A study of the Therapeutic Benefits and Physiological Effects of Nadi Shodhana

Imbalance in the autonomic nervous system and endothelial dysfunction are primary underlying pathologies in managing modern lifestyle disorders, notably hypertension, COPD, type-2 diabetes, and mental stress. The primary objective of the present study is to present a systematic and analytical synthesis of the therapeutic effects, physiological changes and molecular mechanisms of 'Nadi Shodhana' (Anulom-Vilom), a major practice of traditional Hatha Yoga. This study used a narrative/integrative literature review design to thematically extract and synthesize data from peer-reviewed randomized controlled trials (RCTs), meta-analyses, and experimental research obtained from the PubMed database. The analysis indicates that Nadi Shodhana enhances parasympathetic vagal tone and baroreflex sensitivity by attenuating sympathetic nervous system hyperactivity and catecholamine secretion. Its effects have been shown to result in clinically significant decreases in systolic blood pressure (average ~7.06 mmHg), diastolic blood pressure (~3.43 mmHg) and heart rate. At the respiratory level, it reduces airway resistance by optimizing medullary centers, strengthens lung flow rates (FEF, PEFR) and maximum inspiratory pressure (MIP), and accelerates secretion clearance and lung re-expansion in COPD and post-surgical patients. In particular, Kumbhaka induce 'carbogen therapy' and the 'Bohr effect', increasing the availability of nitric oxide, which leads to vasodilation and optimizes cellular oxygen supply. Additionally, this action reduces serum cortisol levels by regulating the hypothalamic-pituitary-adrenal (HPA) axis, thereby reducing anxiety, mental stress, and pain perception and improving patients' quality of life (WHOQOL). Despite limitations such as small sample size and protocol variation, this synthesis demonstrates that vascular resection is a safe, non-invasive, and effective complementary therapy modality in the management and rehabilitation of chronic diseases. Future large multi-center long-term trials are needed to standardize disease-specific therapeutic protocols and accurate molecular biomarkers.