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J Altern Complement Med. 2005 Feb;11(1):189-201.

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Sudarshan kriya yogic breathing in the treatment of stress, anxiety, and depression: part I-neurophysiologic model.

Brown RP, Gerbarg PL.

Columbia College of Physicians and Surgeons, New York, NY.

Mind-body interventions are beneficial in stress-related mental and physical disorders. Current research is finding associations between emotional disorders and vagal tone as indicated by heart rate variability. A neurophysiologic model of yogic breathing proposes to integrate research on yoga with polyvagal theory, vagal stimulation, hyperventilation, and clinical observations. Yogic breathing is a unique method for balancing the autonomic nervous system and influencing psychologic and stress-related disorders. Many studies demonstrate effects of yogic breathing on brain function and physiologic parameters, but the mechanisms have not been clarified. Sudarshan Kriya yoga (SKY), a sequence of specific breathing techniques (ujjayi, bhastrika, and Sudarshan Kriya) can alleviate anxiety, depression, everyday stress, post-traumatic stress, and stress-related medical illnesses. Mechanisms contributing to a state of calm alertness include increased parasympathetic drive, calming of stress response systems, neuroendocrine release of hormones, and thalamic generators. This model has heuristic value, research implications, and clinical applications.

 

Appl Psychophysiol Biofeedback. 2004 Mar;29(1):19-33.

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Yogic versus conventional treatment in diarrhea-predominant irritable bowel syndrome: a randomized control study.

Taneja I, Deepak KK, Poojary G, Acharya IN, Pandey RM, Sharma MP.

Department of Physiology, All India Institute of Medical Sciences, New Delhi 110029, India.

This study was conducted to evaluate the comparative effect of yogic and conventional treatment in diarrhea-predominant irritable bowel syndrome (IBS) in a randomized control design. The patients were 22 males, aged 20-50 years, with confirmed diagnosis of diarrhea-predominant IBS. The conventional group (n = 12, 1 dropout) was given symptomatic treatment with loperamide 2-6 mg/day for 2 months, and the yogic intervention group (n = 9) consisted of a set of 12 asanas (yogic poses, i.e., Vajrasana, Shashankasana, Ushtrasana, Marjariasana, Padhastasana, Dhanurasana, Trikonasana in two variations, Pawanmuktasana, and Paschimottanasana) along with Surya Nadi pranayama (right-nostril breathing) two times a day for 2 months. All participants were tested at three regular intervals, at the start of study--0 month, 1 month, and 2 months of receiving the intervention--and were investigated for bowel symptoms, autonomic symptoms, autonomic reactivity (battery of five standard tests), surface electrogastrography, anxiety profile by Spielberger's Self Evaluation Questionnaire, which evaluated trait and state anxiety. Two months of both conventional and yogic intervention showed a significant decrease of bowel symptoms and state anxiety. This was accompanied by an increase in electrophysiologically recorded gastric activity in the conventional intervention group and enhanced parasympathetic reactivity, as measured by heart rate parameters, in yogic intervention group. The study indicates a beneficial effect of yogic intervention over conventional treatment in diarrhea-predominant IBS.

 

 

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J Affect Disord. 2000 Jan-Mar;57(1-3):255-9.

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Antidepressant efficacy of Sudarshan Kriya Yoga (SKY) in melancholia: a randomized comparison with electroconvulsive therapy (ECT) and imipramine.

Janakiramaiah N, Gangadhar BN, Naga Venkatesha Murthy PJ, Harish MG, Subbakrishna DK, Vedamurthachar A.

Department of Psychiatry, National Institute of Mental Health and Neuro Sciences, Bangalore, India.

BACKGROUND: Sudarshan Kriya Yoga (SKY) is a procedure that involves essentially rhythmic hyperventilation at different rates of breathing. The antidepressant efficacy of SKY was demonstrated in dysthymia in a prospective, open clinical trial. This study compared the relative antidepressant efficacy of SKY in melancholia with two of the current standard treatments, electroconvulsive therapy (ECT) and imipramine (IMN). METHODS: Consenting, untreated melancholic depressives (n=45) were hospitalized and randomized equally into three treatment groups. They were assessed at recruitment and weekly thereafter for four weeks. RESULTS: Significant reductions in the total scores on Beck Depression Inventory (BDI) and Hamilton Rating Scale for Depression (HRSD) occurred on successive occasions in all three groups. The groups, however, did not differ. Significant interaction between the groups and occasion of assessment occurred. At week three, the SKY group had higher scores than the ECT group but was not different from the IMN group. Remission (total HRSD score of seven or less) rates at the end of the trial were 93, 73 and 67% in the ECT, IMN and SKY groups, respectively. No clinically significant side effects were observed. DISCUSSION: Within the limitations of the design (lack of double blind conditions), it can be concluded that, although inferior to ECT, SKY can be a potential alternative to drugs in melancholia as a first line treatment.

 

Indian J Physiol Pharmacol. 2003 Apr;47(2):202-6.

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Effect of yoga on cardiovascular system in subjects above 40 years.

Bharshankar JR, Bharshankar RN, Deshpande VN, Kaore SB, Gosavi GB.

Department of Physiology, Govt. Medical College, Nagpur.

This study was conducted to examine the effect of yoga on cardiovascular function in subjects above 40 yrs of age. Pulse rate, systolic and diastolic blood pressure and Valsalva ratio were studied in 50 control subjects (not doing any type of physical exercise) and 50 study subjects who had been practicing yoga for 5 years. From the study it was observed that significant reduction in the pulse rate occurs in subjects practicing yoga (P<0.001). The difference in the mean values of systolic and diastolic blood pressure between study group and control group was also statistically significant (P<0.01 and P<0.001 respectively). The systolic and diastolic blood pressure showed significant positive correlation with age in the study group (r1 systolic= 0.631 and r1 diastolic = 0.610) as well as in the control group (r2 systolic = 0.981 and r2 diastolic = 0.864). The significance of difference between correlation coefficient of both the groups was also tested with the use of Z transformation and the difference was significant (Z systolic= 4.041 and Z diastolic= 2.901). Valsalva ratio was also found to be significantly higher in yoga practitioners than in controls (P<0.001). Our results indicate that yoga reduces the age related deterioration in cardiovascular functions.

 

J Altern Complement Med. 2004 Apr;10(2):261-8.

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Effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion.

Harinath K, Malhotra AS, Pal K, Prasad R, Kumar R, Kain TC, Rai L, Sawhney RC.

Defence Institute of Physiology and Allied Sciences, Timarpur, Delhi, India.

OBJECTIVES: To evaluate effects of Hatha yoga and Omkar meditation on cardiorespiratory performance, psychologic profile, and melatonin secretion. SUBJECTS AND METHODS: Thirty healthy men in the age group of 25-35 years volunteered for the study. They were randomly divided in two groups of 15 each. Group 1 subjects served as controls and performed body flexibility exercises for 40 minutes and slow running for 20 minutes during morning hours and played games for 60 minutes during evening hours daily for 3 months. Group 2 subjects practiced selected yogic asanas (postures) for 45 minutes and pranayama for 15 minutes during the morning, whereas during the evening hours these subjects performed preparatory yogic postures for 15 minutes, pranayama for 15 minutes, and meditation for 30 minutes daily, for 3 months. Orthostatic tolerance, heart rate, blood pressure, respiratory rate, dynamic lung function (such as forced vital capacity, forced expiratory volume in 1 second, forced expiratory volume percentage, peak expiratory flow rate, and maximum voluntary ventilation), and psychologic profile were measured before and after 3 months of yogic practices. Serial blood samples were drawn at various time intervals to study effects of these yogic practices and Omkar meditation on melatonin levels. RESULTS: Yogic practices for 3 months resulted in an improvement in cardiorespiratory performance and psychologic profile. The plasma melatonin also showed an increase after three months of yogic practices. The systolic blood pressure, diastolic blood pressure, mean arterial pressure, and orthostatic tolerance did not show any significant correlation with plasma melatonin. However, the maximum night time melatonin levels in yoga group showed a significant correlation (r = 0.71, p < 0.05) with well-being score. CONCLUSION: These observations suggest that yogic practices can be used as psychophysiologic stimuli to increase endogenous secretion of melatonin, which, in turn, might be responsible for improved sense of well-being.

 

West Indian Med J. 2004 Jun;53(3):191-4.

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Role of yoga in stress management.

Parshad O.

Department of Basic Medical Sciences, The University of the West Indies, Kingston 7, Jamaica, West Indies. oparshad@uwimona.edu.jm

The state of the mind and that of the body are intimately related. If the mind is relaxed, the muscles in the body will also be relaxed. Stress produces a state of physical and mental tension. Yoga, developed thousands of years ago, is recognized as a form of mind-body medicine. In yoga, physical postures and breathing exercises improve muscle strength, flexibility, blood circulation and oxygen uptake as well as hormone function. In addition, the relaxation induced by meditation helps to stabilize the autonomic nervous system with a tendency towards parasympathetic dominance. Physiological benefits which follow, help yoga practitioners become more resilient to stressful conditions and reduce a variety of important risk factors for various diseases, especially cardio-respiratory diseases.

 

 

Indian J Physiol Pharmacol. 1999 Apr;43(2):218-24.

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Stress due to exams in medical students--role of yoga.

Malathi A, Damodaran A.

Department of Physiology, Lokmanya Tilak Municipal Medical College & General Hospital, Sion, Mumbai.

A student under optimal stress does bring out his or her best, However extremes of stress can result in stress induced disorders and deteriorating performance. Can yoga be of benefit in stress induced effects in medical students? The present study was conducted in first MBBS students (n = 50) to determine the benefit if any of yogic practices on anxiety status during routine activities and prior to examination. Feedback scores were assessed to determine how the students had benefited from the practices. Anxiety status as assessed by Spillberger's anxiety scale showed a statistically significant reduction following practice. In addition the anxiety score which rose prior to exams showed a statistically significant reduction on the day of exam after practice. These results point to the beneficial role of yoga in not only causing reduction in basal anxiety level but also attenuating the increase in anxiety score in stressful state such as exams. The results of the exam indicated a statistically significant reduction in number of failures in yoga group as compared to the control group. The improvement in various parameters such as better sense of well being, feeling of relaxation, improved concentration, self confidence, improved efficiency, good interpersonal relationship, increased attentiveness, lowered irritability levels, and an optimistic outlook in life were some of the beneficial effects enjoyed by the yoga group indicated by feedback score.

 

Indian J Physiol Pharmacol. 2002 Jul;46(3):349-54.

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Improvement in oxidative status with yogic breathing in young healthy males.

Bhattacharya S, Pandey US, Verma NS.

Department of Physiology, King George's Medical College, Lucknow, 226 003.

The modern living lifestyle is known to produce various physical and psychological stresses and subject the individual to produce oxidative stresses as well. The aim of this study has been to assess the effect of yogic breathing exercises (pranayama) on the oxidatives stress. The study group consisted of 30 young male volunteers, trained for the purpose of this study and an equal number of controls were used. The free radicals and Super oxide dismutase levels were measured before the study and at the end of the study. The free radicals were decreased significantly in the study group but the SOD was increased insignificantly as compared to the control group. Yogic breathing exercises not only help in relieving the stresses of life but also improve the antioxidant status of the individual. An improvement in the antioxidant status is helpful in preventing many pathological processes that are known with impaired antioxidant system of body.

 

 

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Biol Psychol. 2003 Jul;63(3):281-91.

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Sudarshan Kriya practitioners exhibit better antioxidant status and lower blood lactate levels.

Sharma H, Sen S, Singh A, Bhardwaj NK, Kochupillai V, Singh N.

Department of Biochemistry, All India Institute of Medical Sciences, Ansari Nagar, New Delhi 110029, India.

Oxidative stress may contribute to the pathophysiology of many chronic diseases. Since psychosocial stress increases oxidative stress, we conducted an exploratory study to investigate the effects of stress reduction with the Sudarshan Kriya (SK) program, on superoxide dismutase (SOD), catalase, glutathione and blood lactate levels in practitioners and non-practitioners of SK. Blood samples of ten practitioners of SK and 14 non-practitioners of any formal stress management technique were analyzed for SOD, catalase, glutathione and lactate levels. Differences between groups and subgroups were analyzed by t-test and correlations between variables compared using Pearson's correlation coefficient. Significantly lower levels of blood lactate (P=3.118e-10) and higher levels of SOD (P=0.0001415), glutathione (P=2.038e-06) and catalase (P=0.001565) were found in practitioners as compared to non-practitioners of SK, thereby suggesting that lower levels of blood lactate and better antioxidant status in practitioners are associated with regular practice of SK technique. However, this study needs to be conducted on a larger sample size to confirm this effect.

 

 

J Am Board Fam Pract. 2003 Mar-Apr;16(2):131-47.

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Mind-body medicine: state of the science, implications for practice.

Astin JA, Shapiro SL, Eisenberg DM, Forys KL.

California Pacific Medical Center, San Francisco 94115, USA.

BACKGROUND: Although emerging evidence during the past several decades suggests that psychosocial factors can directly influence both physiologic function and health outcomes, medicine had failed to move beyond the biomedical model, in part because of lack of exposure to the evidence base supporting the biopsychosocial model. The literature was reviewed to examine the efficacy of representative psychosocial-mind-body interventions, including relaxation, (cognitive) behavioral therapies, meditation, imagery, biofeedback, and hypnosis for several common clinical conditions. METHODS: An electronic search was undertaken of the MEDLINE, PsycLIT, and the Cochrane Library databases and a manual search of the reference sections of relevant articles for related clinical trials and reviews of the literature. Studies examining mind-body interventions for psychological disorders were excluded. Owing to space limitations, studies examining more body-based therapies, such as yoga and tai chi chuan, were also not included. Data were extracted from relevant systematic reviews, meta-analyses, and randomized controlled trials. RESULTS: Drawing principally from systematic reviews and meta-analyses, there is considerable evidence of efficacy for several mind-body therapies in the treatment of coronary artery disease (eg, cardiac rehabilitation), headaches, insomnia, incontinence, chronic low back pain, disease and treatment-related symptoms of cancer, and improving postsurgical outcomes. We found moderate evidence of efficacy for mind-body therapies in the areas of hypertension and arthritis. Additional research is required to clarify the relative efficacy of different mind-body therapies, factors (such as specific patient characteristics) that might predict more or less successful outcomes, and mechanisms of action. Research is also necessary to examine the cost offsets associated with mind-body therapies. CONCLUSIONS: There is now considerable evidence that an array of mind-body therapies can be used as effective adjuncts to conventional medical treatment for a number of common clinical conditions.

 

 

Clin J Pain. 2004 Jan-Feb;20(1):27-32.

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Mind-body therapies for the management of pain.

Astin JA.

California Pacific Medical Center Research Institute, San Francisco, CA, USA. john@integrativearts.com

This paper reviews the evidence for mind-body therapies (eg, relaxation, meditation, imagery, cognitive-behavioral therapy) in the treatment of pain-related medical conditions and suggests directions for future research in these areas. Based on evidence from randomized controlled trials and in many cases, systematic reviews of the literature, the following recommendations can be made: 1) multi-component mind-body approaches that include some combination of stress management, coping skills training, cognitive restructuring and relaxation therapy may be an appropriate adjunctive treatment for chronic low back pain; 2) multimodal mind-body approaches such as cognitive-behavioral therapy, particularly when combined with an educational/informational component, can be an effective adjunct in the management of rheumatoid and osteoarthritis; 3) relaxation and thermal biofeedback may be considered as a treatment for recurrent migraine while relaxation and muscle biofeedback can be an effective adjunct or stand alone therapy for recurrent tension headache; 4) an array of mind-body therapies (eg, imagery, hypnosis, relaxation) when employed pre-surgically, can improve recovery time and reduce pain following surgical procedures; 5) mind-body approaches may be considered as adjunctive therapies to help ameliorate pain during invasive medical procedures.

 

 

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J Gen Intern Med. 2004 Jan;19(1):43-50.

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Use of mind-body medical therapies.

Wolsko PM, Eisenberg DM, Davis RB, Phillips RS.

Division for Research and Education in Complementary and Integrative Medical Therapies, Harvard Medical School, Boston, Massachusetts, USA. pwolsko@hms.harvard.edu

OBJECT: Research demonstrating connections between the mind and body has increased interest in the potential of mind-body therapies. Our aim was to examine the use of mind-body therapies, using data available from a national survey. DESIGN: Analysis of a large nationally representative dataset that comprehensively evaluated the use of mind-body therapies in the last year. SETTING: United States households. PATIENTS/PARTICIPANTS: A total of 2055 American adults in 1997-1998. INTERVENTIONS: Random national telephone survey. MEASURES AND MAIN RESULTS: We obtained a 60% weighted overall response rate among eligible respondents. We found that 18.9% of adults had used at least 1 mind-body therapy in the last year, with 20.5% of these therapies involving visits to a mind-body professional. Meditation, imagery, and yoga were the most commonly used techniques. Factors independently and positively associated with the use of mind-body therapies in the last year were being 40 to 49 years old (adjusted odds ratio [AOR], 2.03; 95% confidence interval [CI], 1.33 to 3.10), being not married (AOR, 1.78; 95% CI, 1.34 to 2.36), having an educational level of college or greater (AOR, 2.21; 95% CI, 1.57 to 3.09), having used self-prayer for a medical concern (AOR, 2.53; 95% CI, 1.87 to 3.42), and having used another complementary medicine therapy in the last year (AOR, 3.77; 95% CI, 2.74 to 5.20). While used for the full array of medical conditions, they were used infrequently for chronic pain (used by 20% of those with chronic pain) and insomnia (used by 13% of those with insomnia), conditions for which consensus panels have concluded that mind-body therapies are effective. They were also used by less than 20% of those with heart disease, headaches, back or neck pain, and cancer, conditions for which there is strong research support. Mind-body therapies were generally used concomitantly with conventional care: 90% of those using a mind-body therapy in the last year had seen a physician and 80% of mind-body therapies used were discussed with a physician. CONCLUSIONS: Although mind-body therapies were commonly used, much opportunity exists to increase use of mind-body therapies for indications with demonstrated efficacy.

 

 

 

Appl Psychophysiol Biofeedback. 2004 Dec;29(4):269-78.

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Treatment of chronic insomnia with yoga: a preliminary study with sleep-wake diaries.

Khalsa SB.

Division of Sleep Medicine, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School, 75 Francis Street, Boston, Massachussets 02115, USA. khalsa@hms.harvard.edu

There is good evidence for cognitive and physiological arousal in chronic insomnia. Accordingly, clinical trial studies of insomnia treatments aimed at reducing arousal, including relaxation and meditation, have reported positive results. Yoga is a multicomponent practice that is also known to be effective in reducing arousal, although it has not been well evaluated as a treatment for insomnia. In this preliminary study, a simple daily yoga treatment was evaluated in a chronic insomnia population consisting of sleep-onset and/or sleep-maintenance insomnia and primary or secondary insomnia. Participants maintained sleep-wake diaries during a pretreatment 2-week baseline and a subsequent 8-week intervention, in which they practiced the treatment on their own following a single in-person training session with subsequent brief in-person and telephone follow-ups. Sleep efficiency (SE), total sleep time (TST), total wake time (TWT), sleep onset latency (SOL), wake time after sleep onset (WASO), number of awakenings, and sleep quality measures were derived from sleep-wake diary entries and were averaged in 2-week intervals. For 20 participants completing the protocol, statistically significant improvements were observed in SE, TST, TWT, SOL, and WASO at end-treatment as compared with pretreatment values.

 

 

 

 

“It is time for the scientific community to stop giving alternative medicine a free ride. There cannot be two kinds of medicine — conventional and alternative. There is only medicine that has been adequately tested and medicine that has not, medicine that works and medicine that may or may not work. Once a treatment has been tested rigorously, it no longer matters whether it was considered alternative at the outset. If it is found to be reasonably safe and effective, it will be accepted. But assertions, speculation, and testimonials do not substitute for evidence. Alternative treatments should be subjected to scientific testing no less rigorous than that required for conventional treatments.”

 

Alternative Medicine — The Risks of Untested and Unregulated Remedies
Angell M., Kassirer J. P.
N Engl J Med 1998; 339:839-841, Sep 17, 1998. Editorials

 

 

 

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            Anne Frobert, 12/03/2005