Deep Breathe to Fall Asleep

Many people visit the doctor because they have trouble falling asleep. According to American Sleep Apnea Association, more than fifty million Americans suffer from eighty different sleep disorders, and even more from intermittent sleep problems. Falling asleep should be easy. But the mind takes on a life of its own, racing from one thought to the next, causing anxiety and fear, to run wild like a child.

Most likely, the doctor prescribes sleeping pills and tells the patient to try deep breathing before bed. But what is deep breathing? To understand this, it’s important to learn about the autonomic nervous system — that is, the body’s response to stress. Naturally, after a day stuffed with difficult people and unpredictable conflict, the brain activates the fight or flight response, and produces, among other things, the stress hormone cortisol. The stress agitates the mind, and the breath follows creating a forest of thoughts, until the path to sleep is lost. When under stress, the mind can hold the breath captive.

One way to reduce stress is to try and calm the breath.

Breath is natural. Breath is constant. Breath moves. In ancient Hindu text, it is known as prana or life force. Ultimately, breath determines state of mind. Mary Wise, MD, Integrative Family Medicine Physician, states that, “Breath is what and who we are as without breath we would not exist.”

Here are some steps to try to fall asleep. One rule of thumb is to turn off all electromagnetic screens. Creating a peaceful environment conducive to rest is essential. Scents like lavender help.

Experience a True Sense of Relaxation

First, try to experience the feeling of relaxation. According to Mary Wise, M.D. “There are many ways to relax. A common one is to do deep breathing focusing on the breath and letting all other thoughts go. Progressive muscle relaxation, guided visualization meditation, and repeating a word or a mantra all work well.”

One way to learn the feeling of relaxation is to lie down with the head on a pillow. Tense up the body as much as possible and then release it – – all at once. Here, experience the sense of relaxation in the physical body after the release of the tension; that feeling is the goal. Once you’re aware of how relaxation feels, the recognition of it as a state of mind becomes familiar and retrievable.

Become Aware of Energetic Chakras

Breath is alive. It travels through the body. Close the eyes and become aware of the seven chakras in the body. Breath is energy that moves from the first chakra upward.

  • Energy begins in the root chakra at the feet, legs, bones, base of spine.
  • Energy travels up to the next chakra, genitals and lower abdomen.
  • Energy moves to the third chakra the naval to solar plexus.
  • Energy rises to the upper fourth chakra heart, lungs, arms, hands.
  • Energy moves into the fifth chakra shoulders, neck, throat, ears.
  • Energy travels into the sixth chakra the eyes.
  • Energy moves into the seventh chakra crown of the head.

Establish a Root

Lie comfortably on the bed. Start with an inhale that begins in the pelvis with a light, subtle contraction. The breath should begin in the second chakra and travel upward. However, this may be too challenging for many, so start the breath where it’s easiest. It might be the stomach or the lungs. The secret is to find the root, where it’s most comfortable. Then, inhale from the root, letting the breath enter there. Allow the breath to move up to the higher chakras, and exit out through the nose.

Let the Breath Travel Up, Up, Up

Take a deep breath with the mouth closed. Ideally, the mouth should always remain closed. If that’s not possible, it’s fine. The action of trying is what matters most. Inhale the breath as deeply as possible, beginning in the pelvis and let it travel up through the stomach, slowly filling and expanding the lungs, into the throat, and after holding it for a few seconds, release it fully and slowly, through the nostrils.  

Once the breath is released through the nostrils, count silently to five. Then, begin a new inhale starting as low as possible in the pelvis, or the stomach, ultimately letting it fill the lungs, as it travels up past the throat and releases through the nose. Again, after a full exhale, count silently to five, and repeat.


The sound of the breath should not be labored. If it’s stressed, it defeats the purpose. It should sound soft and gentle like a wave on a shore. Ideally, visualize a circular motion of the inhale as it travels up the front of the body, and the exhale as it’s released down the backside.

Trouble Shooting

If allergies or other problems prevent breathing through the nose, then release the breath through the mouth, but continue to try and observe the movement of the breath as it makes it way up from the lower chakras (the pelvis) to the higher ones (stomach, lungs).

Oura Ring

Anne E. Appleby, founder of YogaForce, experienced insomnia and recommends the Oura Ring. She says that she “. . . went to three sleep clinics in the San Francisco Bay Area and nothing helped. Finally, a sleep doctor at UCSF suggested the Oura Ring. It has helped me to track my sleep. I’m so competitive that I wanted to get the best sleep score. In a matter of weeks, I was getting the top score of 90+. I have slept well for the past three years.”


Try ten deep breaths at a time, or more, if possible. It takes time. Don’t let frustration limit the action of trying. Master the root of one deep breath. Do this exercise regularly before trying to fall asleep, because practice makes perfect and muscles have memory.

Even one breath can begin to help reduce the stress hormones and allow for the drop into dreamland. The more one practices deep breathing, the easier it becomes to recognize the true state of relaxation and to summon it, when it’s time to fall sleep.


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Yes, Yoga 3x a Week Can Help Prevent Spinal Surgery

Yoga can prevent surgeryYoga may not alter the trajectory of family genetics in a lifetime, but it can prevent the need for spinal surgery.

Renowned orthopedic surgeon Gary Michelson, MD and founder of the Gary Michelson Medical Research Foundation (MMRF) says that, “In essence, being in good shape, having good core strength, and good flexibility is protective against many of the conditions that would have otherwise gone on to lead to spinal surgery. That having been said, there are those conditions which arise from structural defects in the spinal column that are probably not amenable to relief by exercise.”

But a person can “. . .fight heavy genetic issues with yoga and keep spinal surgery at bay,” says Vijay Vad MD, a sports medicine specialist at the Hospital for Special Surgery and faculty at Weill Cornell Medical College.   He’s also the author of Back RX: A 15-Minute-a-Day Yoga- and Pilates-Based Program to End Low Back Pain (Penguin 2004) and PBS national television special “Stop Back Pain Now.”

For example, within a family, if a brother suffers from genetic spinal stenosis and chooses a complex surgery such as cervical laminoplasty to cure his symptoms like progressive numbness and immobility, it’s possible his sibling, who may suffer from the same condition, can prevent surgery by starting and maintaining a yoga practice early in life.

Loren Fishman, MD., Managing Partner of Physical Medicine and Rehabilitation, concurs that “Yes, sometimes, yoga can help with even congenital conditions. The best poses are gentle flexion of the entire spine, and if ability permits, extension of the lumbar spine with flexion of the cervical spine, such as Paschimottasana (Figure 8. p. 246) with head elevated.  These gently move the spinal canal within the canal and may help the cord find the path of least compression.  “When it comes to spinal stenosis, yoga can certainly relieve pain and improve function, though this is more studied in the lumbar than the cervical spine,” says Dr. Fishman.  It does not change the anatomical fact of stenosis, but it does significantly improve people’s ability to function highly with the condition they have, often avoiding surgery for considerable periods of time.

Dr. Vad’s study, “The Role of the Back Rx Exericse Program in Diskogenic Low Back Pain:  A Prospective Randomized Trial”  showed that when practiced regularly, yoga reduces back pain and symptoms, recurring back pain and the chance of surgery, as well as narcotics use.

But yoga can be a double-edged sword.  Dr. Vad emphasizes the need to begin yoga slowly and to not jump into it. “If you jump into it too quickly you can blow your discs,” he says.  “You have to ease into it. You have to start as a beginner or have a modified practice.”

When Dr. Fishman’s spinal patients complain that they simply “can’t” do yoga, he troubleshoots.  First, he asks, “Have you tried?”  If his patient had a negative experience with yoga, he’ll find out why.  In general, Dr. Fishman tries to show the array of yoga available, such as, who (instructor), what kind of yoga (Kundalini, Iyengar, Ashtanga), what kind of setup (class, private), and then find a match for the student (state of mind, body, and goals then and now).

Yoga is the ultimate mind body connection therapy, because of the breathing.  “It isn’t breath that helps the spine, it’s the breathing” says Dr. Fishman.  Certainly, breathing helps posture and self-awareness, because “There’s a feedback loop, and better breathing makes for better alignment, which enhances breathing, which improves alignment and so on.”   To build and maintain a healthy spine, it’s essential to learn the correct technique of  breathing or prana from an expert instructor like Kiki Flynn and combine  it with the physical postures.  Most critically, says Dr. Fishman, “The breathing process focuses one on the apparatus of breathing, and the ribs and spine are the heart of the torso.”

In fact, Dr. Fishman’s study “Yoga for Osteoporosis: A Pilot Study” showed that “Eighty percent of the people who did yoga for two years according to the protocol improved their bone mineral density, even though most were losing bone before the study.”  Yoga strengthened the bones of their hips, spines, and thighs.

Yoga prompts better alignment, better coordination, and moves the spinal cord and cauda equina in the spinal canal, enabling it to settle in the position of least resistance.  The better alignment puts less pressure by reducing twists and turns, however slight they may be, and the better coordination enables multiple levels of the spine to bend smoothly and share tensions, thus reducing tension on the cord itself.  And by putting people in touch with their bodies, that is, mindfulness, it prompts earlier awareness of just how far they can go with reaching, bending, twisting, lifting, and just about everything else.

It also provides better proprioception, how the body senses itself in space, and this perception of balance prevents fewer back injuries, hip fractures, and ankle sprains.  Doctors at the American College of Sports Medicine recommend the YogaForce A-Line Mat to help with proper body alignment and proprioception.

According to Dr. Vad, “Proper exercise that increases the back’s flexibility, strength, and endurance makes good balance and posture possible and can dramatically retard these natural aging processes and moderate their effects.”

He focuses on three goals to maintain a healthy spine.  The first is to gain flexibility.  Lifelong yogi’s, for example, frequently retain well-hydrated discs into advanced old age.  Like the rest of the body, the discs depend on the circulatory system to bring them oxygen, so yoga like walking hydrates the discs of the spine.  Exercising the back prevents the discs’ loss of water, keeping it flexible and resilient.  “I’ve seen seventy-five and eighty-year-old yogi’s whose spines look great,” says Dr. Vad.

Second is the strength to move.  Dr. Vad states that, “The stronger the core trunk muscles [from knee to midsection] the less pressure there will be on the spine’s intervertebral discs and facet joints and the more resistant a person will be to disc herniations, facet arthritis, and other back problems.”

And third, yoga builds endurance to withstand stress, that “Over time, the slow, steady, moderate stresses and focused breathing can build very healthy levels of endurance along with core strength.”

To prevent spinal surgery, Dr. Vad’s prescription is to do yoga three times a week using his DVD Back Rx and implement aerobic training and walking every other day.


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Yoga Cures:  Surviving the Here and Now

Can a daily dose of yoga cure a life-threatening illness?

“One of the underlying powers of yoga is a balancing of the autonomic nervous system,” says Dr. David Riley, editor-in-chief, Alternative Therapies in Health and Medicine and clinical associate professor, University of New Mexico Medical School and medical research director, Integrative Medicine. “Yoga with its flowing rhythm of postures and deep breathing can reset the point of balance in the ANS, lower blood pressure, reduce stress and stimulate the overall immune function.” For women living life in today’s world, the responsibility of balancing job and family, the pressure to eat right and look good on top of concern about hereditary illness can trigger an ANS imbalance manifesting itself in a variety of diseases.

The nerve fibers of the ANS and its two divisions, the sympathetic “fight or flight” response and the parasympathetic “rest and digest” response, exist in a constant state of dynamic balance. “The sympathetic nervous system is like the gas pedal of a car and the parasympathetic nervous system is the brake,” says Dr. C. Noel Bairey Merz, medical director of the Preventative and Rehabilitative Cardiac Center, at Cedars-Sinai Medical Center. Too much of one and not enough of the other can create an imbalance. In fact, accurate measurement of heart rate variability through sophisticated ECG devices and computer analysis can be a definitive marker of an ANS imbalance.

“Ten years ago” says Dr. Merz “we didn’t have computers, cell phones and fax machines.  Now, women can shop online, make dinner and catch up on last minute phone calls all at once.”  As Dr. Merz explains yoga can add some of the brake when we’re speeding too fast down life’s fast lane by creating the kind of training effect a runner gets when preparing for a marathon. While biofeedback, meditation and relaxation response training are techniques that, when combined with aerobic exercise, viably reduce stress, yoga offers that elusive all in one cure. Through yoga and focusing inward we can control heart rate, blood pressure, cholesterol and rebalance the ANS to help prevent and even cure illness.

Yoga helps Tammy survive intense reality of heart surgery

At 29, Tammy Moore was diagnosed with a defective congenital aortic valve. All her life she suffered from dizziness and fainting episodes and in the last few years she experienced difficulty breathing and was so exhausted she gained more than fifty pounds.  Tammy was quickly admitted to Cedars Sinai Medical Center for open-heart surgery the very same day she had an appointment with her cardiologist.  Her surgery revealed a unicuspid valve, a dangerous condition that inhibits blood flow.  A normal valve has three parts, leaflets or cusps, but a stenotic valve may have only one cusp making it a unicuspid.

As part of her rehab, Tammy attended the state-of-the-art Cedars-Sinai Integral Yoga Hatha cardiac class based upon Dr. Dean Ornish’s clinical trials and research in reversing heart disease with certified yoga therapist, Nirmala Heriza.  Also director of the Los Angeles Integral Yoga Institute, founded by Sri Swami Satchidananda, Heriza teaches a traditional form of hatha yoga, a system of physical postures over 3,000 years old that includes relaxation and breathing techniques to promote optimal health and reversal of disease.  Heriza is author of Dr. Yoga.   More and more, Heriza sees physical breakdowns in people in the early to mid-thirties related to heart problems, the nervous system and chronic fatigue.  She believes yoga embodies a specific science that rebuilds the central nervous system, stimulates the liver and the kidneys which supports the immune system and reverses the aging process.  In her first one-hour class with Heriza, Tammy’s blood pressure dropped to 134/70 from 146/90.

The first six weeks after open-heart surgery Tammy found herself focused on basic self-care issues like breathing into her Tri-Flo and keeping her seven-inch incision clean.  She was not allowed to push or pull more than ten pounds and soon found herself bored with routine walking.  Now that her physical recovery is progressing Tammy feels yoga helps with the deeper fears and intense reality of having survived open-heart surgery. “There’s so much activity inside the hospital getting ready for a surgery this major. You’re so engrossed in the process — logistics, recovery, visiting friends, doctors, nurses, medication, breathing exercises. I felt like the doctors owned my body instead of me. I slept very little the entire time and I never had time to meditate on the whole experience. All of a sudden I realized how vulnerable and dramatic and serious my condition was. Yoga helps me to be quiet and to accept and process what happened to me.”

Two weeks after her surgery, lying in bed late one night dozing to a movie on cable, Tammy’s eyes flew open with the sudden realization of what had happened to her. “It takes a long time for the mind to catch up with the body,” Tammy says. “Even though you have all these caregivers in the hospital, they’re concerned about your clinical recovery. Nirmala was the first one to ask about my overall well-being. In the hospital, you’re focused on what you can’t do like breathing and walking and in my yoga class I focus on what I can do. Yoga allows the thoughts and issues of what you’ve been through to surface. It helps me to be still and to continue my healing process.”

In Tammy’s first cardiac yoga class with Nirmala, she learned shoulder stand affects the pineal gland, the sound center, of the brain; in Eastern medicine, it is widely held that chanting OM does as well. In the weeks following surgery, Tammy lost 22 pounds and happily discovered Cobra pose and shoulder stand, which stimulates the thyroid gland, increases circulation into the heart and helps with body weight. Head to knee pose stimulates the sympathetic nervous symptom increasing circulation of blood into the coronary arteries helping to reduce plaque and lower cholesterol. Modified shoulder stand brings fresh blood supply to the heart and the cranial viscera. Yoga nidra, the hatha yoga pose known as guided meditation, is comparable to approximately three hours of sleep in its clinical affect on the nervous system. “Combined,” Heriza says, “all these poses have a cumulative rehabilitative affect for patients who have undergone surgery.”

Yogic breathing techniques bring vital energy into the system, revitalize all the primary organs, oxygenate the blood and system and enhance circulation. Breathing stabilizes the central nervous system and as a result reduces stress, critical for a heart patient like Tammy. “When you wake up from heart surgery your chest feels so tight,” Tammy says. “You have to wear an oxygen mask and breathing tubes until you can breathe on your own. The first time I stood up two days after my surgery I almost collapsed while they were untangling all the wires on me.” Her doctors told her the more breathing exercises she performed the quicker her condition would improve. “The day after I began to truly concentrate on my breathing exercises the way my doctor said,” she says. “I felt so much better. It was amazing. I turned the corner.”

Yoga helps Renée survive painful symptoms of anorexia nervosa

Yoga rescued Renée M. who at age 26 was 5”6 and 80 pounds. After five months on and off a Dallas cardiac unit and suffering from anorexia nervosa for almost ten years, she enrolled for inpatient treatment at  Monte Nido Eating Disorders Center in Malibu, CA. “By the time I got to Monte Nido other programs wouldn’t even take me. No one thought I’d ever survive,” Renée admits. “I was dying.”  Peer pressure, feeling like a “nerd,” an alcoholic parent, and feeling as if she’d never be enough formed the beginning of an eating disorder.  Now fully recovered from anorexia, Renée credits yoga as a big part of her journey. “Yoga was an integral part of my full and complete recovery from an illness that nearly cost me my life.”

When Renée was first admitted into treatment her muscles were so atrophied and her joints so stressed she barely had the strength to hold up her frame.  Muscle constriction exacerbated her breathing and asthma.  Physically, her body was so depleted she had little strength for strenuous exercise. But she felt desperate to move her body and basic yoga meditation, deep breathing and simple stretching was the only form of exercise the doctors allowed.  To her surprise, Renée discovered yoga helped to stretch and strengthen her new, developing muscles. “It’s hard for me to explain but I know as I learned to create space for breathing in my body, I also began to create space for myself in the world. Yoga allows me to move, breathe and feel. For the first time I was sitting still with myself and just being inside a body I had long before discarded and disengaged from,” she says.

For Renée, high impact cardio exercise felt too harsh on a body so weathered having run at least three to five miles a day and often farther when she was sick. Yoga gave her a gentle way to acknowledge her body and a pace that could be eased into with simple stretching. Child’s pose, tree pose, pigeon pose and sun salutations, some of her favorites, began to take away the painful, arthritic strain that had developed in her joints from running so hard during the years of her illness, allowing her to breathe in more air with better expansion and capacity. Both Renée’s internist and chiropractor agree yoga was critical to her recovery.  “I went from bed rest years ago to standing beside Hillary Clinton at the National Eating Disorders Coalition,” says Renée, now a successful healthy 32-year-old therapist. “Having come from a near death place to being fully alive is a wonderful thing.”

Cancer diagnosis affects body, mind and spirit

At 26, Elizabeth, a pediatric registered nurse, was diagnosed with breast cancer and underwent a mastectomy on her right breast.  A competitive swimmer since childhood, Elizabeth quickly returned to swimming on her own after surgery. Bald and sick, one year after she completed her chemotherapy and radiation treatment, she joined a master’s swim team. At her first practice Nike happened to be scouting a swimmer for a commercial. Elizabeth scored as one of several featured female athletes and was impressed by the woman practicing yoga in the same commercial. It wasn’t long before Elizabeth checked out a level one yoga class. “I wish I had known about yoga earlier in my illness,” she says. “Yoga teaches you how to relax in the midst of intensity, which is an essential skill for a cancer patient. You have to be able to take hold and let go at the same time.”  Yoga was a different mindset for her and a real departure from competitive swimming.  For Elizabeth, yoga, with its focus on self-awareness, is more about what you get out of it and not about getting every pose. The class she now attends at Yoga Works in Santa Monica, CA teaches relaxing hatha poses beginning with meditation, sun salutations, standing poses and finishing up with a simple savasana.

Last summer Elizabeth had reconstructive surgery, a procedure called superior gluteal free flap breast reconstruction, where the buttock is used as donor tissue to reconstruct the breast.  For the first two weeks she could not lift her right arm more than 45 degrees. Yoga has been beneficial in regaining her sense of motion.  Where swimming came easily to her, yoga offers her a challenge to stretch her shoulder, chest and right arm. One of her favorite poses is apanasana, knee to chest pose, because it stretches the shoulders and arms when you lie on your back with your knees bent.  After being diagnosed with cancer, Elizabeth felt her body had betrayed her. “Yoga engages the body, mind and spirit all of which are affected by a cancer diagnosis,” she says. “I find yoga very therapeutic in this way.”  Over time she has begun to see herself as a survivor and has found renewed faith in her body.  Elizabeth finds yoga helps her to acknowledge, appreciate and respect her body as a gift.

Lisa chooses yoga as an alternative to spinal surgery

In the nineties, actress Lisa Edelstein, well known for her role in “House” underwent a C4-C5 spinal fusion in her neck.  What had been an optional surgery for a herniated disc turned into an emergency when four days before her scheduled fusion she was rear-ended in a car.  In surgery, the doctors took a bone from her hip and put it into her neck. Two years later, Lisa experienced a spasm in her neck that was so painful her hand went numb. She couldn’t lift her head up all the way, turn it to the right or straighten her arm without excruciating pain; her arm was lined with black bruises from constantly massaging it in an effort to try and stop the ever-present pain shooting down from her shoulder. Exhausted, miserable and depressed on painkillers and anti-inflammatory, she cried non-stop. Her doctor told her C5-C6 was now herniated and would need fusion, a second surgery, and that this domino effect would continue because each fusion would put more pressure on the vertebra around it.  Lisa felt that if surgery had been a solution another wouldn’t be necessary. Instead, she turned to Dr. John Sarno’s book  Healing Back Pain and realized his description of the type of person who might experience this kind of back pain — a perfectionist, ambitious, high energy, goal-oriented — fit her. Dr. Sarno’s book prescribed exercise and inward emotional exploration, saying that stress, not a herniated disc, caused such pain.

After reading Dr. Sarno’s life-altering book, Lisa committed herself to a different future than the bleak one her doctor had prescribed.  She gave Bikram yoga a try, a form of yoga where the room is heated to 90–105 degrees, allowing muscles to quickly warm and stretch. She never discussed her decision with her doctor and never went back to him. Although Lisa believes her doctor might have suggested yoga would be a good way to stretch and possibly reduce the number of surgeries she might need, she doesn’t think he could even begin to imagine the extent of the change that has occurred.  In the stressful world of show business, Lisa says her battle was more emotional than physical. “Thanks to a daily yoga practice I handle stress differently in mind and body. Now, I’m so strong physically that what stress I do have can be tolerated to a much greater degree.”

Within months she went from feeling completely disabled to feeling almost one hundred percent. “It was amazing.  I had my life back,” she says.  After rehabilitating in Bikram yoga for nine months, Lisa started Ashtanga, a more strenuous form of yoga, for strength and meditation doing poses she thought she’d never be able to physically manage again. “I feel incredible. I’m much more flexible than I thought mathematically possible. Sure, I get a stiff neck from time to time like anybody, but I have never fallen back into the state I was way back when.  I feel so strong and powerful.  I have arms and shoulders to support me that I never dreamed imaginable. And I have a practice that helps me quiet my mind and keep me from ever having to take life out on myself again.”

How does yoga, available cost-efficient medical therapy that doesn’t concern itself with preexisting condition, help in curing debilitating and even life-threatening illness?  “We know the autonomic nervous system plays a role in all diseases,” says Dr. Riley. “Yoga postures, deep breathing and inward reflection have the power to put the ANS back in balance. Our ANS is a dynamic system that balances our ability to relax with taking action. In today’s fast paced culture, a discipline like yoga can have profound effects on self-healing.”

published in SELF magazine, 2002


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