Integrative Breathing Therapy: Perspectives on Dysfunctional Breathing in Voice and Upper Airway Disorders

Background: Functional breathing disorders, currently termed “breathing pattern disorders” and “dysfunctional breathing” (DB), are conditions that produce both respiratory and nonrespiratory symptoms that are often resistant to usual treatment. These disorders can occur alongside functional voice disorders, affecting both upper and lower respiratory systems simultaneously, and can be part of a broader pattern of body system dysregulation. Although these disorders can be treated effectively with professional therapy, they often go undiagnosed and untreated due to lack of agreement on diagnostic definitions and standardized assessment and treatment methods. Integrative breathing therapy (IBT) is an approach used in treating DB, which may be applicable to individuals with conditions commonly addressed by speech-language pathologists, such as functional speech and voice disorders and laryngeal breathing disorders. This article explores the potential role of breathing dysfunction and breathing therapy in voice and upper airway (UA) disorders. It describes how the multidimensional and functional systems approach used in IBT provides a model for comprehensive assessment-based treatment applicable to patients whose vocal and UA dysfunctions are associated with systemic breathing dysfunction. Purpose: This article aims to provide background and historical context for the terminology and concepts used in multidisciplinary breathing retraining, describe the key principles of IBT, explore how the functional and multidimensional paradigm and systems approach employed in IBT can guide treatment protocols for conditions relevant to speech-language pathology, and connect breathing therapy with speech-language pathology, offering insights that may enhance treatment strategies for practitioners.