Monday, December 13, 2010

Yoga Therapy and Breath Control in the Prevention of Asthma Attacks

By Roxanna Minor


Imagine that you’ve just sprinted down a few blocks to catch a bus. You missed it by a few seconds, you stop running, and stand by the curb, slightly hunched over, panting. Your heart is racing because of the exertion and currently, it is trying to bring your oxygen levels back to equilibrium. Instead of feeling that slight ease when you regain your breath, you continue to breath heavily, drawing in as much air as you can with each breath. Breathing out seems impossible at this point; it almost burns when you try. You’re stuck in this cyclic hyperventilation, unable to speak or make a sound. For me, this is what an asthma attack feels like; something that I experience at least a few times a month.

Asthma is known as an incurable disease that causes the sufferer to slowly asphyxiate due to their bronchioles closing up when exposed to allergens. More than 20 million people in the United States and 300 million in the world have asthma (National Heart Blood and Lung Institute, 2007). In Western culture, exercise is seen as a practice that is of great importance to help prevent disease, manage weight, and improve quality of life, which is the general well-being of an individual in society (Tecco, 1999). Since one of the main triggers of asthma is physical exertion, most asthmatics are overweight, depressed, and cannot get the exercise they need (American Lung Association, 2009). Research has shown that yoga is better suited for asthmatics as an exercise plan because the movements are slower and less strenuous than other forms of working out (Ellis, 2010). This research is presented as a personal guidance for asthmatics as well as a means to expose research that expounds alternative methods of maintaining a healthy and happy lifestyle. Yoga therapy and breath control are important for asthmatics to maintain a symptom-free lifestyle.

Asthma is closely related to a low quality of life, which involves complications with social, emotional, physical, and occupational aspects in everyday life. (Juniper, Guyatt, Ferrie, & Griffith, 2003; Sundberg, Palmqvist, Tunsäter, & Torén, 2009). There are no known causes, although research has led to a theory that our hygienic and sanitary western lifestyle may increase the chances for a child to develop asthma because they are not subjected to infections in early childhood, which affects the way their immune system develops (National Heart Blood and Lung Institute, 2007). There are many known triggers for asthma, including but not limited to: dust mites, pollen, household cleaners, pet dander, cigarette smoke, and pollution (National Heart Blood and Lung Institute, 2007; Planinz, 2010; Singh, 2006). Asthma is controlled through careful planning and medication; asthmatics are prescribed a quick-relief medicine for an immediate relief of symptoms and a long-term control medicine to reduce inflammation of the bronchioles. Although there has been a significant amount of research on this topic, treatment for it has not progressed and there is still no ‘known’ cure.

A Bit of Personal History

Having had asthma since the age of four, I am avidly interested in alternative treatments for respiratory illness. I have taken a wide range of medications that are supposed to help control my asthma. The medications that I take daily are Abuterol, which is my rescue inhaler, and a Long-Acting Beta-2 Agonist, Advair Diskus. The Advair acts to “help prevent symptoms.” My chronic and unstable asthma calls for high doses of each, giving me side effects such as nervousness, sleeplessness, nausea, and, right after taking a dose, tremors. I visit the hospital more frequently than any asthmatic should. When I arrive, I am given doses through a nebulizer every two hours and if it is severe enough, an adrenaline shot. I live with the fear in the back of my mind that I may one day die from this illness.

When I had my first attack in preschool, I was hospitalized for almost three months. My pediatrician informed my parents about the dangers of airborne allergens, dust mites, and pet dander. When I was released from the ICU, my parents donated every stuffed animal my brother and I had and cleaned the apartment thoroughly every two or three days. I was prescribed the Abuterol inhaler, the nebulizer, and Prednisone, which is a corticosteroid that is an anti-inflammatory. I took the inhaler about 6-10 times daily, the nebulizer once or twice, and Prednisone twice daily. Because Prednisone is a steroid, I gradually began to have mood swings and insomnia.

Although I was being treated for my asthma, I continued to have frequent attacks. The nurses at the hospital began to suppose that my parents were abusive because I was under a great deal of stress.

Overtime, my attacks became less frequent, but the severity was constant. I began to sleep through the attacks I had at night because I hated the hospital so much. My doctor and I have stopped talking about ways to lessen my medication and treat my illness. I have made no progress other than infrequent attacks. My last serious one occurred this past September when I came down with Bronchitis. Having an attack is like breathing through a small straw, except you cannot just make it disappear. Personally, I will not accept that I cannot do anything else to keep the attacks to a minimum.

the effects of yoga and breath retention

My knowledge of asthma is based upon what my doctor has shared with me: It is a chronic disease with no cure. Once someone develops asthma, he or she is likely to have it for life. Even if I do not feel any symptoms of asthma, my bronchioles are still inflamed constantly and an attack can flare up at any time. I need to take control of it through constant attention to how I am feeling and use of my medication. Not doing so can cause a trip to the Emergency Room. I must stay away from what triggers my asthma. I may have a chance to improve the frequency of the attacks, but that is solely through the constant use of medication.

I was not taught any alternative way for managing my asthma except for a practice called “Belly Breathing” or “Abdominal Breathing” (Rakel & Saunders, 2003). I was taught that once I start feeling some chest tightness, I was to be calm and lay down. I then had to place one hand on my abdomen and another on my chest. While I tried to breathe slowly and deeply, I had to focus on moving only the hand on my abdomen, insuring I was not taking shallow breaths. This breathing practice helped me a number of times when I started feeling anxious and began wheezing or breathing erratically. What I did not learn was that this is a breathing technique similar to the pranayama practice in yoga.

Recent research has deduced that yoga improves asthmatics’ exercise tolerance, histamine tolerance, and quality of life (Adhyatmananda, 2001; American College of Sports Medicine, 2009; Benagh, 2001; Gardner, 2009; Gutfeld, Meyers, & Sangiorgio, 1991; Manocha, Marks, Kenchington, Peters, & Salome, 2002; Nagarathna & Nagendra, 1985; Planinz, 2010; Saffron, 1998; Singh, 2006). Unfortunately, the reason why yoga improves these tolerances as well as quality of life is not fully explained in some research studies. Others point out that the practice of controlled breathing creates a significant drop in resting heart rate and sympathetic reactivity, which is caused by the relaxation of the muscles involved with breathing (Adhyatmananda, 2001; Benagh, 2001; Planinz, 2010; Saffron, 1998; Singh, 2006). These specific sources also point out that asthma is a reversible ailment, not a permanent disease.

The Role of the Breath

Breathing is a natural and involuntary bodily function. It is “a process of maximum efficiency with minimum effort” (Singh, 2006, p. 1). It is controlled by the autonomic nervous system, which is broken down into two sections: parasympathetic and sympathetic systems. The parasympathetic branch directs the resting functions of the body while the sympathetic branch controls the “fight or flight” response (Singh, 2006). If the danger is tangible, the excess adrenaline is used, if not, hyperventilation and anxiety ensues.

This hyperventilation, also known as overbreathing, becomes habitual for asthmatics, making them breathe in for much longer than they breathe out (Neves, 2010). The idea of overbreathing is believed to be the root cause of asthma in research presented by Professor Konstantin Buteyko (Benagh, 2001; Lum 1975; Neves, 2010; Planinz, 2010; Rees-Evans, 2010; Saffron, 1998; Singh, 2006). In his investigation, Buteyko linked hyperventilation to several chronic conditions and sought out to develop a technique to normalize breathing patterns (Reese-Evans, 2010). He created the “Buteyko Breathing Process” to reverse asthma symptoms and lessen the need for medication. A brochure describing the effects of hyperventilation and Buteyko’s research states:

You have asthma because you have been habitually overbreathing more air than

your body requires… Every part of your body, every organ and every system is

affected by over breathing. This disorder has been given many names, but

Chronic Hyperventilation Syndrome (CHVS) describes best the huge complex of

symptoms to which it gives rise (Neves, 2010, p. 3).

His research also describes that overbreathing does not produce more oxygen; it instead flushes carbon dioxide, which is essential for the proper oxygenation of the body’s organs As a result, cells receive less oxygen, causing shortness of breath and panting (Neves, 2010; Rees-Evans, 2010; Lum, 1975; Singh, 2006). This causes a severe biochemical disturbance, creating a malfunctioning immune system that gives rise to an allergic response (Neves, 2010).

Hyperventilation is caused by the same sympathetic branch response that I have discussed earlier. The stress that causes the fight or flight response can create habitual hyperventilation which can result in a chronic shortage of carbon dioxide, producing a long-term inflammation of bronchioles.

Barbara Benagh is a yoga instructor who is currently located in Massachusetts discovered this for herself through her own struggles with asthma. She states, “If the way I breathe was causing my asthma, then retaining my breath might alleviate my problems” (Benagh, 2000). Her experiences with pranayama helped her achieve breath retention. Through some experimentation, she found a handful of exercises that worked and created her own breath retention program.

Physical and Mental Harmony

I have found that I subconsciously hold my breath during the day and over breathe. It is difficult for me to fully exhale, so my inhalations are twice as long as my exhalations. I have not fully grasped the ability to control the way I breathe, but I am attending yoga class twice a week and making a conscious effort to lengthen my exhalations for 15 minutes a day. Whenever I practice and slow my breathing and mind, I feel a sense of relaxation and calmness. This definitely contributes to my lower levels of anxiety and stress.

Yoga’s psychological and physical effect on the mind and body has long been used as a treatment in western culture, even though ‘traditional’ yoga was not developed as a system of therapy (Singh, 2006). Hatha yoga, according to Saraswati Muktibodhananda, is “the science of physical and mental harmony” (Muktibodhananda, S., Saraswati S., & Svātmārāma, 1998, p. 19). Without this harmony, human beings suffer from “psychic and mental diseases” (Muktibodhananda, S., Saraswati S., & Svātmārāma, 1998, p. 19). Controlling the breath means controlling the fluctuations of thought. Through this practice, stress levels are kept at a minimum.

In other eastern texts, such as The Spiritual Roots of Yoga, it is clear that breathing plays an important role in maintaining equilibrium in physical and mental health. This text specifically states, “The quality of breathing in a person is intimately and directly connected with the inner state, as apparent from even a superficial observation of oneself” (Ravindra, R. & Priscilla M., 2006, p. 10). Even the Yoga Sutras of Patanjali suggest that disharmony of breath is linked to a disharmony in mentality. He describes that obstacles such as physical illness, doubt, laziness, etc are connected to mental and physical pain, sadness and frustration, unsteadiness of the body and irregularity of breath (Hartranft, C., 2003).


Bio-medical research is beginning to touch upon the healing affects of yoga and breath control. Despite what I have researched and learned for myself, it is not a common practice for pediatricians or doctors to immediately suggest alternative means of treatment for asthma. They instead prescribe medications to alleviate the symptoms of an ailment. Research has found that rescue inhalers and corticosteroids do not fully assist in the treatment and prevention of asthma (Benagh, 2000; Reuters, 2010; Singh 2006). Unfortunately, there is no other medicinal assistance available.

The fact that breathing is an automatic function makes it an act that is taken for granted. Western culture is so heavily filled with distractions that the breath is forgotten most of the time, unlike Eastern cultures who make conscious breathing a part of their lives and have done so since ancient times. This disregard contributes to an asthmatic’s Chronic Hyperventilation Syndrome. Training the breath to return to a normal state has been proven to help alleviate symptoms and greatly lesson the amount of asthma attacks. Consequently, breath control and yoga therapy can be used to reverse inflammation in bronchioles, lessen the need for medication, and improve quality of life. With proper research and testing, breath retention practices can lead to a natural treatment of asthma devoid of side effects.


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  1. Since the beginning of the semester I was wondering how yoga could be used to treat asthma. I remember reading in the Hatha Yoga Pradipika that people with asthma have seen improvements in their symptoms when they practice regularly. However, the text did not provide any scientific support or explanation as to how asthma symptoms could be improved. From what I had read the rest of the semester, I assumed that the controlled breathing patterns in yoga helped the symptoms. Still, I needed more evidence have been wondering about exactly how yoga can assist asthma and what exercises have been most helpful. It was great to read about how you have personally dealt with asthma throughout your life and how you are using what you have learned in class (and yoga classes outside school) to find alternative treatments for your asthma. Personally, I can not imagine what you have gone through since the age of four. However, I can relate in your search to find an alternative treatment, I have suffered from chronic headaches since fourth grade and have tried every medication possible (I have allergies to certain medications). I wish you the best in your search.

  2. Yoga is one form of physical exercise that millions of people all over the world are taking to with lots of interest. Its popularity is growing at tremendous speed and more people are being influenced into practicing it. The most common form of yoga is Hatha Yoga. This form of yoga involves breathing exercises and physical exercises which involve doing postures. Doing dahn yoga makes a person gain strength, stamina, vitality and become flexible. The blood flow throughout the body also improves to a great extent.