Effect Of Nadi Shuddhi Pranayama On Anxiety, Stress, Depression, Quality Of Life, And Physiological Markers In Breast Cancer Patients: A Randomised Controlled Trial
DOI:
https://doi.org/10.48165/IRJAY.2026.90207Keywords:
Nadi Shuddhi; alternate nostril breathing; pranayama; breast cancer; anxiety; stress; depression; quality of life; heart rate; blood pressure; oxygen saturation; yoga therapy; RCT; complementary oncologyAbstract
Background:Breast cancer patients frequently experience elevated anxiety, psychological stress, depression, and significant physiological disturbances as consequences of both the disease and its treatment. Nadi Shuddhi pranayama (alternate nostril breathing), a foundational yogic breathing technique, has demonstrated capacity to modulate autonomic nervous system function and improve psychological well-being. However, its isolated therapeutic effects in breast cancer populations, encompassing both psychological and physiological parameters, have not been rigorously established through randomised controlled methodology. Objective:To evaluate the effect of a structured 12-week Nadi Shuddhi pranayama intervention on anxiety, stress, depression, quality of life, and selected physiological markers (heart rate, respiratory rate, blood pressure, and oxygen saturation) in breast cancer patients. Methods:Fifty breast cancer patients were randomly allocated to an intervention group (n=25) receiving daily Nadi Shuddhi pranayama for 12 weeks, or a control group (n=25) receiving standard oncological care only. Psychological outcomes were assessed using the Depression Anxiety Stress Scale-42 (DASS-42) and Quality of Life Scale (QOLS). Physiological markers including heart rate (HR), systolic blood pressure (SBP), diastolic blood pressure (DBP), respiratory rate (RR), and peripheral oxygen saturation (SpO2) were recorded at baseline and post-intervention. Results:The intervention group demonstrated statistically significant improvements across all psychological parameters: anxiety (DASS-42 severe category: 100% pre vs. 16% post), stress (severe: 24% pre vs. 8% post), and depression (severe: 76% pre vs. 12% post). QOLS scores improved from a mean of 2.88 to 3.91 (p<0.001). Physiological markers showed significant reductions in HR (84.2 to 72.6 bpm), SBP (134.4 to 122.8 mmHg), DBP (88.1 to 79.3 mmHg), and RR (18.6 to 14.2 breaths/min), with a significant increase in SpO2 (96.1% to 98.4%). The control group showed no statistically significant changes in any parameter. Conclusion:Nadi Shuddhi pranayama is an effective, safe, and accessible complementary intervention that significantly improves psychological well-being, quality of life, and key physiological markers in breast cancer patients. Its integration into oncological supportive care is strongly recommended.
Downloads
References
Sung H, Ferlay J, Siegel RL, Laversanne M, Soerjomataram I, Jemal A, et al. Global cancer statistics 2020: GLOBOCAN estimates. CA Cancer J Clin. 2021;71(3):209-49. doi:10.3322/caac.21660.
Bower JE. Cancer-related fatigue: mechanisms, risk factors, and treatments. Nat Rev Clin Oncol. 2014;11(10):597-609. doi:10.1038/nrclinonc.2014.127.
Fann JR, Thomas-Rich AM, Katon WJ, Cowley D, Pepping M, McGregor BA, et al. Major depression after breast cancer. Gen Hosp Psychiatry. 2008;30(2):112-26. doi:10.1016/j.genhosppsych.2007.10.008.
Mitchell AJ, Chan M, Bhatti H, Halton M, Grassi L, Johansen C, et al. Prevalence of depression, anxiety, and adjustment disorder in oncological settings. Lancet Oncol. 2011;12(2):160-74. doi:10.1016/S1470-2045(11)70002-X.
Spiegel D, Giese-Davis J. Depression and cancer: mechanisms and disease progression. Biol Psychiatry. 2003;54(3):269-82. doi:10.1016/S0006-3223(03)00566-3.
Telles S, Singh N, Balkrishna A. Heart rate variability changes during high frequency yoga breathing and breath awareness. BioPsychoSocial Med. 2013;7(1):4. doi:10.1186/1751-0759-7-4.
Shannahoff-Khalsa DS. An introduction to Kundalini yoga meditation techniques for psychiatric disorders. J Altern Complement Med. 2004;10(1):91-101. doi:10.1089/107555304322849011.
Chakrabarty J, Vidyasagar MS, Fernandes D, Joisa G, Varghese P, Mayya S. Effectiveness of pranayama on cancer patients. Indian J Palliat Care. 2013;19(2):98-105. doi:10.4103/0973-1075.116716.
Buffart LM, van Uffelen JG, Riphagen II, Brug J, van Mechelen W, Brown WJ, et al. Physical and psychosocial benefits of yoga in cancer patients and survivors. BMC Cancer. 2012;12:559. doi:10.1186/1471-2407-12-559.
Giridharan S, Pandiyan B, Kumar NV, Soumian S. Effects of pranayama on cancer patients: a narrative review of clinical outcomes. Cureus. 2024;16(2):e54688. doi:10.7759/cureus.54688.
Chandwani KD, Perkins G, Bhattacharyya RS, Courneya KS, Arun B, Nagarathna R, et al. Randomized, controlled trial of yoga in women with breast cancer undergoing radiotherapy. J Clin Oncol. 2014;32(10):1058-65. doi:10.1200/JCO.2012.48.2752.
Bhargav H, Nagendra HR, Gangadhar BN, Nagarathna R. Frontal brain activation and cardiac autonomic changes during cyclic meditation. Int J Yoga. 2016;9(2):124-30. doi:10.4103/0973-6131.183708.
Mohan M, Saravanane C, Surange SG, Thombre DP, Chakrabarti AS. Effect of yoga type breathing on heart rate and cardiac axis of normal subjects. Indian J Physiol Pharmacol. 2011;30(4):334-40.
Jerath R, Edry JW, Barnes VA, Jerath V. Physiology of long pranayamic breathing. Med Hypotheses. 2006;67(3):566-71. doi:10.1016/j.mehy.2006.02.042.
Zamorano JL, Lancellotti P, Rodriguez Munoz D, Aboyans V, Asteggiano R, Galderisi M, et al. 2016 ESC position paper on cancer treatments and cardiovascular toxicity. Eur Heart J. 2016;37(36):2768-801. doi:10.1093/eurheartj/ehw211.
