Colorado Integrative Medicine

Conference

BREATHING AS MEDICINE

Mark J. Mc Ginley, MD

Estes Park

July 24th, 2016

Contact information: mjpmcginley@gmail.com

OBJECTIVES

Highlight diseases of the autonomic nervous system

where breath work has a direct application

Explain how manipulation of the breath impacts the

autonomic nervous system

Gain familiarity with five different breathing techniques

that have direct effects on the autonomic nervous

system

Mark J. Mc Ginley, MD

Focusing Attention on the Breath

Mark J. Mc Ginley, MD

A RESOLUTION FOR THE NEW YEAR

Mark J. Mc Ginley, MD

HEALTH

Mark J. Mc Ginley, MD

STRESS

Mark J. Mc Ginley, MD

The Healing Ability of the Breath

Integrative Medicine

Traditional medical training

Omissions

Yoga

Proper breathing is the master key to good health

Mark J. Mc Ginley, MD

The Healing Ability of the Breath

Breath is free, simple and requires no equipment

Stress

Eustress and Distress

Adaptations to stress

Mark J. Mc Ginley, MD

The Power of Regulating the Breath

Autonomic Nervous System (ANS)

Breath is unique

Window into manipulation ANS and it can be under our

conscious control

Mark J. Mc Ginley, MD

Untapped Potential of the Breath

Breathing and emotions: Reciprocal relationship

Emotional states affect pattern of breathing

Pattern of breathing affect emotional state

Joy/Sadness/Fear/Anxiety/Anger/Passion

Mark J. Mc Ginley, MD

REGULATING THE BREATH

When you are upset you can not always tell yourself to

“settle down”

BUT you can always change your breathing pattern

Mark J. Mc Ginley, MD

Pranayama as Treatment

Disorders of ANS

Hypertension/Arrhythmias/Migraines/Asthma/IBS

Breathing techniques do not act as fast as modern pharmaceuticals

Results are long lasting, provide self mastery and are free of toxicity

Telles, S, et. al. Blood pressure and Purdue pegboard scores in individuals with hypertension after alternate nostril breathing, breath awareness, and no intervention. Medical Science Monitor 2013;19(1):61-66.

Karam M, Kaur BP, Baptist AP. A modified breathing exercise program for asthma is easy to perform and effective, J. Asthma, 2016 June 10:0 [Epub ahead of print]

Sharma P, Poojary G, Vélez DM, Dwivedi SN, Deepak KK.. Effect of yoga-based intervention in patients with inflammatory bowel disease, Int J Yoga Therap. 2015;25(1):101-12.

Mark J. Mc Ginley, MD

http://www.ncbi.nlm.nih.gov/pubmed/23334063http://www.ncbi.nlm.nih.gov/pubmed/27285510http://www.ncbi.nlm.nih.gov/pubmed/26667293

Conscious Breathing:

Mind-Body-Medicine

Breath work can be conscious or unconscious

Can form a bridge between these two mental functions

Breath work is a connection between mind and the body

Mark J. Mc Ginley, MD

Regulated yoga breathing

THE BREATH IS A BRIDGE

MIND BODY

Mark J. Mc Ginley, MD

APPLICATIONS

Mark J. Mc Ginley, MD

Mark J. Mc Ginley, MD

Mark J. Mc Ginley, MD

APPLICATIONS

Relaxation Response

Mark J. Mc Ginley, MD

Breath and Spiritual Growth

In many parts of the world the word for breath and spirit

are the same

Sanskrit ………. Prana

Hebrew ………. Ruach

Greek ………. Pneuma

Latin ………. Spiritus

Mark J. Mc Ginley, MD

Breath and Spiritual Growth

All living organisms breathe

Connection to the beginning and ending of life

Breathing represents expansion and contraction and a

never ending cycle with no beginning and no end

Continuous waveform of inhalation and exhalation

Mark J. Mc Ginley, MD

Breath and Spiritual Growth

This continuous cycle/waveform can be viewed in the

greater universe of which we are an integral part

Day and night

Ocean waves and tides

Seasons of the year

Oscillations of atoms and subatomic particles

Mark J. Mc Ginley, MD

BREATH WORK: GUIDELINES

When you focus your attention on your breath try and make it:

Deeper

Quieter

Regular

Slower

This affects the parasympathetic nervous system and also our

mental state

Sengupta, P. Health impacts of yoga and Pranayama: a state of the art review, Int J Prev Med.

2012 Jul; 3(7): 444–458

Mark J. Mc Ginley, MD

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3415184/

BREATH WORK: GUIDELINES

Repetition and regularity very important

Attempting to change the rhythms in your nervous

system

Constant pressure of a gentle force that produces huge

changes over time

Mark J. Mc Ginley, MD

BREATH WORK: GUIDELINES

Find times in the day when you will not have

interruptions

Make a resolution to devote 10-20 minutes per day to

breath work

You will notice changes over a period of months

Some of the most rewarding work you can do for your

general wellness

Mark J. Mc Ginley, MD

Selected Reference

Mark J. Mc Ginley, MD

Telles S, Naveen KV. Voluntary

breath regulation in yoga: Its

relevance and physiological effects.

Biofeedback 2008;36(2):70-73.

Selected Reference

Telles S, et al. Blood pressure and Purdue pegboard scores in hypertensives after alternate nostril breathing, breath awareness and no intervention.

Medical Science Monitor 2013;19(1):61-66.

Mark J. Mc Ginley, MD

BOOKS

Telles S, Singh N and Bhardwaj AK. Science Studies

Pranayama. (2011), Uttarakhand, Haridwar, India:Divya

Prakashan.

ISBN No. 81-89235-85-0

Iyengar BKS. Light on Pranayama: The Art of

Breathing. (2013), Crossroad, New York.

ISBN No. 0-8264-0048-5

Mark J. Mc Ginley, MD

Let’s Get Started !

Mark J. Mc Ginley, MD

Following the Breath Sit with spine elongated and erect

Close eyes and place attention on the breath

Follow the inhalation-pause-exhalation-pause

When attention wanders, gently bring your attention back to the breath

Notice where you are observing your breath (nose, chest, passage through the airways or

expansion of the abdomen)

This is a subtle and powerful practice

It is both simple and difficult

Forms the basis of any practice of meditation

Mark J. Mc Ginley, MD

Squeezing the Lungs

Lengthening the exhalation by squeezing more air out

Using abdominal and intercostal muscles

By lengthening the exhalation the inhalations will

become deeper

Breathe in….Breathe out, more, more, more.

Mark J. Mc Ginley, MD

Ujjaya: Victorious Breath

Sit with spine elongated and erect

Inhale slowly through nose with the mouth closed.

Contract back of the throat, as if making “ahh” sound, but with mouth closed

This allows you to regulate the flow of the breath, and thereby allowing

prolonging of inhalation and exhalation.

Continuing with slow inhalation, allow abdomen to relax and expand

Continue contracting back of the throat slightly, as if to make an ‘eeee’ sound,

with mouth closed, while exhaling

Control flow of the breath, let it be long and slow

Continue to inhale and exhale in this way

Mark J. Mc Ginley, MD

Nadi Shodana:

Alternate Nostril Breath (ANB) Sit comfortably. Place right hand in the Vishnu mudra (tuck index and middle fingers into palm)

Bring your hand close to your nostrils.

Use the thumb to close off the right nostril and the 3rd and 4th fingers to close off left nostril.

Sequence of Alternate Breathing (Switch after each inhalation)

First close the right nostril with your thumb and breathe in through left nostril to the count of two.

Now, close the left nostril with your 3rd and 4th fingers and breathe out through your right nostril to

the count of four

Now, keep the left nostril closed and breathe in through the right nostril to the count of two

Lastly, keep the right nostril closed with your thumb and breathe out through the left nostril to

count of four

This sequence consists of one round of ANB

To start with, complete eight rounds of ANB. The goal would be to practice for 10 minutes twice a day

Mark J. Mc Ginley, MD

Nadi Shodana:

Alternate Nostril Breath (ANB)

Several studies demonstrate ANB can significantly lower

Systolic Blood Pressure and Diastolic Blood Pressure

These studies also illustrate that the mechanism is via

increased vagal tone

Telles S, Sharma SK, Balkrishna A. Blood Pressure and Heart Rate Variability during Yoga-

Based Alternate Nostril Breathing Practice and Breath Awareness. Med Sci Monit Basic Res.

2014; 20: 184–193

Mark J. Mc Ginley, MD

http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4247229/

Kapalabhati:

Shining Face Breath The exhalation is forced

The inhalation is spontaneous

There is a split second of retention after each exhalation

Exhale vigorously through the nose: at the same time contract abdominal muscles

Then, allow the inhalation to happen passively by relaxing your abdomen

This is one round

Repeat in steady and rhythmic series of exhalations

Emphasize the exhalation each time

Contraindicated for those with ear infections, glaucoma, and hypertension.

Mark J. Mc Ginley, MD

Kapalabhati:

Shining Face Breath

Published studies have demonstrated that Kapalabhati

breathing enables one to:

Improved selective attention

Improved ability to switch attention

Improved working memory

Mark J. Mc Ginley, MD

Bhastrika:

Bellows Breath

Stimulating breath

Raises energy of the nervous system and increases alertness

Breathe in and out through the nose, keeping mouth closed

Inhalation and exhalation should be of equal length and as short as

possible

Start with 15 to 20 seconds and then revert back to normal breathing

Goal is to get up to 60 seconds every day

Great way to wake yourself up and dissipate mental fatigueMark J. Mc Ginley, MD

4-7-8 Breathing Exhale completely through your mouth, making a whoosh sound

Close your mouth and inhale quietly through your nose to a mental count of 4

Hold your breath for a count of 7

Exhale completely through your mouth, making a whoosh sound to count of 8

This is one breath cycle

Now inhale again and repeat the cycle three more times for a total of four breaths

Guidelines:

Do at least twice daily

You cannot do it too frequently

Use it whenever you are aware of internal tension

Use it to help aid with sleep

Start with four breaths and work to a goal of eight breaths at least twice daily

Mark J. Mc Ginley, MD

Closing Comments

It is never too late to learn

Incorporate this into your daily ritual

Teach breath work to your patients

When stress and insomnia visit, remember this is an

invitation to regulate your breath

Mark J. Mc Ginley, MD