Asthma is a chronic disease in which sufferers have repeated attacks of difficulty in breathing and coughing. There seems to be an increase in the amount of asthma all over the world, especially in children. To understand what happens in asthmatic attacks it is helpful to visualise the basic structure of the airway tubes of the lung (bronchi).
In further study by Maher-Loughnan (1970) asthmatic subjects were randomly assigned to either Hypnosis or relaxation therapy. The results showed both treatment modalities of benefit to the patients, but the improvement in the Hypnotherapy group was significantly greater. In addition, only the Hypnotic subjects showed improvement in physiologic measures of respiration (forced expiratory volume).
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The main airway (windpipe, trachea) of the body is about 2-3cm across. It divides into its main branches (bronchi), which lead to the right and left lung, which divide further, like the branches of a tree, to supply air to all parts of the lungs. The smallest tubes (bronchioles) are only millimetres wide and they are made up of ring-shaped muscles that are capable of contracting or relaxing. Anything that makes them contract will narrow the passages, which makes it more difficult for the air to pass through and also gives rise to the characteristic wheezy noise. Asthmatics tend to be sensitive to various types of irritants in the atmosphere which can trigger this contraction response from the bronchial muscles.
The bronchi also have an inner lining that becomes inflamed in asthma, which makes the lining swell and produce an excess amount of the mucus (phlegm) which it normally makes. All of these processes contribute to the airway narrowing and the treatment for asthma is aimed at reversing them as much as possible.
People of all ages get asthma but 50 per cent of sufferers are children, mostly boys, under 10. Among adults, women are more likely to develop asthma than men.
Make sure you use the right technique when you take your asthma medication. Poor technique is the most common reason for ineffective treatment.
How do you 'get' asthma?
Asthma can be triggered by external agents, such as irritants in the atmosphere which are breathed in, or by internal reactions within the body that have been caused by an external influence. The kinds of provoking factors can be divided into two groups:
- non-specific factors: all asthma patients are affected by a number of things that are referred to as irritants. They include exertion, cold, smoke, scents and pollution.
- specific factors: these are irritant or allergens in the form of pollen, dust, animal fur, mould and some kinds of food. A virus or bacteria, chemical fumes and other substances at the workplace and acetylsalicylic acid (aspirin) may also cause asthma.
To acquire asthma, people seem to need to have been born with a predisposition to the disease. It may not reveal itself until they have been exposed to some asthma irritants. Smoking during pregnancy, low birth weight, a lack of exposure to infection in early life and traffic pollution have all been associated with the increase in asthma. Less draughty houses resulting in a higher concentration of house dust mites and cooking gases may also be part of the problem. Currently, a great deal of research looking for the genes that allow asthma to develop is being carried out. But until we can prevent asthma, we have to suppress the symptoms and try to avoid the triggers where possible.
What might trigger acute asthma attacks?
- Air pollution including exposure to certain chemicals. An example is isocynates which are used in some painting and plastics industries.
- Airway infection.
- Allergies, eg to pollens, house dust mites, domestic animals (especially cats), aspirin and non-steroidal anti-inflammatory drugs (NSAIDs) such as ibuprofen.
Recent studies indicate that use of household sprays used for cleaning, polishing and air freshening may increase the risk of astham symptoms by up to 50%. (American Journal of Respiratory and Critical Care Medicine 2007). [The Times Oct 13 07].
What does asthma feel like?
- It is difficult to breathe and there is shortness of breath.
- Wheezing when breathing out.
- Coughing, especially at night and with a little mucus.
Diagnostic and statistical manual criteria (DSM)
Research: Kohen, D. P. (1996). Relaxation/mental imagery (self-hypnosis) for childhood asthma: behavioural outcomes in a prospective, controlled study.
Australian Journal of Clinical and Experimental Hypnosis. 24(1). 12-28.
Results included: (a) fewer emergency room visits in the experimental group; (b) less school missed in the experimental group compared to the traditional control group and to the waking suggestion group; (c) no difference in psychological evaluations between groups; and (d) surprising findings regarding hypnotic and hypnotic-like experiences among subjects.
Ewer and Stewart (1986)
Ewer and Stewart (1986) reported a randomised control trial of Hypnosis in patients with moderate asthma. Patients with a high Hypnotic susceptibility showed a 74.9% improvement in bronchial hyper-responsiveness (to methacholine challenge), a 5.5% increase in peak expiratory flow rate, a 26.2% decrease in the use of bronchodilator and a 41% improvement in daily ratings outside of the clinic. Twelve patients with a high Hypnotic susceptibility score showed a 75% improvement.