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The Physiological Effects of Breathing


              THE PHYSIOLOGICAL EFFECTS OF PRANAYAMA
                                       by Aoife Brennan



    Pranayama is a sanskrit word composed of the words ‘prana’ meaning vital life-

force and “ayama” meaning restraint. The word pranayama thus translates as the regu-

lation or control of life-force. The word prana has been trans-

lated as many things including air, breath, spirit, life-force, en-

ergy, subtle energy, vital energy, soul and principle of life, all es-

sentially trying to convey the all-pervasiveness and vastness of

the life-sustaining energy of the universe which the word prana

represents (Apte, 1965). Prana is a concept central to the prac-

tices of yoga where it is believed to flow through channels in

the body called nadis. In relation to yogic practices pranayama
                                                                          Fig 1. A drawing from an an-
is usually translated more directly as breath control (Feuer-
                                                                          cient parchment showing the
stein, 1998). An alternative root of the word is given by Rama-           main nadis of the body. The
                                                                          artist has drawn some outside
murti Mishra who says that “Expansion of individual energy                the body for purpose of clarity
                                                                          but they are all located within
into cosmic energy is called pranayama” which gives a deeper              the body

insight into the purpose of pranayama to a yoga practitioner.

Pranayama channels the prana in the body to calm, rejuvenate and uplift the mind. It

serves as an important bridge between the external, active and highly physical practice

of yoga asana and the subtle internal practices that lead the yogi into deeper states of

meditation.


    The ancient practice of yoga was composed into a darshan (philosophy) by Patan-

jali in his book Patanjali Yoga Sutra. In this book he formulated yoga as an eight-

limbed path, of which pranayama is the fourth limb. Chapter 2, sutra 49 describe

pranayama as “Tasmin sati svasaprasvasayor-gitivicchedah pranayamah”, “Regulation of

                                               1
The Physiological Effects of Breathing


 breath or the control of prana is the stoppage of inhalation and exhalation, which fol-

 lows after securing that steadiness of posture or seat” (Yoga Sutras, 2:49). Here, Patan-

                                 jali is stating that only those that have mastered their physical

                                 body through asana, such that they can comfortably sit for long

                                 periods of time, can progress to practicing pranayama. As a

                                 consequence, there are differences of opinion between the

                                 major yoga traditions on when a student should be introduced

                                 to the practice of pranayama. In the integral yoga tradition

                                 propounded by Swami Satchidananda, pranayama is incorpo-

                                 rated into every yoga class. A typical session starts with asana,

                                 moves on to pranayama and ends with seated meditation but

Fig 2. A representation of        only at advanced levels are techniques such as breath reten-
Patangali. Hindu tradition
states that when all the mu-      tion (Kunbacha) or the chin lock (jalandhara bandha) intro-
nis and rishis approached
Lord Vishnu for a means to        duced. In Ashtanga ujjayi breathing is taught alongside mula
cure illness (physical, mental
and emotional) he gave them       bandha (root lock) and uddiyana bandha (abdominal lock).
the serpent Adishesha with
1,000 heads (the symbol of        These concepts are introduced to beginners and carried along
awarness) who took birth in
the world as Maharishi
                                  and developed in conjunction with the asana practice. The
Patangali.
                                  practitioner is guided to some degree in this but, like that as-

 ana practice, the ujjayi breath develops with yoga practice and a deeper understanding

 of the asana. Seated pranayamas are also taught as part of this tradition but usually

 only after a practice of three to five years and the mastering of at least the primary se-

 ries of asanas. There are six different pranayamas taught as a series and each one is

 built on the previous technique and are practiced with the eyes open (Cummins, Yoga

 Journal). Iyengar yoga, like ashtanga, only introduces separate pranayama practices after

 a students has a strong asana practice but no specific breathing technique is not taught

 to beginners in conjunction with the asana. Ujjayi breath is taught but only as a sepa-



                                                     2
The Physiological Effects of Breathing


   rate practice after the yogi has first been guided through a supine breath awareness

   practice which is done lying down with the chest and head supported to allow com-

   plete focus on the breath and very precise directions are given to develop breathing

   awareness.




   The Physiology of Breathing and Respiration

   The lungs by themselves are immobile, sponge-like organs consisting of a microfine

   network of tiny air-sacks called alveoli. The alveoli

   sit at the end of a series of branch like tubules that

   spread out from the trachea (windpipe) in the chest.

   The lungs are encased in a the thoracic cavity

   which is formed by the ribs, spine, diaphragm and

   an array of muscles both big and small. It is the

   concerted action of the muscles that brings about
                                                                 Fig 3. Structure and blood supply
   the process of breathing. Unlike many other inter-            of the alveoli of the lungs

   nal processes of the body, such as pumping blood

   and moving of food through the digestive system, breathing results from semi-

                                conscious and habitual contraction of muscles that can be

                                brought to conscious awareness if desired. It is the cultivation of

                                this awareness that is the foundation of all pranayama practices

                                and it is the choice of muscles that we choose to move the lungs

                                that determines the type of breath we take. At the end of a nor-

                                mal exhale, the thoracic cavity is at equal pressure with the out-

                                 side of the body. The contraction of the diaphragm and/or other
Fig 4. The thoracic cavity is
encased in the ribs, dia-        muscles of the thoracic cavity increases the space in the cavity
phragm and surrounding
skeletal muscles


                                                      3
The Physiological Effects of Breathing


and therefore decreases the pressure causing

air to rush into the lungs from outside. When

these muscles relax, space in the cavity de-

creases causing the pressure to increase. This

forces the air out of the lungs until the pres-

sure is yet again equal with that of the exter-

nal environment (Fig 4.). Therefore, in normal

breathing, inhalation is active as muscle con-

traction is required and exhalation is passive
                                                   Fig 5. The role of the diaphragm in chang-
as no energetic input is needed.                   ing the pressure in the lungs in breathing.


    On a cellular level, breathing is the body’s way of absorbing oxygen and excreting

the carbon dioxide (CO2) produced by the body when sugars are metabolised to pro-

duce energy. The body is capable of detecting oxygen levels in the blood but the pri-

mary determinant of the breathing urge is CO2 levels. These levels can profoundly af-

fect the physical and mental states of the body in many ways. CO2 is a primary regula-

tor of the acid-alkaline balance of the body which determines the rate of activity of

other biochemical processes. Breathing that is too slow or shallow can cause respira-

tory acidosis (acidic blood) resulting in headaches, confusion and anxiety.


    Rapid shallow breathing patterns are often associated with people living with

stress where the depleted oxygen levels aggravate the mind further in a vicious cycle.

This is largely due to the fact that, unlike the other organs, the brain need a constant

oxygen supply in order to maintain it’s functional and structural integrity. Long-term

rapid shallow breathing (often caused by poor posture or weak muscles) can result in

the rib cage and surrounding muscles becoming stiff causing inhalation to become

more difficult and deeper breathing almost impossible. Less elasticity and weak mus-



                                               4
The Physiological Effects of Breathing


  cles leave stale air in the tissues of the lungs, preventing fresh oxygen from reaching

  the blood stream. The resultant poor oxygen supply can cause respiratory disease, de-

                                                   crease mental alertness, sluggishness

                                                    or heart disease.


                                                           Rapid deep breathing, or hy-

                                                    perventilation, is usually caused by

                                                    anxiety and causes low blood CO2

                                                    levels. This shifts the body’s pH to-

                                                    wards alkaline, weakening the im-

                                                    mune system. CO2 helps dilate

Fig 6. The anatomy of an asthma attack.             smooth muscle tissue and insufficient

                                                    CO2 can cause spasms throughout the

  body including the brain and bronchi.. Good examples are the spasms that take place

  during asthma attacks and migraines. Therefore, it is evident that the quality and depth

  of the breath can have profound and varying physiological effects on both the body

  and mind.




  The Consequences of Breath Regulation

        Too much CO2 and not enough oxygen creates sluggishness and depression and

  can contribute to anxiety and panic attacks. Long, deep inhales raise oxygen levels to

  rebalance the blood oxygen levels. Examples of pranayama techniques that involve ex-

  tended inhalation include ujjayi breathing and the yogic breath.


        Too much oxygen and not enough CO2 can create an agitated state. Controlled,

  long exhales conserve CO2 , rebalances the system and ensures the complete elimina-



                                              5
The Physiological Effects of Breathing


tion of toxins that can build up with inefficient exhalation. Examples of pranayamas

involving extended exhales include viloma and brahmari breath.


     Breath retention or “kumbhaka” takes two forms in pranayama. Holding the

breath in (antara kumbhaka) and holding the breath out (bahya kumbhaka). This prac-

tice increases heat in the body, improves concentration as mental activity is restricted

and increases lung capacity.


Regardless of the pranayama technique employed pranayama should always follow

some basic principles:


    Breathing exercises should never be pushed to the point of weariness or exhaustion.

    Exercises should not be repeated too often.

    They should not be merely mechanical.

    There should be no hurry or haste.

    Attention should be concentrated on the exercise while it is being performed.

    There should always be variety and change in the exercises.

    Exercise should always be gentle and nonviolent.

    Breathing should not be jerky or irregular, but smooth, steady and continuous.




A selection of pranayama techniques and their physiological effects

Abdominal Breathing

Abdominal or ‘diaphragmatic” breathing consists mainly of breathing deep down into

the abdomen by changing the position of the diaphragm. When you inhale the dia-

phragm gently descends into the abdomen pushing the stomach forward with no strain.

When exhaling you gently allow the stomach to return to its normal position. We often

use this low breathing when we are sleeping or hunched forward. Conscious diaphrag-

                                             6
The Physiological Effects of Breathing


matic breathing is extremely relaxing to the autonomic nervous system (ANS) which is

essential preparation for deep meditation. The ANS controls

heart rate, digestion, respiration rate perspiration and diame-

tre of the pupils. With this breathing more air is taken into

the lungs than in chest breathing as the lower lobes of the

lungs are larger that the upper lobes. The abdominal organs

are also massaged by the movements of the diaphragm and

the celiac (solar) plexus never centre is stimulated. Abdomi-

nal breathing has been shown to improve quality of life in

breast cancer patients after a mastectomy (Kim et al., 2005),       Fig 7. Abdominal breathing

reduce the occurrence of non-sleep bruxism (Ando and Sa-

kurai, 2006) and relieve anxiety of women diagnosed with preterm labour (Shim and

Chang,, 2006). Abdominal breathing, combined with the rhythmical pumping of the dia-

phragm helps turn on the parasympathetic nervous system - our “rest and relax” re-

sponse.



Dirgha pranayama or “yogic breath’

Also know as the three-part breath, dirgha pranayama is done seated and involves taking

a full breath in three separate inhalations, each with a short pause between them; the

first deeply into the abdomen as far as the rib cage, the second into the rib cage expand-

ing the ribs and finally all the way up to the chest and clavicles which actually lift slightly

as the lungs fill with air. The exhale is also done in three parts but in the opposite direc-

tion, clavicles descending first, then ribs and abdomen, again each with a short pause in

between. This is a slow deep breath that utilises all the alveoli in the lungs, flushing the

entire lungs with fresh air and allowing for greater percentage of oxygen to be in hales

making oxygen/CO2 exchange more efficient.



                                              7
The Physiological Effects of Breathing


Ujjayi pranayama

The ujjai breath (”victorious breath”) is best know for it’s use throughout the asana prac-

tice in Ashtanga yoga but it is a separate pryanayama technique in itself involving the

gently contraction and lifting of the uddiyana bandha and the mula bandha to lift the

breath up into the thoracic cavity. It can be practiced with or without kumbhakas. It is

also know as the ocean breath due to the sound made by the gentle engagement of the

jalandhara bandha in the throat to create some resistance to the passage of air. This

sound should become more subtle as the practitioner advances in both asana and

pranayama so that it is audible to only the practitioner themselves. In the yoga sutras

Patanjali suggests that the breath should be dirga (long) and suksma (smooth). It is a bal-

ancing and calming breath which build up internal heat and increases oxygenation

(Telles and Desiraju, 1991).



Nadi shodhana

This pranayama is also known as alternate nostril breathing as the thumb of the right

hand is used to close the right nostril and the ring finger of the same hand is used to

close the left nostril. One round consists of inhaling

through one nostril for a defined length of time (varying

from person-to-person) and exhaling for the same length

of time the same side. This nostril is then closed and the

same breath is repeated through the other nostril. In a

controlled study is was shown that breathing through the
                                                              Fig 8. Alternate nostril
right nostril resulted in a significant increase of 37% in     breathing

baseline oxygen consumption, alternately breathing

through both nostrils showed and 18% increase while breathing through the left nostril

resulted in a 24% increase. The left nostril pranayama group showed in increase in volar

galvanic skin resistance, the electrical resistance of the skin which is a measure of emo-


                                             8
The Physiological Effects of Breathing


tions in people that is part of the polygraph test. Fear, anger, startle response, sexual feel-

ings are all among the emotions which may produce similar GSR responses. An increase

is interpreted as a reduction in sympathetic nervous system activity (Telles et al. 1994).

These results suggest that breathing selectively through either nostril could have a

marked activating effect or a relaxing effect on the sympathetic nervous system.



Viloma pranayama

Viloma means against the natural order of things. In viloma pranayama, inhalation or ex-

halation is done with several pauses. It teaches the practitioner how to fully utilise the

entirety of the rib cage and how to direct the breath into specific areas of the chest en-

suring a deep breath. Viloma can also be practiced through alternate nostrils and is

called anuloma viloma. Viloma aerates the lungs and improves the muscle tone of the

breathing muscles. Both anuloma viloma and viloma have been said to lower blood pres-

sure, however the only controlled scientific study showed that there was an increase in

systolic blood pressure probably due to cutaneous vasoconstriction as shown by the si-

multaneous decrease in digit pulse volume (Telles et al., 1993). Both practices have also

been shown to increase oxygen consumption and therefore may be of benefit to the

obese who are known to have a lowed resting metabolic rate than the non-obese (Dunani

et al., 1986).



Brahmari pranayama

Brahmari means bumble bee. In this breathing practice

your lips are shut, the ears and eyes closed with the fin-

gers and you gently and smoothly make the sound like a           Fig 9. Brahmari pranayama involves
                                                                 humming like a bumble-bee to cre-
humming bee in your throat. The vibrations can be felt in        ate vibrations.

the throat, jaws and face and can be done by anyone re-

gardless of age or fitness level. At the moment there are not detailed scientific studies


                                               9
The Physiological Effects of Breathing


conducted on brahmari pranayama alone but proposed benefits include invigoration of

the thyroid gland increasing metabolism, curing migraine and triggering serotonin re-

lease resulting in balanced moods although altered serotonin levels has been implicated

in causing migraines so caution must be observed.



Sitali pranayama

Sitali is also called tongue hissing due to the sound produced when practicing it. The

tongue is curled up into a tube and during inhalation the air passes over the moist

tongue, cooling down and refreshing the throat. The tongues is drawn back into the

mouth and the lips are closed at the end of the inhalation and the exhalation takes place

either through the throat or alternately through the nostrils. This is a cooling pranayama

which is though to have developed from observation of how animals breath to cool down

using their tongues.



Kapalabhati

Kapalabhati means skull shining breath and is one of the cleansing techniques of yoga. If

there is mucus in the air passages or tension and blockages in the chest it is often helpful

to breath quickly. In this practice the diaphragm and associated muscles are used to

“pump” the air rapidly out of the lungs in a forced exhalation. This is followed by a rapid

but passive inhalation. “Bhati” means “that which brings lightness”. One must be careful

with this technique because there is a danger of creating great tension with the breath or

one may become quite dizzy when breathing becomes rapid. For this reason kapalabhati

is usually concluded with some deep slow breaths. One study showed that kapalabhati

modifies the autonomic status by increasing sympathetic activity (”fight-or-flight”) with

reduced vagal activity (Vagus nerve innervates the lungs and stomach, increases heart

rate and blood pressure) (Raghuraj et al., 1998).




                                             10
The Physiological Effects of Breathing


Conclusion

     Due to the semi-conscious nature of breathing we rarely observe our breath but

since out state of mind is reflected in the way we breath, it follows that by controlling

our breath we can learn to control out state of mind. A calm, peaceful mind is content

and non-violent and more receptive to the sense withdrawal (pratyahara) and deep

concentration (dharana) that bring about states of meditation. The health benefits are

scientifically proven with researchers reporting that pranayama is beneficial in treating

a range of stress related disorders (Brown et al., 2005), improving autonomic functions

(Howorka et al., 1995), relieving symptoms of asthma (Cooper et al., 2003; Vedanthan et

al., 1998), and reducing sigs of oxidative stress (Bhattacharya et al., 2004; Jerath et al.,

2006). Anecdotal evidence from practitioners report that the practice develops a steady

mind, strong will-power and sound judgment (Light on Pranayama, 6th ed.) and also

claim that sustained pranayama practice extends life and enhances perception (Asana

Pranayama Mudra Bandha, 2002). Will all the far-reaching benefits to the mind and

body, pranayama is something that cannot be ignored as part of a solid yoga practice

and should be practiced regularly by yogis of all ages and abilities.




                                      Word count: 3000




                                              11
The Physiological Effects of Breathing


                                        References


Apte, Vaman Shivram (1965). The Practical Sanskrit Dictionary. Delhi: Motilal Banarsi-
dass Publishers. ISBN 81-208-0567-4. (fourth revised  enlarged edition).


Feuerstein, Georg (1998). Tantra: The Path of Ecstacy. Boston: Shambhala Publications.


Mishra, Ramamurti S. (1963). The Textbook of Yoga Psychology. Monroe, New York: Baba
Bhagavandas Publication Trust. ISBN 1-890964-27-1. Reprint edition, 1997.


Cummins, C. Prescriptions for Pranayama. Yoga Journal.


Kim KS, Lee SW, Choe MA, Yi MS, Choi S, Kwon SH. (2005). Effects of abdominal
breathing training using biofeedback on stress, immune response and quality of life in
patients with a mastectomy for breast cancer. Taehan Kanho Hakhoe Chi. 35(7), 1295-1303.


Ando, T. and Sakurai, K. (2006). Effects of Abdominal Breathing on the Occurrence of
Non-Sleep Bruxism. Prosthodontic Research  Practice. 5(4), 189-194.


Joung Ohn Shim, Soon Bok Chang. (2006). Effects of Abdominal Breathing on Preterm
Labor Anxiety. Korean J Women Health Nurs. 12(2), 106-114


Telles, S. and Desiraju, T. (1991). Oxygen consumption during pranayamic type of very
slow-rate breathing. Indian J Med Res. 94, 357-363.


Telles S, Nagarathna R, Nagendra HR. (1994). Breathing through a particular nostril can
alter metabolism and autonomic activities. Indian J Physiol Pharmacol. 38(2), 133-137.


P. Raghuraj, A. G. Ramakrishnan , H. R. Nagendra and Shirley Telles. (1998). Effect of
two selected yogic breathing techniques on heart rate variability. Indian J Physiol Pharma-
col. 42(4), 467-472.


Brown RP, Gerbarg PL. (2005). Sudarshan Kriya Yogic breathing in the treatment of
stress, anxiety, and depression. Part II--clinical applications and guidelines. J Altern Com-
plement Med. 11(4), 1-7.
Howorka K., Pumprla J., Heger G., Thoma H., Opavsky J., Salinger J. (1995). Computer-
ised Assessment of Autonomic Influences of Yoga Using Spectral Analysis of Heart Rate
Variability. Proceedings RC IEEE-EMBS 8 14th BMESI.


                                             12
The Physiological Effects of Breathing




Cooper S, Oborne J, Newton S, Harrison V, Thompson Coon J, Lewis S, Tattersfield A.
(2004). Effect of two breathing exercises (Buteyko and pranayama) in asthma: a random-
ised controlled trial. Thorax. 58(8), 674-679.

Vedanthan PK, Kesavalu LN, Murthy KC, Duvall K, Hall MJ, Baker S, Nagarathna S.
(1998). Clinical study of yoga techniques in university students with asthma: a controlled
study. Allergy Asthma Proc. 19(1), 3-9.


Bhattacharya S, Pandey US, Verma NS. (2002). Improvement in oxidative status with yo-
gic breathing in young healthy males. Indian J Physiol Pharmacol. 46(3), 349-354.


Jerath R, Edry JW, Barnes VA, Jerath V. (2006). Physiology of long pranayamic breath-
ing: neural respiratory elements may provide a mechanism that explains how slow deep
breathing shifts the autonomic nervous system. Med Hypotheses. 67(3), 566-571.


Iyengar, B. K. S. Light on Pranayama, Sixth Edition, Crossroad Publishing Co.


Asana Pranayama Mudra Bandha, 2002.




                                            13

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The physiological benefits of pranayama

  • 1. The Physiological Effects of Breathing THE PHYSIOLOGICAL EFFECTS OF PRANAYAMA by Aoife Brennan Pranayama is a sanskrit word composed of the words ‘prana’ meaning vital life- force and “ayama” meaning restraint. The word pranayama thus translates as the regu- lation or control of life-force. The word prana has been trans- lated as many things including air, breath, spirit, life-force, en- ergy, subtle energy, vital energy, soul and principle of life, all es- sentially trying to convey the all-pervasiveness and vastness of the life-sustaining energy of the universe which the word prana represents (Apte, 1965). Prana is a concept central to the prac- tices of yoga where it is believed to flow through channels in the body called nadis. In relation to yogic practices pranayama Fig 1. A drawing from an an- is usually translated more directly as breath control (Feuer- cient parchment showing the stein, 1998). An alternative root of the word is given by Rama- main nadis of the body. The artist has drawn some outside murti Mishra who says that “Expansion of individual energy the body for purpose of clarity but they are all located within into cosmic energy is called pranayama” which gives a deeper the body insight into the purpose of pranayama to a yoga practitioner. Pranayama channels the prana in the body to calm, rejuvenate and uplift the mind. It serves as an important bridge between the external, active and highly physical practice of yoga asana and the subtle internal practices that lead the yogi into deeper states of meditation. The ancient practice of yoga was composed into a darshan (philosophy) by Patan- jali in his book Patanjali Yoga Sutra. In this book he formulated yoga as an eight- limbed path, of which pranayama is the fourth limb. Chapter 2, sutra 49 describe pranayama as “Tasmin sati svasaprasvasayor-gitivicchedah pranayamah”, “Regulation of 1
  • 2. The Physiological Effects of Breathing breath or the control of prana is the stoppage of inhalation and exhalation, which fol- lows after securing that steadiness of posture or seat” (Yoga Sutras, 2:49). Here, Patan- jali is stating that only those that have mastered their physical body through asana, such that they can comfortably sit for long periods of time, can progress to practicing pranayama. As a consequence, there are differences of opinion between the major yoga traditions on when a student should be introduced to the practice of pranayama. In the integral yoga tradition propounded by Swami Satchidananda, pranayama is incorpo- rated into every yoga class. A typical session starts with asana, moves on to pranayama and ends with seated meditation but Fig 2. A representation of only at advanced levels are techniques such as breath reten- Patangali. Hindu tradition states that when all the mu- tion (Kunbacha) or the chin lock (jalandhara bandha) intro- nis and rishis approached Lord Vishnu for a means to duced. In Ashtanga ujjayi breathing is taught alongside mula cure illness (physical, mental and emotional) he gave them bandha (root lock) and uddiyana bandha (abdominal lock). the serpent Adishesha with 1,000 heads (the symbol of These concepts are introduced to beginners and carried along awarness) who took birth in the world as Maharishi and developed in conjunction with the asana practice. The Patangali. practitioner is guided to some degree in this but, like that as- ana practice, the ujjayi breath develops with yoga practice and a deeper understanding of the asana. Seated pranayamas are also taught as part of this tradition but usually only after a practice of three to five years and the mastering of at least the primary se- ries of asanas. There are six different pranayamas taught as a series and each one is built on the previous technique and are practiced with the eyes open (Cummins, Yoga Journal). Iyengar yoga, like ashtanga, only introduces separate pranayama practices after a students has a strong asana practice but no specific breathing technique is not taught to beginners in conjunction with the asana. Ujjayi breath is taught but only as a sepa- 2
  • 3. The Physiological Effects of Breathing rate practice after the yogi has first been guided through a supine breath awareness practice which is done lying down with the chest and head supported to allow com- plete focus on the breath and very precise directions are given to develop breathing awareness. The Physiology of Breathing and Respiration The lungs by themselves are immobile, sponge-like organs consisting of a microfine network of tiny air-sacks called alveoli. The alveoli sit at the end of a series of branch like tubules that spread out from the trachea (windpipe) in the chest. The lungs are encased in a the thoracic cavity which is formed by the ribs, spine, diaphragm and an array of muscles both big and small. It is the concerted action of the muscles that brings about Fig 3. Structure and blood supply the process of breathing. Unlike many other inter- of the alveoli of the lungs nal processes of the body, such as pumping blood and moving of food through the digestive system, breathing results from semi- conscious and habitual contraction of muscles that can be brought to conscious awareness if desired. It is the cultivation of this awareness that is the foundation of all pranayama practices and it is the choice of muscles that we choose to move the lungs that determines the type of breath we take. At the end of a nor- mal exhale, the thoracic cavity is at equal pressure with the out- side of the body. The contraction of the diaphragm and/or other Fig 4. The thoracic cavity is encased in the ribs, dia- muscles of the thoracic cavity increases the space in the cavity phragm and surrounding skeletal muscles 3
  • 4. The Physiological Effects of Breathing and therefore decreases the pressure causing air to rush into the lungs from outside. When these muscles relax, space in the cavity de- creases causing the pressure to increase. This forces the air out of the lungs until the pres- sure is yet again equal with that of the exter- nal environment (Fig 4.). Therefore, in normal breathing, inhalation is active as muscle con- traction is required and exhalation is passive Fig 5. The role of the diaphragm in chang- as no energetic input is needed. ing the pressure in the lungs in breathing. On a cellular level, breathing is the body’s way of absorbing oxygen and excreting the carbon dioxide (CO2) produced by the body when sugars are metabolised to pro- duce energy. The body is capable of detecting oxygen levels in the blood but the pri- mary determinant of the breathing urge is CO2 levels. These levels can profoundly af- fect the physical and mental states of the body in many ways. CO2 is a primary regula- tor of the acid-alkaline balance of the body which determines the rate of activity of other biochemical processes. Breathing that is too slow or shallow can cause respira- tory acidosis (acidic blood) resulting in headaches, confusion and anxiety. Rapid shallow breathing patterns are often associated with people living with stress where the depleted oxygen levels aggravate the mind further in a vicious cycle. This is largely due to the fact that, unlike the other organs, the brain need a constant oxygen supply in order to maintain it’s functional and structural integrity. Long-term rapid shallow breathing (often caused by poor posture or weak muscles) can result in the rib cage and surrounding muscles becoming stiff causing inhalation to become more difficult and deeper breathing almost impossible. Less elasticity and weak mus- 4
  • 5. The Physiological Effects of Breathing cles leave stale air in the tissues of the lungs, preventing fresh oxygen from reaching the blood stream. The resultant poor oxygen supply can cause respiratory disease, de- crease mental alertness, sluggishness or heart disease. Rapid deep breathing, or hy- perventilation, is usually caused by anxiety and causes low blood CO2 levels. This shifts the body’s pH to- wards alkaline, weakening the im- mune system. CO2 helps dilate Fig 6. The anatomy of an asthma attack. smooth muscle tissue and insufficient CO2 can cause spasms throughout the body including the brain and bronchi.. Good examples are the spasms that take place during asthma attacks and migraines. Therefore, it is evident that the quality and depth of the breath can have profound and varying physiological effects on both the body and mind. The Consequences of Breath Regulation Too much CO2 and not enough oxygen creates sluggishness and depression and can contribute to anxiety and panic attacks. Long, deep inhales raise oxygen levels to rebalance the blood oxygen levels. Examples of pranayama techniques that involve ex- tended inhalation include ujjayi breathing and the yogic breath. Too much oxygen and not enough CO2 can create an agitated state. Controlled, long exhales conserve CO2 , rebalances the system and ensures the complete elimina- 5
  • 6. The Physiological Effects of Breathing tion of toxins that can build up with inefficient exhalation. Examples of pranayamas involving extended exhales include viloma and brahmari breath. Breath retention or “kumbhaka” takes two forms in pranayama. Holding the breath in (antara kumbhaka) and holding the breath out (bahya kumbhaka). This prac- tice increases heat in the body, improves concentration as mental activity is restricted and increases lung capacity. Regardless of the pranayama technique employed pranayama should always follow some basic principles: Breathing exercises should never be pushed to the point of weariness or exhaustion. Exercises should not be repeated too often. They should not be merely mechanical. There should be no hurry or haste. Attention should be concentrated on the exercise while it is being performed. There should always be variety and change in the exercises. Exercise should always be gentle and nonviolent. Breathing should not be jerky or irregular, but smooth, steady and continuous. A selection of pranayama techniques and their physiological effects Abdominal Breathing Abdominal or ‘diaphragmatic” breathing consists mainly of breathing deep down into the abdomen by changing the position of the diaphragm. When you inhale the dia- phragm gently descends into the abdomen pushing the stomach forward with no strain. When exhaling you gently allow the stomach to return to its normal position. We often use this low breathing when we are sleeping or hunched forward. Conscious diaphrag- 6
  • 7. The Physiological Effects of Breathing matic breathing is extremely relaxing to the autonomic nervous system (ANS) which is essential preparation for deep meditation. The ANS controls heart rate, digestion, respiration rate perspiration and diame- tre of the pupils. With this breathing more air is taken into the lungs than in chest breathing as the lower lobes of the lungs are larger that the upper lobes. The abdominal organs are also massaged by the movements of the diaphragm and the celiac (solar) plexus never centre is stimulated. Abdomi- nal breathing has been shown to improve quality of life in breast cancer patients after a mastectomy (Kim et al., 2005), Fig 7. Abdominal breathing reduce the occurrence of non-sleep bruxism (Ando and Sa- kurai, 2006) and relieve anxiety of women diagnosed with preterm labour (Shim and Chang,, 2006). Abdominal breathing, combined with the rhythmical pumping of the dia- phragm helps turn on the parasympathetic nervous system - our “rest and relax” re- sponse. Dirgha pranayama or “yogic breath’ Also know as the three-part breath, dirgha pranayama is done seated and involves taking a full breath in three separate inhalations, each with a short pause between them; the first deeply into the abdomen as far as the rib cage, the second into the rib cage expand- ing the ribs and finally all the way up to the chest and clavicles which actually lift slightly as the lungs fill with air. The exhale is also done in three parts but in the opposite direc- tion, clavicles descending first, then ribs and abdomen, again each with a short pause in between. This is a slow deep breath that utilises all the alveoli in the lungs, flushing the entire lungs with fresh air and allowing for greater percentage of oxygen to be in hales making oxygen/CO2 exchange more efficient. 7
  • 8. The Physiological Effects of Breathing Ujjayi pranayama The ujjai breath (”victorious breath”) is best know for it’s use throughout the asana prac- tice in Ashtanga yoga but it is a separate pryanayama technique in itself involving the gently contraction and lifting of the uddiyana bandha and the mula bandha to lift the breath up into the thoracic cavity. It can be practiced with or without kumbhakas. It is also know as the ocean breath due to the sound made by the gentle engagement of the jalandhara bandha in the throat to create some resistance to the passage of air. This sound should become more subtle as the practitioner advances in both asana and pranayama so that it is audible to only the practitioner themselves. In the yoga sutras Patanjali suggests that the breath should be dirga (long) and suksma (smooth). It is a bal- ancing and calming breath which build up internal heat and increases oxygenation (Telles and Desiraju, 1991). Nadi shodhana This pranayama is also known as alternate nostril breathing as the thumb of the right hand is used to close the right nostril and the ring finger of the same hand is used to close the left nostril. One round consists of inhaling through one nostril for a defined length of time (varying from person-to-person) and exhaling for the same length of time the same side. This nostril is then closed and the same breath is repeated through the other nostril. In a controlled study is was shown that breathing through the Fig 8. Alternate nostril right nostril resulted in a significant increase of 37% in breathing baseline oxygen consumption, alternately breathing through both nostrils showed and 18% increase while breathing through the left nostril resulted in a 24% increase. The left nostril pranayama group showed in increase in volar galvanic skin resistance, the electrical resistance of the skin which is a measure of emo- 8
  • 9. The Physiological Effects of Breathing tions in people that is part of the polygraph test. Fear, anger, startle response, sexual feel- ings are all among the emotions which may produce similar GSR responses. An increase is interpreted as a reduction in sympathetic nervous system activity (Telles et al. 1994). These results suggest that breathing selectively through either nostril could have a marked activating effect or a relaxing effect on the sympathetic nervous system. Viloma pranayama Viloma means against the natural order of things. In viloma pranayama, inhalation or ex- halation is done with several pauses. It teaches the practitioner how to fully utilise the entirety of the rib cage and how to direct the breath into specific areas of the chest en- suring a deep breath. Viloma can also be practiced through alternate nostrils and is called anuloma viloma. Viloma aerates the lungs and improves the muscle tone of the breathing muscles. Both anuloma viloma and viloma have been said to lower blood pres- sure, however the only controlled scientific study showed that there was an increase in systolic blood pressure probably due to cutaneous vasoconstriction as shown by the si- multaneous decrease in digit pulse volume (Telles et al., 1993). Both practices have also been shown to increase oxygen consumption and therefore may be of benefit to the obese who are known to have a lowed resting metabolic rate than the non-obese (Dunani et al., 1986). Brahmari pranayama Brahmari means bumble bee. In this breathing practice your lips are shut, the ears and eyes closed with the fin- gers and you gently and smoothly make the sound like a Fig 9. Brahmari pranayama involves humming like a bumble-bee to cre- humming bee in your throat. The vibrations can be felt in ate vibrations. the throat, jaws and face and can be done by anyone re- gardless of age or fitness level. At the moment there are not detailed scientific studies 9
  • 10. The Physiological Effects of Breathing conducted on brahmari pranayama alone but proposed benefits include invigoration of the thyroid gland increasing metabolism, curing migraine and triggering serotonin re- lease resulting in balanced moods although altered serotonin levels has been implicated in causing migraines so caution must be observed. Sitali pranayama Sitali is also called tongue hissing due to the sound produced when practicing it. The tongue is curled up into a tube and during inhalation the air passes over the moist tongue, cooling down and refreshing the throat. The tongues is drawn back into the mouth and the lips are closed at the end of the inhalation and the exhalation takes place either through the throat or alternately through the nostrils. This is a cooling pranayama which is though to have developed from observation of how animals breath to cool down using their tongues. Kapalabhati Kapalabhati means skull shining breath and is one of the cleansing techniques of yoga. If there is mucus in the air passages or tension and blockages in the chest it is often helpful to breath quickly. In this practice the diaphragm and associated muscles are used to “pump” the air rapidly out of the lungs in a forced exhalation. This is followed by a rapid but passive inhalation. “Bhati” means “that which brings lightness”. One must be careful with this technique because there is a danger of creating great tension with the breath or one may become quite dizzy when breathing becomes rapid. For this reason kapalabhati is usually concluded with some deep slow breaths. One study showed that kapalabhati modifies the autonomic status by increasing sympathetic activity (”fight-or-flight”) with reduced vagal activity (Vagus nerve innervates the lungs and stomach, increases heart rate and blood pressure) (Raghuraj et al., 1998). 10
  • 11. The Physiological Effects of Breathing Conclusion Due to the semi-conscious nature of breathing we rarely observe our breath but since out state of mind is reflected in the way we breath, it follows that by controlling our breath we can learn to control out state of mind. A calm, peaceful mind is content and non-violent and more receptive to the sense withdrawal (pratyahara) and deep concentration (dharana) that bring about states of meditation. The health benefits are scientifically proven with researchers reporting that pranayama is beneficial in treating a range of stress related disorders (Brown et al., 2005), improving autonomic functions (Howorka et al., 1995), relieving symptoms of asthma (Cooper et al., 2003; Vedanthan et al., 1998), and reducing sigs of oxidative stress (Bhattacharya et al., 2004; Jerath et al., 2006). Anecdotal evidence from practitioners report that the practice develops a steady mind, strong will-power and sound judgment (Light on Pranayama, 6th ed.) and also claim that sustained pranayama practice extends life and enhances perception (Asana Pranayama Mudra Bandha, 2002). Will all the far-reaching benefits to the mind and body, pranayama is something that cannot be ignored as part of a solid yoga practice and should be practiced regularly by yogis of all ages and abilities. Word count: 3000 11
  • 12. The Physiological Effects of Breathing References Apte, Vaman Shivram (1965). The Practical Sanskrit Dictionary. Delhi: Motilal Banarsi- dass Publishers. ISBN 81-208-0567-4. (fourth revised enlarged edition). Feuerstein, Georg (1998). Tantra: The Path of Ecstacy. Boston: Shambhala Publications. Mishra, Ramamurti S. (1963). The Textbook of Yoga Psychology. Monroe, New York: Baba Bhagavandas Publication Trust. ISBN 1-890964-27-1. Reprint edition, 1997. Cummins, C. Prescriptions for Pranayama. Yoga Journal. Kim KS, Lee SW, Choe MA, Yi MS, Choi S, Kwon SH. (2005). Effects of abdominal breathing training using biofeedback on stress, immune response and quality of life in patients with a mastectomy for breast cancer. Taehan Kanho Hakhoe Chi. 35(7), 1295-1303. Ando, T. and Sakurai, K. (2006). Effects of Abdominal Breathing on the Occurrence of Non-Sleep Bruxism. Prosthodontic Research Practice. 5(4), 189-194. Joung Ohn Shim, Soon Bok Chang. (2006). Effects of Abdominal Breathing on Preterm Labor Anxiety. Korean J Women Health Nurs. 12(2), 106-114 Telles, S. and Desiraju, T. (1991). Oxygen consumption during pranayamic type of very slow-rate breathing. Indian J Med Res. 94, 357-363. Telles S, Nagarathna R, Nagendra HR. (1994). Breathing through a particular nostril can alter metabolism and autonomic activities. Indian J Physiol Pharmacol. 38(2), 133-137. P. Raghuraj, A. G. Ramakrishnan , H. R. Nagendra and Shirley Telles. (1998). Effect of two selected yogic breathing techniques on heart rate variability. Indian J Physiol Pharma- col. 42(4), 467-472. Brown RP, Gerbarg PL. (2005). Sudarshan Kriya Yogic breathing in the treatment of stress, anxiety, and depression. Part II--clinical applications and guidelines. J Altern Com- plement Med. 11(4), 1-7. Howorka K., Pumprla J., Heger G., Thoma H., Opavsky J., Salinger J. (1995). Computer- ised Assessment of Autonomic Influences of Yoga Using Spectral Analysis of Heart Rate Variability. Proceedings RC IEEE-EMBS 8 14th BMESI. 12
  • 13. The Physiological Effects of Breathing Cooper S, Oborne J, Newton S, Harrison V, Thompson Coon J, Lewis S, Tattersfield A. (2004). Effect of two breathing exercises (Buteyko and pranayama) in asthma: a random- ised controlled trial. Thorax. 58(8), 674-679. Vedanthan PK, Kesavalu LN, Murthy KC, Duvall K, Hall MJ, Baker S, Nagarathna S. (1998). Clinical study of yoga techniques in university students with asthma: a controlled study. Allergy Asthma Proc. 19(1), 3-9. Bhattacharya S, Pandey US, Verma NS. (2002). Improvement in oxidative status with yo- gic breathing in young healthy males. Indian J Physiol Pharmacol. 46(3), 349-354. Jerath R, Edry JW, Barnes VA, Jerath V. (2006). Physiology of long pranayamic breath- ing: neural respiratory elements may provide a mechanism that explains how slow deep breathing shifts the autonomic nervous system. Med Hypotheses. 67(3), 566-571. Iyengar, B. K. S. Light on Pranayama, Sixth Edition, Crossroad Publishing Co. Asana Pranayama Mudra Bandha, 2002. 13