The Autonomic Nervous System - Re-balancing Through Breath Work and Meditation

Updated: Sep 18

“Breathing in, I know I am breathing in. Breathing out, I know I am breathing out.”

~Thich Nhat Hanh


Hey Readers! This blog post is part 3 of my Autonomic nervous system (ANS) series. If you have not read part 1 (which gave an overview of the ANS) or part 2 (which described how yoga helps to re-balance the ANS), I recommend that you go back and read those articles now (click on the link for part 1 and part 2). But, I will give a brief summary to make sure that we all understand this topic in the same way.


Your ANS controls involuntary actions, such as digestion or running away from a dangerous situation. Many people live with ANS imbalance, where the sympathetic nervous system (SNS) is overactive, and the parasympathetic nervous system (PNS) is underactive. When the SNS is turned "on," it causes feelings of panic, anxiety, and excitability. When the PNS is turned "on," it brings about feelings of calm, safety, and harmony. The more time you spend in states of anxiety (i.e. SNS activation), the weaker, and sicker, your body becomes. The key to healing and wellness is to spend more time resting and relaxing so that you engage your PNS more often. When your PNS dominates, your body is able to repair injured or damaged tissue/cells, properly digest foods and liquids, and eliminate waste products via urine or feces. Scientific research has repeatedly shown that yoga helps to increase PNS activity and decrease SNS activity, as measured via heart rate variability (HRV - see part 2 for more information on HRV).


Awesome sauce! Now that we are all caught up, let's get into this week's blog post about re-balancing the ANS through breath work and meditation. In this blog post, I will review what breath work is, my favorite types of breath work, and the scientific evidence for using breath work to re-balance the ANS towards PNS dominance.

What is Breath Work?

Breath work, sometimes referred to as pranayama in the yoga world, is the conscious modification of breath. When you practice breath work, or pranayama, you voluntarily change your natural breathing cadence by using one of the many available breath work strategies. Breath work is usually done to achieve some larger goal such as increasing focus or calming your nervous system. Please note, there are some types of pranayama that can be up-regulating (or excitatory) to the nervous system, but these will not be discussed in this post.


Breathing techniques help you access your nervous system and control your state of mind. Breathing exercises can condition the diaphragm and accessory muscles of respiration (e.g. abdominal muscles, chest muscles, neck muscles, rib cage muscles, etc.), increasing the mobility and functionality of the breathing musculature. This can lead to better breathing mechanics throughout the day. And when you breathe better, everything works better in your entire body. Breathing practices also provide a focal point to divert attention away from negative or noisy thoughts. In this way, breath work is a type of meditation, where you have a central focus for a set amount of time. This can lead to improved focus and concentration. Most of the calming breathing techniques, as discussed in this post, bring about a slower, deeper breath.


How Does Slow, Deep Breathing Affect My Nervous System?

Your breath is a great internal barometer that constantly gives you feedback about your state of mind. But, you can also change your breathing to change your state of mind. For example, rapid, shallow breathing indicates sympathetic dominance, and slow, deep breathing indicates parasympathetic dominance. Additionally, slow, deep breathing can stimulate the PNS, while shallow, rapid breathing inhibits the PNS. Thus, slow, deep breathing literally calms your nervous system. You know how people always tell someone who is upset to “take a deep breath?” Well, this is because that actually works! Those slow, steady, deep inhalations turn on your PNS, allowing your body to enter into a more calm and peaceful state. Conversely, when your breath is fast and shallow, your SNS gets activated, increasing your panic, stress, and anxiety. You can learn to master both observation AND manipulation of your breath, so you can control your body’s physiology and mental state.


Down-regulating Breathing Practices You Should Totally Try

There are many different types of breathing practices you can do. Just a simple Google search for "breathing practices" or "pranayama" will yield A LOT of options. Down-regulating breath work activates the PNS and inhibits the SNS. In contrast, up-regulating breathing practices (which are not discussed in this post), activate the SNS and inhibit the PNS. I will summarize a few of my favorite down-regulating practices here, along with any available scientific research.


Breath awareness (BAW). When you practice BAW, you are not actually trying to change your breath. You are merely noticing yourself breathing in and out, feeling as much of your breath moving through you as you can. You simply follow your breath in and out, again and again. You can notice the sensation in your nose, throat, chest and belly each time you inhale and exhale. You can notice the length of your inhalations and exhalations - again, without trying to change it or judge it. Research has shown that simple BAW can activate areas in your Prefrontal cortex (i.e. the front part of your brain, just behind your forehead) associated with executive functioning (e.g. impulse control, cognitive flexibility, etc.) and inhibit areas in your amygdala associated with fear, rage, and anger. I’ll be honest - BAW takes practice. Your mind will wander, and that is totally okay. In fact, it is completely normal for your mind to wander off to other thoughts, sensations, and emotions. Simply favor the breath. Come back to the breath when you notice your mind has wandered back to your thoughts and to your mind chatter. Do not judge yourself when your mind wanders away from your breath. Instead, notice it, and gently return your attention back to the inhale and exhale.


Diaphragmatic breathing (DB). DB (aka belly, abdominal, abdominal-thoracic breathing), involves using your diaphragm muscle to its fullest range of motion (ROM). Every time you take a breath, your diaphragm contracts whether you use it maximally or not. The problem is that we typically do not use the full ROM of our diaphragm when we breathe, and instead we use our shoulders and neck muscles more readily (known as clavicular breathing). Clavicular breathing has been shown to increase activity in the SNS, making your feel more tense, agitated, and/or anxious. When you consciously mobilize your diaphragm fully, through repeated, mindful contractions, you train your diaphragm to move through its full ROM. Thus, your diaphragm begins to move with much more ease, even when you are not practicing diaphragmatic breathing. To practice DB, it is best to lie on your back, but you can totally do it sitting or standing if you need to/prefer. Place your hands on your belly. Inhale and feel your belly swell like a balloon as it rises into your hands (the reason your belly rises is because your diaphragm contracts downward when you inhale, pushing your belly contents out of the way). Exhale and feel your belly soften like a deflating balloon, as it pulls back towards your center (the reason your belly softens and falls back to center is because your diaphragm relaxes upward into your rib cage when you exhale, allowing your belly contents to return to their resting position). Research as repeatedly shown that DB turns on your PNS (and turns off your SNS), allowing you to enter into a state of down-regulation and ease. When I practice DB, I like to visualize and sense my diaphragm (which sort of looks like an umbrella at rest and a flattened parachute when contracted) moving downwards and upwards as I breathe.

Sama vritti. Sama vritti (aka equal breath) is a breathing technique where you inhale and exhale for the same amount of time. Typically, most people start by inhaling, then exhaling, to a count of 4. The count then increases to 5, and 6, and so on. Sama vritti has been shown to increase activity in the PNS and decrease SNS activity. Sama vritti also helps to increase focus and concentration. I typically practice sama vritti when my yoga practice will involve a lot of balance work or when I personally feel unbalanced, mentally or emotionally.

Square breathing. Square breathing (aka box breathing) is a breathing exercise where you inhale, hold the breath, exhale, and hold the breath again, all to the count of 4 (hence the reason why it is called “square breathing” – squares have four sides). Square breathing has been shown to improve focus and concentration. It also helps to increase PNS activity while decreasing SNS activity. To practice square breathing, you inhale to a count of 4, hold the breath at the top to a count of 4, exhale to a count of 4, and hold your breath at the bottom to a count of 4. Please note, square breathing can be challenging in the beginning. The more you practice it, the easier it becomes. This is one of my absolute favorite breathing techniques to practice. I notice that my breath flows so much easier after I practice square breathing. If four seconds is too long for you to hold, you can modify by doing "triangle breathing" where everything is held for a count of 3.


Extended exhalation (EE). In EE, you consciously make your exhale LONGER than your inhale. For example, you might inhale to a count of 5 and exhale to a count of 8. Your HR slightly elevates when you inhale, and it lowers when you exhale. Thus, when you extend the length of your exhale, your heart rate drops quite a bit, which can trigger the PNS to ramp up. As we have discussed a ton in this series, when your PNS is turned on, it makes your body and mind feel calmer and more peaceful. PNS activation also gives your body time to work on digestion, elimination, and tissue repair, leading to better overall wellness within your body and mind.

Alternate nostril breathing (ANB). ANB is a breathing technique where you close off one nostril (using your finger) while exhaling through the other nostril. Then, you inhale through the same nostril you just exhaled from. Next, you switch nostrils by closing off the first nostril (with another finger), and exhaling, then inhaling, through the other nostril. Repeat this process as many times as you would like. ANB helps to reduce SNS activation and increase activity in the PNS. ANB has also been shown to reduce blood pressure (BP), and after 8 weeks of practicing ANB, the magnitude of BP reduction increased (meaning the BP continued to decrease over time with ANB). ANB has also been shown to increase your concentration/focus and lung function.


Bhramari breath. Bhramari breathwork involves placing your index fingers on the space between your ear and your cheek, one on each side. You can let your other fingers curl into your palm (as in the first picture), or you can place your other fingers on the top of your head (as in the second picture). Inhale and then exhale as you make a humming sound (“mmmm”). Bhramari breath, completed 5 days per week for 5 minutes each day, resulted in increased PNS activity, as measured by HRV in various research studies. Certain sounds, including humming, are also known to be very calming to the nervous system.


How Often, and For How Long, Should I Practice Breath Work?

There is no set rule as to how many minutes or repetitions you need to complete when doing breath work. It is truly up to you and your schedule. I personally think that five minutes is perfect - it is just long enough to be challenging and create change but short enough to not be too daunting or overwhelming. If you cannot devote five full minutes to breath work every day, try to incorporate it when and where you can. For example, maybe you do a few rounds of square breathing while waiting for your coffee at Starbucks, or maybe you do a few rounds of diaphragmatic breathing when driving into work. I often practice breath work in the shower after a long day at work. It really helps me to unwind and let go of any craziness from the day. And sometimes I practice it while waiting for a patient at work or when I am driving in my car. Find what works for you and your schedule so that you can practice breath work everyday. Your body and mind will thank you!


Summary

Breath work, sometimes referred to as pranayama in the yoga world, is the conscious regulation of breath through certain techniques and exercises. Some breathing techniques are up-regulating to the nervous system, which means that they trigger the SNS to turn "on." These up-regulating exercises were not discussed in this blog post. Other breathing techniques are down-regulating to the nervous system, which means that they trigger the PNS to turn "on." There are many varieties of down-regulating breathing exercises, including breath awareness, diaphragmatic breathing, square breathing, and more. These down-regulating exercises increase activity in the PNS, typically measured via heart rate variability (HRV). When your PNS is active, it causes you to feel calm, relaxed, and safe. Increased activity in the PNS also gives your body the opportunity to work on cellular repair, waste removal, and digestion. Thus, when your PNS is dominant, you truly can feel healthier in your body and mind.


As always, the information presented in this blog post is derived from my own personal practice and study of neuroscience, human movement, and yoga. If you have specific questions about beginning a breathing practice, please consult with your physician. If you have not already, please subscribe to my newsletter by adding your email at the bottom of the page. This way you can "stay in the know" about my latest blog posts, coupons, and other health/wellness information. Special thanks to my incredible husband for doing all of the artwork, and taking the photos, in this post.

~Namaste, Jackie Allen, M.S., M.Ed., CCC-SLP, RYT-200, RCYT


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Telles, S., et al. (2014). Blood Pressure and Heart Variability during Yoga-Based Alternate Nostril Breathing Practice and Breath Awareness. Medical Science Monitor Basic Research. 20: 184 – 193.

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