Management of Respiratory Disorders

through Yoga
Yoga has been increasingly recognized as a complementary
approach for managing respiratory disorders due to its ability to
improve lung capacity, enhance oxygenation, and promote
relaxation. Before going there lets first understand what are
some common respiratory disorders.

Disorders of the respiratory system can be

classified into four general categories:
 Obstructive conditions (e.g., emphysema, bronchitis,
asthma attacks)
 Restrictive conditions (e.g., fibrosis, sarcoidosis,
alveolar damage, pleural effusion)
 Vascular diseases (e.g., pulmonary oedema, pulmonary
embolism, pulmonary hypertension)
 Infectious, environmental and other "diseases"
(e.g., pneumonia, tuberculosis, asbestosis, particulate
pollutants)

Common sign & symptoms of respiratory

diseases-

1. Asthma- Bronchial Asthma is a disease of airway that

is characterized by increased responsiveness of the
trachea bronchial tree to a multiplicity of stimuli. It
commonly presents as paroxysmal attacks of dyspnoea,
accompanied by expiratory wheezing, resulting from
responsible narrowing of bronchi due to muscle spasm
mucosal swelling or secretion of thick mucus.

2. Chronic obstructive pulmonary disease-

COPD is a chronic inflammatory lung disease that causes
obstructed air flow from the lungs. Symptoms include
breathing difficulty, cough, mucus (sputum) production
and wheezing. It's caused by long-term exposure to
irritating gases or particulate matter, most often from
cigarette smoke. Emphysema and chronic bronchitis are
the two most common conditions that contribute to COPD.
Chronic bronchitis is inflammation of the lining of the
bronchial tubes, which carry air to and from the air sacs
(alveoli) of the lungs. It's characterized by daily cough and
mucus production.
Emphysema is a condition in which the alveoli at the end
of the
smallest air passages (bronchioles) of the lungs are
destroyed as a result of damaging exposure to cigarette
smoke and other irritating gases and particulate matter.

3. Pneumonia- It is an infection that inflames the air

sacs in one or both lungs. The air sacs may fill with fluid
or pus (purulent material), causing cough with phlegm or
pus, fever, chills, and difficulty in breathing. A variety of
organisms, including bacteria, viruses and fungi, can
cause pneumonia. Pneumonia can range in seriousness
from mild to life-threatening. It is most serious for infants
and young children, people older than age 65, and people
with health problems or weakened immune systems.

4. Tuberculosis (TB)- It is an infectious disease

usually caused by the bacterium Mycobacterium
tuberculosis (MTB). Tuberculosis generally affects the
lungs, but can also affect other parts of the body. Most
infections do not have symptoms, in which case it is
known as latent tuberculosis. About 10% of latent
infections progress to active disease which, if left
untreated, kills about half of those infected. The classic
symptoms of active TB are a chronic cough with blood-
containing sputum, fever, night sweats, and weight loss.
Common treatment modalities for
Respiratory System diseases
It can be divided into certain groups like:
1. Provide symptomatic relief either in emergency or
maintenance phase.
2. Treat the causative factor.
3. Improve the quality of life.
To fulfil the first 2 goals modern system of medicine plays
important role.
For this we use certain Anti allergic, Antitussive,
Bronchodilators, Expectorants, appropriate Antibiotics etc.
All of them have certain limitations besides causing
unwanted side effects. To fulfil the last goal Ayurveda,
Yoga and Physiotherapy along with other alternatives
plays important role. Many of them are no cost and non-
interventional measures without causing any life hazards
or side effects.
Yoga is one among them an important measure that can
contribute
lot in prevention, palliative care as well as improvement of
quality of life in patients suffering from disorders of
respiratory system. It is a system inclusive of physical and
mental training that can benefit people of all ages. The
general lifestyle involved in yoga serve as a good therapy
for respiratory problems. A healthy diet can build your
resistance against cold, allergies and environmental
causes of asthma and other chronic respiratory disorders.
It also promotes non-smoking lifestyle. According to yoga
philosophy, a calm mind produces regular breathing and a
relaxed breathing. So, breathing exercise can definitely
help people with respiratory problem. Yoga does not only
help in managing respiratory ailments but also emotional
and physical factors that causes or aggravates the
problem.
Here is a list of few basic breathing
techniques and yoga postures to deal with
respiratory ailments-
1. Yogic breathing (pranayama)

- Nadi Shodhan pranayama (Alternate nostril breathing

technique)

– Kapal Bhati pranayama (Skull shining breathing

technique)

2. Ardha Matsyendrasana (Sitting half spinal twist)

3. Setu Bandhasana (Bridge pose)

4. Bhujangasana (Cobra pose)

5. Adho Mukha Svanasana (Downward-facing dog

pose)

6. Badhakonasana (Butterfly pose)

7. Poorvottanasana (Upward plank pose)

8. Shavasana (Corpse pose)

1. Deep yogic breaths use our lungs to its

maximum capacity and also help us to learn
breathing correctly.

a) Nadi Shodhan Pranayama (Alternate nostril

breathing technique): -
Begin with this pranayama (breathing technique) to calm
your mind
and relieving the body of accumulated stress. This
breathing technique has a healing effect on many
respiratory and circulatory problems, one feels refreshed
as there is excess of oxygen supply.

Caution- Person with hypertension, cardiac ailments

should not perform kumbhaka.

b) KapalBhati pranayama (Skull shining breathing

technique) : -

Kapala means skull and bhati means light or shine. In this

kriya inhalation is passive and exhalation is forceful. This
breathing technique relaxes the mind and energizes the
nervous system. It also clears all the nadis (energy
channels) and improves blood circulation. Precautions-
one should stop the process on experience of pain or
dizziness.

Contra-indications- heart diseases, hypertension,

vertigo, epilepsy, stroke, hernia, gastric ulcer.

Indications- Asthma, bronchitis, indigestion, diabetes

mellitus.

2. Ardha Matsyendrasana (Sitting half spinal twist)

“Ardha” means half and “Matsya” means fish. The sitting

half spinal
twist opens the chest and improves the supply of oxygen
to the lungs, thereby reducing the probability of asthma
restricting you.

Contraindications- People suffering from knee, hip,

pelvic, low back or ankle pain should practice half fish
pose with caution and begin with modifications.

3. Setu Bandhasana (Bridge pose)

This asana stretches and tones the neck, spine, and chest.
The
lungs are opened up, and thyroid problems are reduced.
The opening of the chest entails an increase in the lung
capacity, and therefore, this asana greatly benefits those
suffering from asthma.

Contraindications- Migraine, shoulder injury, knee pain,

neck pain.

4. Bhujangasana (Cobra pose)

The Cobra pose expands the chest, improves blood

circulation and
is highly recommended for people with asthma. Spinal
region gets
strengthened & chest gets expanded.

Contraindications- Carpal tunnel syndrome, headache,

pregnancy, asthma, ulcers, hernia, recent abdominal
surgeries, hyperthyroid and intestinal tuberculosis.

5. Adho Mukha Svanasana (Downward-facing dog

pose)

This yoga for asthma helps in calming the mind, relieves

stress and is good for people suffering from asthma and
sinusitis. It lengthens the spine, strengthens the muscles
of the chest increasing lung capacity. It also increases
circulation to the brain

Contraindications- Carpal tunnel syndrome, diarrhoea,

pregnancy, high blood pressure or headache, heart
disease, vertigo, slip disc spine.
6. Baddhakonasana (Butterfly pose)
The Butterfly pose stimulates and improves the blood
circulation,
relieves fatigue and has therapeutic effect on asthma.

Contraindications- Groin, hip or knee injury, high blood

pressure and heart problems.

7. Purrvottanasana (Upward plank pose)

The Upward plank pose improves the respiratory system,
stimulates the thyroid gland and also strengthens wrists,
arms, back and spine.

Contraindications- High blood pressure, severe

migraine, any kind of injury at the wrists, neck and back,
heart disease, hernia, stomach ulcers.

9. Shavasana

Lying down for a few minutes in the supine position like a

dead body is shavasana. This pose brings the body in a
meditative state, rejuvenates you and also helps reduce
anxiety and pressure. A calm and relaxed body and
mindset is of essence to tackle asthma. A daily practice of
these postures and breathing techniques for 15 – 20
minutes will considerably reduce your chances of an
asthma attack and may even help you get rid of it. A few
minutes spent meditating will also enhance your
experience and help calm your mind.

Contraindications-Back injury or discomfort, pregnancy.

Physiology of pranayama-

During pranayama the mechanism of respiration is

somewhat different from the normal breathing. From
physiological point of view the mechanism of inspiration
(puraka), retention (kumbhaka) and expiration (rechaka)
is as follows-
I. Puraka phase (inspiration)- in most of the
pranayama air is inhaled slowly and deeply, so lungs
are expended considerably. In normal involuntary
inspiration when inhaled air is more then one litre,
stretch receptors of lungs are stimulated to stop the
process of inspiration, but during pranayama the
normal stretch reflex is inhibited under strong
voluntary control of cerebral cortex. The stretch
receptors are thus trained to withstand more
stretching and air can be held for a longer time with
ease. The practice of prolonged inspiration increases
the cardiac output due to increased venous return,
so the regular practice of slow and deep inhalation is
cardioprotective in nature.

II. Kumbhaka phase (breath retention)- retention

of air is done under voluntary control of cerebral
cortex by inhibiting stretch reflex mechanism. The
duration of kumbhaka is gradually increased over a
long practice of pranayama due to adaptation of
respiratory centre to higher concentration of CO2 in
blood, which produces tranquilizing effect on mind.

Contraindications of kumbhaka-

1. During kumbhaka intrapulmonary pressure rises

upto +60 mmHg, which is dangerous for the
patients with damaged lung tissues e.g.
emphysema, pneumonitis, pulmonary tuberculosis,
fibrotic lung disease.

2. During kumbhaka cardiac output is reduced, so it

is harmful for the patients of heart diseases, e.g.-
CCF, ischemic heart disease and in old age. In these
 persons, kumbhaka causes cerebral ischemia, visual
blackout, unconsciousness etc.

3. In children both lungs and heart are weak, so they

should not perform kumbhaka.

III. Rechaka phase- during expiration intrapulmonary

pressure reduces slowly, but concentration of CO2 in
blood is still increasing. The chemoreceptors are
trying to inhibit exhalation by stimulating the
respiratory. But this reflex is voluntarily control by
cerebral cortex. By the regular practice,
chemoreceptors are adapted to higher concentration
of CO2 in blood. In normal breathing for one minute,
we inhale and exhale about 7.5 litres of air, while
less quantity in pranayama, so the O2 available for
the exchange is less in pranayama than in normal
breathing, therefore it is a misunderstanding that O2
consumption is more in pranayama. Actually
pranayama is a practice to increase the duration of
kumbhaka, for this lungs are improved functionally
and body is adapted to less quantity of O2.
Some specific yogasanas for specific diseases and their
significance-
1. Asthma- Ujayeepranayama, nadishodhana,
ekpadauttanasana, tadasana, simhasana, ushtraasna,
sarvanga asana and matsyasana. It was found that one
preliminary study of yoga therapy for asthma on 46
patients data clearly shows a significant qualitative
improvement in the severity and duration of attacks;
attacks per week and decrease medication use1. 53
patients with asthma underwent training for two weeks in
an integrated set of yoga exercises, including breathing
exercises, suryanamaskar, yogasana (physical postures),
pranayama (breath slowing techniques), dhyana
 (meditation), and a devotional session, and were told to
practise these exercises for 65 minutes daily. They were
then compared with a control group of 53 patients with
asthma matched for age, sex, and type and severity of
asthma, who continued to take their usual drugs. There
was a significantly greater improvement in the group who
practised yoga in the weekly number of attacks of asthma,
scores for drug treatment, and peak flow rate. This study
shows the efficacy of yoga in the long term management
of bronchial asthma. In conclusion, the reduction in
psychological hyper-reactivity and emotional instability
achieved by yoga can reduce efferent vagal reactivity,
which has been recognisedas the mediator of the
psychosomatic factor in asthma.

2. Tuberculosis- Bhastrika, Kapalbhati, other types of

breathing practices, forward and backward bending
movements, and stretching poses may help to increase
the physical stamina of the patients.A study on yoga for
PTB showed better weight gain, symptomatic relief,
increased lung capacity and better sputum conversion
during the intensive phase of ATT3.Another study has
showed improvement in weight gain, BMI, symptoms
score, spirometric variables such as SVC; FVC; FEV1; PEF;
FEF25%; FEF50%; FEF75% and FEF25-75% with
conversion of positive to negative sputum-FME in new
sputum positive pulmonary tuberculosis. The conversion of
positive to negative sputum-FME may attribute to
increased immunity by reduced stress level because yogic
practices are known to reduce stress, which can reduce
vulnerability to infections.

3. COPD- Bhastrika, Anulomvilom, Kapalbhati, Bhramari,

Surya Namaskar, Tadasana, Sukhasana,
Paschimotanasana, Shavasana. Yoga when practiced by
patients with COPD results in improvement in their quality
of life and lung function on a short-term basis5. Through
proper breathing exercises more oxygen is available for
the exchange at tissue level, in turn muscles throughout
the body to do their job efficiently. Breathing exercises and
stretching postures are used to increase respiratory
stamina, relaxation of the chest muscles, expansion of
lungs, raising energy levels and calming the body6. The
further advantage of yogic breathing lies in the fact that it
is more of a vertical breathing. By this vertical breathing,
all the alveoli of both the lungs open up evenly. Due to the
even expansion of all the alveoli, a vast expanse of
alveolar membrane is available for exchange of gases. The
larger the surface available for the process of diffusion,
the better is the process.