ANS function and pranayama yoga

Breathing, the autonomic nervous systems (ANS) function and pranayama yoga

This part is largely based on the work of Professor Paul Johnson MD MA (Oxford University), a clinical physiologist experienced in cardio respiratory and behavioural research from foetal life to old age and in acute and chronic cardio-respiratory conditions, including sleep disorders. He is a pioneer in developing and using tele-monitoring from body wearable sensors, developed and evaluated in multicenter trials in Europe. He has pioneered the use of wearable wireless technology that measures the dynamic condition of the autonomic nervous system (ANS) ‘round the clock’ and especially the importance of breathing, physical activity and diet in self-improving its performance.

We are very grateful to Pr Johnson for his support and his interest in Dominique’s work.

The autonomic nervous system (ANS or visceral nervous system or involuntary nervous system) is the part of the peripheral nervous system that acts as a control system functioning largely below the level of consciousness, and controls visceral functions. The ANS affects heart rate, digestion, respiratory rate, salivation, perspiration, pupillary dilation, micturition (urination), and sexual arousal

“Health is not only the absence of infirmity and disease but also a state of physical, mental and social well-being” WHO 1978

“Breathing rhythm is probably the most important biorhythm. Understanding the physiology of breathing is one thing – doing it well is another.” Prof Paul Jonhson

A fusion of Eastern and Western medicine holds the key to developing a global wellness based health service. This development is predicted as essential for intervening in the unsustainable pandemic of lifestyle related diseases that are increasing western healthcare costs at 7% per annum.

The condition of the autonomic nervous system (ANS) underlies personal health as defined above. The ANS in health is a balancing nervous system, stimulated by the sympathetic system (adrenaline), and inhibited by parasympathetic system, vagal (acetylcholine), which integrates the function from the cells to organs throughout the body awake and asleep. It is affected by genetic and environmental factors and determines our individual phenotype that controls our responses to all challenges, brief and long lasting including stress, infection, and acute and chronic diseases.

There are many ANS rhythms within our body and brain (mind) active over seconds to deal with sudden changes from defense mechanisms to stop foreign liquids entering the lungs, taking evasive action quickly, or arousal during sleep, to minutes and hours as critical adjustments in blood pressure, blood flow, respiration, metabolism, visceral and endocrine function are coordinated. These biorhythms are also modulated by longer ones related to eating, activity, and sleep when we depend on the ‘automatic’ ANS to maintain life and rest.

This circadian rhythm (day/ night) is one of the most important, and yet is the one that has been disturbed most by modern life, which has lost the regular stimulus of the natural light dark cycle. Melatonin uniquely regulates the mammalian sleep wakefulness response to cycles of light and dark and also links appropriate changes in metabolism, blood pressure, breathing, immune and endocrine function. For most of us, this rhythm has lost its coordinating role such that sleep, usually a time of regeneration, restoration and rest, is easily disturbed sometimes continually. This influences all the other biorhythms. Disturbances while awake also disrupt integration or coherence of these biorhythms, which ensures harmony, and resilience of all organ systems.

One of the strongest and most recently explored pathways is the relationship between ANS stress and the immune system, which critically influences a wide range of responses to both communicable and non-communicable diseases. Genetic and specific organ predisposition to dysfunction means that a wide range of apparently organ-specific conditions affecting endocrine organs, cardiac and vascular systems, visceral organs, joints and the nervous system results from chronic ANS stress and immune disorders.

Measuring and analyzing the variation in heart rate (from ECGs) over 24 hour periods has proved a remarkable insight into the presence and coherence, or the absence or reduction of key biorhythms. With the addition of micro-sensors able to track activity in detail, the breathing patterns and temperature changes, it is now possible to determine our usual (not clinic-hospital) individual pattern of the multiple biorhythms in ANS function during the day and night.

Many of these biorhythms are interdependent and ensure stability, efficiency and resilience to respond to daily life. The presence of these biorhythms produces the characteristic variations in heart rate and is best observed at rest. Analysis of the variation in heart rate (HRV) can extract the presence, coherence or abnormal dominance of a biorhythm or arrhythmia (when a rhythm such as the heart beat becomes irregular). Variability usually means that an individual will react well to stresses that are normal part of life. Chronic stress produces a chronic imbalance caused by sympathetic/adrenaline excess that affects most organ systems adversely, especially if there is a predisposing (genetic) vulnerability.

Persistent stress, especially pre-conception, during pregnancy, infancy and early childhood increases the chance of genetic change – so called ‘translation’ so that increased risk for many diseases, notably diabetes, becomes genetic and not simply environmental. A minority of us are functioning optimally ‘round the clock’.

In health, the most prominent biorhythm for the heart rate when resting is the oscillation related to breathing. This is still referred to as respiratory sinus arrhythmia (RSA), although it is rhythmic with breathing. Heart rate slows when breathing in – caused by slow acting vagal stretch receptors (SARS) in the lower airways. During expiration the vagal activity decreases and sympathetic activity may also increase increasing heart rate. This rhythm assists cardiac function by as much as 15%. One of the remarkable findings in recent science has been the link between breathing pattern, blood pressure, heart rate, cardiac output, blood flow to vital organs including the brain, and higher and lower brain function itself – contributing to mindfulness and meditation.

Even more remarkable for the human is that breathing effectively at 6 per minute (normal frequency for the adult is 12-15 breaths per minute) produces the most prominent coherence such that all these functions oscillate together. This potent coherent breathing frequency coincides with an oscillation in blood pressure described in 1876 by Mayer. This cardiovascular oscillation has been largely ignored perhaps because of it relative complexity considered to involve both peripheral and central regulatory mechanisms. This ‘optimal’, but subnormal, breathing frequency has been found by research from many directions; from that seeking to find best strategies for clinical care of patients with heart failure (such patients usually breath faster and shallowly often with distress (called dispend), to studies of yoga breathing and meditation. The latter practices vary – not least because of variation by teachers as well as long standing traditions (>2000 years) before scientific measurement or knowledge existed. Most meditation practices emphasize awareness of breathing patterns by usually lengthening the breath cycle though seldom measuring it.

Nevertheless, repetitive practice breathing at 6 per minute (not easy to achieve for everyone), by whatever means – from entrainment biofeedback tools such as Resperate and Emwave (Heartmath) or mindfulness, meditation, CBT (some) is an effective way of improving ANS function, HRV and wellbeing, reducing risk and improving or reversing many chronic diseases, over 60% of which are now lifestyle related.

A decisive ‘breakthrough’ scientific observation is the recent (2003) chance finding that the fundamental Pali Yoga mantra, Om-manipadme-om, the Rosary – Ave Maria (in Latin), and some ancient Persian poems, chanted aloud repetitively reduce breathing to 6 per minute – and cause the maximal oscillation in heart rate, blood pressure, blood flow to the brain and the EEG. ‘Beyond science’ – but confirmed by science, Historical review confirms the influential link between the Buddhist Yoga mantra and the other two above. The evolutionary contribution remains conjecture.

Most of us have lost the basic art of breathing – in fact ‘degenerated’ to breathing badly. This includes over breathing (hyperventilation)– especially considering the stresses with which we now live, often subconsciously and under-breathing (hypoventilation). Both are inefficient and destabilizing, which leads to many life-style related acute and chronic diseases. Breathing ‘physiologically’ imposes a rhythm, called respiratory sinus arrhythmia RSA that can be seen in the heart and cardiovascular system rhythms but with potent ‘unseen’ benefits in the nervous, endocrine and metabolic systems. Recent research has shown that breathing slowly (6 per minute), primarily by extending expiration, makes breathing more efficient for health and to prevent disease and remarkably this slow rhythm improves the coordination of many cardiovascular and brain rhythms. Sympathetic nervous activity, the stimulating ‘half’ of the autonomic nervous system, which becomes dominant and damaging with chronic stress, is reduced as vagal or parasympathetic activity increases – often within a few breaths. Blood pressure, heart rate and mental relaxation follow. Meditation and mindfulness is improved. Yogic breathing is a unique method for balancing the autonomic nervous system and influencing psychological and stress-related disorders. Monks chanting the Pali Yoga mantra Om-manipadme-om breathe at 6 per minute and these other biorhythms – cardiovascular and brain – are coordinated by this chanting.

The solution

Many of us breathe badly – often over breathing subconsciously or involuntarily, such as in anxiety or panic, and during hours of sedentary life both work and leisure, or increasingly during sleep. Knowledge, flexibility, fitness and practice can dramatically change this situation and its benefit is most when breathing rhythmically at 6 breaths per minute.

Pranayamic breathing, the platform for effective Yoga for centuries, is remarkable because it involves deep slow -3 phase – thoracic and abdominal breathing in ‘yogic’ postures, many of which seem extreme to the western novice. However, in addition to producing effective slow rhythmic breathing, development of its full range of breathing positions provides exercise and restoration of flexibility and posture; a complete wellbeing program in its own right for an active life at any level, from the office to sport.

Therefore, not only do we need to breath but we need to re-train our breathing system to breath well as it has a scientifically proven major impact on our state of well-being.