Breath Awareness Research Articles

Mindful Aging: The Effects of Regular Brief Mindfulness Practice on Electrophysiological Markers of Cognitive and Affective Processing in Older Adults

There is growing interest in the potential benefits of mindfulness meditation practices in terms of counteracting some of the cognitive effects associated with aging. Pursuing this question, the aim of the present study was to investigate the influence of mindfulness training on executive control and emotion regulation in older adults, by means of studying behavioral and electrophysiological changes. Participants, 55 to 75 years of age, were randomly allocated to an 8-week mindful breath awareness training group or an active control group engaging in brain training exercises. Before and after the training period, participants completed an emotional-counting Stroop task, designed to measure attentional control and emotion regulation processes. Concurrently, their brain activity was measured by means of 64-channel electroencephalography. The results show that engaging in just over 10 min of mindfulness practice five times per week resulted in significant improvements in behavioral (response latency) and electrophysiological (N2 event-related potential) measures related to general task performance. Analyses of the underlying cortical sources (Variable Resolution Electromagnetic Tomography, VARETA) indicate that this N2-related effect is primarily associated with changes in the right angular gyrus and other areas of the dorsal attention network. However, the study did not find the expected specific improvements in executive control and emotion regulation, which may be due to the training instructions or the relative brevity of the intervention. Overall, the results indicate that engaging in mindfulness meditation training improves the maintenance of goal-directed visuospatial attention and may be a useful strategy for counteracting cognitive decline associated with aging.

Healthcare provider contact for children with symptoms of sleep-disordered breathing: a population survey.

Symptoms of sleep-disordered breathing in children, such as frequent snoring, apnoea and choking, may lead to health problems if untreated. The caregiver's level of awareness of these symptoms has been poorly studied. This study aimed to study healthcare provider contact related to sleep-disordered breathing symptoms in a population of children aged 0-11 years. A total of 1320 children were randomly selected from a national database that included all children living in Sweden. Caregivers answered a questionnaire about sleep-disordered breathing symptoms during the last month and healthcare provider contact related to these symptoms. A total of 754 answers were received. The prevalence of sleep-disordered breathing symptoms was 4.8 per cent. Of this subgroup, 69 per cent had not been in contact with a healthcare provider regarding their symptoms. This study shows that sleep-disordered breathing in children is underestimated and that there is a need to increase caregiver and healthcare provider awareness of sleep-disordered breathing in children.

Dyspnoea: Pathophysiology and a clinical approach.

Dyspnoea, also known as shortness of breath or breathlessness, is a subjective awareness of the sensation of uncomfortable breathing. It may be of physiological, pathological or social origin. The pathophysiology of dyspnoea is complex, and involves the activation of several pathways that lead to increased work of breathing, stimulation of the receptors of the upper or lower airway, lung parenchyma, or chest wall, and excessive stimulation of the respiratory centre by central and peripheral chemoreceptors. Activation of these pathways is relayed to the central nervous system via respiratory muscle and vagal afferents, which are consequently interpreted by the individual in the context of the affective state, attention, and prior experience, resulting in the awareness of breathing. The clinical evaluation and approach to the management of dyspnoea are directed by the clinical presentation and underlying cause. The causes of dyspnoea are manifold, and include a spectrum of disorders, from benign to serious and life-threatening entities. The pathophysiology, aetiology, clinical presentation and management of dyspnoea are reviewed.

Children’s metacognition and mindful awareness of breathing and thinking

Children ages 4, 6, and 8-years old were tested for their introspective capacity to mindfully attend to the natural flow of their breath and thought as well as their objective knowledge of breathing and thinking as continuous, necessary bio-psychological processes. Results showed consistent developmental progression in breath awareness as well as process knowledge about both breathing and thinking. Distinctly, there was no improvement in thought awareness with age, which remained consistently poor. However, children who received the breath awareness task first performed better on the thought awareness task, suggesting that breath awareness may facilitate thought awareness. Process knowledge about breathing and thinking was significantly inter-correlated, but such knowledge was not significantly related to awareness abilities when controlling for age. The study points to the need for more systematic applied research examining development of mindfulness practices and metacognitive knowledge.

The Process of Personal Transformation for Adolescents Practicing Mindfulness Skills in an Alternative School Setting

This qualitative study examined the experiences of alternative school students as they participated in a mindfulness skills program. A 7-month school-based mindfulness skills program was integrated into the Grade 10 curriculum for high school students (N = 19; 10 boys and 9 girls, ages 15–17). Students engaged in mindfulness practices twice weekly during class time. Students practiced breath awareness, and seated, walking, and lying mindfulness meditation during the course of the program. Students completed initial and final questionnaires about their experiences as well as written journal entries based on their experiences in the program. At the completion of the program, 14 of the 19 program completers were interviewed (6 boys and 8 girls). Data analysis yielded two broad areas of perceived benefits of participation in the mindfulness skills program: intrapersonal benefits and interpersonal benefits. Intrapersonal benefits included themes of self-awareness and self-regulation (including cognition, emotions, and behavior). Interpersonal benefits included themes of building relationships (with peers, family members, and teachers) and learning to trust. These findings may be useful when planning school-based mindfulness programs and may serve as a guide for researchers studying mindfulness practices for youth.

Metabolic and Ventilatory Changes During and After High-Frequency Yoga Breathing.

BackgroundPracticing high-frequency yoga breathing (HFYB) induced a hypermetabolic state in a single subject during the practice but the effect has not been studied in multiple practitioners.Material/MethodsHealthy male volunteers (n=47, group mean age ±S.D., 23.2±4.1 years) were recruited as an experimental group and another twenty volunteers were recruited as a control group. The experimental group practiced either HFYB (Breath rate 1.0 Hz) or breath awareness (BAW) on two separate days. The sequence was reversed for alternate participants. The control group was assessed under similar conditions while sitting at ease. The breath rate (RR), tidal volume (VT), ventilation (VE), VO2, VCO2, arterial PCO2 and energy expenditure (EE Kcal/day) were assessed for 35 minutes using an open circuit oxygen consumption analyzer. The assessment period was divided into before, during and after conditions. Repeated measures analyses of variance (ANOVA) were used to compare data recorded during and after the two practices with data recorded before. Before-After comparisons in the control group were with paired t-tests.ResultsThe most relevant significant changes were increases in VE, VO2, VCO2 and EE during HFYB, while the same variables decreased during the control period. However after HFYB there was no change in VO2 or EE, although VE decreased as it did after the control period.ConclusionsHFYB induces a hypermetabolic state for the duration of the practice which returns to baseline after HFYB suggesting a possible application for HFYB in hypometabolic states.

A brief, interpersonally oriented mindfulness intervention incorporating Functional Analytic Psychotherapy׳s model of awareness, courage and love

A brief, group mindfulness intervention targeting both state mindfulness and social connectedness was developed based on Functional Analytic Psychotherapy׳s model of awareness, courage, and love. A total of 114 college students were randomly assigned to one of three conditions: (1) a nature video control, (2) a traditional intrapersonal mindfulness intervention focused on awareness of breath and private stimuli such as bodily sensations, thoughts, and feelings, or (3) an interpersonal mindfulness intervention that emphasized (a) expanding awareness from private internal to external public stimuli associated with the presence of others, (b) a contemplation of common humanity and risks participants could take to improve a specific relationship, and (c) a brief small group interaction involving courageous sharing of these risks. Results indicated significant benefits of all three conditions with respect to state mindfulness with both mindfulness conditions outperforming the nature video, and significant benefits of both mindfulness conditions with respect to social connectedness, with the interpersonal mindfulness condition outperforming the intrapersonal condition. Limitations include no follow-up data to explore the maintenance of gains over time.

Surya namaskara training for enhancing selective attention in orphan boys: A randomized control study

Background: Surya namaskara (SN) training is a part of yoga; it consists of a sequence of postures done with breath regulation, relaxation and awareness of energy centers. The selective attention (SA) is a vital function mediated by the right frontal-parietal cortex. The cancellation tests require visual selectivity and a repetitive motor response. The six letter cancellation task (SLCT) is useful to assess functions such as SA, focused attention, visual scanning, and the activation and inhibition of rapid responses. Assessing SA in orphan boys (OB) is a part of the neuropsychological evaluation to know their academic performance (AP). Objective: To assess the effect of SN training on SA in OB using SLCT. Subjects and Methods: Sixty OB with 11.3 ΁ 2 years of mean age were divided randomly, using computerized random number table into two groups ( n = 30 in SN training group and n = 30 in control group). The SLCT data were collected before (pre) and after (post) the SN training and control of 1 month duration. Results: The Shapiro-Wilk Test and Paired Samples Test using Statistical Package for the Social Sciences 16 (IBM Corporation, USA) showed that there was 50.75% increase ( P P Conclusion: The present study suggests that SN training may enhance SA among OB, thus, may prove useful for their AP. Additional well-designed studies are needed before a strong recommendation can be made on the efficacy of SN training for enhancing SA, and thereby improving AP.

Role of respiration in mind-body practices: concepts from contemporary science and traditional yoga texts.

The concept that interactions between the mind and body influence physical health has existed for a long time (1). These interactions form the basis for mind–body practices. They are considered bi-directional (“top-down” and “bottom-up”), with connections between the brain and peripheral tissues (2). Top-down mechanisms are initiated by the cerebral cortex and include clinical hypnosis, imagery, meditation, and breath awareness. Bottom-up mechanisms on the other hand, stimulate various somato-sensory, viscero-sensory, and chemo-sensory receptors (3, 4), which influence ascending pathways from the periphery to the brainstem and cerebral cortex. Mind-body practices are believed to act at multiple levels from gene expression at the cellular level to interaction between central brain regions (2). Taylor et al. (2) have proposed four mechanisms: (a) reorganization of cortical and subcortical structures and better interhemispheric balance; (b) improved central regulation of autonomic and immune functions; (c) re-patterning of primary interoceptive and higher order homeostatic mechanisms; and (d) modulation of epigenetic factors such as growth factors or hormones. These four effects are achieved by different ways including mental imagery, somatic relaxation, and deep breathing. Based on these effects, most mind–body practices are used in the treatment of psychosomatic illness. The ancient Indian practice of yoga is a mind–body practice. According to yoga texts, it is important to understand the origin of psychosomatic illness in order to treat it (Taittiriya Upanishad, circa 1200 B.C1) (5). This text continues to state that mental conflict, especially conflict between the intellect (called the vignanamaya kosha in Sanskrit) and the instinct (called the manomaya kosha in Sanskrit) causes a disturbance in the subtle, life energy, called prana in Sanskrit (5). This concept of an imbalance in the subtle life energy is mentioned in traditional descriptions of yoga but is not mentioned in contemporary medicine. Traditional yoga texts also suggest a solution for the imbalance in prana, through slow, deep breathing [Hatha Yoga Pradipika, circa 300 A.D.1] (6). It has been said that “when the mental state is disturbed, the life energy (prana) gets unbalanced and this leads to irregular breath; hence to regulate the mental state the yoga practitioner should regulate the breath” [Hatha Yoga Pradipika, circa 300 A.D.; Chapter 2, Verse 161] (6). Yoga regulated breathing acts as both a top-down and bottom-up mind-body practice. There is sufficient neuroanatomical evidence to support the idea that apart from the metabolic (chemoreceptor based) regulation of breathing internal and external factors influence breathing, which has been called behavioral breathing (7). Connections between cortical regions and brainstem respiratory neurons indicate that influences from higher centers can modify metabolic breathing (8, 9). A functional magnetic resonance study in normal subjects who had air hunger (with a low tidal volume) induced by mechanical-ventilation showed increased activity in limbic and paralimbic loci (10). Apart from these central connections, peripheral factors can also influence respiration. Nasal breathing activates olfactory cells; they activate the olfactory bulb and in turn the pre-piriform cortex and piriform cortex (11). Olfactory information ascends directly to limbic areas and hence olfactory information, which can be indirectly connected to breathing, influences emotions. Apart from being slow, deep and diaphragmatic, yoga breathing includes awareness of the movement of air in the nasal passages (12). Subjective awareness of inner sensations is referred to as interoception (13). An imaging study matched individuals’ subjective perception of their heartbeat with psychometric measures of their interoceptive awareness and emotionality (14). Their findings showed that the right anterior insula (rAI) is important for explicit subjective awareness. Conventional physiology has found benefits of deep breathing supporting the importance given to regulating the breath in yoga. Slow breathing had a balancing effect on the autonomic nervous system via enhanced parasympathetic activation (15). Slow and deep breathing stimulates inhibitory signals induced by stretch and hyperpolarizes cells, leading to synchronization of neural elements in the heart, lungs, limbic system, and cortex (16). Slow breathing also enhances vagal activity leading to reduced psychophysiological arousal, decreased sympathetic activity, and stress responses (17). Other effects include an increase in the antioxidant levels and hence deep breathing may help to reduce oxidative stress (18). In addition, deep breathing has been found to decrease cortisol and increase melatonin (19), possibly by the effects on the hypothalamic neuroendocrine regulation (15).

The Clinical Handbook of Biofeedback: A Step-by-Step Guide for Training and Practice with Mindfulness.

<i>The Clinical Handbook of Biofeedback: A Step-by-Step Guide for Training and Practice with Mindfulness.</i>

Oral hygiene practices and self-perceived halitosis among dental students

Background: Halitosis represents a common dental condition, although sufferers are often not conscious of it. It is common among humans around the world and is usually caused by an accumulation of bacteria in the mouth as a result of gum disease, food, or plaque. This study aimed to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlate the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodor. Materials and Methods: Clinical examination of 250 dental students and a self-administered questionnaire were included in this study. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating. Results: The results indicated that female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.000) was found in female dental students (40%) as compared to male (70%). It was found that smoking had statistically highly significant correlation with halitosis (P = 0.000). Presence of other oral conditions such as dental caries and filled carious lesions also showed higher prevalence of halitosis in dental students. Conclusion Oral hygiene practices and oral health conditions are very important factors in halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.

Practical tips for using mindfulness in general practice

In a recent BJGP Viewpoint article1 we discussed how both GPs and their patients have become more open to the prospect of using mindfulness meditation as a mainstream medical intervention. Mindfulness derives from Buddhist practice and is described as the process of developing an open and unbroken awareness of present-moment cognitive-effective and sensory experience.2 Following on from our previous article, here we provide seven practical tips for the effective use of mindfulness techniques in a general practice setting. ### Use meditative anchors The majority of clinically focused mindfulness programmes begin by instructing patients how to use a meditative anchor. The most commonly taught meditative anchor is that of observing one’s breath. Full awareness of the in-breath and out-breath helps patients to ‘tie their mind’ to the present moment and to regulate thought rumination. For patients with concentration deficits, instructing them to count their breath (that is, from one to ten and then back down to one) is normally beneficial. Similarly, some patients find it easier if they are guided using simple and gently spoken phrases such as ‘ breathing in, I am fully aware of my in-breath ’ and ‘ breathing out, I am fully aware of my out-breath ’. Other examples are ‘ breathing in, I am here; breathing out, I am now ’ and ‘ breathing in, there is nowhere I need to be; breathing out, I am already home ’. ### Don’t force the breath When using breath awareness as a meditative anchor, it …

Associations between attention, affect and cardiac activity in a single yoga session for female cancer survivors: an enactive neurophenomenology-based approach.

Yoga practice is reported to lead to improvements in quality of life, psychological functioning, and symptom indices in cancer survivors. Importantly, meditative states experienced within yoga practice are correlated to neurophysiological systems that moderate both focus of attention and affective valence. The current study used a mixed methods approach based in neurophenomenology to investigate associations between attention, affect, and cardiac activity during a single yoga session for female cancer survivors. Yoga practice was associated with a linear increase in associative attention and positive affective valence, while shifts in cardiac activity were related to the intensity of each yoga sequence. Changes in attention and affect were predicted by concurrently assessed cardiac activity. Awareness of breathing, physical movement, and increased relaxation were reported by participants as potential mechanisms for yoga's salutary effects. While yoga practice shares commonalities with exercise and relaxation training, yoga may serve primarily as a promising meditative attention-affect regulation training methodology.

The Effects of Acceptance of Thoughts, Mindful Awareness of Breathing, and Spontaneous Coping on an Experimentally Induced Pain Task

The current study examined the effects of acceptance of thoughts, mindful awareness of breathing, and spontaneous coping on both pain tolerance and pain threshold during a cold pressor task. Eligible participants (N = 58), 16 males and 42 females (M age = 29.31, SD = 11.21), were randomized into three groups and completed two cold pressor trials. The first cold pressor trial formed a baseline for all three groups. The acceptance of thoughts and mindfulness of breathing groups listened to recorded instructions and then completed a second administration of the cold pressor task. The spontaneous coping group completed the cold pressor task twice with instructions to select their own coping style. Multilevel linear modeling showed significant group differences in pain tolerance. The acceptance of thoughts and mindfulness of breathing conditions resulted in significantly higher pain tolerance in post hoc analysis than spontaneous coping. Results were interpreted to be consistent with Acceptance and Commitment Therapy. Further examination of the effects of ACT processes on experimentally induced pain tolerance is needed.

The patient with dyspnea

Dyspnea is the uncomfortable awareness of difficult breathing. It is a common symptom in primary and nonprimary care settings. Although multiple disorders and diseases may cause breathlessness, the majority of the conditions are of cardiac or pulmonary origin. The challenge is to establish the diagnosis timely and with minimized investigations. Frequently, information about onset, progression, and circumstances of occurrence considerably narrow the underlying etiology. In most cases, a carefully taken history and a comprehensive physical examination lead to the correct diagnosis. Nevertheless, one should be aware of concomitant conditions and not be satisfied with a diagnosis if comorbidity may still be a candidate in causing dyspnea. Otherwise, it has been observed that chronic obstructive pulmonary disease was over-diagnosed in patients with systolic heart failure and dyspnea. A prudential use of investigating modalities for confirmation and exclusion of a questionable diagnosis is the key for allocating the correct therapy and achieving fast symptom relief in patients with dyspnea.

Promoting Resilience with the Mindfulness-Based Stress Reduction Program in Patients With Chronic Illness

Objectives: Twenty-first century patients need to take a proactive stance with regard to their health in order to cope well with chronic illness. Mindfulness-Based Stress Reduction (MBSR) is an 8-week structured group program that encourages patients to take responsibility for their health and teaches them to cope with stressors inherent in living with illness.Methods: Patients with chronic illnesses (e.g., breast cancer, chronic pain, multiple sclerosis) participated in the MBSR program from 2006-2012. They completed questionnaires pertaining to depression, medical symptoms, stress, coping, sense of coherence, and mindfulness pre- and post-MBSR. They filled out a follow-up questionnaire that asked them to rate the program and its components. A self-care index was created from 5 items.Results: Of the 126 patients, 85.7% were woman, breast cancer was the most common illness (46.8%), and the average age was 52.3 (SD = 13.3). There were significant improvements on the following outcomes: depression, stress, and medical symptoms. With regard to process measures, there were significant increases in: mindfulness, sense of coherence (comprehensibility, manageability, and meaningfulness of life), as well as significant decreases in emotional coping. Patients rated the program with a mean of 8.94 (1 to 10 scale) for importance. They rank ordered the program components in terms of helpfulness with awareness of breath, the silent retreat day, and yoga practice as the highest of 10 items. There was a significant positive correlation between self-care index at the end of the course and its perceived importance. Moreover, self-care was positively and significantly correlated with post-MBSR mindfulness and viewing life as meaningful.Conclusions: Patients who took the MBSR program reported mental and physical health benefits. Furthermore, being mindful enabled them to cope better, take care of themselves, and view life as more coherent such that they became more stress resilient.

Living With Chronic Lower Pulmonary Disease

In this article, I present a phenomenological study of individuals’ experiences of living with moderate to very severe chronic lower pulmonary disease (chronic obstructive pulmonary disease, asthma, or both). Phenomenology is a philosophy, distinct from descriptive or thematic research, which is useful as a foundation for scientific inquiry. In this study, I used the lens of Merleau-Ponty to understand and interpret participants’ experiences of living with pulmonary disease, and the approach of van Manen for analysis. I conclude that in chronic pulmonary disease, awareness of breathing and the body is experienced in the sounds, sensations, and signals of breathing and the body, and in the experiences of the body-in-the-world. Central themes of being-in-the-world from the study describe the disruption of the embodied phenomenological self: Participants experienced slowing down, doing less, and having to stop due to shortness of breath. Both chronic and acute dyspnea were prevalent and the taken-for-granted aspects of daily activities were disrupted. Findings of this study have implications for public and patient education, and opportunities for integration of experiential aspects within nursing education and practice.

A Comparative Study of Immediate effects of Yogic Techniques on Human Memory

Regulating the breath is an important part of yogic techniques. A study was started with the selection of fifty normal subjects of both genders, age 25±5 years. The subjects were trained for forced nostril breathing, which is a type of yogic techniques; i.e. right nostril breathing, left nostril breathing, alternate nostril breathing and breath awareness for duration of 30 minutes daily for two week. The subjects were examined before and after two week yoga training for immediate effect of forced nostril breathing in memory performance using WECHSLER memory scale. The aim of this study was to compare the effects of yoga between male and female in memory performance. Measure ANOVA analysis revealed a significant increase in Digit Span Forward, Digit Span Backward and associate learning recall performance due to forced nostril breathing at P<0.001 level. Comparative data shows that increment of digit span forward and associate learning memory in both males and females was almost equal at P<0.001 level and findings of digit span backward revealed that forced nostril breathing influences differently in males and females. Data of digit span backward test shows better memory performance in females.

A Study to Determine the Immediate effect of Forced Nostril Breathing in Memory Performance

Study was done to determine the immediate effect of forced nostril breathing in memory performance. Fifty normal subjects of both genders, age 25±5 years were enrolled. The subjects were trained for forced nostril breathing; i.e. right nostril breathing, left nostril breathing, alternate nostril breathing and breath awareness for duration of 30 minutes daily for two week. The subjects were examined before and after two week yoga training for immediate effect of nostril breathing in memory performance using WECHSLER memory scale. This was self-control study to determine the immediate effect of forced nostril breathing in memory performance. Measure ANOVA analysis revealed a significant increase in Digit Span Forward , Digit Span Backward and associate learning recall performance due to forced nostril breathing at P<0.001 level.

Correlation of oral hygiene practices, smoking and oral health conditions with self perceived halitosis amongst undergraduate dental students.

Objective:The present study was undertaken to determine the prevalence of oral hygiene practices, smoking habits and halitosis among undergraduate dental students and correlating the oral hygiene practices, oral health conditions to the prevalence of self perceived oral malodour.Materials and Methods:A self-administered questionnaire was distributed among 277 male and female students. A questionnaire was developed to assess the self-reported perception of oral breath, awareness of bad breath, timing of bad breath, oral hygiene practices, caries and bleeding gums, dryness of the mouth, smoking and tongue coating.Results:The results indicate female students had better oral hygiene practices. Significantly less self-reported oral bad breath (P = 0.007) was found in female dental students (40%) as compared to their male counterparts (58%). It was found that smoking and dryness of mouth had statistically significant correlation with halitosis (P = 0.026, P = 0.001). Presence of other oral conditions such as tongue coating and dental caries and bleeding gums also showed higher prevalence of halitosis in dental students.Conclusion:A direct correlation exists between oral hygiene practices and oral health conditions with halitosis. Females exhibited better oral hygiene practices and less prevalence of halitosis as compared to male students.