Breathing is fundamental to being alive. It’s something we do between 17,000-30,000 times per day – or more! From a yogic perspective, breathing is a central aspect of our whole being. It’s tied to physiology and the health of the musculoskeletal system. It’s deeply related to psychological and emotional states and even spiritual health.

Asthma is a lung disease that makes breathing difficult for millions of people worldwide. Yoga is invaluable as an effective method of helping those living with asthma bring more awareness to how they breathe, learn more efficient ways to breathe, transform the stress related to living with the disease, and most importantly improve their quality of life. Asthma is a chronic inflammatory disorder where airways become repeatedly obstructed due to narrowing, swelling, and increased mucus production. It is not well understood why some people get asthma while others do not, but it is likely a combination of environmental, genetic, and behavioral factors. The attack is initiated by an immune response to a unique combination of triggers, such as environmental allergens, cold weather, dry air, air pollutants, exercise, certain medications, some sulfites and food preservatives, or respiratory infection. Less acknowledged, but valid in my experience, is that strong emotions or stress may also trigger an attack. Once elicited, an attack causes chest pain, coughing, wheezing, shortness of breath, and an array of unfavorable emotions such as anxiety, panic, and helplessness. They feel like they cannot get air into the lungs and it’s a struggle to “catch their breath.” For some, asthma is a seasonal minor issue and for others it is life threatening.

Asthma impacts lifestyle. For example, it may impact work tolerance, willingness to participate in family or social activities, or decrease interest in exercise. These effects may reduce overall wellbeing and physical condition which can unfortunately increase the likelihood of an asthma attack. It’s important to keep asthma well controlled so that fitness is not sacrificed. Exercise has many benefits, but a few important ones for the asthma sufferer are:

1) keeps the lungs strong which promotes good stamina and decreases breathlessness with activity

2) boosts the immune system

3) releases ‘feel good’ chemicals that help lift and keep mood stable.

Medical management addresses treatment of acute attacks and control of chronic symptoms. The most common treatments include prescription inhalers and pills that help prevent or treat the symptoms by opening the airways and reducing inflammation. These meds may be hard to obtain for low income patients and often have adverse side effects. Top notch care will include frequent reassessment of the patient so medications can be modified or reduced as good control of symptoms is achieved. In addition to educating the patient, clinical providers also try to educate the family and empower the pediatric patient to communicate symptom changes to the school nurse for immediate support.

Unfortunately, this is not always enough and patients are forced to seek urgent medical care for acute attacks. To understand the significance uncontrolled asthma symptoms have on the healthcare system consider that the CDC estimated 1.8 million visits to the emergency room for asthma in the US in 2011. That’s a lot! Medical intervention is important and often essential, but falls short of serving the full spectrum of unique needs for this population. This brings to light the definite need for more comprehensive and preventative care solutions for this population. There is a huge gap in treatment for this population that yoga is well suited to address. Yoga is a practice of self-awareness that benefits this population most specifically by teaching awareness of posture, emotional reactivity to the symptoms, and awareness of breathing behavior, both at rest and when faced with asthma symptoms. After developing these essential awareness skills, yoga teaches these individuals psycho-emotional and breath self-regulation. Asthma sufferers learn how to breathe with a more efficient pattern that is less likely to trigger an attack and learn how to minimize their system’s response once an attack is under way.

Yoga offers gentle physical challenges that build strength and postural endurance, enhances mobility, and improves exercise tolerance. It can truly transform their relationship to the disease and change how they view themselves. In this way, yoga is a powerful yet gentle healing modality that can complement medical treatment to restore well-being to the hundreds of millions of people living with asthma. It’s important to note that not just any yoga is sufficient for this population. Certain yogic breathing techniques can trigger or prolong asthma symptoms and movement should be customized to the specific physical ability and postural needs of the client. A yoga teacher or yoga therapist should be knowledgeable in respiratory chemistry and physiology to safely work with this population and create individualized treatment plans. In general, fast or deep breathing practices are not advised and cooling breaths, like Shitali, should be avoided due to the potential for airway constriction. To identify the best pranayama for this population just think “slow, nose, low, and gentle.” Slower, more effortless breathing practices are best and breathing through the nose is preferred because it promotes better diaphragm muscle function and helps warm, filter, and humidify the air. Using a diaphragmatic (low) breathing pattern helps improve respiratory physiology, uses less energy, calms the nervous system, and engages fewer neck, shoulder, and chest muscles for breathing. Gentle versus deep breathing is definitely best since these individuals already have a tendency to hyperventilate. Yoga can teach the asthma sufferer to learn to breathe efficiently and effortlessly and to trust their body again. They can learn to manage their fears and keep their nervous system calm in the face of triggers. Yoga may help reduce the frequency of asthma attacks or use of medication, but most importantly it supplies mind-body skills that allow sufferers to participate more fully in the activities that make them feel alive, engaged, and whole.

Current research is very supportive of yoga as an integrated component of the patient care model for asthma, but more research is needed to validate specific yoga therapy protocols to use for suffers with mild, moderate, and severe asthma.

References • Centers for Disease Control and Prevention.(link is external)(link is external) • Chaitow, Leon, Dinah Bradley, and Christopher Gilbert. Multidisciplinary Approaches to Breathing Pattern Disorders. N.p.: Elsevier Science, 2002. Print.

• Global Asthma Report 2014.(link is external)(link is external) • McCall, T. B. (2007). Yoga as medicine: The yogic prescription for health & healing: A yoga journal book. New York, NY: Random House.

• Mekonnen, Demeke, and Andualem Mossie. "Clinical Effects of Yoga on Asthmatic Patients: A Preliminary Clinical Trial." Ethiopian Journal of Health Sciences. Research and Publications Office of Jimma University, July 2010. Web. 16 Oct. 2016. Further Reading or Viewing

• Mayo Clinic - Excercise Induced Asthma(link is external)(link is external) • Transformational Breath(link is external)(link is external) *Please Note: The information in this article is intended for your educational use only and does not necessarily reflect the opinions of YogaMate or it's Panel of Advisors.

*Please Note: The information in this article is intended for your educational use only and does not necessarily reflect the opinions of YogaMate or it's Panel of Advisors. This information it nota substitute for professional medical advice, diagnosis, or treatment. Always seek the advice of your physician or other qualified health providers with any questions you may have regarding a medical condition..

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