Key Points
A 6-month yoga-breathing program (SKY) significantly reduced PTSD as assessed by the CAPS score
Yoga breathing could be a valuable complementary therapy for the treatment of PTSD
The Breathing Diabetic Summary
It is estimated that ~7-8% of the U.S. population will have post-traumatic stress disorder (PTSD) at some point in their life. And it is not just limited to military and first responders. PTSD can happen to anyone who experiences a traumatic event.
Even with the universal awareness of PTSD and its negative side effects, conventional treatments are often insufficient, and many patients remain chronically ill.
However, before we review this research, I don’t want anyone to have the impression that breathing will cure PTSD. What we’re looking for is a complementary therapy that can be integrated as part of a complete treatment plan to aid in healing.
This study chose the Sudarshan Kriya Yoga (SKY) program as that complementary therapy. Their version of the SKY program involved slow and fast breathing, mobility exercises, and group therapy sessions. The researchers also incorporated warrior values to make it more appealing to veterans.
They studied 25 male Vietnam veterans from Australia. The subjects participated in a 22-hour SKY training course spread out over 5 days. After that, they met once a week for one month, and then once a month for the following 5 months. The entire program lasted 6 months. The subjects were encouraged to practice yoga breathing for 30 minutes a day on their own time, but there was no record of their compliance. No changes were made to their medication throughout the study.
Their breathing protocol started with Ujjayi breathing (ocean breathing) with a 4 sec inhale, 4 sec hold, 6 sec exhale, 2 sec hold. After that, they performed 20 fast breaths at 50-60 breaths/min and then rested for 30 seconds before starting over. They did not give the exact times for each breathing practice, but it looks like they completed this cycle several times over 30 minutes.
In any case, because there were several therapeutic components to the SKY program, we cannot isolate breathing alone for any changes observed.
The researchers made several assessments of PTSD, but the one they focused on most was the CAPS score. The Clinician Administered PTSD Scale is a 30-question interview to assess PTSD severity. The average CAPS score at the beginning of the study was 56.3. At week 6, the average scores had significantly fallen down to 42.1. Finally, at the end of the 6 months, the average scores had dropped to 26.2.
An interesting result was that the effect size (ES) of the difference in baseline CAPS scores and 6-month CAPS scores ranged from 0.88 to 2.9. Anything above 0.8 is considered a “large” effect. Most antidepressant trials achieve an ES of around 0.5.
Overall, the SKY program significantly reduced PTSD severity as measured by the CAPS score. Because yoga breathing techniques are simple and have almost no side effects, the authors suggest that they could easily be incorporated into the military health care system and serve as a valuable complementary therapy for treating PTSD.
Abstract
Objective: It is appropriate to acknowledge that despite treatment, Post Traumatic Stress Disorder (PTSD) continually debilitates many Vietnam veterans. Although therapies have been developed, remission is hard to obtain with either pharmacotherapy or psychotherapy. Evidence has suggested that some forms of yoga may reduce sympathetic overactivity and increase parasympathetic activity, thereby improving stress resilience. Sudarshan Kriya Yoga (SKY) was hypothesized in this study to be potentially useful for lessening symptom severity on the Clinician Administered PTSD Scale (CAPS) in Vietnam veterans with treatment-resistant PTSD. Method: Fifty male Vietnam veterans with PTSD (DSM-IV) were referred to the study. Thirty-one participants meeting criteria were subsequently randomized to either the SKY Intervention (adapted for veterans) group or a 6-week wait-list Control. The intervention consisted of 22 hours of guided group yoga instruction over a duration of 5 days, followed by a 2-hour group session which following 5 months. Severity of PTSD symptoms was assessed at pre-intervention, 6-week post-intervention, and 6-month follow-up for both groups using the CAPS. Additional questionnaires to measure PTSD, depression, quality of life, and alcohol consumption were administered at pre-intervention, post-intervention and follow-up time frames as well. Results: completed the study, of which 14 received immediate intervention while 11 constituted the Control group. The Intervention group intervention completion, while the Control group had zero decline within this period. At this point, the Control group received the SKY improvements were maintained in both groups 6 months following receipt of treatment. The results indicate that multi-component interventions with yoga breath techniques may offer a valuable adjunctive treatment for veterans with PTSD.
Journal Reference:
Carter JJ, Gerbarg PL, Brown RP et al. Multi-Component Yoga Breath Program for Vietnam Veteran Post Traumatic Stress Disorder: Randomized Controlled Trial. J Trauma Stress Disor Treat. 2013;2(3). doi:http://dx.doi.org/10.4172/2324-8947.1000108.