Yoga and Asthma

Brian Cameron

Yoga: Theory, Culture, and Practice

Yoga and Asthma: Is it an Effective Treatment?

Introduction

Yoga concentrates on the breath and the process of controlling it. The question, is this activity having a negative effect for people with breathing problems such as asthma? Exercise can trigger asthma; can the same be said about yoga? Many times yoga is linked together with other alternative and complementary treatments for sufferers of asthma. Do these treatments work more effectively than western medicine such as inhalers and steroids?

In the past two years, I have experienced asthma. I had shortened breath, which resulted in my coughing non-stop. It was extremely tough at night and I found the best thing to do was simply not focus on what my body was doing. Participating in yoga this semester, I have been paying much more attention to my breath. Yoga also focuses on controlling the breath, and holding it. I have not liked this aspect of the practice and feel that it puts strain on my lungs. Because of this I usually ignore this part of the practice and I wonder if the result is the same for others with asthma, or if this work would benefit me.

What is Asthma?

Asthma is a problem in the airways in a person. These pathways can shrink and can become inflamed, making it hard to breathe. Common side effects are: coughing, wheezing, shortness of breath, and chest tightness. It is estimated to be present in 22 million people in the United States (Gerace 2010).

Asthma can be triggered by: allergies, smoking, cold, flu, strong perfumes, cleaning products, exercise, weather, strong emotions, and certain medications. It can also appear at any age for a person, but usually it shows up in people under forty. While a person with asthma can seem normal to the naked eye, they can undergo an asthma attack. This is when symptoms dramatically increase, cutting of airflow in a person (Saxena 2009).

The west has a few medications to help sufferers with asthma. The basic ones are inhaled steroids. Inhaled corticosteroids are the one of the most common drugs. These are usually taken on a daily basis. The problem with these is that in order for the treatment to be effective, the medicine needs to constantly be taken. Depending on the case, some people may be able to get off the inhaler for a couple of months at a time, but it always reoccurs and they have to go back onto the inhaler. Beta2-agonists are a stronger type of inhaled steroid. These are the emergency inhalers that take effect in fifteen minutes or less. Shots can also be used in cases where the asthma is caused by allergies or other elemental things. These can be the weather and environment. There are risks with these medicines. Side effects include irritation in the throat, cough, adrenal suppression, reduced growth in children, and osteoporosis among others. The treatments have been very effective for those with asthma, but people become dependent on these medicines. If there were a treatment that allowed patients to get off the inhaled steroids, it would be healthier in the long run for the patients. Yoga may be helpful as it allows one to concentrate on their breath and to breath fully into their body. It makes one focus on the inhalations of the breath and could be helpful for those who breathe too short or shallow (Price 1995).

Looking at the Research of Yoga and Asthma

The research on the effects of yoga on asthma sufferers is just barely scratching the surface of it. The research that exists has mixed results (Kenchington 2002, Britton 1990). For some, yoga was proven to be an effective treatment for people with asthma (Blazek-O’Neill 2005, Anonymous 2009, Alric 2005). Other studies yielded little to no results (Coon 2003, Anderson 2003).

The studies look at various aspects when measuring effectiveness. A big importance is on the symptoms and lowering them as much as possible. For instance if one is being woken up five times a night, the quality of life is poor. Along with that, if symptoms are in the way of going to work or school, then it is impacting the person’s life. They also look at how long one can hold their breath. However, once these are under control, the focus is then control of the disease. This is looking at how to prevent asthma attacks, and prevent the need for steroids and other medicines. This is also the condition of the lungs and windpipes. Concentrating on disease control is now the focus in much of the research. That is because if you fix the symptoms of a disease you help the suffering, but you don’t heal the disease, which will later provoke long-term effects (Doddanagali 2011).

Results of Studies

The research of yoga and asthma has different results, (Coon 2003, Anderson 2003), when looking at what yoga helps with asthma. I have found that these depend heavily on the type of yoga being done. The type that has been shown to not be an effective treatment is Buteyko yoga. This technique was founded by Konstantin Buteyko of Russia. He believed that asthma was due to hyperventilation in people. By learning this technique, people learn how to decrease the frequency and depths of their breaths. Buteyko was found to be able to reduce symptoms of asthma, but wasn’t found to change bronchial responsiveness and lung function (Coon 2003, Anderson 2003).

Other research, (Kenchington 2002, Britton 1990), yielded little improvement; some would say not enough to make a difference. In these studies results showed that people seemed to stabilize, but it was far from being able to get off their prescription medications. The trouble with these types of reports is that it is not so clear how much the yoga practices have helped. Some would argue that any little bit helps, and that perhaps long exposure and practice would yield better results. The real question for me is that if there is some improvement, no matter how little, should western science simply ignore it even though some people are trying everything to get their asthma under control? I think that studies look at the long term effects of yoga. Perhaps it will help with problems encountered later on in life (Kenchington 2002, Britton 1990).

Yet other articles, (Blazek-O’Neill 2005, Anonymous 2009, Alric 2005), have results that showed that yoga was quite effective for yoga. The articles that had big results for yoga on asthma had a lot to do with the emotional triggers of asthma. Approximately 40% of people with asthma have stress triggers (Alric 2005). Anxiety, panic, and depression are also common in people with asthma and can be linked with asthma. Because of this, stress reduction plays a vital role in treating asthma. What is important to note however, is that yoga is a great stress reducer and that is the reason it has an effect on asthma (Blazek-O’Neill 2005, Anonymous 2009, Alric 2005).

There has also been a lot of research, (Blank 2011, Bijlani 2009), using yoga as a tool alongside other alternative therapies. These other therapies include: journaling, biofeedback, meditation, acupuncture, and nutritional supplements. It was interesting that some studies had two groups both using conventional medicine and one doing yoga along with that. That is interesting because yoga’s effects are not strong enough to not need the prescription medication. Yoga is only something to be done on the side in hopes of stabilizing the patient’s asthma (Blank 2011, Bijlani 2009).

How Yoga Heals

One of the most important factors that yoga brings is stress reduction. This is a key factor for those with asthma. Yoga is a great anti-stress treatment for someone. It calms people down and allows people to realize how to calm down if they are dealing with stress in their lives or panic in an asthma attack. People with chronic asthma can have an asthma attack at any time. These are triggered by things such as the environment or allergies. A trigger people can psychically control more is stress. Some people with chronic asthma have uncontrolled stress that heightens their symptoms. Learning to lower stress has yielded lowered attacks in people. Another way to think about it is once an attack begins, a person can easily panic which makes it worse. Learning how to calm down can help reduce the severity of the attack (Blank 2011, Saxena 2009, Kravitz 2007, Alric 2005).

Another key factor that yoga brings are the yoga postures. They can help open up a person’s body to better breathing positions. For someone like me who has poor posture, I know that it has an effect on my body. My posture doesn’t allow for optimum oxygen flow. Opening up the body, while difficult, can be beneficial. The studies, (Ehrlich 2010, Blazek-O’Neill 2005), showed that it was successful, but I feel something more than yoga needs to be implemented for people like me. That is because my muscles are weak and cannot support posture after a yoga session. While in the postures the airflow is optimal, afterwards my posture returns to normal. Something like weight training could be beneficial (Ehrlich 2010, Blazek-O’Neill 2005).

Since I have so much trouble with the postures, a type of yoga that may be effective for me is Iyengar Yoga. This type of yoga focuses on using aids such as cushions, blocks, blankets, belts, etc. This type of yoga thinks that because not everyone is the same, and people have weaknesses in their bodies, that using props to help them get into the right position is a good thing. It helps a lot in physical therapy as well because it helps someone move even with an injured leg or arm. In my case it would help with the weakness in my back. I believe this is important to mention because once someone gets into the optimal position, their airflow is therefore at an optimal position. This may have an effect on the breath and maybe even one’s asthma (http://iynaus.org/iyengar-yoga/bks-iyengar).

The Breath

Yoga highly focuses on the breath. So what is the breath and what are these breathing patterns in yoga? Breathing uses the diaphragm in a person’s body. When taking in breath the diaphragm fills, and empties upon exhale. What most breathing practices bring awareness to is using the diaphragm instead of other muscles in the body, such as the chest muscles. When the air goes into the body, it refreshes your blood with oxygen and you breath out carbon dioxide. An imbalance in breathing can lead to a person not getting enough oxygen in the body and especially their brain. For people with asthma, since the windpipes are smaller, not as much air can get through with each breath (Kravitz 2007).

Breathing itself is part of the autonomic system. That means it is not something you have to think about doing, your body does it on its own. When the body isn’t breathing enough, or is having too much carbon dioxide in the body, the body responds with breathing more. This tells the chemorecptors to tell the brain to increase breathing. This usually happens during exercise, but the same can be said for asthma. Kravitz says, “Rather, much of the aim of pranayama breathing is to shift or alter the balance of the autonomic nervous system away from a sympathetic (excitatory) dominance”(Kravitz 2007). It is also mentioned that the breathing techniques can alter oxygen consumption and metabolism (Kravitz 2007).

The article also talks about the different types of breathing techniques used in yoga. One is the complete yoga breath; this is when you breathe completely into the lungs. Then there is interval breathing. This is when you change the length of the inhale and exhale. This can be the type of breath to put stress upon the lungs. Among other techniques are belly breath and alternating nostril breathing. There can be dangers, especially for people with asthma, in some of the pranayama breathing techniques. That is because some of the fast breathing can cause hyperventilation (Kravitz 2007).

Barbara Benagh is a yoga teacher who believes that yoga does in fact help with asthma. Her main point is that it is vital to slow down the breath in order to relieve asthma symptoms. She believes that asthmatics are stuck in a bad behavioral pattern of breathing and this type of breathing is responsible for the asthma. I found it interesting that her site also has warnings to people to not stop taking their medications, and that the process is slow. She acknowledges that breathing exercises that could be beneficial to non-asthmatics can be detrimental to asthmatics. Her methodology is based upon the need to slow the breath in asthmatics, but this seems skeptical. That is because while short breath may tighten the windpipes, the windpipes can also become inflamed due to irritants in the air (Gerace 2010). How does deeper breathing help when it is the materials in the air that are also a problem? This is what the system leaves out in Benagh’s yoga (Benagh 2001).

Reactions to the Literature

I found the literature to be really lacking. I would think more studies would have been done, especially because yoga is so emphasized on the breath. I am surprised that in allergy and asthma offices they don’t recommend breathing exercises, but I think I know why. Yoga in the west is thought of as a mainly physical activity that pushes your body to strengthen it. This description may not be best for an extreme sufferer of asthma. Yoga can be too much for someone with severe symptoms. I think yoga breathing practices can be of benefit but you need to start at lower levels than what a regular yoga class may have.

Also I have noticed that a lot of the literature was done in India. This is important because there are different views in different countries. The West has fewer experiments with eastern medicine/practices as they focus on their scientific model of western medicine. The East is more inclined to have experiments with the yoga practices and eastern medicine that are practiced there. However are the experiments done in India less inclined to be science based? Are these experiments likely to be accepted by western scientists?

Another thing I noticed about the literature is that in one study in particular, (Emst 2000), the participants where tracked even years after the study. Most did not continue the practice of yoga. This is because of two things, the benefits from the practice are not big enough for people to continue it, and that people may get too busy to put time into the practice even if it does work for them (Emst 2000).

My Experience

I have found that yoga has not always been helpful with my asthma. I really don’t like trying to control the breath and having the exhale be twice as long as the inhale. It has been challenging, but I found that trying to control my breath when I am already having problems with my asthma was not a good idea. I’d rather simple notice the breath and watch it than to try to control it. One thing to note is that my asthma is caused specifically from allergies. This means stress reduction may not play such a big role in controlling my asthma.

Conclusion

From looking at the research on yoga and asthma, I think that the practice should be used on a case-by-case basis. Those suffering from emotional triggers should by recommended to practice yoga or another stress treatment in order to help bring that under control. Other than that, I think that there is not enough research to recommend to patients. I would like to see more research into the different types of yoga, and which forms can help people with asthma the best. I also would like to see studies that go on for longer. Perhaps yoga can have long term effects and help yoga in a way that can only be seen over a long period of time. I feel that if someone wants to try it, they are more than welcomed to add other practices and treatments to the prescription medicines to see if there is an improvement.

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