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

Brigham & Women’s Hospital Harvard Medical School Yoga for Respiratory Function Yoga Alliance Webinar April 30, 2020 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

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 of 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

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

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

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.” 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.

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

Breathing and Control of Attention Caudal Medial Frontal Cortex 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

Breathing, Control of Attention and the Locus Coeruleus 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.

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 of the internal organs improve when they are provided with an increased amount of oxygen- rich blood.” ⚫ The blood is normally already amply saturated with O 2 ⚫ Increasing ventilation will reduce CO 2 causing hyperventilation ⚫ Proper slow deep yogic breathing does not change O 2 & CO 2

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.

“Prā ṇ āyāma 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 prā ṇ āyāma techniques were shown to produce different effects…” https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5382821/?report=printable

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

“The main effects of slow breathing techniques cover autonomic and central nervous systems activities as well as the psychological status.” https://www.frontiersin.org/articles/10.3389/fnhum.2018.00353/pdf

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 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.” 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.

“…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

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.” 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.

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 “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.” 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.

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.