Covid 19 takes lot of toll on body and mind and effectively reduces immunity. It also disturbs sleeping rhythm another immunity reducer. Of breathing exercises Abdominal (Diaphragmatic) Breathing and Bhramari (Humming Bee) Pranayam have been even researched to help in mild Covid cases. So starting it as tool to build up body strengths and immunity is excellent idea.
Proper breathing helps oxygenation of blood, removal of carbon dioxide thereby mental concentration, good health, and longevity. It provides oxygen to the cells of various organs including brain, heart and kidney. Oxygen gives life to the cells and keeps them alive. That is the reason air is known as pranvayu, giving life to the human body. Breathing exercises have probably been labelled as Pranayama, as these are responsible for providing the life energy to our body. Breathing exercises are useful not only in maintaining good health and prevention of various systemic diseases, they keep us alert, active and socially compatible and maintain a positive state of physical, mental, social wellness. Exercises have been studied extensively regarding their role in different medical diseases. Its role in asthma, chronic obstructive pulmonary diseases, systemic hypertension, post-operative management in general surgery, cardiovascular surgeries, and head and neck surgeries has been documented. Yoga has been noted to improve visual, mental and neurological functions also. The article attempts to outline various types of breathing exercises and their role in overall human well- being.
The Three Phases of Pranayama Breathing
No matter how you practice breath control, there are essentially three stages of pranayama breathing. The three components to the breath are
- Purak (inhalation)
- Kumbhak (retention)
- Rechak (exhalation)
One yogic breathing technique, for example, might instruct that the inhaling and exhaling is done slowly with a pause in between. Another might instruct that the inhaling and exhaling are done rapidly without any pause in between.
No matter how long you hold your breath or how many seconds you take for each inhalation and exhalation, though, all types of pranayama will move through these three stages.
BREATHING EXERCISES AND ITS TYPES
Breathing exercises should normally be done in a sitting and comfortable position of lower limbs, either in ‘padmasana’ or ‘vajrasana’ or in sitting cross-legged position. In case of hip and knee joint diseases causing difficulty in sitting cross-legged or extreme flexed position, one can do these while sitting on a chair. One should be sitting comfortably with erect spine. Breathing exercises should not be done after meals and at least an interval of three hours should elapse between the last meal and exercises. Preferred time is early morning after bowel emptying or a minimum of three hours after meals. Exercises should be learned properly and chosen each type should be done at least 5 – 10 times in the beginning, which can be increased gradually every week.

1. Normal / Natural Breathing
It is the naturally and involuntarily occurring breathing in which mostly the inspiration time exceeds the expiration time. It can also be called as quiet breathing as it continues to occur at all times during the life of a person without any sound production or voluntary effort. It mostly utilizes the abdomen and moves diaphragm for inhalation and exhalation. Its normal rate is 12 – 16 / minute. In cases of chronic pulmonary disease, it may become shallow and slower. In a normal healthy person chest expansion on full inspiration should be 5 cm. In diseases of the lungs and chest this expansion becomes reduced. In ankylosing spondylitis due to involvement of costo-vertebral joints, chest expansion becomes reduced up to 2 cm. Normal breathing becomes laboured when there is gross decrease in oxygen supply. Most of the times it changes to gasping in the terminal stages of a fatal disease. At the gasping stage, accessory muscles of respiration such as neck muscles come in action. In COPD cases also neck muscles may be used for normal respiration.
2. Equal Breathing
It is the type of breathing in which the inspiration and expiration phase take equal time in the respiration cycle. Actually, it is improved version of the normal breathing. It is important to practice this because it ensures the removal of total carbon-dioxide from the lungs before starting new inspiration. In normal breathing, many among us inspire for a longer duration than the time for expiration, thereby leaving a part of the lung filled with deoxygenated air which in turn reduces the amount of air inhaled. bhastrika (bellow’s breath) is a special type of equal breathing in which short, sharp, even inhales and exhales are done through the nose. It may sound like a dog panting when done fast and continuously. It is initially done voluntarily, but later may become natural for the person. For beginners, it is best to inhale fresh air deeply to a count of three and then slowly exhale it to a count of further three, making it 4, 5 and 6. This should be repeated at least 10 times in a slow and rhythmic manner. Among breathing exercises, this is mostly done as the starting exercise.
3. Thoracic Breathing
It is the type of breathing in which thoracic (intercostal) muscles are used more than the diaphragm. It is a component of a normal breathing cycle but may need extra effort by a sedentary individual. This type involves action of 12 pairs of ribs along with its attached intercostal muscles. During inhalation ribs move superiorly and anteriorly, and go back inferiorly and posteriorly in exhalation. It mostly comes in its full role after physical activities like running, skipping, and out-door games due to increased oxygen requirements. In cases of cervical spine injury, intercostal muscles may stop functioning due to paralysis and the patient’s respiration primarily becomes abdominal. In COPD and Ankylosing spondylitis, this is primarily affected. In the paralysis of diaphragmatic and thoracic muscles, the patient starts using accessory neck muscles for breathing. Depending on the part of thorax being primarily used in breathing, thoracic breathing can be sub-classified into:
Clavicular Breathing: It is the type of breathing in which the upper part of thorax (clavicular / apical area of lungs) is voluntarily put into action to help lung’s expansion and contraction in respiration. It can be assessed by measuring the expansion of this area by tape. Alternatively, one can keep his both open hands on the upper chest, finger-tips touching in the sternal area and assessing expansion by the increase in distance between fingers. This breathing may be decreased in apical lobe involvement in pneumonia or tuberculosis.
Costal Breathing: It is the thoracic breathing utilizing primarily the middle part of thorax with the efforts of intercostal muscles. This is involved in generalized lung disease, pneumonia, silicosis and similar occupation related pulmonary conditions. Its extent can also be measured by tape or noting the expansion by digital distancing. It refers to normal breathing site in laymen’s language. This is also seen to be occurring to a deficient degree, as many persons use neck muscles instead of intercostal muscles. This causes a superior and inferior movement of the chest instead of outward and transverse expansion of the chest.
5. Deep Breathing
It is the breathing in which inspiration and expiration are repeated after longer intervals in each cycle. It makes the breathing pattern slow, long, and deep. It helps in more utilization of the vital capacity of lungs and instils a feeling of calmness in the person. Deep breathing may be done in ratios, thereby prolonging inspiration or expiration time in relation to each other.
6. Fast (Quick) Breathing
It is the opposite of the deep breathing. In this inspiration and expiration are done for a shorter duration in a fast manner. It is used in certain types of breathing such as anulom vilom. Quick breathing can also be done with either left nostril or right nostril alone.7. Alternate Nostril Breathing (Anulom Vilom or Nadi Shodhan Pranayam)It is the special type of breathing cycle involving alternate nostril, and gets commenced after expelling air forcefully from one nostril from which inspiration is to commence. For example, if inhalation is done from the right nostril, the left nostril is kept closed. After full inhalation, the right nostril is closed and the air is expelled from the left nostril. After a full exhalation, now inhalation is done again from the left nostril, and exhalation from the right nostril, after closing the left nostril. Thus, in any action of inhalation or exhalation, only one nostril is used. Air is inhaled from the nostril through which it has been exhaled previously. Due to use of alternate nostril, it is named as “Alternate Nostril Breathing”.
It is supposed to be of great importance for our overall health. It is based on the basic presumption that at a time only one of our two nostrils remain active. This breathing type helps thorough cleansing of our nasal tract and its continuation to the lungs. It cures simple upper respiratory tract infections and oxygenates the blood properly. Its rate and rhythm can be varied easily by the person. It instantly gives a feeling of freshness and well-being. It is advised to do Anulom Vilom at least for 10 minutes every day for its gainful benefit. It should be learnt suitably before practicing. The rate of inspiration and exhalation are similar and can be modified by the person at his will. Anulom Vilom is a specialized breathing giving peace, calmness and good exercise.
8. Bhramari (Humming Bee) Pranayam
It is the slow exhalation from the nose with mouth closed, after a deep inhalation, creating a humming sound from the closed mouth. In its modified form, exhalation can also be done through the softly closed mouth and creating a sound of ‘Ohm’ continuously. It should be done at least for 5 times. This is supposed to help in concentration and relaxation after doing vigorous bhastrika, anulom vilom and kapalbhati breathing exercises.
9. Ujjayi (Victorious) Pranayama
It is a technique that helps calm the mind and warm the body. In this breathing, deep inhalation is done, and with slightly contracting the throat, the air is exhaled out through the nose. This breathing technique is used throughout Ashtanga and Vinyasa yoga practices. It is supposed to be useful for correcting hormonal imbalance.
10. Tribandha Pranayama
It is special pranayama, in which air is exhaled out forcefully and breath is held. Then perineal muscles are contracted (mula bandh), followed by upper abdominal muscles contraction (uddiyana bandh), and chin is lowered down contracting neck muscles (jalandhara bandh), causing tribandha. It is held as such for a half to 1 minute, and then air is inhaled deeply, and all the three contracted group of muscles are relaxed, releasing the tribandha. It can be repeated a few times. It is necessary to learn and do it under supervision before independent execution.
11. Surya Bhedan Pranayama (Right Nostril Breathing)
It is a type of breathing in which inspiration is done from the right nostril only and expiration is done from the left side. Its repetition is done in the same way. It is different from anulom vilom, in which both the nostrils are used alternatively for inspiration and expiration. It increases the metabolism and helps in weight loss.
12. Sitali Pranayama (The Cooling Breath, Purses Lip Breathing)
In this type of breathing, inhalation is done through the mouth, while rolling the tongue into semi-tubular shape. The air going in causes a cooling and calming effect on the nervous system. Expiration is done from both the nostrils.
The above breathing types are commonly practiced types. There are many other types serving specific function. Breathing exercises in combination with Asanas and dhyan provide complete route to positive health. A combination of all the three components in proper proportion is fruitful for overall benefit.
Pranayama means control of our life force using various breathing exercises, dhyana and concentration. It harnesses the power of human brain to a higher degree. It requires to be done initially under the supervision of the trainer or Guru to avoid mistakes in technique and obtain the maximum benefits. Ujjayi (victorious) pranayama and tribandha pranayama should be learned and practiced before doing independently. Other types of breathing exercises may be learned relatively easily. These breathing exercises are maximally beneficial on doing these regularly, and for adequate time. For a normal person of either sex exercises like, equal breathing, clavicular breathing, costal breathing, diaphragmatic breathing (kapalbhati), alternate nostril breathing (anulom vilom) and bhramari pranayam for adequate duration regularly helps in disease prevention and positive health maintenance. Due to simultaneous diet control, better oxygenation of body cells and positive thought process, these are supposed to prevent genesis of cancerous growth also.
Breathing exercises and Pranayama also help in rehabilitation of person suffering from physical or mental illness. Due to various physical postures adopted, joints become lax and mobile. Physical exercises can be done better and strength & range of movement can be gained easily. Due to the calming effect on mind mental status and concentration also improves. Sambhavi mahamudra Kriya is especially useful in controlling behaviour of psychiatric patients.