Yogic pranayama and diaphragmatic breathing (YPDB) contribute to a significant reduction of intraocular pressure (IOP) in glaucoma, according to findings published in the Journal of Glaucoma.

Researchers at the All India Institute of Medical Sciences (AIIMS) conducted a prospective, randomized trial to show whether YPDB exercises, in combination with glaucoma medication, reduce IOP. The study included 90 participants (180 eyes) with primary open-angle glaucoma, a control group and a group that practiced YPDB exercises daily for 28 weeks. IOP was measured at baseline and after 1, 3, and 6 months. Both groups also used prescribed topical medications throughout the study.

The results of the study show that in the group that practiced YPDB, IOP was significantly reduced (right eye: 20.85 mm Hg ± 3.39 mm Hg to 14.90 mm Hg ± 2.86 mm Hg; left eye: 20.30 mm Hg ± 4.12 mm Hg to 14.25 mm Hg ± 3.85 mm Hg; P <.001) compared with controls. 


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In the YPDB group, participants attended sessions for breathing exercises under the guidance of a trained yoga instructor during the first 4 weeks. For the next 24 weeks thereafter (follow-up period), they continued the YPDB at home daily. Practice sessions were 30 minutes, 7 days per week. 

The study outlines the steps of diaphragmatic breathing, which involves the contraction and expansion of the diaphragm as well as deep inhalation and exhalation.

“Patients were asked to breathe in through the nose for about 2 seconds and experience the air moving through nostrils into the abdomen,” the study explains. During this type of breathing, the stomach moves outward and the chest remains relatively still. Finally, patients were instructed to purse their lips and press gently on their stomachs while exhaling slowly for approximately 2 seconds. These steps were repeated 5 times.

Similarly, the study explained that pranayama involved a process of inhaling through 1 nostril and exhaling through the other, which was repeated 4 times. It also mentioned past data showing the positive effects of yoga-based intervention on ocular outcomes and also on conditions such as asthma, hypertension, diabetes, obesity, and aging. 

Despite the ability of YPDB to decrease IOP, the researchers say there were no significant changes in the results of the visual field or Average Retinal Nerve Fiber Layer (RNFL) analyses in either study group. Limitations included the measuring of IOP only once daily, as it varies diurnally.

Reference

Udenia H, Mittal S, Agrawal A, Singh A, Singh A, Mittal S. Yogic pranayama and diaphragmatic breathing: adjunct therapy for intraocular pressure in patients with primary open.-angle glaucoma.. J Glaucoma. 2021;30:115-123. doi:10.1097/IJG.0000000000001697.