Yogic Breathing Techniques in the Management of Anxiety and Depression: Systematic Review of Evidence of Efficacy and Presumed Mechanism of Action

Nupur Tiwari, David S Baldwin


Mood and anxiety disorders are the cause of much individual personal distress and also a major public health problem. A recent review of the epidemiological studies of mental disorder within the European Union demonstrated that when grouped together anxiety disorders and the principal mood disorders had an estimated 12-month prevalence rate of approximately 14% and 7.8%, respectively.1 Using estimates to calculate the size of the population in the European Union that would be affected (69.1 million people), it was estimated that in 2010 anxiety disorders (excluding post-traumatic stress disorder) cost approximately 66 billion Euros and mood disorders (affecting 33.3 million people) cost approximately 113 billion Euros.2 Furthermore, three anxiety disorders (panic disorder, obsessive-compulsive disorder, post-traumatic stress disorder) and two mood disorders (unipolar depression and bipolar disorder) were among the major medical causes of disability.


Yogic breathing (Pranayam) involves control of the rate, depth and type of breathing and is considered to be an important component of yogic practice. “Breathing exercises” are frequently recommended, as part of the overall management plan for patients with anxiety disorders, though formal evidence for efficacy is limited and the potential mechanisms underlying beneficial effects are not fully clarified. We undertook a systematic review of published studies examining the efficacy and putative mechanisms of yogic breathing in anxiety disorders. There are few adequately designed randomised controlled trials in patients with anxiety disorders; though benefits have been reported in healthy volunteers and in patients with physical health problems, evidence for potential efficacy in anxiety disorders rests largely on the findings of case series and uncontrolled studies. There is a persisting need for well-designed randomised controlled trials in clinical samples of patients with anxiety disorders.


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