Yoga and Asthma and Pranayama (yoga breathing) for Asthma Relief

Yoga and Asthma

The simple act of breathing is something most of us take for granted. Though our amazing bodies are designed to do this without any conscious thought, this is not the case for those with Asthma. I have been told that when you are having an Asthma attack it is as close to suffocating as you will get.  

I cannot think of many things more terrifying, yet for millions of Americans this is a frequent occurrence with symptoms ranging from mild to severe, and in some cases, even fatal results. This can leave even the strongest person feeling out of control, anxious and helpless.  

When I was asked to write this article “Yoga Postures for those with Asthma”, I immediately knew that I wanted to take this in the direction of what I have found effective in my classes and workshops; The practice of Pranayama, or yogic breathing. In the Indian Tradition there are 8 limbs of Hatha Yoga. One limb is Yoga the Asana or postures. Then there is Meditation which usually includes no postures. And Pranayama is yet another separate limb altogether. While there is significant emphasis on the breath in Yoga and Meditation, this is usually limited to one technique. Following in the tradition, I also teach the limbs separately. 

Pranayama, or yoga breathing, has been proven in clinical studies to help with many medical conditions. While learning to breathe properly is beneficial to every human being, for those with Asthma it is essential. The breath is the most vital process of the body, the most important aspect of life. Though you can sustain life for a few weeks without food and a few days without water, you cannot live for more than a few minutes without the breath. The breath is linked to all aspect of human experience.  

What is Pranayama 

Pranayama means the expansion of life force through breath control. Prana=life force. Yama=control, or discipline. Ayam =  expansion.  Asthma comes from the Greek word panting. In a Pranayama practice various breathing techniques are utilized that induce and enhance relaxation, concentration (Dharana), and meditation (Dhyana). 

Pranayama is about making the unconscious act of breathing, conscious. It is essential to breathe properly in order to make this process more efficient and to balance the oxygen, carbon dioxide and other soluble gas levels in the blood. Since few of us are immune to the constant stresses and strains of modern life, most of us tend to take short shallow breaths, using only a half to two thirds of our lung capacity. And asthmatics chronically over-breathe, often at a rate two to three times faster than normal which robs the cells of essential fuel versus providing more oxygen.

The more stress, pressure and emotion we experience, the more restricted the breath becomes, as the alarm bells of the sympathetic nervous system are constantly being rung. This perpetuates the cycle of stress, anxiety and shallow breathing. This in turn deprives the body of oxygen and the prana essential to its good health. It takes a lot of practice to develop the real act of consciousness necessary to maintain a healthy autonomic balance. 

Asthma is characterized by coughing, wheezing, and inflamed airways. Asthmatics always have some degree of inflammation, but experience increased swelling, mucus production, coughing, and a tightening of the smooth muscle around the airways during an attack, or flare up. As these airways close, breathing becomes shallow, fast, and difficult. The positive news is that Doctors say that is it a reversible chronic lung disease.

Armed with the information from your Doctor, do as much research as possible to find holistic alternatives and treatments to support what your Doctor prescribes. There are many suggested treatments. But as is the case with so many, especially those involving drugs, they usually treat the symptom not the problem. And the additional health risks can make the cure worse than the condition. There are also many myths regarding various treatments, so suffice it to say a proven treatment is elusive. I am no medical expert so cannot speak to this aspect. However, there are experts on breathing that have concluded that poor breathing habits could be the cause of Asthma which supports starting a Pranayama practice to assist with retraining the breath.  

How does Pranayama Work

The breath influences the activities of each and every cell. And most importantly, it is intimately linked with the performance of the brain. Human beings breathe about 7-15 times per minute, or 21,600 times per day. Respiration fuels the burning of oxygen and glucose, producing energy to power every muscular contraction, glandular secretion, and mental process.

During respiration the lungs are oxygenated when we inhale. When we exhale we expel carbon dioxide and other waste gases from the blood. This subconscious or autonomic process is known as alveoli. When our breathing is on auto pilot it is not happening in a balanced or efficient manner. All of the air from the lungs is not exhaled, so carbon dioxide remains in the lungs and the windpipe. This reduces the amount of new oxygen available for avioli. By breathing deeply and completely emptying the lungs, far less of this stale air and carbon dioxide remains in the lungs improving the effectiveness of each breath.

A regular Pranayama practice allows you to take control of your breath. This leads to effective, efficient and optimal breathing and up to fifty percent more oxygen transferred into the blood. This is extra nourishment to every muscle and cell. It also forms a bridge between the conscious, and unconscious areas of the mind which results in more  natural, relaxed rhythms of the body, and mind. Through the practice the energy trapped in neurotic, unconscious mental patterns may be released for use in more creative, and joyful activity.

Breathing and Life Span

Slow, deep and rhythmic respiration sublimates, and is stimulated by calm, content, states of the mind. When you breathe incorrectly it disrupts the rhythms of the brain. This leads to physical, emotional, and mental blocks. This in turn leads to inner conflicts, imbalances, personality disorders, destructive lifestyles and disease. By establishing regular breathing patterns through your Pranayama practice, the process is reversed, and negative cycles are broken. In yogic terms this is essential for concentration (Dharana) and meditation (Dhyana). In practical terms this leads to happier, healthier and more balanced states of mind.

In addition to influencing the quality of life, the length, or quantity of life is also dictated by the rhythm of the respiration. The ancient yogis and rishis studied nature in great detail. They noticed that animals with a slow breath rate such as pythons, elephants, and tortoises have long life spans. Where as, those with a fast breathing rate such as birds, dogs, and rabbits, live for only a few years.

From this observation they realized the importance of slow breathing for increasing the human lifespan. Those who breathe in short, quick gasps are likely to have a shorter life span than those who breathe slowly, and deeply. On the physical level, this is because the respiration is directly related to the heart. A slow breathing rate keeps the heart stronger, and better nourished, and contributes to a longer life.

Deep breathing also increases the absorption of energy by the pranamaya kosha, enhancing dynamism, vitality and general wellbeing. Pranayama establishes a healthy body by removing blockages in the pranamaya kosha, enabling an increased absorption of prana. After your practice most people experience a more relaxed tranquil state of min. Many pranayama techniques utilize kumbhaka, or breath retention, to establish control over the flow of prana, calming the mind, and controlling the thought process. Once the mind has been stilled and prana flows freely in the nadis and chakras, the doorway to the evolution of consciousness opens, leading the aspirant into higher dimensions of spiritual experience.

In The Science of Pranayama, Swami Sivananda writes, "There is an intimate connection between the breath, nerve currents, and control of the inner prana, or vital forces. Prana becomes visible on the physical plane as motion, and action, and on the mental plane as thought. Pranayama is the means by which a yogi tries to realize within his individual body, the whole cosmic nature, and attempts to attain perfection by attaining all the powers of the universe." 

The Pranayama Practice 

The practice is based on a 4 part breathing cycle which focuses on:

• Inhalation (Puraka) - controlling the intake of prana (air) keeping it smooth and efficient
• Internal retention of prana (antara kumbhaka) - controlling the retention of air within the lungs after an inhalation
• Exhalation (Recaka) - controlling the expelling of used prana and other wastes  from the lungs
• External retention (bahya kumbhaka) - controlling the retention of empty lungs after an exhalation.

This may sound simple but it isn’t. Most of us have developed such poor breathing habits that retraining and relearning efficient and effective breathing habits takes time, patience and commitment. Additionally, controlling the breath in this manner requires the use of the mind to resist the natural and automatic impulses and desires of the body to breath, particularly during the internal and external retention of the breath.

Not all Pranayama techniques focus on extending the time for each of these 4 stages of the breathing cycle. On the inhalation this could include developing a long, smooth and steady inhalation with the exhalation matching the inhalation, making sure that the lungs are completely full, or completely empty at the end of each. It also includes extending the length of time the breath is held with the lungs full and the lungs empty to increase the efficiency of the breathing cycle. It is this particular aspect I have found the most important and beneficial.

The benefits of Pranayama

Anatomical, the breathing techniques improve the strength of the diaphragm and the capacity of the lungs to improve the efficiency of the respiratory system, helping to increase fitness and increase the amount of oxygen entering the blood stream per breath. This oxygen helps to provide essential energy for muscle and brain function resulting in:

• Increased efficiency of each breath
• Increased lung capacity
• Increased flow of oxygen to all parts of the body
• Increase concentration, creativity and cognitive brain functions
• Increase relaxation and calmness by releasing tension
• Improved mind and body control, helping control emotions and relieve tension.
• Improved abdominal and diaphragm control and strength.

Specific conditions that respond to improved breath control include:

• Asthma,
• Allergies,
• High or low blood pressure,
• Stress-related heart conditions,
• Hyperactivity,
• Insomnia,
• Chronic pain,
• Some psychological conditions,
• Metabolic and endocrine imbalances.

How often should I practice Pranayama

There is no exact formula here. But like everything, practice, practice, practice is what produces results. I would like to see people spend at least 15 minutes a day focused on connecting to the breath, working with the 4 cycles of breathing. This can easily be done in the morning before you get out of bed. Or, in the evening before falling asleep, but even with 3 times a week one will see results.

Pranayama Precautions

Pranayama can actually trigger an Asthma attack due to the ongoing fight between the mind and the body around the retention of breath. It is important that Pranayama be done under the guidance of a Yoga or Pranayama Instructor that has specific knowledge, training and experience in this practice. Once you learn the proper techniques if you want to do this on your own it should not be a problem.  

Your teacher will help to establish a stable state of mind which is essential to avoid stress, anxiety and other mental imbalances that can occur when the mind and body dance this dance of ‘Who is in charge’. On a more practical level restricting oxygen flow to the brain can lead to faintness, light-headedness or dizziness. Stop the practice, relax and resume your normal breathing should this happen. If this subsides and you feel comfortable resume your Pranayama practice. Be aware of pain or more adverse affects that would require medical attention.

Before you begin your Pranayama Practice

In Pranayama we use nose breathing. This can be the most difficult part of the Pranayama practice for anyone, but especially Asthmatics who are often chronic mouth breathers, which can be the result of poor breathing. This is essential for warming, moistening and filtering the air we are bringing into the body, making it just right for sensitive airways. Nose breathing also promotes correct diaphragmatic action since it makes hyperventilation more difficult.

Being upside down can help open the nasal passages so you may want to do a forward bend. Inhale deeply through the nose and exhale as you are bending. Once you are down hang heavily. Head relaxed, arms relaxed, shoulders relaxed. Gently shake the head back and forth, up and down, synchronizing the breath with the movement. Or, grab the outer edges of the elbows but continue to hand heavily. Use the wall if you want more support, standing with your feet away from the wall as you exhale down, then tipping the weight onto the heels, letting the wall support you.

You can also face the wall inhaling up, exhaling down and once down, leaning into the wall. Find what works for you. Never force the breath. Invite the breath into the body. Take the focus to the throat and imagine you are breathing from here. Do not pull air into the nostrils, relax and flare them while the breath enters the body through the hollow of the throat.  

Decide on your practice time and don’t eat at least 1 and a half hours prior to your practice, as Pranayama is best done on an empty stomach. However, it is always good to be hydrated so drink water before, during if you must, and after your practice.

Get your mind and body ready by mentally relaxing and releasing any feelings of anxiety or expectation. Surrender any urge to push your practice. There are no goals. Accept where you are each and every moment, letting your breathe guide your practice. Stop for a few moments if you feel anxious. If this continues stop the practice completely. 

Avoid any physical restrictions by wearing loose fitting clothing that allows full expansion of your chest and abdomen.  

Choose a quiet place where you won’t be disturbed. Your bed or the floor works well so that you can lie on your back which requires less effort of the diaphragm. If you get frustrated visualize being able to breath smoothly through your nostrils and realize that you are breaking a bad habit and replacing it with a healthy one. This takes time.

There are many breathing techniques available to you. It is always a good idea to experiment to see what happens with each technique. And keep in mind that what may not work today may tomorrow. Be aware and make the effort to observe what is happening, and how it is affecting your body, and your mind.

As with anything new, patience and perseverance is the mantra of the day. Ingrained patterns are stubborn, hard to identify and even more difficult to change. Be kind and loving to your self understanding that it took years to get to where you are today, and that unlearning this will not happen overnight.

Pranayama Technique #1
Finding the Breath

I like to do this technique while lying in bed, or on the floor. Close your eyes. Put the palm of your right hand on your abdomen. Put the palm of your left hand just above your right hand. Gently bring your attention to your breath. Feel the breath enter the body through the warm passages of the nostrils. Without force, draw the breath into the abdomen and fill the hands move as the abdomen begins to expand. Continue drawing the breath up the body from the abdomen into the sternum and feel it rising. With no strain keep drawing the breath up until the collar bones expands. Retain the breath for just a moment, then begin to gently exhale from the collar bone, down to the sternum, and lastly from the abdomen as you feel each area sinking towards the bed, or floor.

Practice this several times until you begin to feel comfortable. Now you can begin to lengthen the breath. As you begin your slow inhalation into the belly, start counting, 1001, 1002, etc.. By the time you have reached the collarbone whatever this number is, use it during the retention of the breath, and on your exhalation. This is your own unique rhythm, gives you a benchmark for your practice, and keeps the mind occupied.  Initially you may only be able to count to 3 or 4. Eventually you could increase your expansion to a count of 6 or 7. With years of practice even more. Depends on where you are starting from.

Again, as you become more comfortable and relaxed you can bring in other aspects. For example: Keeping your awareness on the breath, take your focus to your belly button. Gently engage the muscles, feeling the belly button move towards the spine. As you inhale keep the belly button softly engaged. On the inhalation the breath will hit this wall forcing more air into the lower lung lobes. Continue the inhalation as before, up the body. Notice that the belly no longer inflates but the area just above, or the lower lung lobes, do. This gentle engagement of the belly button is called a Bandha, or energy lock. Try to keep it engaged throughout all the cycles of your practice.

Try to do at least 5, 10 or 15 minutes of these techniques several times a day. Be mindful of staying relaxed, aware, calm and focused on breathing smoothly, deeply, and effortlessly. Once you feel comfortable with the hands on the belly, take the hands and place them alongside the body with the palms facing up. Note any shifts or changes to your breathing.

Cautions: Never force the breath. Stay relaxed and in the present moment. Should the mind begin to wander, bring it back to the breath, reminding yourself that this is the most important thing you can be doing. Focus on filling the body with air like you would a pitcher of water. On the inhalation the breath begins just above the belly button and expands up to the collarbone. On the exhalation the breath leaves the body from the collarbone down to just above the belly button.

Be patient with yourself. Observe. Release any feelings of expectation. Do not analyze, judge or criticize. Simply observe. 

Pranayama Practice #2
Convergence of the Breath and the Body

Sit in a comfortable cross legged position. I sometimes like to practice this technique with my back against a wall for extra support. Following the same methods outlined above, bring your focus to the breath and begin your 3 part breathing (filling up the lower, middle and upper lung lobes) using the 3 cycles (inhalation, retention, exhalation). After a 5 or 6 repetitions try adding in the 4^th cycle, breath retention at the end of the exhalation. Sit quietly with your eyes closed. Hands can be laying in your lap or anywhere comfortable. Make sure you feel no strain in the neck or shoulders. Chin is parallel to the floor. Chest is lifting and expanding with each breath. But shoulders are not lifting. The crown of the head is lifting towards the sky. The shoulders are not lifting. Stay aware, stay focused. On the breath, the Bandha, where the shoulders are, any stresses or strains in the body.

Try to complete a 15 minute cycle with moving. If the body becomes a distraction ignore it as long as you aren’t in any serious pain. After 15 minutes, or sooner if you need to, while keeping the eyes closed, softly stretch the legs then refold the opposite way and continue the practice.

Retraining the breath takes time. It is a journey with no destination. There are no goals, no where you have to be. The ability to do these two basic practices is all you need, but should you wish to develop an even deeper practice it is wise to start with a strong foundation. These two techniques are a good foundation, and enough for most people.

Deb Bobier is a certified and registered (YA500 level) Yoga Instructor. She is founders of YogaBound.com, a website that focuses on Yoga and Wellbeing from a Holistic perspective. She also hosts Yoga, Meditation and Pranayama classes, workshops and retreats, Nationally and Internationally including retreats in Bali and Thailand. She designs and manufacturers her own line of Yoga Products, and Beachwear.

Debra has extensive training, more than 1000 hours, of Hatha Yoga training in the Ashtanga, and Iyengar styles of Yoga, including intensive training with prominent teachers in the US, Australia, India and other parts of the world. Her interest in Eastern philosophies and homeopathy has directed the many facets her life has taken. In addition to traveling, reading, writing and nature, her interests are in the areas of 'Wellbeing' from a holistic approach. She embraces all dimensions of healing using tools, techniques, and philosophies from Yoga, Metaphysics, Holistic Healing, as well as the strengths of Western medicine.