Yoga for Respiratory Function Yoga Alliance Webinar April 30, 2020 - - PowerPoint PPT Presentation

Brigham & Women’s Hospital

Harvard Medical School

Yoga for Respiratory Function

Sat Bir S. Khalsa, Ph.D.

Assistant Professor of Medicine, Harvard Medical School Director of Yoga Research, Yoga Alliance Director of Research, Kundalini Research Institute Editor in Chief, International Journal of Yoga Therapy Research Associate, Benson Henry Institute for Mind Body Medicine Research Affiliate, Osher Center for Integrative Medicine

Yoga Alliance Webinar April 30, 2020

Pranayama in Patanjali’s Yoga Sutras

1.34 The mind is also calmed by regulating the breath, particularly attending to exhalation and the natural stilling

• f breath that comes from such practice.

2.50 … pranayama has three aspects of external or outward flow (exhalation), internal or inward flow (inhalation), and the third, which is the absence of both during the transition... These are regulated by place, time, and number, with breath becoming slow and subtle.

http://www.swamij.com/pdf/yogasutrasinterpretive.pdf

Pranayama in Hatha Yoga Pradipika

Chapter 1

• 51. The Yogi who, sitting with Padmasana, can control

breathing, there is no doubt, is free from bondage. Chapter 2 Shatkarma and Pranayama

• 2. Respiration being disturbed, the mind becomes
• disturbed. By restraining respiration, the Yogi gets

steadiness of mind.

http://www.swamij.com/hatha-yoga-pradipika.htm

https://www.yogajournal.com/yoga-101/science-breathing From: The Science of Breathing, Levine J, Yoga Journal, updated Feb 28, 2018

Anatomy of Breathing

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/pdf/EDU-0098-2017.pdf

Physiology of Breathing

From: The physiological effects of slow breathing in the healthy human. Russo MA, Santarelli DM, O'Rourke D, Breathe (Sheff), 13:298-309, 2017.

From: Training to yoga respiration selectively increases respiratory sensation in healthy

• man. Villien F, Yu M, Barthélémy P, Jammes Y, Respiratory Physiology and Neurobiology,

146:85-96, 2005.

Conditioning of Slow Yogic Breathing

“…[yoga respiration training] induced long- lasting modifications of the ventilatory pattern with a significant lengthening of expiratory duration and a modest tidal volume increase.”

Nasal Cycle

From: Is the nasal cycle an artifact? The role of asymmetrical postures, Haight JS, Cole P, Laryngoscope, 99:538-41, 1989.

From: Breathing above the brain stem: volitional control and attentional modulation in humans, Herrero JL, Khuvis S, Yeagle E, Cerf M, Mehta AD, Journal of Neurophysiology, 119:145–159, 2018

Caudal Medial Frontal Cortex

Breathing and Control of Attention

From: Coupling of respiration and attention via the locus coeruleus: Effects of meditation and pranayama, Melnychuk MC, Dockree PM, O’Connell RG, Murphy PR, Balsters JH, Robertson IH, Psychophysiology 55:e13091, 2018.

Breathing, Control of Attention and the Locus Coeruleus

Yoga Myth: Oxygenating the Blood

“You generate prana, and push out every ounce of carbon dioxide, replacing it with life-giving oxygen.” “Oxygen is not only important for muscles; it’s also vital for the brain to carry out all its functions. In addition, all

• f the internal organs improve when they are provided

with an increased amount of oxygen-rich blood.”

⚫ The blood is normally already amply saturated with O2 ⚫ Increasing ventilation will reduce CO2 causing hyperventilation ⚫ Proper slow deep yogic breathing does not change O2 & CO2

Use of Yoga Breathing Practices

From: Perceived Benefits of Kripalu Yoga Classes in Diverse and Underserved Populations, Wilson AM, Marchesiello K, Khalsa SBS, International Journal of Yoga Therapy, 18:65-71, 2008.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382821/?report=printable

“Prāṇāyāma is known since ancient times to relieve stress and stabilize autonomic function of the body. It is easy to learn, practice and follow in our daily life. It can be learned and practiced by patients. Its potential in reducing BP makes this technique a promising non-pharmacologic tool for BP reduction in pre-hypertensive patients.” “Different types of prāṇāyāma techniques were shown to produce different effects…”

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5709795/pdf/EDU-0098-2017.pdf

https://www.frontiersin.org/articles/10.3389/fnhum.2018.00353/pdf

“The main effects of slow breathing techniques cover autonomic and central nervous systems activities as well as the psychological status.”

https://www.sciencedirect.com/science/article/pii/S0975947617303224

Mechanisms – Pranayama

⚫ Increases in physiological pulmonary function ⚫ Improvement in respiratory efficiency ⚫ Increase in heart rate variability ⚫ Changes in chemoreflex characteristics ⚫ Reduction in oxygen consumption ⚫ Reduction in oxidative stress levels ⚫ Regulation of psychophysiological arousal ⚫ Regulation of blood pressure ⚫ Regulation of psychological state

Mechanisms – Pranayama

⚫ Increases in physiological pulmonary function ⚫ Improvement in respiratory efficiency ⚫ Increase in heart rate variability ⚫ Changes in chemoreflex characteristics ⚫ Reduction in oxygen consumption ⚫ Reduction in oxidative stress levels ⚫ Regulation of psychophysiological arousal ⚫ Regulation of blood pressure ⚫ Regulation of psychological state

Pranayama Emotion Regulation

Breathing and Emotion

From: Specific respiratory patterns distinguish among human basic emotions, Bloch S, Lemeignan M, Aguilera N, International Journal of Psychophysiology, 11:141-54, 1991.

“…emotions can affect respiration and respiration can also influence emotions, yet this well-established relationship is not utilized in conventional treatments. Breathing and meditation techniques are simple, easy, and cost-effective yet they are not widely used as treatments.” “…breathing techniques could be used as first-line and supplemental treatments for stress, anxiety, depression, and some emotional disorders.”

Slow Breathing and Emotion Regulation

From: The effect of deep and slow breathing on pain perception, autonomic activity, and mood processing--an experimental study. Busch V, Magerl W, Kern U, Haas J, Hajak G, Eichhammer P, Pain Medicine, 13:215-28, 2012.

Relaxed Deep and Slow Breathing

“…we found a significant reduction of tension, anger, and depressive feelings…” “…several studies parallel to our findings have demonstrated a reduction of negative feelings due to breathing exercises…in…healthy controls.”

“…a positive affective state was induced by slow breathing and a negative affective state was induced by fast breathing in this study, consistent with the measured affective changes in our prior study.” “These observations support practical behavioural methods that human beings have used for millennia to modulate emotional experience, such as meditative breathing.”

Pranayama Stress Regulation

From: Training to yoga respiration selectively increases respiratory sensation in healthy

• man. Villien F, Yu M, Barthélémy P, Jammes Y, Respiratory Physiology and Neurobiology,

146:85-96, 2005.

Conditioning of Slow Yogic Breathing

“…[yoga respiration training] induced long- lasting modifications of the ventilatory pattern with a significant lengthening of expiratory duration and a modest tidal volume increase.”

Pranayama and Sympathetic Deactivation

From: Abdominal breathing increases tear secretion in healthy women, Sano K, Kawashima M, Ikeura K, Arita R, Tsubota K, Ocular Surface, 13:82-7, 2015.

Slow Breathing and Blood Pressure

From: Device and non-device-guided slow breathing to reduce blood pressure: A systematic review and meta-analysis. Chaddha A, Modaff D, Hooper-Lane C, Feldstein DA. Complement Ther Med. 45:179-184, 2019.

“Non-device slow breathing trials showed a slightly larger reduction in SBP of −8.45 mmHg and a significantly greater reduction in DBP of −6.90 mmHg.”

Slow and Fast Pranayama on Stress

From: Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students. Sharma VK, Trakroo M, Subramaniam V, Rajajeyakumar M, Bhavanani AB, Sahai A, International Journal of Yoga, 6:104-10, 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734635/?report=printable

Slow and Fast Pranayama on Stress

From: Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students. Sharma VK, Trakroo M, Subramaniam V, Rajajeyakumar M, Bhavanani AB, Sahai A, International Journal of Yoga, 6:104-10, 2013. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3734635/?report=printable

Slow Breathing on Stress

From: How breathing can help you make better decisions: Two studies on the effects of breathing patterns on heart rate variability and decision-making in business cases. De Couck M, Caers R, Musch L, Fliegauf J, Giangreco A, Gidron Y, International Journal of Psychophysiology, 139:1-9, 2019.

“I used alternate nostril breathing before a test and it helped ... I did well on the test.” “Before you’re taking a test ... relax and breathe and you don’t get as nervous

• r as tense.”

“I used breathing outside the classroom in my life to calm me down… if I was stressed or angry I would then do the breathing to calm me down and I will probably continue to do this…I was less anxious about school in general...” “If you had a lot of stuff on your mind or something you could just use some of those exercises... I just felt calmer and stuff, if I was stressed out or angry for some reason, I’d use that at some point. I’d do their breathing exercises and they’d calm me down.” “Many of them used yoga postures and breathing to aid in falling asleep at night and/or waking up in the morning.”

From: Qualitative evaluation of a high school yoga program: Feasibility and perceived benefits, Conboy LA, Noggle JJ, Frey JL, Kudesia RS, Khalsa SBS, Explore: The Journal of Science & Healing, 9:171-180, 2013.

Student Use of Yoga Breathing Practices

“We found a neuronal subpopulation in the mouse preBötzinger complex (preBötC), the primary breathing rhythm generator, which regulates the balance between calm and arousal behaviors.” “…the breathing center has a direct and powerful influence on higher-order brain function. It will thus be important to map the full range of behaviors and functions the breathing center controls.”

From: Slow Breathing Can Be Operantly Conditioned in the Rat and May Reduce Sensitivity to Experimental Stressors, Noble DJ, Goolsby WN, Garraway SM, Martin KK, Hochman S, Frontiers in Physiology, 8:854, 2017.

Rat Pranayama