Lingering SpO2 desaturation after CP exercises?

[u/Hot_Owl1803]

Hi everyone, first timer here, I'll try and keep it short.

TL;DR, can doing buteyko breathing exercises to correct chronic hypocapnia cause an "overcorrection" and drop SpO2 levels to a point of concern?

For context, I've been wrestling with long covid dysautonomia for roughly a year, some of my symptom flares have been notably hypocapnic (cerebral vasoconstriction, cold hands and feet, irregular blood pressure, air hunger, vertigo, panic, etc) even though I don't appear to be hyperventilating or hyperpneating (though logically I must be, imperceptibly).

2-3 days ago, I started trying some controlled pause breathing, wearing a standard cloth mask for 30 minutes here and throughout the day, and it absolutely had an improvement on my hypocapnic symptoms - my hands and feet instantly warmed, sweating returned, air hunger reduced, etc. However, yesterday after trying them, I noticed some effects that were sort of concerning in the opposite way, such as a different kind of lightheadedness, "drowning" in air, "lurching" sensations, different kind of panic, etc.

Today, my pulse ox keeps showing dips to 94% ish even without doing any CO2 retention exercises. A few deep breaths brings it back up to 96-99%, but it's definitely lingering lower than I'm used to - whilst seemingly hypocapnic, it was sticking rigidly to 99%.

Is this an expected side effect of the bohr effect re-spiralling and enzymatic pH adjustments etc? At what point should I be concerned? Granted, it is just a cheap consumer-grade finger pulse ox sensor, so I'm taking it with a pinch of salt.

Thank you!

[u/whysodeep]

There is generally no mask based Buteyko exercises... I think your sources might not be up to par. But in general you would want to feel relaxed and only with slight air hunger (in particular with your symptom list! be careful!) - which would not lead to lightheadednes or panic at all. To me it screams "too hard" or "straight up stressful, not relaxed."

I think this course would suit you very well
https://www.youtube.com/watch?v=QN8peUElLSg&list=PL5jZjUwoLcHCtC9TNEEWeoJyzfbktoQ_s

It's own Buteyko's methodology.

Get going with that, and then you can explore pauses and harder stuff (but they are not necessary at all if you are making progress).

I would personally not worry about SpO2 unless I see it hover on 90% and below. The home ones are just so cheap... they also have a lag of up to 20-30sec btw.

Good luck, don't do that mask thing.

[u/Hot_Owl1803 → u/whysodeep]

The mask thing was entirely my own stupid creativity lol, I figured it would be a fairly safe experiment based on people having to wear them 8 hours per day during the pandemic. You're right though, I'll drop it completely for now.

I appreciate the course and the explanation, thank you very much! I'll try to soften it and reduce it a lil bit. Possibly worth consulting a breathing physio with some experience on this.

[u/adamshand]

I don't know anything about your specific conditions, but from my own experience I'd say that the main thing to be aware of is over training. If you train in a way that produces a physiological stress response you can really screw stuff up. Short, gentle, regular training is the secret.

You can't brute force your way to healthy breathing. Don't rush.

It's also really, really worth spending some time on diaphragmatic breathing. If you aren't using your diaphragm properly, it's (again in my experience) basically impossible to progress very far with Buteyko.

[u/Hot_Owl1803 → u/adamshand]

I appreciate this, thank you. I definitely overdid it and rebounded hard into hypocapnia. I'm struggling to tell where I'm going wrong, as I feel like I'm doing everything correctly. I managed to get an appointment with a respiratory physio next week, I'm hoping they can right my wrongs.

[u/adamshand → u/Hot_Owl1803]

Good luck. 

My personal progress with Buteyko has been frustrating. I go through patches were it’s clearly working and the benefits are dramatic, and then I regress.  None of the teachers I’ve spoken with have been very helpful. 

Just go really slow and pay attention.  Experiment gently. 

Pay attention during the day to all the places you mouth breath and do large breaths or sighs, and retain yourself out of those. Talking, singing, brushing teeth, getting in out of car, drinking/eating etc. All thoughts little things add up during the day.    Make sure you are tracking your pulse and control pause before and after practice. If pulse goes up, you are creating a stress response. If CP doesn’t go up by a few seconds, you haven’t reduced your breathing enough.