Research on Diaphragmatic Breathing

The following information was presented during the Research Panel at the 2019 NQA Annual Conference on Diaphragmatic Breathing. It includes a summary of current research on diaphragmatic breathing.

ABSTRACTS  

ARTICLE

Diaphragmatic Breathing

• Diaphragmatic breathing and meditative movements such as those found in Qigong have been shown to have a regulatory effect on the autonomic nervous system, mainly through engaging the parasympathetic system.
• Slow, deep breathing has been shown to increase parasympathetic activity in both healthy and symptomatic populations through influence on the vagal nerve [1,2]
• This leads to decreases in heart rate and blood pressure, muscle relaxation, improved digestion, improved sleep cycles, enhanced anti-inflammatory effects, and enhanced mood [3]
• Additional benefits include increased oxygenation of the blood and removal of waste products such as carbon dioxide. Combining this with maintenance of proper upright posture will aid in enhancing one’s respiratory capabilities.
  
  

Inflammation

• Among the leading causes of morbidity and mortality in Western societies are heart disease, cancer, stroke, diabetes and sepsis. [4]
• Inflammation accelerates deposition of atherosclerotic plaques leading to myocardial and cerebral infarction; mediates insulin resistance; stimulates tumor growth; and causes organ damage in lethal sepsis.
• Additional disorders related to chronic inflammation include Central Nervous System disorders such as Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS), gastrointestinal disorders, clinical depression, and multiple forms of arthritis [5]
• The body is able to help suppress inflammation through the parasympathetic nervous system, including the vagus nerve.
• The “inflammatory reflex,” an anti-inflammatory neural circuit, was discovered in the late 1990’s by LV Borovikova et al. [6, 7]
• This neurological mechanism involves the vagus nerve, which can sense peripheral inflammation and transmit action potentials from the periphery to the brain stem. This in turn leads to the generation of action potentials in the descending vagus nerve that are relayed to the spleen, where pro-inflammatory cytokine production is inhibited [8, 9]
• Qigong and Tai Chi have been shown to decrease inflammatory markers Interleukin-6 and C-Reactive Protein in the blood [10– 12]
• It is known that the regular practice of breathing exercise increases parasympathetic tone, decreases sympathetic activity, improves cardiovascular and respiratory functions, decreases the effect of stress and strain on the body and improves physical and mental health. One of the ways in which this occurs is through decreasing sympathetic activity or by increasing vagal tone. [13, 14]
• Previous researchers have also indicated that qigong regulated the autonomic nervous system by adjusting parasympathetic nervous system activities or stabilizing the sympathetic nervous system, specifically by improving heart rate variability [15]
• Lu and Kuo observed that the heart rate variability parameters of T’ai Chi Ch’uan practitioners were all significantly higher than those of non-practitioners in a cross-sectional analysis; however, the number of years of T’ai Chi Ch’uan experience did not correlate with the value of heart rate variability parameters [16]
  
  

References  - FULL ABSTRACTS

1 -Pal G, Velkumary S, Madanmohan. Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res 2004;120(2): 115–21.
2- Mourya M, Mahajan AS, Singh NP, Jain AK. Effect of slow- and fast-breathing exercises on autonomic functions in patients with essential hypertension. J Altern Complement Med. 2009; Jul;15(7):711-7
3- Lehrer PM., Gevirtz R. Heart rate variability biofeedback: how and why does it work? Frontiers in Psychology. (5):2014; 756.
4 -M. Huston, J. Tracey. The pulse of inflammation: heart rate variability, the cholinergic anti-inflammatory pathway and implications for therapy. Journal of Internal Medicine.2011; 269 (1): 45 - 53.
5- Libby P. Inflammatory mechanisms: the molecular basis of inflammation and disease. Nutr Rev. 2007 Dec;65(12 Pt 2):S140-6- Borovikova LV, Ivanova S, Nardi D et al. Role of vagus nerve signaling in CNI-1493-mediated suppression of acute inflammation. Auton Neurosci 2000; 85: 141–7.
7 -Borovikova LV, Ivanova S, Zhang M et al. Vagus nerve stimulation attenuates the systemic inflammatory response to endotoxin. Nature 2000; 405: 458–62
8 - Tracey KJ. The inflammatory reflex. Nature 2002; 420: 853–9.. FULL TEXT
9 -Huston JM, Ochani M, Rosas-Ballina M et al. Splenectomy inactivates the cholinergic anti-inflammatory pathway during lethal endotoxemia and polymicrobial sepsis. J Exp Med 2006; 203: 1623–8
10 -Oh B, Butow P, Mullan B, Clarke S, Beale P, Pavlakis N, Kothe E, Lam L, Rosenthal D. Impact of medical Qigong on quality of life, fatigue, mood and inflammation in cancer patients: a randomized controlled trial. Ann Oncol. 2010 Mar;21(3):608-14.
11 -Oh B, Butow PN, Mullan BA, Clarke SJ, Beale PJ, Pavlakis N, Lee MS, Rosenthal DS, Larkey L, Vardy J. Effect of medical Qigong on cognitive function, quality of life, and a biomarker of inflammation in cancer patients: a randomized controlled trial. Support Care Cancer. 2012 Jun;20(6):1235-42.
12 -Irwin MR, Olmstead R. Mitigating cellular inflammation in older adults: a randomized controlled trial of Tai Chi Chih. Am J Geriatr Psychiatry. 2012 Sep;20(9):764-72.
13 -Mohan M, Saravanane C, Surange SG, Thombre DP, Chakrabarthy AS. Effect of yoga type breathing on heart rate and cardiac axis of normal subjects. Indian J Physiol Pharmacol 1986; 30: 334-40
14 -Pal G, Velkumary S, Madanmohan. Effect of short-term practice of breathing exercises on autonomic functions in normal human volunteers. Indian J Med Res 2004;120(2): 115–21.
15 -Lee, M. S., Huh, H. J., Kim, B. G., Ryu, H., Lee, H. S., Kim, J. M., & Chung, H. T. Effects of Qi-training on heart rate variability. The American Journal of Chinese Medicine. 2002; 30: 463-470.
16 -Lu WA, Kuo CD. The effect of Tai Chi Chuan on the autonomic nervous modulation in older persons. Med Sci Sports Exerc. 2003 Dec;35(12):1972-6.

Vagus Nerve

Breathing

Breathing. It is something that we all take for granted. It is nothing we really need to think about yet we do it 12-20 times a minute, and over 20,000 times a day. Proper breathing can have a profound impact on your health- more than  simply completing the process of respiration. It has effects on almost every major system in your body, including your cardiopulmonary, nervous, lymphatic, digestive, immune, and musculoskeletal systems. But what if I told you most of us are doing it wrong?

When we are babies, we all breathe using our diaphragm. This is known as abdominal breathing  or belly breathing. The diaphragm is a large dome shaped muscle that lies at the lower end of our ribs and separates our lungs and heart from the rest of our internal organs. As we breathe in, our diaphragm contracts and pulls down, acting like a vacuum and decreasing pressure in the chest. As we breathe out, the diaphragm relaxes and causes us to exhale. On the outside, our belly pushes out as we breathe in, and moves in as we exhale. This allows our lungs to inflate most efficiently, allowing for important exchange of oxygen and nutrients and removal of waste products. However, as we get older, we begin to breathe much shallower. We tend to use muscles in our neck, between our ribs, and our chest. This can lead to neck and shoulder pain as well as intense headaches from over active muscles. In addition, your lungs never get a chance to fully inflate or deflate. This causes your body to retain more waste products and does not allow for circulation of oxygen and important nutrients. Long term shallow breathing can decrease how well your body fights disease and infection, puts more work on your heart, and makes any respiratory conditions much worse and harder to fight.

Combining diaphragmatic breathing with proper posture

Diaphragmatic breathing activates your parasympathetic nervous system, mainly through influence on your vagus nerve. This allows your body to slow down and heal.  These effects can lower heart rate and blood pressure, relax muscles, improve digestion, decrease stress, increase energy levels, improve sleep cycles, and enhance mood. Conversely, chest breathing, or shallow breathing activates the sympathetic nervous system, or the “fight or flight” response. This is your body’s stress response. It raises your blood pressure and heart rate, increases muscle tension and respiration rate, increases stress, and decreases energy and mental clarity. When your body is at a high state of stress for long periods of time, your immune system also becomes very inefficient. As time progresses, the build-up of minor, trivial irritations can lead to significant issues like anxiety and depression, and frequent illness and infections.

Through its influence on the parasympathetic nervous system, abdominal breathing is also able to decrease inflammation in the body. Among the leading causes of morbidity and mortality in Western societies are heart disease, cancer, stroke, diabetes and sepsis. Chronic inflammation is a significant contributing factor to each of these conditions. Inflammation accelerates deposition of atherosclerotic plaques leading to heart attack and stroke, mediates insulin resistance, stimulates tumor growth, and causes organ damage in lethal sepsis. Additional disorders related to chronic inflammation include central nervous system disorders such as Multiple Sclerosis (MS) and Amyotrophic Lateral Sclerosis (ALS), gastrointestinal disorders, clinical depression, and multiple forms of arthritis.

The “inflammatory reflex,” an anti-inflammatory neural circuit, was discovered in the late 1990’s by LV Borovikova. This neurological mechanism involves the vagus nerve, which can sense peripheral inflammation and transmit signals from the periphery to the brain stem. This then leads to communication with the spleen where pro-inflammatory chemicals are suppressed. Qigong and Tai Chi have also been shown to decrease inflammatory markers such as C-Reactive Protein in the blood, meaning there are less inflammatory processes in the body.

A frequently overlooked benefit of abdominal breathing is that the up and down plunger-like action of the diaphragm when it contracts helps to massage and stimulate our abdominal cavity and digestive organs. Abdominal breathing also plays a role in affecting hormones and emotions which may impact your digestive system. It aids in release of serotonin in the body, which is often referred to as the “happy chemical.” It not only contributes to well-being and happiness but can reduce cravings for processed carbohydrates and other junk food. Abdominal breathing can also aid in weight loss by balancing stress hormones with anabolic hormones.

Unlike your circulatory system which relies on the heart, your lymphatic system does not have its own pump. It relies heavily on motions of muscles and joints, including contraction and relaxation of your diaphragm during breathing, to circulate lymph throughout your body.The lymphatic system is a network of tissues, organs, and vessels that help the body remove toxins, waste and other unwanted materials. Its primary function is to transport lymph which is a fluid containing infection-fighting white blood cells throughout the body. Lymph flows in the body only one direction — upward toward the neck. Lymphatic vessels connect to two subclavian veins, which are located on either side of the neck near the collar bones, and the fluid re-enters the circulatory system, according to the Mayo Clinic.

Great news! You do not need any special equipment or training to learn how to breathe correctly. Sit up straight in a chair and put your hands on your belly. As you breathe deeply through your nose, feel your belly push your hands out. As you exhale, your belly shrinks and your hands return to the starting position. With practice, this pattern will become automatic and you will be able to do this all day, everyday with no conscious effort. After all, if you breathe over 20,000 times a day, why not do it correctly and take advantage of all of the benefits?

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