- The NO value of Hummm Breathing (aka Bee Breath)The practice of repeating the monosyllabic sound of Om on one exhalation is noted in ancient texts over 2,000 years ago. In addition to the prolonged exhalation value as noted in point 7 it introduces a vibration due to the sound of Om across the pharynx, nasal, and sinus regions. A later developed Hatha yoga practice, documented 700 years ago but most likely practiced longer than that, imitates the sound of the black bee which lends it its name in Sanskrit, bhramari. This is also a humming type of breath but more isolated to the region of the soft palate in the naso-pharyngeal space. The former reference of Om places it in the context of psychological well-being to focus and clear the mind resulting in a calm, peaceful state. The latter reference of bhramari extends beyond this psychological value to a physiological benefit in terms of health. Recent discoveries involving the molecule nitric oxide (NO) confirm its valuable health-promoting effects in terms of blood pressure regulation to antimicrobial defense (8) and that the isolated practice of humming on exhalation can increase nasal NO levels 15-fold compared to quiet exhalation (9). As a dedicated breathing exercise inserted into a routine (see Breathwork for Anxiety and Other Difficulties ) it offers the advantages of regulated breathwork and the added health benefits of increased nitric oxide production in the nasal and sinus regions.
- Respiratory System Plasticity and its Anatomical and Functional InfluenceRespiratory neuroplasticity is characterized by previous experience long-lasting expressions and is now considered an intrinsic feature of the respiratory control network that extends into adult life (10). This is a sword that cuts both ways as it could either exacerbate maladaptive responses to poor and obstructed respiratory functioning or it could confer greater advantages when breathing is trained enhancing respiratory plasticity. The respiratory apparatus functions as a pump in a closely interrelated role with the cardiovascular system so together they eliminate CO2 and metabolites from cells while deliver oxygen and nutrients to those same cells. The central respiratory control has been shown to couple with sympathetic activity, and when particularly maladaptive due to poor respiration, can influence the development of hypertension (11). Breathing exercises are consciously controlled respiratory events, trained in a graded manner over time, to influence the function of the respiratory diaphragm, intercostal muscles, and as a result pulmonary function and health. Each ebb and flow of inspiration and expiration expand and contract the lungs and by default impact the heart. Additionally, the movement of the diaphragm with varied intercostal activity depending on the depth of the inhalation alternates intrathoracic and intraabdominal pressure providing a massage stimulation to the visceral organs. This mechanical process of respiration influences the rhythm of cardiac, sympathetic, and respiratory systems. Each inspiration creates a negative thoracic pressure that increases venous return and heartrate through cardiac stretch receptors. Simultaneously pulmonary mechano-receptors, and baro- and chemo-receptors provide sensory input in a feedback loop to central respiratory processing. Better trained respiratory muscles, for example via breathing exercises as part of a regular comprehensive yoga practice, subsequently augment plastic adaptation of the respiratory system, improve heart and lung function, potentially aid enteric function through pressure from improved diaphragm movement, not only during the time of practice but based on the learned plastic effect leads to an improved respiratory function across a 24-hour period. This 24-hour improved functionality not only increases daily well-being and sleep quality but as a byproduct of efficient mechanical respiration improves oxygen delivery and uptake across a 24-hour period. Finally, trained respiration with optimal diaphragmatic usage influences the spinal column as the crura of the diaphragm are attached directly to the spine at approximately T11 to L3 where they also overlap with the attachment of the psoas muscle, considered crucial for posture. Each inspiration contracts the diaphragm and when working more deeply pulls on these crura to stimulate the spinal column and its intervertebral discs.
- Psychological well-beingThe act of respiration has broad impact on cell function, on physiological activity via the autonomic nervous system with a direct role in the stress response, on several bodily systems, as well as cardiac and brain rhythms. Maladapted modes of breathing, particularly hyperventilation, are associated with emotional disturbance such as in an anxiety attack or conditions like agoraphobia (12). The pacification of anxiety attacks through a change in breathing, the robust handling of a stressor as well as the resilience to continuous stress as measured by autonomic outcomes such as Heart Rate Variability (HRV), improved lung function especially as a predictor of CHD and all-cause mortality, and self-reporting in evaluative psychological surveys all point to a role for trained breathing in handling emotions and improving psychological well-being. Chang et al. were able to show that a slow-breathing state in humans, from 16 down to 8 breaths per minute, increased parasympathetic activity, reduced sympathetic activity, shifted sympathovagal balance toward vagal activities, changes considered to promote autonomic cardiovascular regulation (13). A comprehensive yoga approach incorporates meditational, relaxational, and breathing techniques, amongst other elements, that, according to Jerath et al., counteract the deleterious effects of stress, anxiety, negative emotions, and sympathetic dominance thereby being a plausible behavioral approach to support stress, anxiety, depression, and some emotional disorders, collectively promoting psychological well-being (14).
The current COVID-19 pandemic has captured people’s attention globally. Though physical infection is close to 6.5 million people its full impact has reached over 6 billion people if not more. Governments and organizations are mounting heroic efforts to prescribe some form of medical care, develop drugs to buffer it and eventually a vaccine, and to put in place adequate infrastructural support so no unnecessary suffering and stress is incurred. Important to these approaches is that of the living human being experience, how we process these changes and challenges psychologically and how capable are we physiologically. In an informal sense many people look to some form of behavioral lifestyle support, often within the complementary health approach. Now more than ever is a time to draw full attention to people’s daily habits and self-care. It is essential to address psychological and physiological hygiene through attention on the breath, sleep, diet, ecology, being in-the-moment, and the language of the heart as we navigate social, political, economic, environmental, and health uncertainties. A comprehensive yoga approach offers a time-sensitive, robust practice combination, that must be sincerely taken on and done in a regular manner to aid a lived life handle, even thrive, in what is an unavoidable time of mass societal change.