity and awareness. The two therapeutic procedures are closely matched on
important variables such as duration and the nature of patient-therapist interaction,
monitoring asthma related status and the medication intake, use of scientific equipment and
monitoring devices to increase adherence, and initial plausibility. Asthma patients will be
evaluated before, during, directly after, and at 1 month and 6 months after training. The
primary goal of this training is to determine if a capnometry-assisted breathing training to
raise end-tidal CO2 will produce more improvement in asthma control than a control training
of breathing awareness. The second goal is to determine if capnometry-assisted breathing
training for raising pCO2 will lead to higher pCO2 levels after training than before training
on all three measures of pCO2 (the 2-hour monitoring, the standardized training sessions, and
the homework assignments). The last objective is to determine if the clinical improvement in
asthma outcomes for the raise-pCO2 breathing group will be greater in patients with more
improvement in their pCO2.

Inclusion Criteria:

1. Men or women between 18 and 65 years of age

2. Understand and read english adequately

3. A previously documented history of asthma from intermittent to severe (symptoms plus
objective documentation of at least partially reversible airflow obstruction)

4. Willing to undergo a 5-session course of breathing training

5. Current asthma symptoms

Exclusion Criteria:

1. Clinically significant heart disease

2. Clinically significant cerebrovascular disease

3. Clinically significant thyroid dysfunction

4. Out-of-control diabetes

5. Use of oral corticosteroids in the last 3 months

6. Active smokers or more than 10 pack years

7. Clinically significant chronic obstructive pulmonary disease

8. Clinically significant emphysema

9. Current alcohol and substance dependence

10. Psychotic disorders and high risk for personality disorders

11. Having received previous breathing training exercises for asthma

12. Not willing to abstain from taking the morning dose of their long-term bronchodilator
or leukotriene inhibitors or from using their short-acting beta-2 adrenergic agonists
or anticholinergic bronchodilators for 8 hours before the pre-treatment,
post-treatment, 1-month follow-up, and 6-month follow-up assessments (Medication
withdrawal will be discouraged if patients should experience significant symptoms
before the assessments. They will be offered to reschedule the appointment without any
consequences for their enrollment in the study.)

13. Night shift workers

14. Tuberculosis

15. Pregnant, plan on becoming pregnant, or nursing during the course of the study