In Tibetan Heart Yoga there is a tradition of beginning a breath with an exhalation -- as a protest, a way of not accepting the status quo -- and completing the breath with an inhalation. In that Tibetan tradition we begin my class at the Rebecca and Gary Sakwa Adult Day Care Center at the Alzheimer Association with an exhale, as a way of protesting against Alzheimer’s disease and other forms of dementia. The inhalation that completes our breath is for the future and hope for a cure. 

There is another reason I begin with an exhale -- to stimulate and wake-up the brain and the body.    As we age or become more sedentary, our breath becomes shallower, using only the upper third of our lungs.  This is primarily because the volume of our exhalation decreases, reducing the exchange of gasses in our body.  Since the brain uses about 20% of the oxygen we breathe, inefficient breathing reduces oxygen to the brain.  A study reported in 2006 by the University of British Columbia, in Vancouver, Canada suggested that insufficient oxygen in our brain contributes to the build up of beta-amyloid (protein) associated with Alzheimer’s. 

To increase oxygen in the body, it is out with the old.  We need to increase our exhalation to release the byproducts of our body such as carbon dioxide.  This allows more oxygen to fill up lungs and move efficiently through our system, resulting in more clarity and more energy.   As they say “What is good for the cardiovascular system is good for the brain”. 

It is very difficult for individuals with Alzheimer’s or dementia to do traditional yoga breathing exercises.  You need to add stimuli to the breathing process and change the focus of breathing from the inhalation to the exhalation.  The exhalation is an active beginning to the deep breathing process, while the inhalation is a passive response to our exhalation.   It is only when we fully exhale that we are able to inhale deeply.  

The easiest way to do this is through sound.  The longer a sound is expressed, the greater the exhalation.  One of the simplest and most efficient ways to fully exhale is whistling.  Try whistling a song and observe if you notice any difference in clarity.  Another example of a breathing exercise you can do at home is the following exercise I use to begin my class at the Rebecca and Gary Sakwa Adult Day Care center.

(1) While standing or sitting, place your hands in front of your body, just below the chest, with palms facing down. 
(2) Gently press your palms downward, straightening your arms, while saying “hooooo”, do this 3 times. 
(3) Inhale, take a brief break, repeat 2 more times; remember to inhale between sets. 

Breathing exercises should be the foundation of any activity involving confused or sedentary individuals.  So in the Tibetan tradition, begin your activity with a deep exhalation, and finish your breath by inhaling the oxygen we all share, in faith that one day there will be a cure for Alzheimer’s. 

Denise Murray is a certified Tai Chi for arthritis Instructor, trained Arthritis Foundation exercise program instructor, and registered yoga teacher.