Yoga Breathing to Fight Against COVID-19




This article explains the yoga breathing and yoga respiratory cleaning techniques to fight against COVID-19 viruses and to build a strong respiratory system.

The COVID virus moves in two ways in the body. The virus moves downward along the respiratory tract;  nose – mouth – throat, and to the lungs.   In the severe cases of COVID-19, the virus moves upward to the brain through the nose and reach the olfactory bulb of the brain and then the respiratory center in the brainstem areas.

To stop the downward movement of the virus we have discussed the Ayurveda techniques earlier. This article explained how yoga breathing techniques like kurma breathing, alternate nostril breathing and yoga cleaning techniques like jal neti, can help us to improve our immunity and fighting capability against COVID-19 viruses. Several studies suggested that practice of proper yoga breathing exercises for a short duration (3 months) of time can significantly improve respiratory muscle strength.  Social distancing, hand washing, wearing face-masks and improving immunity are the key tools to fight against Coronaviruses. Here, we will also review the yoga breathing techniques with respect to COVID challenge.

Yoga Breathing to Fight Against COVID-19
Yoga Breathing to Fight Against COVID-19

Psychological stress of COVID Patients

The most common cause of hyperventilation in COVID patients is extreme psychological stress. The negative mental health problems arise mostly from worry or stress over coronavirus uncertainties. Due to fear and fever there is an abnormal increase in the rate and depth of respiration. Brain tries to adjust the respiratory rate until the desired pH and PaCO2 goals are met, but often the sympathetic nervous system become overactive and causes problems.

However, yogic slow breathing can increase the oxygen absorption that follows greater tidal volume as a result there can be reduction in the anatomical and physiological dead space and finally the psychological stress.

Science of Breathing 

Respiration rate, tidal volume and the inspiration/expiration ratio are the three primary measurements for scientific breathing.  Tidal volume is the volume of air moved per breath into or out of the lungs during normal quiet breathing. In a healthy, young human adult, tidal volume is approximately 500 mL per inspiration or 7 mL/kg of body mass. Venous blood always has a lower PaO2 and higher PaCO2. Hence there is a partial pressure gradient driving Oxygen in and CO2 exhalation is out of the pulmonary capillary blood. Inhalation is an active process requiring muscular effort, while exhalation is usually a passive and relaxing process.

Inspiratory : Expiratory ratio refers to the ratio of inspiratory time : expiratory time. In normal spontaneous breathing, the expiratory time is about twice as long as the inspiratory time (1:2). Inspiration is normally an active process (requiring work). Expiration is passive, and usually longer than the time required for exhalation, resulting an a no-flow period. This ratio is reduced to 1:4 or 1:5 in the presence of obstructive airway diseases. 

Generally, yoga breathing techniques are performed to build strong respiratory system with exercises at various rates and ratios of inspiration/expiration ratio to bring the normal breathing rate at 6 breath/min so that the lung and the respiration system can withstand any challenge. 

How COVID-19 Effects the Respiratory System

Respiratory Control Centers in Brain Stem

According to the recent research, the SARS-CoV-2 virus might infect PreBötzinger complex (PBC), located within the ventrolateral medulla, the primary center of the brain that controls the respiratory rhythm generation. Which explains that collapse of the respiratory center in the brain may be responsible for breakdown of COVID-19 patients. Another recent study from a group of scientists at King’s College London, UK highlighting loss of smell was one of main symptoms of COVID-19 patients, hinting at the involvement of the same route through which SARS-CoV-2 may enter the brain.

How COVID Virus Enters the Human Body

A virus infects your body by entering healthy cells.  Specifically, the S-proteins of the virus clubs into the healthy cells of the body through the ACE2 receptors. Once inside the cell, the coronavirus hijacks healthy cells and takes the control. There, the invader makes copies of itself and multiplies throughout the body. The life cycle of the SARS-CoV-2 virus explains how it grows inside the host cell. 

For most people, the symptoms end with a cough and a fever. More than 8 in 10 cases are mild. But for some, the infection gets more severe. About 5 to 8 days after symptoms begin, they have shortness of breath (known as dyspnea). Acute respiratory distress syndrome (ARDS) begins a few days later. 

The lower airways in the body have more ACE2 receptors than the rest of your respiratory tract. SARS-CoV-2 may target the PBC of the brainstem that controls respiration and causes respiratory collapse of COVID-19 patients.  

The Neuroscience of Breath

The motor pattern during normal breathing was considered to consist of three phases: inspiration, post-inspiration, and late expiration. Studies confirmed that prolonged exhalation and other yogic slow breathing techniques promote calmness and  parasympathetic dominance. Heart rate slowing during exhalation is the result of greater parasympathetic activity during exhalation. Yogic breathing techniques decrease the activity of  sympathetic nervous system to the bronchioles and increases parasympathetic input.

The pre-BötC of the brain area contains a heterogeneous population of excitatory neurons, including cells with intrinsic bursting properties, with mutual synaptic interconnections that generate rhythmic bursts of inspiratory activity and drive inspiratory motor output.  Both the pre-BötC and BötC are critically involved in generating the normal rhythmic respiratory neural activity.

Tortoise Breathing to Counter COVID Viruses 

Tortoise BreathingA tortoise lives up to 200 to 400 years. The key reason of longevity is they breathe only 3 to 4 per breath. All turtles and tortoises breathe air and must surface at regular intervals to refill their lungs.  However, turtle’s shell cannot expand and contract the way a person’s ribs do. During normal respiration, the mouth is held closed and air enters through the nostrils which appear to be always open and lack valves. The abdominal muscles of the turtles take the primary role in breathing functions. 

The shell of the turtle poses a special problem in the ventilation of the lungs. The rigidity of the shell prevents the use of the ribs in the aspiration pump. Alternatively, turtles possess sheets of muscle within the shell that, through contraction and relaxation, force air in and out of the lungs. In addition, turtles can alter the pressure within the lungs by moving the limbs in and out of the shell.

“Kurma breathing – the slow equal deep abdominal breathing is the secret of yoga and it is the secret of long life.” — Amit Ray

Kurma Breathing to Strengthen the Respiratory System

Yogic breathing (pranayama) is a well-known ancient practice of controlled breathing, often performed in conjunction with meditation or yoga, for its spiritual and perceived health-enhancing effects. Various forms of pranayama exist, such as nostril breathing (double, single or alternate), kurma breathing, diaphragmatic breathing, slow breathing, abdominal breathing, forceful breathing and vocalised (chanting) breathing, which are performed at varying rates and depths.

The typical respiratory rate in humans is within the range of 10–20 breaths per min (0.16–0.33 Hz). In ancient yoga, the tortoise breathing or slow breathing is defined as breathing rate from 4 to 10 breaths per min (0.07–0.16 Hz).  Several research evidence has indicated that slow diaphragmatic breathing significantly reduces blood pressure and increases heart rate variability (HRV) and oxygenation.

The major respiratory muscle in our body is in the diaphragm, which, during normal inspiration, contracts and flattens, pushing on the abdomen, while the lower ribs are pushed upwards and outwards. Expiration is generally passive, with the diaphragm returning to its domed resting configuration, causing the lungs to deflate and expel air.

The biomechanics of lung ventilation are carefully coordinated with blood oxygen, carbon dioxide and pH homeostasis. Normally, decreasing respiratory rate and increasing tidal volume has been shown to improve breathing efficiency. Slow respiration at 6 breaths per min was found to be optimal for improving alveolar ventilation. 

Kurma Breathing Practices

Kurma breathing is a slow equal abdominal breathing technique. You can practice the kurma breathing, slow equal abdominal breathing from a sitting or lying-down position. Whichever position you choose, be sure to get comfortable.

  1. Shut your eyes and pay attention to the way you normally breathe for several breaths.
  2. Then, slowly count 1-2-3-4-5 as you inhale through your nose.
  3. Exhale for the same 1-2-3-4-5 count.
  4. As you inhale and exhale, be mindful of the feelings of fullness and emptiness in your lungs.

As you continue practicing equal breathing, your second count might vary. Be sure to keep your inhale and exhale the same and keep your attention in the movement of the diaphragm. 

Alternate nostril breathing

To practice alternate nostril breathing, sit down in a comfortable place, straightening your spine and opening your chest.

Rest your left hand in your lap and raise your right hand. Then, rest the index and middle fingers of your right hand on your forehead, in between the eyebrows. Close your eyes, inhaling and exhaling through your nose.

  1. Use your right thumb to close the right-hand nostril and inhale slowly through the left.
  2. Pinch your nose closed between your right thumb and ring finger, holding the breath in for a moment.
  3. Use your right ring finger to close your left nostril and exhale through the right, waiting for a moment before you inhale again.
  4. Inhale slowly through the right nostril.
  5. Pinch your nose closed again, pausing for a moment.
  6. Now, open the left side and exhale, waiting a moment before you inhale again.
  7. Repeat this cycle of inhaling and exhaling through either nostril up to 10 times. Each cycle should take up to 40 seconds.

Cleaning the Olfactory Nerves of the Brain

Jal Neti  is one of the six-purification kriyas or cleaning procedures or ‘Shatkarmas’ mentioned in Hatha Yoga Pradipika, an ancient yoga text. The ‘nasal wash’ has its origin in ancient India and has been practiced for ages by ancient yogis and people for the cleansing process. 

Jal Neti Procedure

This is a easy practice. It can be done along with your daily morning routines. You can do it just right after brushing your teeth in the morning. It takes just a few minutes. It required a Neti-pot. Filled the neti pot with warm salt water. Tilt your head to one side, and comfortably put the pot’s spout inserted into the upper nostril. Normally, breathe through your mouth, keeping it open. Late the water slowly poured into the nostril, and allow it to drain through the lower nostril. The same process is then repeated on the second side. When both sides have been cleansed, the excess water is blown out of the nostrils using Kapalbhati breathing technique. 

Eight Top Yoga Breathing Exercises

In the table below I explained the eight popular yoga breathing exercises. 

Name of the yoga breathing exercises Breathing excise procedure
1. Breath of fire (Kapalabhati) Sitting with back and neck erect, one should inhale through both nostrils and exhale rapidly by flapping the abdomen during each exhalation at a pace of 60–120 breaths/min.
2. Bellow breathing (Bastrika) One should inhale and exhale quickly and forcefully without straining by flapping the abdomen. This should be practiced for up to 100 breaths.
3. Alternate nostril breathing (Nadishodhana/Nadishuddhi ) With the right thumb, close the right nostril and inhale through left nostril. Closing the left nostril, exhale through right, following which inhalation should be done through right nostril. Closing the right nostril, breath out through left nostril. This is one round. The procedure is repeated for desired number of rounds.
4. Right uninostril breathing (Suryanuloma Viloma) Closing the left nostril, both inhalation and exhalation should be done through right nostril, without altering the normal pace of breathing.
5. Left uninostril breathing (Chandranuloma Viloma) Procedure similar to Suryanuloma Viloma, breathing is done through left nostril alone, by closing the right nostril.
6. Right nostril initiated breathing (Suryabhedana) Closing the left nostril, inhalation should be done through right nostril. At the end of inhalation, close the right nostril and exhale through the left nostril. This is one round. The procedure is repeated for desired number of rounds.
7. Psychic Breathing (Ujjayi  Pranayama) Inhalation and exhalation are done through the nose at normal pace, with partial contraction of glottis, which produce light snoring sound. One should be aware of the passage of breath through the throat during the practice.
8. Female honeybee humming breath (Bhramari Pranayama) After a full inhalation, closing the ears using the index fingers, one should exhale making a soft humming sound similar to that of a female honeybee.
   

Conclusions and Future Directions

It has been suggested that in order to achieve a long-term shift towards parasympathetic dominance, prolonged practice of slow breathing is necessary, as was observed in healthy humans who practiced slow breathing regularly for 3 months.

In order to fight against COVID viruses, the access of the COVID-19 virus to the brain must be stopped. Early isolation of the SARS-CoV-2 virus from the zones that are in proximity to the olfactory bulb of the brain is very effective to stop the spread of the virus.

These techniques are helpful in general, but check with your doctor first before trying this out because it may not be suitable for everyone. COVID treatment must be done in a clinical environment under careful monitoring by trained medical professionals. 

When a person breathes the olfactory nerves situated in the roof of the nose are stimulated. Here, we discussed the Jal Neti,  Kurma breathing, Alternate nostril breathing and other yoga breathing exercises to reduce the effectiveness of the COVID viruses and to strengthen the respiratory system.