Integrating efficient breathing practices with conventional medicine is critical in improving and sustaining health and well-being. Breath has Transformative Power to enhance the quality of life. Proper breathing is a priority to strengthen the immune system, improve circulation, reduce stress, and clear the mind.
Variety of evidence-based breathing techniques that can reduce stress, tension, and burnout providing how-to instructions and demonstrations to incorporate them into professional and personal life. The course discusses the physiology of breathing and examines the art and science behind stress-relieving breathing techniques and incorporating stress relief modalities in the workplace and learning environments - Integrating Eastern Insight & Modern Medical Care
The breathing practices work through the autonomic nervous system, which is associated primarily with vagal stimulation, and the central system through the diaphragm and the phrenic nerve. The effect of breath on the central nervous system and the Autonomic nervous system is essential for regulating stress. Additional well-known impacts are nitric oxide production and vasodilation, body temperature maintenance, lymphatic flow increase, and waste disposal. In addition, proper breathing induces vagal stimulation has an anti-inflammatory effect.
Recognizing sub-optimal breathing patterns and utilizing types of breathing that promote health helps medical practitioners provide non-invasive health management methods. In addition, it can be used as a complementary therapy and as preventive medicine for health maintenance.
We will analyze this dire situation from a variety of angles, discuss problems such as poor breathing habits and comorbidities, and share breathing techniques:
"Just by paying attention to breathing, you can access new levels of health and relaxation that will benefit every area of your life." - Deepak Chopra, MD
Millions of Americans suffer from mood problems and stress-related issues like anxiety, depression, insomnia, and PTSD. Many of them take medications that have troublesome side effects, withdrawal symptoms, and disappointing success rates.
Different emotions are associated with varying breathing patterns, so changing how we breathe can change our feelings. When you follow breathing patterns associated with different emotions, you’ll begin to feel those corresponding emotions.1 Breathing changes in response to emotional states, such as sadness, happiness, anxiety, and fear. For example, increased anxiety or anger causes a higher respiratory rate, and the breathing is irregular, short, fast, and shallow. With sadness, anxiety, or rage, the body enters an arousal state. As a result, the sympathetic nervous system predominates, providing more oxygen to help fight or flee whatever's causing the disturbance.
With happiness, as when being with a loving person, smelling a rose or baking bread, the breath is slow, rhythmic, deep, and comfortable.
This indicates that something is regarded as "safe" and kicks off the associated pleasurable emotional state, slowing your heart rate and stimulating the vagus nerve. This activates the parasympathetic nervous system and helps to calm down. Conscious, long, slow, diaphragmatic breath is calming because the mind is relaxed. It is also wise to breathe slowly and intentionally and be calm before making critical decisions.
Stress is “our reaction to events, environmental or internal, that tax or exceed our adaptive resources.” Each of us has a certain repertoire of coping skills, and when they are strained or exhausted, stress usually manifests. Stress reactions consist of both physical and emotional responses.
Stress is not inherently wrong. Results from stress depend on coping mechanisms an individual chooses and uses effectively. In the face of stress, a person selects a coping response. If it is an effective mechanism, stress is reduced. If ineffective, stress is increased.
Stress is difficult to prevent entirely, and therefore we must learn to recognize it better and manage stress to improve outcomes. Over time, unresolved stress leads to burnout. Burnout syndrome is characterized by losing enthusiasm for work (emotional exhaustion), treating people inhumanely (depersonalization), and developing a sense that work is no longer meaningful (low personal accomplishment).
Various problems such as lack of self-care (sleep, exercise), work-life balance (family/parenting) can be partly resolved by appropriate breathing exercises. Proper breathing helps work-life integration, alignment of values and expectations, relationships, and social support. The psychological, neurological, and biochemical impacts of stress and trauma can be addressed by proper breathing techniques and even reversed. We can heal. In addition, demanding work and personal commitments can cause stress, mental and emotional fatigue, and physical tiredness. The incessant mental activity, overthinking, analyzing, and worrying interferes with our ability to rest or enjoy life. Proper breathing balances the nervous system and increases resilience in times of stress. Antidotes for excessive stress include exercise, meditation, yoga, laughter, sex, and playing with the kids. These calm-inducing activities help burn up excess cortisol. Increased awareness about holistic health and complementary medicine has brought modern-day medicine closer to yoga and pranayama breathing practices (see below).
Taking air in, letting it out twelve to twenty times each minute adds up to some 25,000 breaths over a day. Yet, most people are not getting the full benefit of this life-sustaining activity. Effective breathing, with awareness, helps transform health. With practice, people can reshape their breathing. Combining breathing with other wellness practices, such as yoga and meditation, enable us to live healthier lives and empower us to help patients prevent or manage disease conditions through enhanced breathing. Breath is a powerful healing tool: knowledge and management of the breath must be part of a robust wellness toolkit.
"Life isn't about waiting for the storm to pass. It's about learning how to dance in the rain." - Vivian Greene
Chronic stress is associated with a greater risk of depression, heart disease, infectious diseases, and common cold symptoms. In addition, psychological stress is associated with the body losing its ability to regulate the inflammatory response.
People breathe incorrectly for several reasons - hunched over a computer, sitting on the couch watching TV for prolonged periods. Mouth breathing causes excess air inhalation and increases stress. This over-breathing depletes the body of CO2. While CO2 is primarily thought of as waste gas, CO2 is the catalyst required for oxygen-carrying hemoglobin to release the oxygen molecules to the tissues that need it. Therefore, if there is a lower level of CO2 in the body, the blood is less efficient at oxygenating bodily tissues.
Breathing in, I calm my body & mind
Breathing out, I smile
Dwelling in the present moment, I know this is the only moment
-Thich Nhat Hanh, author, Being Peace
Amid all scientific and technological advances, it is essential to realize two paths to healing the body and mind. One relies on medicines and external aids. The other enhances the body's capacity to heal itself from within.
a) Deactivate SNS and engage PNS
b) Resonance Breathing & Respiratory Sinus Arrhythmia
"Breathe. Let go. Remind yourself that this very moment is the only one you know you have for sure." - Oprah Winfrey
Stimulate Vagus Nerve for Relaxation:
The Vagus nerve is a part of the Parasympathetic nervous system (PNS). It stretches from the brainstem down into the abdomen and is involved in heart rate control, gastrointestinal peristalsis, and sweating. When the Vagus nerve gets stimulated, the body turns into "rest and digest” mode and chills out. This causes relaxation of blood vessels, decreasing total peripheral resistance. Lengthening exhalation makes it possible to turn on the rest-and-digest (parasympathetic) nervous system—the opposite of fight-or-flight. Relaxation occurs with prolonged exhalation, leading to calmness<./p>
To optimize health and wellbeing, breathe through your nose: Slow, deep, and low. This activates the body's Vagus nerve, slows your heart rate, lowers blood pressure, and decreases cortisol, putting you on a path to better brain health.
Slow breathing helps with respiratory muscle activity, ventilation efficiency, chemoreflex and baroreflex sensitivity, heart rate variability, respiratory sinus arrhythmia, cardiorespiratory coupling, and sympathovagal balance. Enhance HR variability & baroreflex sensitivity by synchronizing inherent CV & Respiratory system arrhythmia (RSA).
Yogis knew this long ago, Science validates
Most people breathe at a rate of about two or three seconds per inhale and exhale. In Coherent breathing, the goal is to extend the length of both the inhale and exhale to around six seconds. In The Healing Power of the Breath, Dr. Richard P. Brown and Dr. Patricia L. Gerbarg provides a practical way to treat stress by proper slow breathing. Drawn from yoga, Buddhist meditation, the Chinese practice of qigong, and other sources, their science-backed methods activate communication pathways between the mind and body to impact the brain positively and calm the stress response.
CCT involves biofeedback to control heart rate variability (HRV) — the moment-to-moment change in heart rate. Cardiac coherence exercises involve inhaling for 6-seconds, then exhaling for the same amount of time (for a 12-sec respiratory cycle).
4 to 6 breaths/minute but often people breathe 3 times faster. Most people breathe at a rate of about 15 to 20 times per minute.
If the mind begins to wander, refocus on breathing and counting the length of the breaths. Stay relaxed, and do not try to force your breath. After doing this for about five minutes, gradually work up to 20 minutes. It can be practiced anywhere - in bed at night, while waiting at the doctor's office, or walking in the park. For relaxed breathing, it's better to have a longer exhale than inhale.
Coherent breathing is helpful for insomnia, anxiety, depression, stress, immune system response, alertness, concentration, vitality, post-traumatic stress disorder (PTSD), and attention deficit disorder (ADD). One study showed that gamma-aminobutyric acid (GABA) levels increased after controlled breathing; GABA is essential because of its anti-anxiety effects. Another study showed cytokines (linked to inflammation and stress) are lowered after coherent breathing. As many employees will now be set to work from home for an extended period, taking care of their mental health and learning how to deal by themselves with feeling stressed is especially important. When people get stressed, their body automatically triggers a series of different physiological changes, their hearts beat faster, breathing quicken, muscles get tenser, and some start to sweat. These changes have evolved and are called “fight or flight response,” The body goes into survival mode. So how can we deal with “fight or flight” stress-related responses?
Diaphragmatic Breathing is a deep breathing technique in which you breathe with your abdomen instead of your chest. Slow, deep ‘belly’ breathing helps reset the nervous system and, if incorporated into daily life, helps to lower the body’s response to stress.
Diaphragmatic Slow, deep ‘belly’ breathing helps regulate the autonomic nervous system by lowering heart rate, blood pressure, and the stress hormone cortisol, which helps relaxation. (see Ujjayi breathing, below)/p>
Invigorating breathing is like using the diaphragm as the second engine of life after the heart. The diaphragm’s back and forth movement also assists in digestion and food transit; its pump effect helps venous circulation. Abdominal breathing is a youthful breath, ensuring health and stability. It is the natural breathing of babies!/p>
"Where the breath goes, so the mind goes, and vice versa. We must lasso our breath to keep our mind still." - Thebreathproject.org
Ancient doctrines from India, well over 2000 years ago, describe controlled breathing methods to influence body, mind, and spirit. For example, Pranayama means the ability to expand or stretch our life force (prana) by controlling our breath. Prana means vital force, energy, or internal breath that flows through the body. Breath is a gross manifestation of this cosmic/universal life force that keeps us alive. 'Ayama' means control/restraint and to stretch/elongate/expand.
The Chinese call this energy Qi, or Chi, pronounced chee. Chi is present in every cell, throughout our mind, body, and soul. Chi energy flows in every living creature. It flows through charted meridians in acupuncture.
Breathing, Pran Tatva is essential for all living forms. Several breathing techniques are used to allay apprehension and restore tranquility. In the 1970s, Swami Rama was a consultant in a research project investigating the voluntary control of the so-called involuntary muscles like the heart and lungs at the Menninger Foundation, Topeka, KS. Swami Rama applied his expertise to link body and mind through an understanding of the breath. With increased awareness and control of the subtle aspects of breathing, he could effectuate physical and psychological changes to master the mind’s roaming tendencies.
Alternate nostril breathing is a diaphragmatic breathing practice called Anulom Vilom, or Nadi Shuddhi. (Nadi means a pathway of energy, Shuddhi means purification) Our bodies often favor one nostril over the other. Alternate nostril breathing involves closing the right nostril with the right thumb and inhaling deeply through the left. Close off the left nostril with the ring finger at the inhalation peak, then exhale through the right nostril. Breathing in and out should be done, with a soft sound, gently and without any force. Anulom Vilom can be done along with deep breathing following inhalation (4 counts), retention (7 counts), and exhalation (8 counts) to experience more relaxation and calming. (i.e., Exhale twice as long as inhale.)
This technique is employed in various Yoga and Taoist practices, often used to support yoga postures, especially in the Vinyasa yoga, helping to calm the mind and warm the body. Vinyasa means “breath for movement,” ideally keeping both the breath and movement in sync during the yoga practice. Ujjayi means to conquer or be victorious over the mind. Ujjayi’s sound helps to synchronize movements and breathing. The “ocean” sound can soothe, energize, and relax body, mind, and spirit.
To perform Ujjayi Breathing:
Length & speed of breath is controlled by the diaphragm. A slight hissing sound is made while slightly contracting the throat and breathing through the nose.
Bhamra=bee. Mentally visualize that the humming sound travels to every part of the body. This breathing practice soothes the nervous system because of increased parasympathetic activity. Prolonged humming increases endogenous nasal nitric oxide production by 15-fold compared with quiet exhalation. Oscillating airflow vibrations produced by humming enhances sinus ventilation and generates nitric oxide. This decreases the risk of sinusitis in patients susceptible to upper airway infection. Nitric oxide has bactericidal, virucidal, and antifungal properties. Humming Bee breathing with Om sound and slow chanting is appropriate before bedtime. Helps to calm the mind, opens sinuses, de-stress and eliminates toxins.
To perform Bhramari Pranayama:
Practical guided meditations, breathing exercises, relaxation techniques, and self-hypnosis help calm the mind and relax the body in preparation for sleep.
To perform effective breathing for relaxation & sleep:
Daytime vs. Night-Time Breathing: By practicing breathing at the correct rate, rhythm, and volume during the day, it is possible to boost energy levels for the daytime. Then, reset to deliver quieter, softer, and more regular breathing at night. The goal is to get deep, peaceful sleep, fully relaxed for physical and mental rest.
"Without full awareness of breathing, there can be no meditative stability and understanding." - Thich Nhat Hanh
The contemporary forms of mindfulness meditation emphasize breathing-based exercises.
Benefits of Mindful Breathing and Meditation:
"Feelings come and go, like clouds in a windy sky. Conscious breathing is my anchor. If you want to conquer the anxiety of life, live in the moment, live in the now." - Thich Nhat Hanh
Meditation is a relaxed state of consciousness, not doing anything. Think about Reassuring Thoughts While Breathing: With each breath, think soothing thoughts (I am inhaling calm). Imagine expelling your fears and worries (I am exhaling stress). Progressive muscle relaxation, Yoga helps with Hypo-metabolic state.
Meditation is for mental hygiene, just like dental and body hygiene. The external dimensions of life can bring comfort and convenience. But the inner dimension can bring fulfillment.
Introspection-meditation is to contemplate, go inside. Insight, not excite. Physiological changes noted with meditation include:
"Changing your breathing patterns can affect and improve you mentally, emotionally, and physically." - Andrew Weil, M.D.
Breath awareness means being aware and observing breath’s qualities, whether long or short, smooth or uneven, deep or shallow, easy or labored. Awareness of breath, synchronizing breath to movement, is an integral part of yoga – more so than other forms of exercise and gymnastics. So, incorporate conscious breath into daily life situations, especially when feeling stressed or tired at work, home, or school. Focusing on slow inhales and prolonged exhales to calmness and relaxation. Integrating a positive resolve or mantra during yoga sessions helps the breathing process. This can be a single word or phrase. So, during inhalation, gather up the stress and worries; during exhalation, visualize tension flowing out of the entire body.
Proper breathing involves observing the flow of breath and respiratory movements. Being aware of each inhalation and exhalation helps focus attention. It is essential to feel the sensations as the air passes through the nose, throat, expanding abdomen like a balloon. When thoughts drift (which is natural), redirecting attention to the breath is helpful.
Breathe light to breathe right mile. A healthy mind has an easy breath.
Slow Breathing, Benefits:
A proper slow, diaphragmatic breath is an integral part of any workout. In addition, the physiological effects of slow breathing help respiratory, cardiovascular, cardiorespiratory, and autonomic nervous systems. This includes ventilation efficiency, chemoreflex and baroreflex sensitivity, heart rate variability, blood flow dynamics, respiratory sinus arrhythmia, cardiorespiratory coupling, and sympatho-vagal balance.
Slow breathing enhances HR variability & baroreflex sensitivity by synchronizing inherent CV & Respiratory system arrhythmia (RSA.) Slow breathing techniques activate the hypothalamus connected to the pituitary gland that sends out neurohormones that inhibit stress-producing hormones and trigger a relaxation response in the body.
Breath is the bridge that connects life to consciousness, which unites your body to your thoughts. So, whenever your mind becomes scattered, use your breath as the means to retake hold of your mind - Thich Nhat Hanh.
Conscious breathing aids in leveraging one’s mind, body, and emotional health. Reshaping one’s breathing habits will transform health and well-being. Breath awareness creates a calm, relaxed, alert, and creative state that is subconsciously communicated to those around us. Conscious breathing is an umbrella term for medical and therapeutic methods to improve breathing function. The behavioral or voluntary control of breathing is in the brain’s cortex. It describes that aspect of breathing with conscious control, such as a self-initiated change in breathing before a vigorous exertion or effort. However, unconscious breathing is controlled by the medulla oblongata in the brain stem, the older part of the brain. Conscious breathing affects neurological programming through a state of intentional awareness, affecting individuals biologically, emotionally, and physically in a positive way. Mindful breathing techniques are effectively used by mountain climbers and divers, Olympic athletes, Zen archers, musicians, performing artists, and healing professionals from every discipline.
Benefits of Conscious Breathing:
Studies show that regulation of breathing can impact the mind and body. Breath is fundamental to yoga practice, intrinsic to vitality, and creating mind-body transformation. Where the breath goes, so the mind goes, and vice versa. We must lasso the breath and rein it in to keep the mind still. Most people know the concept of stopping and counting to 10 before speaking when stressed. What is equally important is what occurs during that “time out.”
Introduce imagery suggestive of the R-State (Relaxed Breathing with Stretching.) For example, inhale when stretching arms to the sky, imagining a tree with branches reaching high into the sky. Exhale while gradually bowing down and touching the floor. End imagery by imagining a warm, relaxing pond of water, feeling the warmth and heaviness.
"Keep coming back to your breath. Just take a moment. This will give your mind steadiness and your breath gracefulness. There’s so much to let go of. Your nostalgia and your regrets. Your fantasies and your fears. What you think you want instead of what is happening right now. Breathe.." - Rodney Yee, Yoga: The Poetry of the Body
Breath influences physiological factors (primarily by stimulating the parasympathetic nervous system) and psychological factors (diverting attention from thoughts). It helps to induce relaxation, reduce stress, control emotion, prevent insomnia and chronic illnesses.
Learn to breathe intentionally and increase awareness of the body and mind. Focus on breathing with a sense of gratitude. The goal for Meditation and Breathing is to create a sense of space between you and your stress. It is the perfect way to wind down after a long day and welcome a night of deep, restorative sleep. graces we have received.
Let’s express gratitude for the air we breathe, with a song in our heart, a spring in our step. Chanting mantras, humming and bhramari are motivating and stress-relieving. Then, when things get tough, optimize breathing and adopt a gratitude hand-washing ritual, thinking of 10 things to be grateful for — one for every finger washed.
Although breathing is an essential biological function of an inherently intuitive nature, most people do not comprehend the full benefits of proper breathing. Pervasive faulty breathing habits that erode our health are:
By identifying dysfunctional breathing habits, we can systematically replace them with healthy breathing patterns mitigating some of these comorbidities.
Better Health with Each Breath : Proper Breathing is the Gateway to our Wellbeing
Proper breathing starts with gentle inhalation through the nose as the diaphragm contracts and the belly expands for air to flow into the lungs. This improves lung sac capacity.
Nose breathing provides a myriad of crucial benefits:
4-7-8 Breathing for Relaxation and Optimal Health:
When you are sad, stressed, or scared, you can sit, stand, or lie down to inflate and deflate the abdomen like a balloon. This breathing practice activates the parasympathetic nervous system while reducing anxiety and anger responses.
*Inhale for 4 seconds through the nose. Hold for 7 seconds. Exhale for 8 seconds by breathing out as if breathing through a thin straw.
Prolong the exhale, letting out air with a “whoosh” sound. Repeat for a few minutes to allow a buildup of carbon dioxide, which calms the nervous system. Breath-holding helps to increase lung capacity. If you feel agitated or stressed, lengthen your exhales.
Alternate Nostril Breathing:
Alternate nostril breathing is a diaphragmatic practice called Anulom Vilom (Anu means with, Loma means the grain or natural). This technique helps cleanse your breathing channels, referred to as Nadi Shuddhi (Nadi means energy pathway, Shuddhi means purification).
*Close the right nostril with your right thumb and inhale deeply through the left. At the peak of the inhalation, close off the left nostril with the ring finger and retain the breath. Then exhale through the right nostril. Keeping the left nostril closed, inhale deeply through the right. Close off the right nostril with your right thumb and retain the breath at the peak of the inhalation. Then exhale through the left nostril. Breathing in and out should be done gently without any force.
To experience more relaxing and calming, you can follow the ratio of inhalation (4 counts), retention (7 counts), and exhalation (8 counts).
Benefits of Anulom Vilom include:
Bhramari Pranayama / Humming Bee Breath
Bhramri means bee. This technique involves making a high-pitched humming sound in the throat during inhalation followed by a low-pitched humming sound during exhalation. Throughout this entire process, the lips are closed, and the ears remain closed with the fingers. This gently vibrates the tongue and sinuses, increasing parasympathetic activity, which helps relieve stress, agitation, and anger. The acoustic vibrations calm your body and mind, especially before meditation or sleep.
Ujjayi /Ocean/Victory Breathing
Victory Breathing means to conquer or be victorious over the mind. It assists in synchronizing your movements along with your breath.
*By gently contracting your throat while nose breathing, a slight hissing sound is made in the throat. The resulting “ocean” sound and vibrations help to soothe, energize, and relax your body, mind, and emotions. The vagal stimulation also helps to relieve stress, build stamina, and increase endurance.
Slow, nasal diaphragmatic breathing at a rate of about 4 to 7 breaths per minute helps to lower stress by sending impulses to the brain to calm down and relax. This is the breathing rate that Hindu/Buddhist monks and yogis naturally enter while meditating (however, even at rest, most people breathe more than 15 times per minute).
Resonance breathing supports the innate ability of our body, nervous system, and emotions to restore themselves by balancing the complementary branches of our autonomic nervous system. It promotes a calming balance between the sympathetic (which moves us towards activity like fight or flight) and the parasympathetic (which moves towards rest, repair-heal, regenerate, resilience, rejuvenate, and digest). Increased tone of the vagus nerve helps lower blood pressure, anxiety, and depression. It also improves heart rate variability (HRV) and helps with physiological and emotional balance.
Kapalbhati breathing or Skull Shining Breath (also called the breath of fire)
This technique involves taking short explosive exhalations generated by powerful contractions of the lower belly. It thus helps push air out of the lungs and strengthens the diaphragm and abdominal muscles. The focus is on forceful exhalation with contraction of the abdomen, followed by passive inhalation and effortless abdomen release.
Pursed Lips Breathing
This breathing technique is designed to enhance your breathing by making your breaths slower and more intentional. A slower breathing rate helps to relieve shortness of breath (dyspnea).
*Breathe in, through the nose, as if you are smelling a rose for two seconds and then exhale as if you are blowing out a candle for four seconds through pursed lips.
Breathing & Coughing Relieves Excess Chest Secretions in Prone position
Prone positioning (face down on the abdomen) can be easily implemented. Lying prone can improve breathing comfort and get more oxygen into the body. The higher density of pulmonary vessels in the dorsal (back part) lung region improves ventilation and helps open up these partially deflated areas.
It also relieves pressure on the heart and the diaphragm, helping the forced cough be more effective. It helps to remove mucus buildup in the lungs. Excess mucus can block the ability to breathe and increase infection vulnerability. Self‐proning and alternating positioning in a semi-propped position with assistance improves breathlessness. Additionally, using pillows or rolled towels increases comfort and relieves pressure on the bones.
*In prone or child-pose (balasana) follow the "rule of threes"— Inhale normally, exhale completely, and then hold for three seconds. Repeat three times. Then cough forcibly three times. Repeat the entire process three times.
Proper Breathing Enhances Almost Every Aspect of Our Life:
Improve lifestyle of people with an emphasis on healthy breathing habits.
Although breathing is intuitive, many of us do not pay attention to the way we breathe. Chronic stress, sedentary lifestyles, and an unhealthy diet lead to adverse respiratory conditions. Complementary, holistic approaches are of paramount importance for optimum health and wellbeing. The breathing methods and behavioral strategies outlined should be introduced in our educational systems, societal institutions, occupational settings, and workplaces. Improving health and resilience of individuals will develop healthy individuals with the ability to confront various illnesses.
- Nick Nipan Shroff, MD, ERYT