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Mazur MD, Hamner JW, Anand AN, Taylor JA. Cardiorespiratory Effects of Yogic Versus Slow Breathing in Individuals with a Spinal Cord Injury: An Exploratory Cohort Study. JOURNAL OF INTEGRATIVE AND COMPLEMENTARY MEDICINE 2024. [PMID: 38507692 DOI: 10.1089/jicm.2023.0641] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 03/22/2024]
Abstract
Background: An intricate physiological and pathophysiological connection exists between the heart and lungs, which is especially important in individuals with spinal cord injury (SCI). While an exercise intervention may seem the best approach to leverage this relationship, the prior work has shown that, despite numerous health benefits, regular exercise training does not improve cardiorespiratory control in individuals with SCI. Breath training presents an alternative intervention that is uniquely accessible, with yogic breathing directly engaging linked fluctuations in respiration and cardiovascular control. In addition, there is evidence across a range of populations that regular yogic breathing reduces cardiovascular disease risk. It is possible that the chronic decrease in breathing frequency associated with regular yogic breathing, rather than the specific yogic breathing techniques themselves, is the primary contributor to the observed risk reduction. Methods: Therefore, in 12 individuals with traumatic SCI from C4 to T8, the authors compared Unpaced and conventional 0.083 Hz (Slow) paced breathing with various yogic breathing techniques including: (1) inspiratory-expiratory breath holds (i.e., Kumbhaka or "Box Breathing"), (2) extended exhalation (1:2 duty cycle), and (3) expiratory resistance via throat constriction (i.e., Ujjayi). Beat-to-beat heart rate and blood pressure were measured as well as end-tidal CO2 and O2 saturation were measured. Statistical analysis was performed using a one-way repeated-measures analysis of variance with post hoc pairwise t tests corrected for multiple comparisons. Results: As expected, all slow breathing patterns markedly increased respiratory sinus arrhythmia (RSA) compared with Unpaced in all (n = 12) individuals. More importantly, Ujjayi breathing appeared to improve ventilatory efficiency over Unpaced breathing in individuals with SCI by increasing O2 saturation (97.6% vs. 96.1%; p = 0.042) and tended to decrease end-tidal CO2 (32 mmHg vs. 35 mmHg; p = 0.08). While other slow breathing patterns demonstrated similar effects, only Ujjayi improved RSA while increasing heart rate and improving ventilatory efficiency. Conclusions: Hence, slow breathing per se can result in important cardiorespiratory changes, but the yogic breathing practice of Ujjayi, with glottic throat resistance, may hold the greatest promise for improving cardiorespiratory control in individuals with SCI (CTR ID No. NCT05480618).
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Affiliation(s)
- Marc D Mazur
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
| | - Jason W Hamner
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
| | - Amit N Anand
- St. Elizabeth's Medical Center, Brighton, MA, USA
| | - J Andrew Taylor
- Cardiovascular Research Laboratory, Spaulding Hospital Cambridge, Cambridge, MA, USA
- Physical Medicine and Rehabilitation, Harvard Medical School, Boston, MA, USA
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Mo X, Qin Q, Wu F, Li H, Tang Y, Cheng Q, Wen Y. Effects of Breathing Meditation Training on Sustained Attention Level, Mindfulness Attention Awareness Level, and Mental State of Operating Room Nurses. Am J Health Behav 2021; 45:993-1001. [PMID: 34969411 DOI: 10.5993/ajhb.45.6.4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022]
Abstract
OBJECTIVES In this paper, we explore the effects of breathing meditation training on the sustained attention level, mindfulness attention awareness level, and mental state of nurses in the operating room. METHODS We enrolled 40 nurses from September 2019 to December 2019, and divided them into a control group (N=20) and an observation group (N=20) using a random number table. The control group received routine training, based on which the observation group received breathing meditation training. We compared their sustained attention index, fatigue score, mindfulness attention awareness score, mental state score, work stress score, career satisfaction score, and career happiness index. RESULTS After training, the sustained attention response time was shorter at 8:00 and 18:00 in the observation group than in the control group (p < .05). The physical fatigue score, mental fatigue score, reduced activity score, reduced motivation score, and overall fatigue score of the observation group were lower than those of the control group (p < .05). The observation group had a higher mindfulness attention awareness score than did the control group (p < .05). The SAS and SDS scores of the observation group were lower than those of the control group (p < .05). The work stress score of the observation group was lower than that of the control group, whereas the career satisfaction score and career happiness index were higher (p < .05). CONCLUSION Breathing meditation training can improve the sustained attention level and mindfulness attention awareness level, reduce the feeling of fatigue and work stress, help adjust the mental state, and enhance the career satisfaction and career happiness of nurses in the operating room.
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Affiliation(s)
- Xiuxian Mo
- Xiuxian Mo, Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Qixian Qin
- Qixian Qin, The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Fengji Wu
- Fengji Wu, The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Huying Li
- Huying Li, The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Yanni Tang
- Yanni Tang, Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Qingyi Cheng
- Qingyi Cheng, The First Affiliated Hospital of Guangxi University of Science and Technology, Liuzhou, Guangxi Province, China
| | - Yuping Wen
- Yuping Wen, Liuzhou Municipal Liutie Central Hospital, Liuzhou, Guangxi Province, China;,
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Anasuya B, Deepak KK, Jaryal AK, Narang R. Effect of slow breathing on autonomic tone & baroreflex sensitivity in yoga practitioners. Indian J Med Res 2021; 152:638-647. [PMID: 34145104 PMCID: PMC8224157 DOI: 10.4103/ijmr.ijmr_559_19] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Background & objectives: Slow breathing increases parasympathetic activity and baroreflex sensitivity (BRS) in healthy individuals, also similarly observed in yoga practitioners. Pranayama which is an important component of yoga when practiced at a slow pace was at a respiratory frequency of around 0.1 Hz (6 breaths/min). Therefore, it was hypothesized that yoga practitioners might have adapted to slow breathing. This study was aimed to decipher the role of yoga on cardiovascular variability during slow breathing (0.1 Hz) in yoga practitioners. Methods: A cross-sectional study was undertaken in naïve-to-yoga individuals (n=40) and yoga practitioners (n=40) with an average age of 31.08 ± 7.31 and 29.93 ± 7.57 yr, respectively. The analysis of heart rate variability, blood pressure variability (BPV) and BRS during spontaneous and slow breathing was compared between the two groups. Results: During slow breathing, the heart rate (P<0.01) was lower, respiratory rate interval (P<0.05) and pNN50 per cent (P=0.01) were higher, mean systolic BP (SBP) (P<0.05) and SDSD (Standard deviation of successive beat to beat systolic blood pressure differences) (P<0.01) of SBP variability were lower with sequence BRS (P<0.001) and α low frequency (P<0.01) and α high frequency (P<0.001) of spectral BRS were higher in yoga practitioners. Interpretation & conclusions: The present study indicated higher parasympathetic activity and BRS with lower SBP variability at rest and during slow breathing in yoga practitioners compared to naive group. Findings indicate that the short-term practice of slow breathing complements the augmented parasympathetic activity and BRS in the yoga group.
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Affiliation(s)
- Boligarla Anasuya
- Department of Physiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore Kumar Deepak
- Department of Physiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok Kumar Jaryal
- Department of Physiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India
| | - Rajiv Narang
- Department of Cardiology, Cardiothoracic Sciences Center, All India Institute of Medical Sciences, New Delhi, India
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Peyser D, Scolnick B, Hildebrandt T, Taylor JA. Heart rate variability as a biomarker for anorexia nervosa: A review. EUROPEAN EATING DISORDERS REVIEW 2020; 29:20-31. [PMID: 32975349 DOI: 10.1002/erv.2791] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Revised: 07/17/2020] [Accepted: 08/19/2020] [Indexed: 01/13/2023]
Abstract
OBJECTIVE Anorexia nervosa (AN) typically begins in early adolescence and other than weight status has few reliable biomarkers. Early diagnosis is a critical prognostic factor, but this can be clinically challenging. Heart rate variability (HRV), the beat-by-beat variance in heart rate (HR), may provide a unique assessment for the presence of AN because it has clinical utility as a biomarker of cardiac autonomic control in various populations (e.g., athletes, the aged, those with cardiovascular diseases, etc.). We present a review of the literature examining HRV in those with AN. METHOD Relevant publications were selected from PubMed using the search terms 'anorexia nervosa AND (HR OR HRV)'. Twenty papers were selected and reviewed. RESULTS The majority of studies suggest that those with AN have markedly and consistently elevated HRV compared to controls, even greater than among young athletes. However, no studies have explored HRV as a biomarker for AN. DISCUSSION Future studies on HRV should elucidate its role as a diagnostic biomarker for AN as well as its responsiveness with serial measurement to track response rates and predict relapse.
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Affiliation(s)
- Deena Peyser
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Barbara Scolnick
- Department of Psychology, Boston University, Boston, Massachusetts, USA
| | - Tom Hildebrandt
- Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - J Andrew Taylor
- Spaulding Research Institute and Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston, Massachusetts, USA
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Anasuya B, Deepak KK, Jaryal AK. Autonomic Tone and Baroreflex Sensitivity during 70° Head-up Tilt in Yoga Practitioners. Int J Yoga 2020; 13:200-206. [PMID: 33343149 PMCID: PMC7735502 DOI: 10.4103/ijoy.ijoy_29_20] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2020] [Revised: 06/05/2020] [Accepted: 06/15/2020] [Indexed: 11/29/2022] Open
Abstract
Introduction: The intervention of yoga was shown to improve the autonomic conditioning in humans evident from the enhancement of parasympathetic activity and baroreflex sensitivity (BRS). From the documented health benefits of yoga, we hypothesized that the experience of yoga may result in adaptation to the orthostatic stress due to enhanced BRS. Aim: To decipher the effects of yoga in the modulation of autonomic function during orthostatic challenge. Materials and Methods: This was a comparative study design conducted in autonomic function test lab, of the Department of Physiology, All India Institute of Medical Sciences, New Delhi, India. Heart rate variability (HRV), blood pressure variability, and BRS were analyzed on forty naïve to yoga (NY) subjects and forty yoga practitioners with an average age of 31.08 ± 7.31 years and 29.93 ± 7.57 years, respectively. All participants were healthy. Seventy degrees head up tilt (HUT) was used as an intervention to evaluate the cardiovascular variability during orthostatic challenge. Results: During HUT, the R-R interval (P = 0.042), root mean square of succesive R-R interval differences (RMSSD) (P = 0.039), standard deviation of instantaneous beat-to-beat R-R interval variability (SD1) (P = 0.039) of HRV, and sequence BRS (P = 0.017) and α low frequency of spectral BRS (P = 0.002) were higher in the yoga group. The delta decrease in RRI (P = 0.033) and BRS (P < 0.01) was higher in the yoga group than the NY group. Conclusion: The efferent vagal activity and BRS were higher in yoga practitioners. The delta change (decrease) in parasympathetic activity and BRS was higher, with relatively stable systolic blood pressure indicating an adaptive response to orthostatic challenge by the yoga practitioners compared to the NY group.
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Affiliation(s)
- Boligarla Anasuya
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Kishore K Deepak
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
| | - Ashok K Jaryal
- Department of Physiology, All India Institute of Medical Sciences, New Delhi, India
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Shinba T, Inoue T, Matsui T, Kimura KK, Itokawa M, Arai M. Changes in Heart Rate Variability after Yoga are Dependent on Heart Rate Variability at Baseline and during Yoga: A Study Showing Autonomic Normalization Effect in Yoga-Naïve and Experienced Subjects. Int J Yoga 2020; 13:160-167. [PMID: 32669772 PMCID: PMC7336948 DOI: 10.4103/ijoy.ijoy_39_19] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2019] [Revised: 10/31/2019] [Accepted: 12/12/2019] [Indexed: 12/04/2022] Open
Abstract
Background: Yoga therapy is widely applied to the maintenance of health and to treatment of various illnesses. Previous researches indicate the involvement of autonomic control in its effects, although the general agreement has not been reached regarding the acute modulation of autonomic function. Aim: The present study aimed at revealing the acute effect of yoga on the autonomic activity using heart rate variability (HRV) measurement. Methods: Twenty-seven healthy controls participated in the present study. Fifteen of them (39.5 ± 8.5 years old) were naïve and 12 (45.1 ± 7.0 years old) were experienced in yoga. Yoga skills included breath awareness, two types of asana, and two types of pranayama. HRV was measured at the baseline, during yoga, and at the resting state after yoga. Results: In both yoga-naïve and experienced participants, the changes in low-frequency (LF) component of HRV and its ratio to high-frequency (HF) component (LF/HF) after yoga were found to be correlated negatively with the baseline data. The changes in LF after yoga were also correlated with LF during yoga. The changes in HF as well as the raw HRV data after yoga were not related to the baseline HRV or the HRV during yoga. Conclusion: The results indicate that yoga leads to an increase in LF when LF is low and leads to a decrease in LF when it is high at the baseline. This normalization of LF is dependent on the autonomic modulation during yoga and may underlie the clinical effectiveness of yoga therapy both in yoga-naïve and experienced subjects.
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Affiliation(s)
- Toshikazu Shinba
- Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Shizuoka, Japan.,Department of Psychiatry, Shizuoka Saiseikai General Hospital, Shizuoka, Japan.,Healthcare Systems Engineering Laboratory, Graduate School of Systems Design, Tokyo Metropolitan University, Tokyo, Japan
| | - Tomoko Inoue
- Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Shizuoka, Japan.,Healthcare Systems Engineering Laboratory, Graduate School of Systems Design, Tokyo Metropolitan University, Tokyo, Japan.,Japan Yoga Therapy Society, Yonago, Tottori, Japan
| | - Takemi Matsui
- Healthcare Systems Engineering Laboratory, Graduate School of Systems Design, Tokyo Metropolitan University, Tokyo, Japan
| | | | - Masanari Itokawa
- Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Shizuoka, Japan
| | - Makoto Arai
- Schizophrenia Research Project, Tokyo Metropolitan Institute of Medical Science, Shizuoka, Japan
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Role of yoga in the prevention and management of various cardiovascular diseases and their risk factors: A comprehensive scientific evidence-based review. Explore (NY) 2020; 16:257-263. [DOI: 10.1016/j.explore.2020.02.007] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/12/2019] [Revised: 02/06/2020] [Accepted: 02/23/2020] [Indexed: 11/22/2022]
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Abstract
OBJECTIVE Changes in heart rate variability (HRV) associated with breathing (respiratory sinus arrhythmia) are known to be parasympathetically (vagally) mediated when the breathing rate is within the typical frequency range (9-24 breaths per minute [bpm]; high-frequency HRV). Slow yogic breathing occurs at rates below this range and increases low-frequency HRV power, which may additionally reflect a significant sympathetic component. Yogic breathing techniques are hypothesized to confer health benefits by increasing cardiac vagal control, but increases in low-frequency HRV power cannot unambiguously distinguish sympathetic from parasympathetic contributions. The aim of this study was to investigate the autonomic origins of changes in low-frequency HRV power due to slow-paced breathing. METHODS Six healthy young adults completed slow-paced breathing with a cadence derived from yogic breathing patterns. The paced breathing took place under conditions of sympathetic blockade, parasympathetic (vagal) blockade, and placebo. HRV spectral power was compared under 11 breathing rates during each session, in counterbalanced order with frequencies spanning the low-frequency range (4-9 bpm). RESULTS HRV power across the low-frequency range (4-9 bpm) was nearly eliminated (p = .016) by parasympathetic blockade (mean (SD) spectral power at breathing frequency = 4.1 (2.1)) compared with placebo (69.5 (8.1)). In contrast, spectral power during sympathetic blockade 70.2 (9.1) and placebo (69.5 (8.1)) was statistically indistinguishable (p = .671). CONCLUSIONS These findings clarify the interpretation of changes in HRV that occur during slow-paced breathing by showing that changes in low-frequency power under these conditions are almost entirely vagally mediated. Slow-paced breathing is an effective tool for cardiac vagal activation.
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Nuckowska MK, Gruszecki M, Kot J, Wolf J, Guminski W, Frydrychowski AF, Wtorek J, Narkiewicz K, Winklewski PJ. Impact of slow breathing on the blood pressure and subarachnoid space width oscillations in humans. Sci Rep 2019; 9:6232. [PMID: 30996273 PMCID: PMC6470142 DOI: 10.1038/s41598-019-42552-9] [Citation(s) in RCA: 20] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2018] [Accepted: 03/29/2019] [Indexed: 02/08/2023] Open
Abstract
The aim of the study was to assess cardiac and respiratory blood pressure (BP) and subarachnoid space (SAS) width oscillations during the resting state for slow and fast breathing and breathing against inspiratory resistance. Experiments were performed on a group of 20 healthy volunteers (8 males and 12 females; age 25.3 ± 7.9 years; BMI = 22.1 ± 3.2 kg/m2). BP and heart rate (HR) were measured using continuous finger-pulse photoplethysmography. SAS signals were recorded using an SAS monitor. Oxyhaemoglobin saturation (SaO2) and end-tidal CO2 (EtCO2) were measured using a medical monitoring system. Procedure 1 consisted of breathing spontaneously and at controlled rates of 6 breaths/minute and 6 breaths/minute with inspiratory resistance for 10 minutes. Procedure 2 consisted of breathing spontaneously and at controlled rates of 6, 12 and 18 breaths/minute for 5 minutes. Wavelet analysis with the Morlet mother wavelet was applied for delineation of BP and SAS signals cardiac and respiratory components. Slow breathing diminishes amplitude of cardiac BP and SAS oscillations. The overall increase in BP and SAS oscillations during slow breathing is driven by the respiratory component. Drop in cardiac component of BP amplitude evoked by slow-breathing may be perceived as a cardiovascular protective mechanism to avoid target organ damage. Further studies are warranted to assess long-term effects of slow breathing.
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Affiliation(s)
- Magdalena K Nuckowska
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Marcin Gruszecki
- Department of Radiology Informatics and Statistics, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland
| | - Jacek Kot
- National Centre for Hyperbaric Medicine, Institute of Maritime and Tropical Medicine, Faculty of Health Sciences, Medical University of Gdansk, Gdynia, Poland
| | - Jacek Wolf
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Wojciech Guminski
- Department of Computer Communications, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | | | - Jerzy Wtorek
- Department of Biomedical Engineering, Faculty of Electronics, Telecommunications and Informatics, Gdansk University of Technology, Gdansk, Poland
| | - Krzysztof Narkiewicz
- Department of Hypertension and Diabetology, Faculty of Medicine, Medical University of Gdansk, Gdansk, Poland
| | - Pawel J Winklewski
- Department of Human Physiology, Faculty of Health Sciences, Medical University of Gdansk, Gdansk, Poland.
- Department of Clinical Anatomy and Physiology, Faculty of Health Sciences, Pomeranian University of Slupsk, Slupsk, Poland.
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