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Journal of Clinical and Diagnostic Research. 2016 Feb, Vol-10(2): CC01-CC03 11
DOI: 10.7860/JCDR/2016/12361.7197 Original Article
INTRODUCTION
Yoga includes practices such as physical postures (asanas),
voluntary regulation of breathing (pranayama) and meditation,
among other techniques [1]. The nasal cycle is phenomenon
of alternate periodic breath functions and its variations are
characterized by the alternating patency of the nostrils for every
two to eight hours [2], with a rhythmic and alternating shift of activity
in the autonomic nervous system and cerebral activity [3]. Practice
of asanas, pranayama and meditation improves autonomic cardio
respiratory variables [4]. Joshi M has shown that immediate effect
of right and left nostril breathing increases verbal and spatial
scores corresponding to the cerebral hemispheres contra lateral
to the patent nostril [5].
The memory is one of the ability of the brain to store and retrieve
information of both verbal and non verbal nature. The Patanjali
yoga sutras describe memory as ‘an experienced object not being
lost from the mind’. Explicit or declarative memory is that memory
that can be brought to conscious awareness. Visual and spatial
memory is an important part of explicit memory [6]. Anterior areas
of the temporal cortex are involved in representation of verbal
conceptual knowledge organized categorically [7]. Various studies
have shown that lesions in the left temporal lobe disrupt verbal
memory to a greater extent and the lesions in the right temporal
lobe disrupt visual-spatial memory [8]. Many studies have shown
that there is improvement in academic performance in subjects
performing transcendental meditation [9-16].
AIM
The present study was designed to study the effect of unilateral
right nostril breathing, left nostril breathing and alternate nostril
breathing on verbal and spatial memory scores in female subjects
because at present there are no such studies in the female subjects
alone.
MATERIALS AND METHODS
This study was conducted by the Physiology department of
Santosh Medical College Ghaziabad after taking the proper ethical
Keywords: Nostril breathing exercise, Spatial memory scores, Verbal memory scores, Wechsler memory scale
Physiology Section
Effect of Left, Right and Alternate
Nostril Breathing on Verbal and
Spatial Memory
RINKU GARG1, VARUN MALHOTRA2, YOGESH TRIPATHI3, RITU AGARAWAL4
ABSTRACT
Introduction: Yoga has beneficial effects on memory. In fem-
ales, left hemisphere of the brain is responsible for verbal
memory and right hemisphere is responsible for the spatial
memory, while the opposite is true for males.
Aim: Aim of the present was to study the effect of unilateral
right nostril breathing, left nostril breathing and alternate nostril
breathing on verbal and spatial memory scores.
Materials and Methods: A total of 51 female subjects (age
18-25 years, mean±SD =21.71±3.11) were taken and divided
into three groups (n=17). Each group was imparted one of
the three different types of nostril breathing practices such as
Right Nostril Breathing (RNB), Left Nostril Breathing (LNB) and
Alternate Nostril Breathing (ANB) for 1 week for 45 minutes
daily. Subjects were given the memory test, before and after 45
minutes of intervention for three consecutive days. Memory tests
were performed by using Wechsler Adult Intelligent Scale.
Statistical Analysis: Results were analysed by ANOVA with
SPSS version 17.0.
Results: Results showed that there was increase in recall of
digit span-forward, digit-span backward, associate learning
and spatial memory scores with RNB, LNB and ANB, which
were statistically highly significant(p<0.005).
Conclusion: Inclusion of nostril breathing in exercise regimen
may be helpful in improving recall of memory.
clearance. For the study 51 healthy female students of Santosh
medical college Ghaziabad with age group ranging from 18-25
years, were chosen in the post menstrual phase. Sample size
was calculated on the basis of an effect size of (0.69) which was
obtained from the previous study on verbal and spatial memory on
yoga breathing of Naveen, Nagarathana, Nagendra & Telles,1997
[17]. It was calculated using G-power software, where the level
was 0.05 and power was 0.95. Health status of the subjects was
ensured on the basis of general physical examination and personal
history. Those with any medical complications were excluded from
the study. Informed consent was taken from them. Subjects were
randomly divided into three groups of 17 subjects each. (n=17)
Each group was imparted one of the three different types of nostril
breathing practices such as right Nostril Breathing (RNB), Left
Nostril Breathing (LNB) and Alternate Nostril Breathing (ANB) for
1 week for 45 minutes daily. Subjects were given the memory test
before and after 45 minutes of intervention for three consecutive
days [18].
The right nostril breathing (RNB) involves alternate cycle of
inhalation and exhalation through the right nostril while the left
nostril is occluded and left nostril breathing (LNB) involves alternate
cycle of inhalation and exhalation through the left nostril while the
right nostril is occluded. Alternate nostril breathing (ANB) involves
inhalation through one nostril while the other nostril is occluded
and vice versa.
Memory tests that were performed by using Wechsler Adult
Intelligent Scale (WAIS) [19] scale included: a) Digit span forward;
b) digit span backward; c) paired associative learning (easy and
hard) with 10 items each.
Digit span forward includes six pairs for the numerical items of
easy task and four pairs for the numerical items of hard task. The
test material was projected on a screen, allowing 10 sec for each
slide. After the 10 slides were shown, an arithmetic problem (e.g.
+ 5-4+9-6-8-3) was projected on the screen. Immediately after
this, subjects were asked to recall and write down (or in case of
spatial memory, to draw) within 60 sec the 10 test items which
were shown to them.
Rinku Garg et al., Effect of Left, Right and Alternate Nostril Breathing on Verbal and Spatial Memor www.jcdr.net
Journal of Clinical and Diagnostic Research. 2016 Feb, Vol-10(2): CC01-CC03
22
[Table/Fig-1]: Demographic data of the subjects (51 females).
Mean ± SD
Age (y) 21.71± 3.11
Height (cm) 155.4± 4.13
Weight (kg) 47.3±4.17
[Table/Fig-3]: Intra group comparison of all the three groups LNB, RNB and ANB,
for before and after DSF, before and after DSB, before and after AL and before and
after SMT using paired t-test.
Group Comparisions Difference p-value
LNB DSF after Vs before 1.93 <0.005
DSB after Vs before 1.92 <0.005
AL after Vs before 1.83 <0.005
SMT after Vs before 1.87 <0.005
RNB DSF after Vs before 1.01 <0.005
DSB after Vs before 1.00 <0.005
AL after Vs before 0.98 <0.005
SMT after Vs before 0.99 <0.005
ANB DSF after Vs before 1.01 <0.005
DSB after Vs before 1.03 <0.005
AL after Vs before 1.02 <0.005
SMT after Vs before 1.04 <0.005
[Table/Fig-4]: Inter group comparison between all the three groups LNB, RNB and
ANB, for After DSF, After DSB, After AL and After SMT by using ANOVA.
Tests Parameters Mean ± S.D p value
After DSF LNB 8.06±1.0 p<0.005
RNB 6.70±0.6
ANB 7.16±1.0
After DSB LNB 7.12±0.4 p<0.005
RNB 6.05±0.7
ANB 6.15±.74
After AL LNB 13.53±1.9 p<0.005
RNB 12.40±1.0
ANB 12.71±0.7
After SMT LNB 7.33±0.7 p<0.005
RNB 6.39±0.7
ANB 6.60±0.6
Digit span backward is a test in which the subject recalls digits
sequence in a reverse order. This is opposite to digit span forward,
in which the numbers have to be recalled in the same sequence
order as they have been given.
Paired associate learning is a text in which the subject is presented
with ten pairs of unrelated words. The first word provided by the
investigator has to be associated appropriately by the subjects
for example paper-pen. Spatial memory test consist of simple
line diagrams. The drawing was easier to produce. Drawings that
could be reproduced verbally example square and circle were not
used. For both the verbal and for the spatial memory test a correct
response was scored as 1 and incorrect as‘0’. This was based on
the conventional scoring for Wechsler memory scale [20,21].
STATISTICAL ANALYSIS
Paired t-test was used for intra group comparison (i.e. before and
after the yoga training). Inter group comparison between all the
three groups LNB, RNB and ANB was done with ANOVA. Results
were analysed by using SPSS version 17.0.
RESULTS
[Table/Fig-1] shows that the mean age of the subjects was
21.71±3.11 years, mean height was 155.4±4.13 cm and mean
weight was 47.3±4.17 kg.
As shown in the [Table/Fig-2] with (LNB) there is increase of digit
span forward, digit span backward and associate learning scores.
Spatial memory scores are also increased. With (RNB) there is
an increase of digit span forward, digit span backward, associate
learning and spatial memory scores. With (ANB) also there is
increase of digit span forward, digit span backward, associate
learning scores and spatial memory scores.
As shown in the [Table/Fig-3], for LNB, results are significant for
DSF, DSB, AL and SMT (p<0.005). For RNB results are significant
for DSF, DSB, AL and SMT (p<0.005). For ANB also results are
significant for DSF, DSB, AL and SMT (p<0.005).
As shown in the [Table/Fig-4] when all the three groups LNB, RNB
and ANB were compared for After DSF, After DSB, After AL and
After SMT. It was found that the left nostril breathing(LNB) has
better memory scores as compared to right nostril breathing(RNB)
and alternate nostril breathing (ANB), for all after DSF, after DSB,
after AL and after SMT (p<0.005).
DISCUSSION
Memory is the latent capacity to retain and recall information about
past and present incidents. This recall process involves generation
of a sequence of entities in the response set which corresponds
to the entities of stimulus set that decides the nature of recall
function [18]. In order to perform important duties, recall valuable
experiences for guidance in daily living, or to write, think and feel,
one must utilize the material recalled to conscious mind by the
power of memory.
Our study assessed the effect of three different types of yogic
breathing practices, right nostril breathing (RNB), left nostril
breathing(LNB) and alternate nostril breathing (ANB) on verbal
(digit span forward DSF, digit span backward DSB, associate
learing AL) and spatial memory scores SMT. Results had shown
that there was increase in recall of all digit span-forward, digit-span
backward, associate learning and spatial memory scores, with all
the three types of yoga breathing practices (p<0.005). Further
it was found that LNB has better memory scores as compared
to RNB and ANB (p < 0.005). Our study results are comparable
to Meesha et al., [5]. They showed that LNB causes increase in
memory scores, while in our study not only LNB but RNB and ANB
also increased the verbal and spatial scores. Our study results are
also comparable to Naveen et al., [17]. They showed that with
nostril breathing there is increase in only spatial scores, while in
our study there is increase of both verbal and spatial scores.
The possible mechanism of how unilateral nostril breathing affects
central nervous system is not clearly understood. Keuning and
Parameters Verbal Memory Test Spatial Memory Test (SMT)
Digit Span Forward(DSF) Digit Span Backward(DSB) Associate Learning(AL)
Before After Before After Before After Before After
Left nostril Breathing(LNB) 6.11±0.6 8.06±1.0* 5.18±1.1 7.12±0.4* 11.68±0.9 13.53±1.9* 5.43±0.8 7.33±0.7*
Right nostril Breathing(RNB) 5.68±0.9 6.70±0.6* 5.04±0.8 6.05±0.7* 11.43±0.7 12.40±1.0* 5.38±1.0 6.39±0.7*
Alternate nostril breathing (ANB) 6.13±1.0 7.16±1.0* 5.11±0.8 6.15±0.74* 11.68±1.0 12.71±0.7* 5.53±0.7 6.60±0.6*
[Table/Fig-2]: Effect of three yogic breathing practices on immediate verbal and spatial memory scores (Mean ± SD).
*p<0.005
www.jcdr.net Rinku Garg et al., Effect of Left, Right and Alternate Nostril Breathing on Verbal and Spatial Memor
Journal of Clinical and Diagnostic Research. 2016 Feb, Vol-10(2): CC01-CC03 33
Eccles and Lee showed that with the airflow into the nostril,
mechanical receptors in the nasal mucosa are activated and
this signal is unilaterally transmitted to the hypothalamus, which
is considered the highest centre for autonomic regulation [2,22].
Stimulating the hypothalamus or mesencephalon causes nasal
vasoconstriction, hence more free airflow, which is greater on the
ipsilateral side than on the contra lateral side, which differentially
affect the ipsilateral and contralateral cerebral hemispheres,
thereby changing the relative EEG activity and hence influencing
relative spatial and verbal performance.
Our results are contradictory to the results of Thakur et al., [18].
They showed that RNB and ANB causes more increase in memory
scores as compared to LNB. While in our study LNB causes more
increase of memory scores as compared to RNB and ANB. Our
study results are also similar to Manjunath et al., [23]. They showed
that that yoga practices including physical postures, pranayamas
and meditation improves delayed recall of spatial information.
Some of the studies gave explanation that nostril breathing reduces
the anxiety which thereby improves the performance for tasks
requiring memory. Attention is the needle that cuts the grooves in
record of memory cells thereby improving the attention span and
memory as assessed in a study by decrease in reaction times [24].
Further studies are warranted to know the exact mechanism.
CONCLUSION
Memory is required for performing day to day activities and
recall of happy events. Inclusion of right, left and alternate nostril
breathing in daily exercise regimen will be helpful in improving
recall of memory.
Lacunae and further study: Further studies are needed on
amnesic patients to extend the application of the pranayamas for
their help.
ACKNOWLEDGMENT
The authors are thankful to subjects and all the technical staff of the
Department of Physiology for their contribution in the completion
of the project.
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PARTICULARS OF CONTRIBUTORS:
1. Associate Professor, Department of Physiology, Santosh Medical College, Santosh University, Ghaziabat, U.P., India.
2. Professor and Head of Department, Department of Physiology, Santosh Medical College, Santosh University, Ghaziabat, U.P., India.
3. Dean Faculty of Medicine, Santosh Medical College, Santosh University, Ghaziabat, U.P., India.
4. Associate Professor, Department of Microbiology, Santosh Medical College, Santosh University, Ghaziabat, U.P., India.
NAME, ADDRESS, E-MAIL ID OF THE CORRESPONDING AUTHOR:
Dr. Rinku Garg,
MP1/204, Eldeco Aamantran, Sector 119, Noida-201301, India.
E-mail: Rgrinkigarg6@gmail.com
FINANCIAL OR OTHER COMPETING INTERESTS: None.
Date of Submission: Dec 20, 2014
Date of Peer Review: Mar 24, 2015
Date of Acceptance: Nov 24, 2015
Date of Publishing: Feb 01, 2016