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Sudarshan Kriya Yogic Breathing in the Treatment of Stress, Anxiety, and Depression: Part I—Neurophysiologic Model
Abstract
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.
... This stress can adversely affect parents' well-being and their ability to support their child's recovery [2] . Various interventions have been explored to mitigate this stress, with mind-body practices such as pranayama-controlled breathing exercises rooted in yoga-gaining attention for their potential benefits [3] . Pranayama involves deliberate regulation of breath and has been shown to activate the parasympathetic nervous system, inducing relaxation and reducing stress [4] . ...
... Need for the study Despite the recognized stress experienced by parents during their child's cardiac surgery, there is a paucity of research focusing on interventions to alleviate this burden [1] . Given the promising outcomes of pranayama in reducing anxiety in clinical populations, it is imperative to investigate its effectiveness specifically among parents of children undergoing cardiac surgery [3] . Assessing the impact of pranayama on parental stress can inform supportive care strategies, potentially enhancing parental well-being and, by extension, benefiting the child's recovery process [4] . ...
... This, in turn, reduces amygdala hyperactivity, a key driver of stress and emotional distress. [5][6][7] A recent meta-analysis of randomized controlled trials on breathwork and mental health found that individuals who practiced controlled breathing techniques for eight weeks experienced significant improvements in emotional regulation, stress resilience, and overall well-being. Participants reported lower anxiety and depressive symptoms, indicating that Pranayama could serve as a cost-effective and accessible tool for mental health management. ...
News: The Role of Pranayama in Managing Mental Health Disorders Among Youth Individuals Mental health disorders are conditions that impact a person's thoughts, emotions, mood, and behaviour, often causing distress and interfering with daily life. In 2019, approximately one in eight people worldwide—around 970 million individuals—were living with a mental disorder, with anxiety and depression being the most common. The COVID-19 pandemic in 2020 further exacerbated these conditions, leading to a sharp rise in cases.[1] Chronic stress plays a significant role in mental health deterioration, primarily due to the overactivation of the hypothalamic-pituitary-adrenal (HPA) axis, which results in increased levels of the stress hormone cortisol.[2] As concerns over mental health continue to rise, especially among adolescents and young adults, researchers and wellness experts are increasingly exploring non-pharmacological interventions that provide relief without side effects. One promising approach is Pranayama, a yogic breathing practice that has been shown to alleviate mood disorders like anxiety and depression in young individuals.[3,4] Studies suggest that Pranayama exerts its benefits through the vagus nerve, influencing key brain regions such as the solitary nucleus, thalamus, limbic system, and prefrontal cortex. This practice is believed to enhance parasympathetic nervous system activity, which helps regulate stress hormones and increases GABA inhibition from the prefrontal cortex and insula to the amygdala. This, in turn, reduces amygdala hyperactivity, a key driver of stress and emotional distress.[5-7] A recent meta-analysis of randomized controlled trials on breathwork and mental health found that individuals who practised controlled breathing techniques for eight weeks experienced significant improvements in emotional regulation, stress resilience, and overall well-being. Participants reported lower anxiety and depressive symptoms, indicating that Pranayama could serve as a cost-effective and accessible tool for mental health management. [8] Recognizing these benefits, various schools and universities in Western countries have begun incorporating Pranayama sessions into their wellness programs. Educators and wellness professionals believe that breathing exercises enhance oxygenation to the brain, regulate the autonomic nervous system, and promote a sense of calm, ultimately contributing to improved mood stability and emotional well-being. Views: Why pranayama could be a game-changer for youth mental health? The modern world presents numerous challenges for young individuals, including academic stress, social pressures, and digital overstimulation. These factors contribute to a surge in mood disorders, and the increasing reliance on pharmaceutical interventions often comes with side effects and accessibility challenges, making it imperative to explore sustainable and accessible solutions. Pranayama, an ancient practice rooted in yogic traditions, offers a scientifically backed, natural method for managing stress, anxiety, and depression. The fact that it influences the vagus nerve and key brain regions involved in emotional regulation highlights its potential as a holistic and effective therapy. Unlike conventional treatments, it is cost-effective, accessible, and free from side effects, making it an attractive option for individuals seeking alternative or complementary mental health interventions. Pranayama holds great promise as a natural approach to improving mental health, but it is most effective when combined with other evidence-based strategies such as mindfulness, and healthy lifestyle habits. To ensure its widespread adoption, trained instructors and greater scientific awareness are needed to implement it effectively. While further large-scale studies would help strengthen the evidence, current research suggests that incorporating Pranayama into daily routines can be a powerful tool for young individuals struggling with mood disorders. As awareness of mental health continues to grow, Pranayama may soon become a widely recommended practice for emotional well-being. Educational institutions play a crucial role in this movement by integrating breathwork into wellness programs, equipping students with lifelong skills to manage stress and build resilience. This proactive approach is especially important in the post-pandemic era, where mental health challenges among young adults have escalated. Ultimately, the increasing recognition of Pranayama reflects a positive shift in mental health care, one that embraces a balanced blend of modern science and ancient wisdom to promote holistic well-being.
... [16,17] Additionally, one study reported that yoga directly increases parasympathetic nervous system output, potentially through vagus nerve stimulation. [18] Likewise, another studies of yoga on healthy volunteers have shown that after short term yoga exercise, there is significant increase in the vagal tone, decrease of sympathetic discharge in the form of significantly decreased heart rate response on standing as well as decreased catecholamine levels in plasma. [19,20] This shift from sympathetic to parasympathetic dominance enhances cardiovagal function, neuroendocrine balance, and metabolic responses. ...
Context: Previously, yoga has a relaxing effect on the mind and can potentially improve sleep quality. However, it is still needed to clarify the beneficial effect of yoga in individuals with poor sleep quality. Middle-aged women usually encounter poor sleep quality. Aims: The present study aimed to investigate the beneficial effect of yoga in middle-aged women with poor sleep quality. Material and Methods: A total of 68 middle-aged women with an age range of 40 to 59 years were studied to determine the sleep quality by using the Pittsburgh Sleep Quality Index (PSQI) questionnaire. Women with global PSQI score more than 5 was categorized as having poor sleep quality. Thirty-one middle-aged women (45.6%) with poor sleep quality [age: 47.58 ± 6.03 years, body mass index (BMI) 25.37 ± 3.46 kg/m 2 ] underwent online yoga practice one hour per day, three days a week for 12 weeks. After intervention, sleep quality was reassessed by the PSQI questionnaire. Results: The median and interquartile range (IQR) of the global PSQI score before yoga intervention was 10 (9-14) and that after yoga intervention was 3 (2-6) in the participants. The global PSQI score was significantly decreased after 12 weeks of yoga practice (p < 0.001) indicating the improved sleep quality. Conclusions: The present study indicates that 12 weeks of online yoga practice interventions has beneficial effect in middle-aged women with poor sleep quality. Yoga practice may be useful as a non-pharmacological approach to improve sleep quality.
... More specifically, breathing is a fundamental component of Pilates and plays a crucial role in modulating autonomic nervous system (ANS) activity. Diaphragmatic and controlled breathing promotes greater cardiac coherence, positively influencing the balance between the sympathetic and parasympathetic branches of the ANS [32]. Previous studies demonstrated that conscious breathing techniques can reduce the hyperarousal of the ANS associated with chronic stress, modulating physiological responses to anxiety [33]. ...
Background: The positive effects of Pilates on balance, resistance, strength, and flexibility have been described several times. Additionally, positive effects on psychological symptoms, such as anxiety and depression, were documented. However, the change in behaviors at risk for stress-related physical disorders has not yet been validated in a group of people practicing Pilates. In light of these assumptions, changes in risk behaviors for stress-related physical disorders were assessed along with psychological symptoms, comparing a group of people practicing Pilates with non-active controls. Methods: The study was observational. Data from an experimental group of twenty-five people practicing Pilates (five males and 20 females between 50 and 64 years old) were compared to those of a control group of 24 people (seven males and 17 females between 54 and 65 years). Psychological symptoms were assessed through the Symptom Questionnaire (SQ) while the P Stress Questionnaire (PSQ) investigated risk behaviors for stress-related physical disorders. Results: The analyses attested a significant decrease in anxiety (time × group effect: F = 17.38; p < 0.001), depression (time × group effect: F = 5.44; p < 0.05), and somatization (time × group effect: F = 11.25; p < 0.01), as well as an improvement in stress-risk behaviors, especially in the ability to benefit from spare time by “taking one’s mind away” from commitments (time × group effect: F = 8.56; p < 0.01). Conclusions: Although the literature describes benefits for anxiety and depression following moderate-intensity sporting activities, our study also noted positive effects from Pilates on stress and psychological symptoms. Our findings suggest that Pilates may be appropriate for people who can perform light to moderate exercise.
... AFT outcomes are proxy measures for an athlete's capacity to regulate stress, maintain peak performance, and recover efficiently [10] . It has been consistently shown in scientific studies that yogic interventions can greatly increase HRV and autonomic function in trained athletes [11,12] . Yet, research on athletes in Jaipur and its surrounding regions is limited [13] . ...
... According to R. P. Brown and Gerbarg (2005) ...
This is an open access journal, and articles are distributed under the terms of the Creative Commons Attribution-NonCommercial-ShareAlike 4.0 License, which allows others to remix, tweak, and build upon the work non-commercially, as long as appropriate credit is given and the new creations are licensed under the identical terms. For reprints contact: reprints@medknow.com How to cite this article: Hasan A, Saboo N, Kacker S. Effect of yoga and diet on cognitive functions among hypertensives: a review. MGM J Med Sci 2025;12:147-54. Abstract Hypertension (HTN), often referred to as a "silent culprit behind multiple bodily dysfunctions," is a growing global health burden, with its prevalence rising daily. Among its many complications, cognitive dysfunction in hypertensive individuals remains largely unnoticed, impacting daily life and personality traits. Unhealthy lifestyle choices and poor dietary habits further heighten the risk of cognitive impairment. Global research highlights the significant role of yoga and a balanced diet in reducing the risk of cognitive decline among individuals with HTN. Yoga originated in India over 5000 years ago and has become vital to a healthy lifestyle. Dietary factors, such as excessive salt and sugar intake, physical inactivity, obesity, smoking, and alcohol consumption, are key modifiable risk factors for HTN. However, only a limited number of studies have explored the impact of yoga and diet on cognitive function in hypertensive individuals. This review aims to emphasize the role of yoga and diet in addressing oxidative stress and inflammation, which contribute to the pathogenesis of HTN. By focusing on lifestyle modifications, this article seeks to raise awareness about the benefits of yoga and diet in mitigating the overall risk of cardiovascular (CV) diseases. Cognitive function will be assessed using event-related potential P300, mini-mental state examination, and Montreal Cognitive Assessment A and B, while quality of life will be measured using the Quality of Life Scale and stress levels using the Perceived Stress Score. Yoga has been widely recognized for its therapeutic benefits in enhancing immunity and aiding in managing chronic conditions such as CV, respiratory and endocrine disorders, obesity, cancer, and metabolic syndrome. Specific yoga practices, including asanas (postures), pranayama (breathing exercises), and dhyana (meditation), strengthen the immune system, regulate inflammation, and help prevent chronic diseases. These techniques effectively reduce both the psychological and physiological impact of chronic stress. Given the rising burden of lifestyle-related diseases, integrating yoga and dietary modifications into daily routines can significantly improve chronic disease management and overall well-being.
Background
Although an alarming number of diabetes mellitus patients suffer from diabetes-related distress, little has been done to offer a solution to eliminate this unique, often hidden emotional burden. Sudarshan kriya yoga (SKY), a unique breathing technique developed by the Art of Living Organization, has been studied in persons living with diabetes (PWD).
Objective
The objective of this study was to undertake a narrative review of clinical studies of SKY’s role in emotional diabetic distress and quality of life (QOL) parameters in PWD.
Methods
Keyword searches of Medline and PubMed database.
Results
Four clinical studies have studied the effect of SKY practice on quality-of-life parameters in PWD. Analysis of the results reveals that SKY practice can improve QOL, relieve anxiety and depression, and improve dietary practices and medication adherence in PWD.
Conclusion
Diabetes distress (DD) takes a toll on motivation for self-care and increases the chances of diabetes complications and related mortality. There is an urgent need to screen, prevent, and treat DD. SKY practice is an effective and easy way to manage DD and must, therefore, be taught to PWD with the goal of optimizing health outcomes and health-related QOL.
The limitations of current methods of treatment for dysthymic disorder justify experimentation with new alternatives. Techniques of yoga hold promise. A brief package; Sudarshan Kriya exerts demonstrable effects on brain functioning and may have effects akin to ECT in depression. Sudarshan Kriya Yoga (SKY) was used to treat 46 hospital out-patients (22 males) of dysthymic disorder. Over 3 months, they had to practice it everyday for half-an hour and avoid any medication. They were assessed initially, at one and 3 months on interviews video-rated and self-report scales. In a subsample of mates (n=12), plasma prolactin and cortisol levels were obtained before and after the first full SKY session. 37 patients completed the treatment through three months and 25 (68%) of them remitted. A higher proportion of those practising SKY regularly remitted. Significant elevation of plasma prolactin, but not cortisol occurred after the first SKY session. SKY has demonstrable biological effects and is therapeutic in dysthymic disorder.
We explored relationships between anxiety and antisocial behavior and autonomic heart rate regulation in a homogenous sample (N= 175 (of 15-year-ofd males. Measures for anxiety and antisocial behavior were obtained at yearly intervals over a period of 4–6 years. Components of heart rate variability associated with postural (sympathetic) and respiratory (vagal) change and transfer of respiratory to heart rate variability were estimated an age 15 using Spectral analytic techniques. Anxiety and antisocial behavior were predictably related to enhanced and diminished levels of mean heart rate, respectively. Anxiety was also predictably related to enhanced sympathetic mediation of phasic postural effects on heart rate. Antisocial behavior was unexpectedly related to disruption of vagally mediated, phasic respiratory effects on heart rate. Anxiety and antisocial behavior showed distinct relationships to heart rate, and to the autonomically mediated component, of heart rate variability from postural and respiration sources. Spectral analytic techniques helped elucidate these unique regulator; patterns, suggesting utility for future research in this area.
Left vagus nerve stimulation (VNS) is a promising new treatment for epilepsy. In 1997, VNS was approved in the United States as an adjunctive treatment for medically refractory partial-onset seizures in adults and adolescents. For some patients with partial-onset seizures, the adverse effects of antiepileptic drugs (AEDs) are intolerable; for others, no single AED or combination of anticonvulsant agents is effective. Cerebral resective surgery is an option to pharmacotherapy in some cases, but many patients with partial-onset seizures are not optimal candidates for intracranial surgery. VNS entails implantation of a programmable signal generator—the Neurocybernetic Prosthesis (NCP)—in the chest cavity. The stimulating electrodes of the NCP carry electrical signals from the generator to the left vagus nerve. Although the mechanism of action of VNS is not known, controlled studies have shown that it is safe and well-tolerated by patients with long-standing partial-onset epilepsy. Side effects, which are generally of mild to moderate severity, almost always disappear after the stimulation settings are adjusted. Encouraging results have also been reported in pediatric patients.
The purpose of this study was to examine the effects of paced respiration on autonomic and self-report indices of affect within a clinical population. Thirty-six alcohol-dependent inpatients scoring high in trait anxiety were randomly assigned to either a pacing or attention control group. The paced subjects received 10 minutes of slow-breathing training during the first experimental session, while control subjects simply counted the pacing tones. In a second session, paced subjects were asked to breathe at the same lowered rate (10 cycles per minute) on their own, while the remaining subjects were instructed to relax. Prior to and following each session, self-ratings of tension level and state anxiety were collected. As expected, paced subjects evidenced greater reductions in self-rated tension, state anxiety, and skin conductance levels compared to the control subjects. It was concluded that respiratory pacing is an easily learned self-control strategy and potentially may be a useful therapeutic tool.
This study examined the psychophysiological effects of slow-paced breathing while subjects breathed through external respiratory resistive loads. Twenty-four normal volunteers completed four 5-min trials of paced breathing (.125 Hz) through an inspiratory resistive wire mesh screen (0 to 25 cm H2O/L/s). Each trial was followed by a 5-min rest trial. There was evidence for hyperventilation and/or fatigue during paced breathing. Also, respiratory sinus arrhythmia (RSA) was elevated in the first minute of paced breathing, and then declined toward baseline. Heart period decreased during paced breathing trials, and fell significantly below baseline during rest periods. These data suggest decreased vagus nerve activity and/or sympathetic activation, following an initial increase in parasympathetic activity during paced breathing. They are not consistent with the use of .125-Hz paced breathing as a relaxation technique, particularly during respiratory resistive stress. Finally, although RSA and average heart period changed synchronouslywithin paced breathing and rest conditions, they diverged incomparisons between pacing and rest. This dissociation suggests that different mechanisms mediate these two cardiac parameters. These data are consistent with Porges' theory that vagal influences on tonic heart rate are mediated by the combined effect of vagal projections from both the nucleus ambiguus and the dorsal motor nucleus, while RSA is mediated only through the nucleus ambiguus alone.
Recent neurophysiological findings in relation to thalamocortical mechanisms for sensory processing, together with established anatomical and expanding functional evidence, have provided a rational theoretical framework for the interpretation of normal and abnormal EEG rhythmic activities. This perspective is integrated here with earlier animal studies which were the foundation for many current applications of EEG self-regulation as a clinical tool. Basic evidence concerning the origins, frequency modulation, and functional significance of normal EEG rhythmic activities is reviewed here in an effort to provide guiding principles for the interpretation of clinical abnormalities and their remediation with EEG feedback training.
The nonapeptide oxytocin is released into systemic circulation in situations of psychosocial interaction, and has been shown
to be involved in mechanisms of social bonding and social recognition in laboratory studies. In view of disturbances in psychosocial
relationships being a triggering factor for depression and anxiety, it is interesting to note that experimental studies have
shown oxytocin to possess antidepressant- and anxiolytic-like actions. Thus, in the present study we examined effects of the
SSRI citalopram (20 mg/kg IP) on plasma oxytocin, acutely and upon repeated administration, in adult male Sprague-Dawley rats.
Plasma oxytocin, and some functionally related peptides (CCK, gastrin, somatostatin and insulin), were measured by standard
radioimmunoassay techniques. Acute citalopram administration produced a statistically significant increase in plasma oxytocin
and CCK levels. Administration of citalopram for 14 days did not attenuate the oxytocin-releasing effect to a challenge dose
of the SSRI zimeldine (20 mg/kg SC), whereas CCK levels were not increased after the subchronic citalopram treatment. Thus,
the SSRI citalopram produces increased plasma oxytocin levels acutely, and there appears to be no or little tolerance to this
effect upon repeated administration. There were no, or variable, effects on plasma levels of gastrin, somatostatin or insulin.
It is suggested that oxytocin release is an important aspect of the pharmacological actions of SSRIs, and this could be an
important contributory factor for the clinical profile of this group of antidepressants with particular efficacy in disorders
of psychosocial origin.
The effects on the EEG rhythms recorded from the sensorimotor cortex (post-sigmoid gyrus) of anaesthetized cats were studied under 4 conditions of artificial mechanical hyperventilation (HV) before and after cervical bilateral vagotomy. In animals with intact vagus nerves, using visual examination, EEG changes were only observed within the 2nd min during HV produced by increased stroke volume (delta V) with associated hypocapnia. Quantitative EEG (qEEG) showed that, for the same increase in minute ventilation and the same degree of hypocapnia, delta V induced a greater and earlier relative decrease (2nd min) in the power density of delta, theta and alpha bands, than increased pump frequency (delta F). The delta F tests produced a fall only in the theta band and within the 3rd min. With constant paCO2, transient modifications occurred only with delta V and were limited to the first 30 sec. In bivagotomized cats, moderate EEG responses to delta V plus associated hypocapnia persisted partly in the alpha band. Finally, no changes appeared with delta V or delta F when the vagus nerves were cut and paCO2 was maintained constant. The present data suggest strongly that, in anaesthetized cats, peripheral vagal afferents from the respiratory system play a major role in the EEG changes caused by artificial hyperventilation.