Patrick McKeown's roughly eleven-minute demonstration of the Buteyko breathing exercise for adults rests on an idea most people were taught to avoid: that holding your breath, done gently and for a set purpose, can open a blocked nose. Published in January 2017 on the Buteyko Clinic International channel, the video walks viewers and an on-camera group through a short hold-and-release routine, explains the physiology McKeown links to it (carbon dioxide in the blood, the sympathetic nervous system, the diaphragm and the phrenic nerve), and spends real time on who should skip it, what can go wrong, and where the method runs out of road. The claim is modest and specific. The nose can be cleared within minutes, and bringing breathing volume closer to normal is what keeps it clear.
WhatdoestheButeykonoseexerciselooklikeinpractice?
McKeown opens the session the way a good session leader opens a rehearsal: with ground rules before the first note. He asks the group to take a small, gentle breath in through the nose, a small gentle breath out, then pinch the nose closed and hold. While holding, you may sway or nod the head slightly, which he describes as a distraction, and you should keep your body relaxed rather than tense. The hold ends when you feel a medium to strong need for air, and you release the nose, breathe through it, and calm your breathing right away.
The video's written routine, printed in the description, spells out the cycle: breathe out gently through the nose, pinch, hold for as long as possible, release, resume normal breathing, then wait half a minute to a minute before repeating. The description lists six repetitions. In the spoken instruction, McKeown says five times, and he is consistent about the rest interval. Either way, the point is repetition with recovery, not one heroic breath-hold. Pacing matters as much as the hold itself, and the rest between rounds is part of the exercise.
The target is specific. In the spoken instruction, McKeown says the aim is a hold of around thirty seconds or more, long enough to produce what he calls medium to strong air hunger. Less than that, the exercise is a pleasant pause. More than that, without care, it becomes a strain.
Whywouldholdingyourbreathclearablockednose?
This is the question the video is built around, and McKeown's answer is a chain of cause and effect rather than a slogan. As you hold your breath, carbon dioxide accumulates in the blood. McKeown's reading of the evidence is blunt about where the credit lands:
"carbon dioxide builds up in the blood and it seems to be carbon dioxide that's causing the dilating of the nasal cavity" (McKeown, Buteyko Clinic International video, about 1:43)
He adds a second possibility: activation of the sympathetic nervous system, the branch of the autonomic system tied to the body's activating responses, may also help decongest the nose. He draws a parallel with physical exercise, which also opens the nasal passages, though he notes the nose may run a little as well. The physiology is still being argued over in the research literature, and McKeown frames his explanation as what the evidence seems to suggest, not settled fact.
The video description goes further, summarizing research it describes as showing that breath holding increased nasal volume, apparently through prompt and even shrinkage of the nasal membrane within the nasal cavity. It also reports that nasal airway resistance decreased during breath holding in humans, and during experimentally induced asphyxia in animals. Read carefully, the description's language is hedged ("results suggested"), and it is a summary of studies rather than the speaker's own experiment. It is useful context, not a guarantee.
There is a practical lesson in the mechanism, though. The exercise works by changing blood gases and nervous system tone, not by forcing air through a narrow passage. That distinction explains why the instruction is to keep the breath gentle at the start and the hold soft at the middle, and why McKeown keeps returning to calm breathing at the end.
Whichnostrilismoreblocked,andhowdoyoucheck?
Before the big hold, McKeown offers a simple test that doubles as a self-assessment. Block one nostril, breathe through the open one, then switch. The side that feels harder to breathe through is the more obstructed side. He presents this as a simpler stand-in for a fogging test, and it requires nothing but your fingers and a mirror if you want one. It is a useful baseline: if you repeat the exercise and return to the test afterward, you can see whether the open side has changed.
McKeown uses this check during the session itself, asking participants to compare their nostrils before and after rounds. Several people in the room report that their nose is beginning to open after the first set, and he treats that as an encouraging early sign rather than proof of anything long term.
Whoshouldnotdothebreathhold?
This is the part of the video that deserves the most attention from viewers, and McKeown gives it real weight. He names several situations in which the exercise should not be done, or should be approached very lightly:
Pregnant women, who are asked not to do it.
People with obstructive sleep apnea, who should skip it or go lightly.
Anyone already holding their breath during sleep, who should not add breath holds during the day.
Anyone with cardiovascular issues, who should not do it.
Outside those cases, he says, the exercise is "pretty safe," and he grounds that reassurance in a familiar comparison: holding the breath is a natural thing to do. Anyone who has stayed underwater while swimming has done it. The caution is about dosage and about people for whom any deliberate breath hold carries extra risk. Viewers with a heart condition, sleep apnea, or who are pregnant should check with their own clinician before trying the exercise, and no online demonstration substitutes for that conversation.
Whydoesthediaphragmmatterinanoseexercise?
McKeown's most interesting digression is about the diaphragm, the dome-shaped muscle at the base of the lungs that does most of the work of breathing. He describes how, during a hold, the brain senses changing blood gases, and the diaphragm also registers discomfort. Signals travel from the brain to the diaphragm through the phrenic nerve, and the diaphragm begins to contract. "You're starting to give it a workout," he says in effect.
His broader concern is that many people breathe with their mouths open and rely on the upper parts of the lungs, leaving the diaphragm stiff and underused. Holding the breath, he argues, can improve respiratory muscle strength by engaging the diaphragm. That is a claim worth flagging as the speaker's position, since the video does not present data for it, but it explains why he treats the nose exercise as more than a decongestant. The hold is a way of re-engaging a muscle that daily habit may have let go slack.
Cantheexercisebackfire,andhowdoyouhandlecoughing?
Coughing is a common reaction during breath holds, and McKeown addresses it directly. Holding the breath can dilate the airways, and mucus may start to move. But he identifies a specific cause: holding too long, followed by big breaths at the end, can produce hyperventilation, and that alone can trigger a cough. His advice is practical, not alarmed:
"the hyperventilation could just trigger the cough but that's your symptom it's easy to address it if you change your breathing" (McKeown, Buteyko Clinic International video, about 4:52)
The fix, in other words, is in the exit. Release the nose, breathe gently through it, and let the breathing settle rather than gasping for a large volume. Anyone who coughs repeatedly, or who feels lightheaded, should stop the session and not push through it.
Whataboutadeviatedseptumoranosethatwon'topen?
The video's most honest passage comes when McKeown works with a volunteer who has a badly blocked nostril. Before he proceeds, he tests the volunteer's left and right sides, then sends the volunteer through a stronger variant: a small breath in, a small breath out, a pinch, and then walking as many paces as possible while holding, with the breath released when the air hunger becomes fairly strong. The nostril improves. McKeown is careful to say that if the blockage is physical, a complete deviated septum, there is not much the exercise can do.
He draws a distinction that matters. The exercise can help with reversible obstruction, the kind that changes with breathing pattern. Structural problems are another matter. The volunteer describes a deviated septum that clinicians have imaged, and McKeown responds with reassurance, not false promise:
"the human body is very resilient" (McKeown, Buteyko Clinic International video, about 8:15)
His argument is that when you bring breathing volume down toward normal, you are not forcing a large volume of air through a restricted passage, and most people, to a lesser or greater degree, have some deviation in the septum anyway. The lesson for viewers with a structural block is to set realistic expectations and to pursue medical evaluation rather than assume breathing work will fix an anatomical problem.
McKeown says the approach is taught to children from age five upward in Hong Kong, and he recounts a hospital case in which a young child with an adenoid face and one nostril completely blocked was guided through the exercise, with the nose decongested within five minutes. He offers this as a demonstration of how quickly decongestion can happen, not as a clinical study, and the video does not supply outcome data for children.
The more durable point is about volume. McKeown says:
"when you start bringing breathing volume down towards normal the nose will remain more permanently decongested" (McKeown, Buteyko Clinic International video, about 2:38)
That is the thread that ties the whole video together. The hold clears the nose in the moment, but the lasting effect, in his framing, comes from breathing more gently and more quietly over time. For readers, that suggests the exercise is best understood as a tool within a wider approach to breathing, not a one-time fix.
Wheretogofromhere
If the exercise appeals to you, start slowly. Do the nostril check first, try a single round of the gentle hold, and stop well before strong distress. Build toward five rounds only if you feel steady and clear afterward. If you have any of the conditions McKeown flags, or any heart, lung, or pregnancy concern, talk to your clinician before you try it. For a deeper look at the method, the Buteyko Clinic International website is the place McKeown points viewers to for more information on how the breathing exercises are taught.
The video's real gift is its honesty about limits. It offers a clear, repeatable routine, a plausible physiology that the speaker himself hedges, a list of people who should not try it, and an admission that structure beats technique when the blockage is physical. Watch it with a notebook and a timer, and treat it as an invitation to pay closer attention to how you breathe, not as a promise that a held breath will fix everything.
Take a small gentle breath in and out through the nose, pinch the nose closed, and hold your breath while relaxing your body and gently nodding or swaying your head. Release when you feel a medium to strong need for air, breathe through your nose, and calm your breathing. Wait half a minute to a minute before repeating the cycle.
McKeown describes the exercise as pretty safe for most people, comparing breath holding to what happens when you swim underwater. He advises against it for pregnant women, people with obstructive sleep apnea or who hold their breath during sleep, and anyone with cardiovascular issues. Check with a clinician if any of those apply to you.
McKeown says carbon dioxide builds up in the blood during a breath hold, and that carbon dioxide seems to be causing the nasal cavity to dilate. He also suggests that activation of the sympathetic nervous system may help decongest the nose, and notes that physical exercise similarly opens the nasal passages.
The video's written description lists six repetitions, while McKeown says five times in the spoken instruction. In both cases, you wait roughly half a minute to a minute between rounds before repeating the hold.
McKeown says that for a complete deviated septum he can't do much, though the exercise can help with reversible obstruction. He notes that most people have some degree of septal deviation and that the body is resilient when breathing volume is brought down toward normal. Structural problems should be assessed by a medical professional.
McKeown explains that holding too long and then taking big breaths at the end can trigger hyperventilation, which can cause coughing. Change your breathing by releasing the nose and breathing gently rather than gasping. If coughing persists or you feel lightheaded, stop the exercise.
McKeown says the method is taught to children from age five upward in Hong Kong and describes one hospital case in which a child's nose was decongested within five minutes. The video offers this as an example, not as outcome data, so it should not be treated as proof of results for children.
