Abstract Rationale Asthma is a chronic inflammatory disease characterized by airway hyperresponsiveness and obstruction, with significant morbidity worldwide. The Buteyko Breathing Technique (BBT), developed in the 1950s, aims to normalize breathing patterns, reduce hyperventilation, and alleviate asthma symptoms through controlled nasal breathing and breath-holding exercises. Despite the long-standing use, no prior systematic review and meta-analysis has comprehensively evaluated its clinical effectiveness. This study synthesizes evidence from randomized controlled and quasi-experimental trials to assess the effects of BBT on pulmonary function and Quality of Life (QoL). Methods This systematic review and meta-analysis were conducted in accordance with PRISMA 2020 guidelines and registered in PROSPERO. A comprehensive search was conducted in PubMed, Scopus, Web of Science, and Cochrane up to 14 September 2025. Eligible studies included randomized or quasi-experimental trials involving asthma patients receiving BBT compared with control, pranayama, or usual care. Data analysis was performed using Review Manager (RevMan) version 5.4. Results Fourteen studies comprising 892 participants (338 in BBT groups and 385 in comparators) were included. Analysis of the FEV1/FVC ratio revealed no significant improvement following BBT compared with control (MD = 1.57, 95% CI: −0.28-3.42, p = 0.10) or pranayama (MD = 0.90, 95% CI: −0.91-2.71, p = 0.33), with low heterogeneity (I² = 19%, p =0.27). In the eight studies assessing QoL, no statistically significant difference was found between BBT and control (SMD = 0.17, 95% CI: −0.12-0.45, p = 0.26). When compared with the Pranayama technique, the BBT group demonstrated a better, though still nonsignificant, quality of life (SMD = 0.28, 95% CI: −0.06-0.62, p = 0.10). Both comparisons exhibited no significant heterogeneity (I² = 0%, p = 0.91). Conclusion This meta-analysis found no statistically significant improvement in pulmonary function or quality of life among asthma patients practicing BBT compared with control or pranayama interventions. Nonetheless, the observed positive direction of effect suggests potential symptomatic benefits that warrant further investigation through high-quality, standardized randomized trials to confirm these findings and clarify the role of BBT as a complementary component of evidence-based asthma management This abstract is funded by: none
Allahaweh et al. (Fri,) studied this question.