Expert Advice

Stress Management Through Breathwork (Pranayama)

Acella Pharmaceuticals, LLC., is partnering with Lexi Hawks, an E-RYT 500 Hr Yoga Alliance Certified Teacher to bring greater awareness to the importance of thyroid care and education. This post is sponsored by Acella Pharmaceuticals and should not be construed as medical advice. Please talk to your doctor about your individual medical situation

Disclaimer: The information provided is for educational purposes only and does not substitute professional medical advice. Consult a medical professional or healthcare provider before beginning any exercise, fitness, diet, or nutrition routine.

Pranayama is the ancient yogic practice of regulating and directing vital life force energy called Prana. Pranayama techniques may help decrease perceived stress and anxiety, which is very important for patients with hypothyroidism.1,2 As a yoga educator I recommend two different breathwork techniques that patients can use in their day-to-day lives to change their relationship with stress

Most people are generally unaware of their breath until there is an issue with breathing. Whether caused by a simple cold or an allergy, congestion impacts our ability to breathe, communicate, move, and sleep comfortably. We realize just how important breathing is when it’s been compromised, and we hope to find a quick remedy and return to its regular function.

What would happen if we spent time attending to our respiratory system on a daily basis? When we purposefully work with our breath through pranayama, we can "flush" our system, build capacity and function more optimally. Additionally, we can use our breath to help manage and regulate some emotional and physical conditions, such as stress.

The autonomic nervous system is responsible for involuntary physical processes such as heart rate and blood pressure and is directly impacted by breathing. The autonomic system includes the sympathetic and parasympathetic divisions. The sympathetic nervous system helps to prepare the body for physical exertion – think fight/flight/freeze responses – and is emphasized by the inhale. The parasympathetic nervous system prepares the body for rest, sleep, and digestion, which is emphasized by the exhale.

By learning simple breathing techniques, we can prompt the parasympathetic system, help the body slow down, and perhaps even experience relaxation.

Pranayama Technique #1: Breath Ratio 2:1

1. Sit in a comfortable and upright position, either on a chair or on the floor.

2. Widen the collar bones and gently wrap the outer shoulders back. This will widen the chest to breathe optimally

3. Breathe in a diaphragmatic method (allow the belly to expand outward with the inhale, and contract inward with the exhale) with an equal inhale and exhale (three to five mental counts). Relax the body and mind on each exhale.

4. After establishing equal breath without any strain, breathe in a 2:1 ratio. For example, if your total breath count is six (three counts in and three counts out), shift to a two-count inhale and a four-count exhale.

5. Continue this breathing technique for seven to 10 cycles at minimum

Pranayama Technique #2: Nadishodhana (alternate nostril breathing)

Alternate nostril breathing is a pranayama technique that has been studied in clinical trials to successfully help reduce stress and anxiety.2

1. Sit in a comfortable and upright position, either on a chair or on the floor.

2. Widen the collar bones and gently wrap the outer shoulders back. This will widen the chest to breathe optimally.

3. To start, breathe in a diaphragmatic method with an equal inhale and exhale (three to five mental counts). Relax the body and mind on each exhale for one to two minutes.

4. Place your left hand on top of your left thigh and relax that arm.

5. Bring the right index and middle finger pads to touch the space between your brows. (Use the tip of your thumb to close your right nostril and the tip of your ring finger to close your left nostril)

6. After a single exhale through both nostrils, gently press your right nostril closed with your right thumb and inhale slowly through your left nostril until full. At the top of the inhale, briefly pause and close your left nostril so that both nostrils are momentarily sealed.

7. Release the thumb away from your right nostril (keeping the left sealed), and exhale slowly and completely. At the bottom of the exhale, briefly pause.

8. Inhale slowly through your right nostril (keeping your left sealed) until full. Pause briefly at the top of the inhale and close both nostrils momentarily.

9. Exhale slowly and completely through your left nostril (keeping the right sealed). Pause briefly at the bottom of the exhale.

10. Repeat this cycle a minimum of seven times.

To end the pranayama techniques, stop the practice and return to a natural and normal breath. Sit quietly and observe any sensations created by the breathwork. Chances are, you’ll be feeling very calm.

Please talk to your doctor before practicing breathwork. If you experience dizziness or mental or physical stress during pranayama, please stop your self-practice and work in person with a certified yoga teacher or breath coach.

REFERENCES: 1. Nemati A. (2013). The effect of pranayama on test anxiety and test performance. International journal of yoga, 6(1), 55–60. 2. Sharma, V. K., Trakroo, M., Subramaniam, V., Rajajeyakumar, M., Bhavanani, A. B., & Sahai, A. (2013). Effect of fast and slow pranayama on perceived stress and cardiovascular parameters in young health-care students. International journal of yoga, 6(2), 104–110.


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Revised 10/2023