Alternate Nostril Vs Balanced Breath For Hypertension

Several studies have indicated the positive effects of alternate nostril breathing (ANB)/anuloma viloma on heart rates, blood pressure, and hypertension. The study cited below provides some of the specific research papers. However, this study in the International Journal of Yoga, Ghiya S, Lee CM. Influence of alternate nostril breathing on heart rate variability in non-practitioners of yogic breathing. Int J Yoga 2012;5:66-9,  compares the effect of ANB to the practice of paced breathing (PB)/samavritti pranayama. Why is this important?

The breathing in both is paced at the same rate, but in one it alternates between nostrils and in the other it is through both nostrils.

The aim of the study was to compare the effects of the two types of yogic breathing in people who had no experience of either practice. Here is the description of the breathing practices used in the study along with the rate of breathing and the time spent on it. It works as a yogic breathing prescription for stage 1 hypertension.

“Alternate nostril breathing : While sitting in a crossed leg position, participants inhaled through the left nostril, held the breath for a moment while keeping both nostrils closed, then exhaled from the right nostril keeping the left nostril closed. This was followed by inhalation through the right nostril and exhalation through left nostril in the same manner. The participants repeated this cycle at a breathing rate of 5 breaths/min-1 for 30 min. Paced Breathing: The participants were instructed to breathe normally while maintaining a breathing rate of 5 breaths/min-1 for 30 min. An investigator provided verbal cues to ensure that the appropriate breathing rate was maintained.”

It is known that ANB may increase parasympathetic activity (ida nadi) for reduced basal heart rate, lower blood pressure and improved autonomic nervous system function over the long-term.

The study states that, “On the other hand, there is less information on autonomic nervous system function in the time period immediately following a session of yogic breathing.” So we still do not know the immediate effect conclusively according to the authors.

They concluded that their research suggests that both ANB and PB were equally effective in their sample.

Now this is of great interest and important to me as two of the seniors I work with have Parkinson’s. They both find ANB helpful in calming anxiety and a reduction in tremors for short durations of time. However, they can only practice 10 breaths with comfort (about one or two minutes). After that they feel light- headed. The arm gets tired (for most people) as the right hand is used to manipulate the nostrils. What if PB, which does not require the arm to be held up, has the same effect? Is it possible to practice PB for longer periods of time than ANB and have the same effect? Does the light-headed feeling lessen or disappear with PB? It is something we shall try out. These are questions for a vast range of people, not just seniors or those who suffer from Parkinson’s.


Ghiya S, Lee CM. Influence of alternate nostril breathing on heart rate variability in non-practitioners of yogic breathing. Int J Yoga [serial online] 2012 [cited 2012 May 26];5:66-9. Available from:

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