Breathing is something we do every minute of every day, mostly without giving it a second thought. However, as a physician and a yoga teacher, I've come to appreciate the profound impact that conscious breathing, or pranayama, can have on our physical and mental well-being. In this article, I will delve into the science behind pranayama and explain how it can be a powerful tool for connecting the mind and body.

Understanding Pranayama

Pranayama is a Sanskrit word that translates roughly to the control (‘yama’) of the life force (‘prana’). In the context of yoga, it refers to breathing exercises designed to control this life force through the regulation of your breath. Although pranayama breathing can be practiced independently of yoga, it is often integrated into a yoga practice.

The Physiology of Breathing

Breathing is a complex process. It involves both the respiratory system and the nervous system, including the brain. When you inhale, your diaphragm contracts and moves downward towards the belly. This creates a vacuum that allows air to flow into your lungs. Oxygen from this air is then exchanged for carbon dioxide in the blood—a process essential for life.

The Link Between The Breath and the Nervous System

Breathing is both an involuntary and a voluntary process. In large part it is controlled by the autonomic nervous system (ANS). The ANS has two main branches: the sympathetic nervous system (SNS), which is often referred to as the ‘freeze, fight or flight’ system, and the parasympathetic nervous system (PNS), known as the ‘rest and digest’ system.

By consciously altering your breathing patterns through pranayama, you can influence your ANS.

When done mindfully, both yoga and slow pranayama have the power to shift your body's balance towards relaxation.

On the other hand, rapid breathing techniques might increase the tone of the sympathetic nervous system. Despite these differences, one study found that regular practice of several different types of pranayama seems to reduce overall feelings of stress.

Common Pranayama Techniques and Their Physical Effects

1. Deep Breathing (Diaphragmatic Breathing)

Deep, diaphragmatic breathing is sometimes called savitri pranayama or box breathing. In box breathing, you breath in, hold, exhale, and hold for a specific count. Typically, this might be three to four seconds in each phase.
This form of breath work encourages full oxygen exchange and can slow the heartbeat and lower or stabilize blood pressure, promoting relaxation.
Some people may feel uncomfortable with such intentional breathing. In that case, simply slowing down and becoming gently aware of the breath, without trying to change it, may be most helpful.

2. Nadi Shodhana (Alternate Nostril Breathing)

This technique involves slowly and mindfully alternating the breath through the nostrils. Usually that means alternating closing one nostril while breathing through the other over the course of several minutes.
Like diaphragmatic breathing, nadi shodhana is a slow practice. Traditional practitioners report that alternate nostril breathing can foster mental clarity and a calm state of mind.
There is some evidence that there is a difference in the way that left nostril breathing affects the brain compared to the right side, but medical research studies suggest that this difference is not substantial.
If you have congestion, a deviated septum, or other limitations, the physical practice of nadi shodhana might not be accessible. In that case, simply thinking about alternate nostril breathing (what is sometimes called a mental practice) can be beneficial.

3. Kapalabhati (Skull Shining Breath)

Kapalabhati is a stimulating technique that involves short, powerful exhales and passive inhales for several minutes at a time. In order to create the rapid exhales, the belly muscles are forcefully contracted. Some practitioners believe kapalabhati to be energizing.
Since this practice can mimic hyperventilation, it may cause dizziness, headache, and a rapid heart rate. If you have blood pressure problems, neurological issues, or anxiety, it’s usually best to avoid kapalabhati. And because of the abdominal effort required, it should generally not be done while pregnant.
Kapalabhati breathing tends to stimulate the sympathetic nervous system. In general, research suggests that this type of breathing practice does not have the same benefits as the slower forms of pranayama.
As a cardiologist, I find that the downsides of kapalabhati usually outweigh the possible benefits, so this is one form of pranayama that I do not recommend.

The Impact of Pranayama on Mental Health

Recent studies have shown that both yoga and pranayama can have a significant positive impact on mental health. They may reduce symptoms of anxiety, depression, and stress by influencing the production of stress hormones and increasing the release of endorphins, the body’s natural mood elevators.

Incorporating Pranayama into Your Daily Life

Practicing pranayama doesn’t require special equipment or a lot of time. Even a few minutes a day can make a significant difference. Here are some tips for getting started:

Find a quiet, comfortable space where you can sit or lie down without interruptions.
Incorporate deep breathing into your mindfulness meditation practice.
Intentionally practice pranayama breath as you flow through your yoga practice.
When faced with a stressful or challenging situation at home or work, think about taking a few moments to reconnect with your breath.

Don’t worry if you lose the flow. Returning to the practice with awareness is an important part of the process.

Pranayama Offers A Bridge Between the Mind and Body

Pranayama provides a tool that can enhance both physical and mental health. As a physician, I see pranayama not just as a part of yoga practice but as a way to bring mindfulness and presence into your daily routine. I encourage you to explore these techniques and experience the transformative power of the breath.

As always, consult with your physician before starting any new physical regimen, especially if you have any existing health concerns.

If you’ve enjoyed this article and would like to stay in touch, sign up for my email list and I’ll share periodic updates about evidence-based yoga and mindfulness practices. When you do, I’ll send you a free copy of my ebook, Prana, a photographic exploration of our shared life force energy.

The Science of Breath: A Physician Explains Pranayama