Is yoga a potential treatment for asthma? The research has been mixed, but people with asthma who practice yoga report feeling better.

This isn’t surprising. There’s plenty of good evidence – see here and here – that practicing yoga lowers stress hormones and increases feel-good chemicals in the brain. As a consequence, anxiety tends to drop and one’s mood tends to improve.

Given that stress can trigger an asthma attack, this is no small thing.

However, yoga’s standing as a front-line clinical treatment for asthma hasn’t been established.

Rather, a new meta-analysis has found it serves as a complementary treatment that works well in tandem with other forms of exercise to increase lung capacity.

What is asthma?

Asthma is a long-term condition where the airways become periodically inflamed and narrowed when a sufferer is exposed to triggers, such as allergens, weather or temperature changes, and irritants like smoke, fumes and pollution. And, as mentioned, stress is also a potential trigger.

In an attack, or exacerbation, the muscles around the airways contract and the airways produce extra mucus, causing the breathing to become difficult. According to Asthma Australia, the most common symptoms are:

1. Persistent cough, irrespective of sound it makes.
2. Wheezing – high pitch whistling sound made by narrowing of airways
3. Breathing difficulties – sometimes the signs of airways tightening do not result in any sounds (silent asthma) such as wheezing and coughing.
4. Tightening of chest and chest pain.

According to the Australian Institute of Health and Welfare, there are about 2.7 million people with asthma in Australia,.

In 2020-21 there were 25,000 hospitalisations with a primary diagnosis of asthma – and most of those patients were children. Last year, the Royal College of General Practitioners reported that child hospitalisations were the highest in a decade.

Having a targeted management plan is regarded as the moss effective way of dealing with asthma. But only one in three people with asthma (34.6 per cent) has a written action plan.

People aged 18 and over with asthma rated their health more poorly when compared with the general population.

So while medication tends to alleviate or lessen symptoms during an attack, the overall wellbeing of patients requires something other than drugs, which is essentially an emergency response.

The paradox of asthma and exercise

For a long time, exercise was seen as a problem for people with asthma. In fact, sufferers were discouraged from exercising. Namely because aerobic exercise can trigger or worsen asthma-related symptoms.

This is known as exercise-induced asthma or exercise-induced bronchoconstriction (EIB).

You can have suffer EIB even if you don’t have chronic asthma.

According to a fascinating report from Ohio State University, between 20 and 50 percent of Olympic athletes experienced exercise-induced asthma (the coughing and wheezing) but didn’t know they had the condition. Many of these athletes also didn’t know they had the condition and saw the symptoms as “normal physical responses to exertion”.

People who live with asthma, and who have suffered exacerbations while engaging in aerobic exercise, tend to be hesitant, naturally, about exercising at all.

However, regular physical activity can decrease asthma symptoms by improving your lung health. The key is to do the right kind of exercises, including breathing exercises and relaxation techniques, and to be well prepared for a flare-ups.

All of this you can determine in consultation with your doctor as part of a recommended action plan (the plan two-thirds of Australian asthmatics don’t have). For more general information about asthma and exercise, see here.

Yoga as an alternative?

Yoga’s appeal for people with asthma is obvious. It’s a form of exercise that open the chest muscles and encourages deep breathing. But it doesn’t require the kind of effort needed in aerobic exercise. Therefore it might be less prone to triggering an attack.

A very small 2010 study, found that “yoga exercise among asthmatic patients resulted in a decreased number of day and night attacks and use of drugs”.

Yoga was also associated with “significant improvement in the peak expiratory flow rate”.

Medication tends to be the front-line defence against an asthma attack. Photo: Getty

Peak expiratory flow (PEF) measures how much air you can breathe out in one quick exhalation. In the monitoring and treatment of asthma, it’s used to tell how well the lungs are functioning.

This was great news. The researchers advised more studies were needed to support the findings.

But a 2014 review of 14 studies found minimal evidence that yoga could reduce symptoms. Nor was it found to improve lung function and quality of life.

They concluded yoga couldn’t be prescribed as a routine treatment. But it had some value as a supplement therapy on the basis that it helped patients feel better.

A 2016 study found moderate evidence that yoga could provide minor benefits.

Still, researchers have kept at it – and a new meta-analysis of 28 randomized controlled studies seems to show how yoga can be an effective part of clinical treatment.

 The latest study

The study involved a total of 2155 people with asthma and examined the effects of breathing training, aerobic training, relaxation training, yoga training, and breathing combined with aerobic training, on lung function.

All five types of exercise interventions “demonstrated greater effectiveness in improving lung function measurements compared to the conventional rehabilitation control group”.

Specifically, the study found improvements in the levels of FEV1. This is the ‘forced expiratory volume’ an individual can exhale during a forced breath in one second.

There were also improvements levels in Peak Expiratory Flow (PEF) – a key measure of how well the lungs are functioning. Yoga training had the most significant effect on improving PEF levels (as per the 2010 study cited above).

The findings demonstrate “just how effective specific types of exercise training can be to enhance lung function for those with adults”, said lead author Shuangtao Xing, an Associate Professor at the School of Physical Education at Henan Normal University in China.

“Breathing training combined with aerobic training, and yoga training, appear to be particularly advantageous – offering potential avenues for effective treatment approaches.”

Bottom line: the study “highlights the importance of integrating appropriate exercise training into asthma management plans”.

If you suffer with asthma, and don’t have a management plan, please see your doctor and get one.