Yoga For Asthma

Respiratory illnesses are medical conditions that affect the organs and tissues of higher organisms that allow gas exchange, as well as disorders of the upper respiratory tract, trachea, bronchus, bronchus, pulmonary vasculature, tuberculosis, and pneumonia. Colds, bacterial inflammation of the lungs, pulmonary embolism, acute asthma, and lung cancer are all life-threatening disorders that can be relieved and self-limited by respiratory diseases (1).

Asthma

Asthma is a chronic inflammatory respiratory condition for which inhaled corticosteroids are the recommended treatment. Long-term clinical results are, however, inconsistent, and not all patients react to corticosteroids adequately. Researchers’ finding is based on the fact that asthma is a diverse illness with distinct phenotypes triggered by different inflammatory pathways (1, 2). 

Asthma is an inflammatory respiratory illness that may be increased by certain stimuli, and several supplements are now being researched to see whether they might lower a person’s reaction to these stimuli (3).

Bronchial Asthma

Bronchitis is a more serious lung disorder than asthma. Asthma also referred to as bronchial asthma, is a lung condition. It is a serve chronic (continuing) disease, which means it won’t go away and will require ongoing medical care. It is a severe lung and bronchial infection that can progress to chronicity. This disorder is generally caused by inhaling polluted air and smoking (2).

The bronchi have become inflamed as a result of a bacterial or viral infection. It might appear quickly after a head cold (acute bronchitis), will last years, or come back on a regular basis, causing progressive bronchitis and lung damage (chronic bronchitis) (2).

The color of the growths (mucus) indicates the severity of bronchitis.

• Acute Bronchitis – Colds of the head and nose, colds, fever, muscles, and potentially back discomfort are the initial symptoms of acute bronchitis. The most noticeable symptom is a chronic cough.
• Chronic bronchitis – It is characterized by an expectorant cough (mucus), and other symptoms are dependent on the degree or severity of emphysema.

Asthma Attack

When you breathe regularly, the muscles around your airways relax, allowing air to pass through freely and softly (4).

Three things can happen during an asthma attack-

• Bronchospasm – The muscles that surround the airways tighten (tighten). When they contract, your airways narrow. Constrained airways prevent air from flowing freely.
• Inflammation – Swelling of the lining of your airways. Swollen airways restrict the amount of air that enters and exits your lungs.
• Mucus production – Your body produces more mucus during an infection. The mucus is so thick that it plugs the airways.

When your airways get constricted, you produce a sound called wheezing when you breathe, and your airways make a noise when you exhale. An asthma attack is also known as an exacerbation or a flare-up. It’s a term that describes when your asthma isn’t under control.

Other Different Types of Asthma

Asthma is classified into several categories depending on the cause and severity of symptoms.

Asthma is defined by physicians as-

• Intermittent asthma – This kind of asthma comes and goes, allowing you to function normally in between attacks.
• Persistent – If you have persistent asthma, you will experience symptoms almost all of the time. Symptoms may range from mild to severe. The severity of asthma is determined by how frequently you have symptoms. They also reflect your ability to do tasks during an attack.

Asthma can be triggered by other factors-

• Allergies – Allergies can trigger an asthma attack in certain people. Molds, pollens, and pet hair are examples of allergens.
• Non-allergic – Asthma flare-ups can be triggered by non-allergic reasons. Exercise, stress, illness, and the weather can all contribute to a flare-up.

Asthma can also be caused by-

• Adult-onset asthma – This kind of asthma develops after the age of 18 years old.
• Pediatric asthma, also known as childhood asthma, affects children under the age of five and can affect infants and toddlers. Asthma can be outgrown in children. Before deciding whether or not your kid needs to have an inhaler on hand in case of an asthma attack, you should consult with your physician. Your child’s doctor can assist you in comprehending the dangers.

There are also the following forms of asthma-

• Exercise-induced asthma – This kind is caused by physical activity and is also known as exercise-induced bronchospasm.
• Occupational asthma – This kind of asthma affects persons who work in environments that include irritating substances.
• Asthma-COPD overlap syndrome (ACOS) – When you have both asthma and chronic obstructive lung disease, you have ACOS (COPD). Both conditions make breathing difficult.

How Yoga can help with Asthma

Many people with asthma say that performing yoga makes them feel better. Yoga is considered to be beneficial because it improves posture and opens the chest muscles, which allows for improved breathing. It may also help you learn to manage your breathing and reduce stress, which is a significant cause of asthma symptoms (5).

Beneficial for Patients With Asthma

Yoga breathing has been discovered to be an effective way of enhancing pulmonary function, and there is minimal evidence of its effects on the respiratory system, suggesting a positive tendency to improve respiratory physiology was brought out in our study to raise people’s awareness of practicing yoga for a healthy life in the modern world (6).

Yoga increases chest wall expansion and expiratory lung volume, which improves respiratory capacity. Yoga enhances lung capacity, resulting in a 15 to 25% increase in oxygen consumption. Yoga is also known to promote somatic muscle relaxation, which leads to a decrease in airway resistance. It improves lung responsiveness as well (7, 8).

Among persons with asthma, studies have indicated moderate-quality evidence that yoga leads to minor benefits in quality of life and symptoms. There is more uncertainty concerning yoga’s possible negative consequences on lung function and medication use. However, further study is needed to clarify the effects of yoga on asthma (9).

Beneficial For Pregnant Women with Asthma

Yoga has been shown to be useful to asthmatic pregnant women in research. The Global Initiative for Asthma Control (GINA) considers breathing techniques (Beutyko) to be an adjuvant treatment for better asthma control. Yoga can be a helpful strategy in the management of asthma, according to studies, and it can be used in combination with regular medical therapy to enhance outcomes (10).

Beneficial for Children with Asthma

According to a study, yoga may help asthmatic children manage better with their condition by lowering their sickness score and medicine usage. As a result, it should be used as a supplement to current medication in the treatment of bronchial asthma in children. It should be done on a regular basis and under the supervision of a yoga professional (11).

Yoga Poses, Breathing Exercises for Asthma

Patients with asthma require their bodies to work extra hard in order to breathe. Yoga Poses & Breathing Exercises can help patients with asthma improve their breath and body awareness, lower their respiratory rate, encourage calm, and relieve tension.

Meditation

Meditation cleanses and relaxes the mind resulting in reaching a state of peacefulness. It increases physical fitness and relaxation by removing weariness and tension. It helps people with psychiatric disorders, mental illnesses, sleeplessness, and hypertension. In both healthy and asthmatic people, it increases lung function.

How To Practice

1. Close your eyes and concentrate on the tip of your nose in a good position facing north.
2. Slowly inhale while mentally reciting “SO.” Hold the breath for 5 seconds, then gently exhale while mentally saying “HAM.”
3. Repeat the “SO” and “HAM” breathing meditation for 10 to 20 minutes in the morning and evening on a regular basis.

Pranayama

These exercises can be performed alone or as part of a mild yoga practice (12, 13).

Nadi Shodhana (Alternate nostril breathing)

Alternate nostril breathing is a common yoga method for stress relief. It can also help with asthmatic breathing difficulties.

How To Practice

1. Sit with your legs crossed on the floor or in bed. Exhale. Your right thumb should be placed on your right nostril. Take a deep breath in through your left nostril.
2. Your right ring finger should be placed on your left nostril. Inhale through your right nose and exhale through your left nostril.
3. Take a deep breath into your right nostril and shut it with your right thumb. Inhale via your left nose and exhale through your right nostril.
4. As needed, repeat the process.

Ujjayi pranayama (Victorious breathing)

Victorious breathing is a yoga practice that, when combined with diaphragmatic breathing, can assist in improving lung function. An audible breath is also used in the method, which is supposed to aid in relaxing.

How To Practice

1. Sit cross-legged on the floor, tall.
2. Slowly inhale through your nose.
3. Slowly exhale through your mouth, making the sound “aah.”
4. Exhale loudly with closed lips as you get the hang of this breath. Exhale through your nose while expelling a breath from the back of your throat that is audible.

Kapalbhati (Breathe of fire)

This breathing method calms the mind while also energizing the nerve system. It also increases blood circulation and clears all Nadis (energy channels).

How To Practice

1. Sit in any comfortable asana and attempt to forcefully exhale through your nostrils.
2. Inhale without exerting any effort.
3. Do it 15-20 times at first, then progressively increase the number as per your capabilities.

Breathing Exercises

Breathing exercises are meant to assist you in gaining control of your breathing. These strategies, when used correctly, can help you breathe more effectively (12).

Buteyko Breathing

Buteyko breathing is a sequence of movements that can assist relieve asthma symptoms, while it is not generally taught as part of a yoga practice. This is one method for relieving coughing and wheezing.

How To Practice

1. Take a few deep breaths and hold them for 3–5 seconds. Repeat the process several times.
2. Exhale slowly and deeply through your nose.
3. Pinch your nose with your thumb and pointer finger.
4. For 3 to 5 seconds, hold your breath.
5. Take a 10-second breath. If your symptoms persist, repeat the procedure.

Use your rescue inhaler if your symptoms do not improve within 10 minutes or if your asthma symptoms are severe.

Pursed lip breathing

Shortness of breath can be relieved by using a technique known as pursed lip breathing. The activity increases the amount of oxygen in your lungs, slowing your breathing rate.

How To Practice

1. Take a seat in a chair. Neck and shoulders should be relaxed.
2. To the count of two, gently inhale through your nostrils. Maintain a puckered lip as though you’re ready to extinguish a candle.
3. To the count of four, carefully exhale through your lips. Take a deep breath and expel all of the air from your lungs.
4. Repeat this process until your breathing returns to normal.

Diaphragmatic breathing

Diaphragmatic breathing reduces effort by opening airways, strengthening abdominal muscles, and improving lung and heart function. This activity may help in the relief of asthma symptoms.

How To Practice

1. Lie down in bed or sit in a chair. Place one hand on your stomach to feel how it moves in and out.
2. Slowly inhale through your nose. You should feel your stomach expand, like a balloon, as it fills with air.
3. Exhale slowly and deeply through pursed lips for two or three times as long as you inhaled. As the air leaves your lungs, your stomach should move in.

Yoga Poses

Yoga has emerged as a discipline of holistic therapies that are shown to be useful in the treatment of noncommunicable diseases like asthma (13).

Bow (Dhanurasana)

It strengthens back muscles and opens up the chest, neck, and shoulders as a result, breathing is improved, and asthma and bronchitis symptoms are relieved.

How to Practice

1. Lie face down on your stomach, full length on the floor.
2. Exhale deeply while bending your knees. As you stretch your arms back, hold the left foot toe with the left hand and the right foot toe with the right hand.
3. Exhale completely and draw the legs up to the ceiling, elevating the knees above the floor and the chest off the floor. The arms and hands operate like a bowstring, pulling the body taut in the same manner as a bent bow does.
4. Raise your head as high as you can and bring it back as far as you can. Do not lie down on your ribs or pelvic bones. The abdomen bears the entire weight of the body on the floor.
5. When raising the legs, do not combine them at the knees; otherwise, the legs will not be elevated high enough. Connect the thighs, knees, and ankles once you’ve finished the whole stretch upwards.

Cobra (Bhujangasana)

This pose encourages thoracic-diaphragmatic respiration, expands the chest, strengthens the upper back and shoulders, and reduces kyphosis.

How to Practice

1. Begin on your stomach, with your feet hip-distance apart and your hands beside your ribcage.
2. Extend your big toes straight back and push down with all ten toenails to stimulate your quads.
3. Rotate your inner thighs toward the ceiling to expand your lower back.
4. Raise your head and chest while softly pressing down with your hands, rotating your shoulders back and forth.
5. Maintain a long neck with your sternum up rather than your chin.
6. Keep your arms straight and your shoulders away from your ears. Maintain a small bend in your elbows.
7. Return to your mat to exit the pose.

Bridge Pose (setu bandha sarvangasana)

The bridge is a prominent yoga pose that expands the chest and promotes deeper breathing.

How To Practice

1. Lie down flat on your back. Your feet should be shoulder-width apart, and your knees should be bent. Place your palms face down on the floor.
2. Move your pelvis up while inhaling and maintaining your shoulders and head flat. Take a couple of deep breaths in and out.
3. Lower your pelvis to the floor slowly.

Fish Pose (Matsyasana)

This asana expands the rib cage, deepens the breath, and reverses kyphosis.

How To Practice

1. Lie down on your back, flat. Bring your feet closer together.
2. Place your hands beneath your thighs, palms down, near to the buttocks. Then, by pressing the elbows into the ground, raise the chest.
3. Drop the head back till it touches the floor when the chest is as high as feasible and comfortable.
4. It’s important to remember that the body’s weight should only be supported by the elbows, not the head. Breathe deeply while keeping your chest arched in this position.
5. Stay in this posture for about a minute. Lift the head and straighten the back to get out of the posture, then slowly descend the upper body to the ground. Relax.

Butterfly Pose (baddha konasana)

Butterfly asana is a relaxing pose that improves hip joint flexibility, provides adequate blood flow to the legs, reduces sciatica pain, crams, and leg numbness, and provides relief from asthma.

How To Practice

1. Sit on the mat with your back straight and knees bent in a comfortable position.
2. Move your bent knees to the outside of your body so that the soles of both legs touch in the middle.
3. With your hands, grasp the ankles of both feet.
4. Slowly bend your body forward, as far as you can, while using your abs. Relax after 30 seconds to 2 minutes of holding the pose.

Wind-Relieving Pose (Pavanamuktasana)

Pawanmuktasana is a yoga pose, that aids in the stimulation of intestinal function. It boosts the liver’s overall effectiveness. When paired with its counter-position Setubandhasana, it strengthens the spine, particularly the lumbar region.

How To Practice

1. On the yoga mat, lie down on your back. Maintain a side-by-side position with your arms at your sides and your feet together.
2. First inhale, then exhale as you lift both knees to your chest.
3. Your hands should be clasped around your legs and your thighs should be squeezed towards your body.
4. In and out of this posture, take a few deep breaths. When breathing, tighten the grip and loosen it when inhaling.

Sitting Half Spinal Twist (Ardha Matsyendrasana)

Ardha Matsyendrasana strengthens the spinal nerves and ligaments, promotes digestion, and enhances the health of the liver and pancreas.

How To Practice

1. To begin, take a Dandasana position (with your legs straight forward, with a pillar on your buttocks).
2. Keep your spine straight by placing your hands on the ground on each side of your hips. Now gradually bend your left leg such that the heel of your left leg contacts the right hip.
3. Cross your right leg across your left leg so that it comes to a stop near to your left knee.
4. Keep your left-hand parallel to your right leg while bending your upper body to the right. With your left hand, touch your right toes.
5. Slowly inhale and exhale, remaining in this posture for 30-60 seconds. Exit the posture carefully, relax for a few seconds, and then repeat on the opposite side.

Standing forward bend (Padahastasana)

This is inverted pose that gives your body the stamina and energy it needs, as well as teaches you how to keep your body balanced and your internal systems strong. The major physical benefit is that it stretches the full rear of the body from the head to the heels.

How To Practice

1. Bring your legs together and stand tall. Inhale deeply and raise your arms straight over your head until your biceps meet your ears.
2. Take a deep breath out and lean forward from the waist.
3. The spine should be straight, and the legs should be straight as well. The heels should bear the brunt of the body’s weight.
4. Interlock the fingers around the toes with your hands on the ground. Hold for five seconds, then gradually increase to one minute.

Triangle (Trikonasana)

Trikonasana (triangle pose) supports the action of the Half Spinal Twist by providing a good lateral stretch to the spine, toning the spinal nerves, and assisting the digestive system’s correct functioning.

How To Practice

1. Stand with your legs apart and your back straight. The length of your legs should be longer than the width of your shoulders.
2. Take a deep breath in. Raise your right hand over your head in a straight line. Parallel to the right ear, the right arm should be.
3. Take a deep breath out. Bend your torso to the left side at the waist. Slide your left arm down your left leg until your fingers are at your ankle at the same time.
4. Your right arm must be horizontal at this time, and your head must be inclined left.
5. Keep your knees and elbows straight while you hold the posture. For 30 seconds, stay in this posture.
6. Inhale deeply. Straighten your spine and take a firm stand. On the other side, repeat the pose.

Shoulderstand (Sarvangasana)

This is an inverted position in which the body is supported by the shoulders. Shoulderstand stimulates deep abdominal breathing (because to the limited use of the upper lungs), thereby enhancing the efficacy of each breath; improves digestion and heals constipation by releasing gravitational compression on the colon; and gives a gentle massage to the heart and lung area.

How To Practice

1. Lie down on your back, feet together, arms close to your body. Breathe deeply as you elevate both legs to 90 degrees, keeping your head and neck on the floor.
2. Place your hands on your hips and move up toward your shoulder blades as you lift your hips toward the ceiling.
3. Raise your hips as high as you can while keeping your chest close to your chin.
4. Maintain a firm grip on your back with your hands, and make sure your feet are straight over your head.
5. In this pose, take slow, deep breaths and concentrate on your throat.

Conclusion

Asthma is a widespread chronic inflammatory disorder that affects around 300 million people globally. Yoga, as a holistic therapy, has the ability to alleviate both physical and psychological suffering in persons with asthma.

References and Further Reading

1. Butani, Lavjay, and Edward J. O’Connell. “Functional respiratory disorders.” Annals of Allergy, Asthma & Immunology 79.2 (1997): 91-101.
2. Schuliga, M. (2015). NF-kappaB signaling in chronic inflammatory airway disease. Biomolecules, 5(3), 1266-1283.
3. Holt, P. G., Macaubas, C., Stumbles, P. A., & Sly, P. D. (1999). The role of allergy in the development of asthma. Nature, 402(6760), 12-17.
4. https://my.clevelandclinic.org/health/diseases/6424-asthma
5. Mekonnen, D., & Andualem, M. (2010). Clinical Effects of Yoga on Asthmatic Patients: A Preliminary Clinical Trial, Jimma, Southwest Ethiopia. Ethiopian journal of health sciences, 20(2).
6. Doijad, V. P., & Surdi, A. D. (2012). Effect of short term yoga practice on pulmonary function tests. Indian Journal of Basic & Applied Medical Research, 1(3), 226-230.
7. Chanavirut,  R., Khaidjapho,  K., Jarce,  P. andPongnaratorn,  P. (2006).  Yoga exercise increases  chestwallexpans  ion  and  lung  volumes  in  young  healthy  thais.  Thai  Journal  of Physiological Sciences.19: 1-7.
8. Miles,  WR.  (1963).  Oxygen  consumption  during  the  three  type  of  breathing.  J  Appl Physiol.19(1):75-82.
9. Yang, Z. Y., Zhong, H. B., Mao, C., Yuan, J. Q., Huang, Y., Wu, X. Y., … & Tang, J. L. (2016). Yoga for asthma. Cochrane Database of Systematic Reviews, (4).
10. Agnihotri, S., Kant, S., Singh, R., Mishra, S. K., Kumar, S., & Verma, A. Role of Yoga in Pregnancy with Asthma.
11. Jasrotia, R. B., Mondal, S., Kumar, V., & Gandhi, A. (2019). Impact of adjunct treatment with yoga on severity, illness score, and drug dosage in controlled asthmatic children. National Journal of Physiology, Pharmacy and Pharmacology, 9(11), 1139-1144.
12. Das, R. R., Sankar, J., & Kabra, S. K. (2021). Role of Breathing Exercises in Asthma—Yoga and Pranayama. Indian journal of pediatrics, 1-7.
13. Agnihotri, S., Kant, S., Mishra, S. K., & Singh, P. (2017). Role of Yoga in childhood asthma.